Afghanistan: Providing essential medical care through thick and thin at Boost Hospital – Afghanistan

Médecins Sans Frontières (MSF) supported the 300-bed Boost provincial hospital in Lashkar Gah, the capital of Afghanistan Helmand Province, since 2009. This is our largest project in Afghanistan and a lifeline for the 1.4 million people living in Helmand Province, providing hard to reach secondary health care find elsewhere.

In the months later the Islamic Emirate of Afghanistan (IEA, also known as the Taliban) seized power and declared the decades-long war over, MSF hospitals in the five provinces where we work – Khost, Kandahar, Kunduz, Helmand and Herat – have seen a surge in patients seeking care. Several factors have contributed to this, including the improving security situation and the lack of alternative health care options, as many medical facilities have closed or are barely functioning due to lack of funding, supplies or personnel.

In January 2022, photographer Oriane Zerah spent several days at the hospital documenting patients and staff.

Working alongside Ministry of Health staff, MSF teams support the emergency room (ER), surgical unit, inpatient department, maternity department, neonatology unit, laboratory, radiology department, pediatric department and an inpatient therapeutic feeding center (ITFC).

Throughout the 20-year war in Afghanistan, the southern province of Helmand has been affected by outbreaks of conflict, culminating most recently in May 2021 when the IEA began its takeover of the country.

Some of our employees have done the difficult choice stay and continue to work during the fighting, sometimes sleeping in the hospital when it became too dangerous to travel. When the front lines reached the city, many people were afraid to leave their homes and had to choose between risking being caught in the crossfire and delaying urgent medical attention. Many have decided not to seek care until the fighting subsides.

Since the end of the conflict in August 2021, huge numbers patients have been coming to the hospital, in part because of the improved security situation that has made it easier for patients to navigate roads that for decades were strewn with pitfalls.

The reduction in violence is not the only factor influencing the increase in the number of patients. While the crisis has strained Afghanistan’s health system – with governments and institutions suspending or reducing funding – it has been underfunded, understaffed and dysfunctional for yearsand people still struggle to find the care they need.

People travel long distances to access free care in MSF facilities, often borrowing money to pay for transportation. Despite this, Boost Hospital has seen an astonishing number of patients in recent months and has been over capacity all year. More than 2,400 people are admitted to hospital and more than 20,000 people are triaged in the emergency room every month.

Boost’s ITFC Hospital continues to be extremely busy as many factors causing malnutrition remains: People are struggling to get food, and persistent drought and displacement caused by the conflict have left people with fewer supplies. We also see a very high number of measles casea particularly dangerous disease for malnourished children.

At the height of the fighting in August, only 10 women a day went to the hospital to give birth – that number was usually around 80. Pregnant women again come to the hospital to give birth. In January, our team assisted 1,832 deliveries.

As the future of the health system is uncertain, MSF is committed to continuing to provide free, high-quality health care to Afghans.

At Boost Hospital, in 2021, more than 164,000 patients came to the emergency room and 30,900 were admitted to the hospital. Medical staff assisted over 18,900 births, admitted over 3,200 severely malnourished children and performed over 6,900 surgeries.