Since 2009, Médecins Sans Frontières (MSF) has supported the 300-bed Boost provincial hospital in Lashkar Gah, the capital of Afghanistan’s Helmand province. This is our biggest project in Afghanistan and a lifeline for the 1.4 million people living in Helmand. province, providing secondary health care not readily available elsewhere.
In the months following the takeover of power by the Islamic Emirate of Afghanistan (IEA, also known as the Taliban) and the end of the decades-long war, MSF hospitals in the five provinces where we work – Khost, Kandahar, Kunduz, Helmand and Herat – have seen a surge in the number of 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.
Alongside Ministry of Health staff, MSF teams support the emergency room (ER), surgical unit, inpatient ward, maternity ward, neonatology unit, laboratory, radiology, the pediatric department and an inpatient therapeutic feeding center (ITFC).
Throughout Afghanistan’s 20-year war, the southern province of Helmand has been plagued by flare-ups of conflict, most recently peaking in May 2021 when the IEA began its takeover of the country.
Some of our staff made the difficult choice to stay and continue working during the fighting, sometimes sleeping in 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, a large number of patients have visited the hospital, in part due to the improved security situation which makes 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 the Afghan health system – with governments and institutions suspending or cutting funding – it has been underfunded, understaffed and dysfunctional for years, and people still struggle. struggling to find the care they need.
People travel long distances to access free healthcare at MSF facilities, often borrowing money to pay for transport. 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.
ITFC at Boost Hospital continues to be extremely busy as many of the factors that cause malnutrition remain: people are struggling to get food, and the ongoing drought and displacement caused by the conflict have left people with fewer reservations. We also see a very high number of cases of measles, a particularly dangerous disease for malnourished children.
At the height of the fighting in August, only 10 women a day came to the hospital to give birth, with the number usually around 80. Pregnant women are again coming 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.