Posts tagged afghanistan

Photo by Peter Casaer “Today I saw the worst case of breast cancer I have ever seen” “Sometimes, the seeming futility of this job overwhelms me. We see so many diseases – both chronic and acute – that we are unable to do anything about. When I considered coming to Afghanistan, I felt I was prepared to see malnutrition, wounded patients, trauma, etc. I did not realize the amount of chronic diseases and other conditions that we would be helpless to treat. At home, this woman would have had a mammogram and ultrasound when she first noticed a lump in her breast. She would have received free health care that would have, in all likelihood, saved her life. We have no chemotherapy, radiation therapy, mammography, or indeed oncologists here in Helmand [Afghanistan].” Read more at http://blogs.msf.org/afghanistan/2013/06/what-if/

Photo by Peter Casaer

“Today I saw the worst case of breast cancer I have ever seen”

“Sometimes, the seeming futility of this job overwhelms me. We see so many diseases – both chronic and acute – that we are unable to do anything about. When I considered coming to Afghanistan, I felt I was prepared to see malnutrition, wounded patients, trauma, etc. I did not realize the amount of chronic diseases and other conditions that we would be helpless to treat. At home, this woman would have had a mammogram and ultrasound when she first noticed a lump in her breast. She would have received free health care that would have, in all likelihood, saved her life. We have no chemotherapy, radiation therapy, mammography, or indeed oncologists here in Helmand [Afghanistan].”

Read more at http://blogs.msf.org/afghanistan/2013/06/what-if/

MSF Logistician Ben King building kites with the community. Afghanistan 2013 © Ben King

“My vision of this country before I arrived saw kites flying everywhere, filling the air with the exuberance of small boys interacting with others far beyond the high walls of their own compounds. A kind of invisible communication that creates infinitely strong bonds between the people and their country. My visions were true when I arrived, but as the temperatures began to plummet, the kites, one by one, disappeared from the crystal clear skies. Finally, though, it was our chance to try our hand at it…

For now, I will enjoy watching them dance about as a beacon of hope for a brighter future for this ever colourful and complex land”

Read more from Ben’s blog and leave questions and comments below his post.

Usually we receive no warning of the imminent arrival of bomb blast victims. They normally arrive in a cloud of panic; chaotic screaming ensues and staff members run to man their posts. This time we are prepared. From the time of the phone call it should be twenty minutes before they arrive, not much time to ready the Emergency Room but I am surprised at how much gets done. We clear the resuscitation room and triage area, we prepare IV bags and bandages and then we prepare a queue of stretchers outside.
MSF doctor Stefan writes from Kunduz, Afghanistan, on treating people injured by IEDs and traffic accidents. Please leave your questions and comments for Stefan below his blog post.  
 Photo: Getting healthcare to people living in freezing conditions in temporary camps in Kabul © Ben King/MSF Snowed InLogistician Ben describes the process in photos on the MSF Afghanistan blog.  “These people live in incredibly difficult conditions in camps spread throughout Kabul. Surviving by their pure will to live, in deep snow and sub-zero conditions. MSF has started an emergency mission to provide basic healthcare services to some of these people who are not being helped out by other NGO’s. We are working in six camps within Kabul city so far and seeing around 60 patients each time we run free public clinics. This will continue until the worst of the winter weather is over and the small children get some respite from the cold at which time they can fully recover from their respiratory illnesses which is the major ailment that comes through our clinics.”

 Photo: Getting healthcare to people living in freezing conditions in temporary camps in Kabul © Ben King/MSF

Snowed In
Logistician Ben describes the process in photos on the MSF Afghanistan blog. 

“These people live in incredibly difficult conditions in camps spread throughout Kabul. Surviving by their pure will to live, in deep snow and sub-zero conditions. MSF has started an emergency mission to provide basic healthcare services to some of these people who are not being helped out by other NGO’s. We are working in six camps within Kabul city so far and seeing around 60 patients each time we run free public clinics. This will continue until the worst of the winter weather is over and the small children get some respite from the cold at which time they can fully recover from their respiratory illnesses which is the major ailment that comes through our clinics.”

Photo: The gate of Ahmad Shah Baba Hospital in Kabul Afghanistan 2012 © MSF Hospitality Lessons During a Mobile Clinic in Afghanistan “You’re a brave man, coming here without arms,” the Malik told me halfway through lunch. I wondered why I would need any courage to eat some meat and bread, after all, the Malik—governmental leader of a town or community—had just finished a story to illustrate the concept of Pashtu hospitality. During our briefing at a mobile clinic, he stopped us and invited us for tea to get to know each other a bit better. He hinted the tea could be taken in a tea shop next to the clinic, or at least this is how I interpreted his pointing of the chin towards to entry gate of the hospital. Two minutes later, however, we stepped into his car, and not into the tea shop, and sped away over the sandy road towards his house a few hundred meters away. Carelessness from our side, you might wonder? On the contrary, in rural areas such as these, and at this moment in time, we feel more at ease. Receiving invitations to work in these communities is the best protection possible, as illustrated by the anecdote above. Afghan people judge you not only by what you do, but also by how you do it. Refusing the tea invitation would probably have been a mistake.

Photo: The gate of Ahmad Shah Baba Hospital in Kabul Afghanistan 2012 © MSF

Hospitality Lessons During a Mobile Clinic in Afghanistan

“You’re a brave man, coming here without arms,” the Malik told me halfway through lunch. I wondered why I would need any courage to eat some meat and bread, after all, the Malik—governmental leader of a town or community—had just finished a story to illustrate the concept of Pashtu hospitality.

During our briefing at a mobile clinic, he stopped us and invited us for tea to get to know each other a bit better. He hinted the tea could be taken in a tea shop next to the clinic, or at least this is how I interpreted his pointing of the chin towards to entry gate of the hospital. Two minutes later, however, we stepped into his car, and not into the tea shop, and sped away over the sandy road towards his house a few hundred meters away.

Carelessness from our side, you might wonder? On the contrary, in rural areas such as these, and at this moment in time, we feel more at ease. Receiving invitations to work in these communities is the best protection possible, as illustrated by the anecdote above. Afghan people judge you not only by what you do, but also by how you do it. Refusing the tea invitation would probably have been a mistake.

We first met Karim when he had sustained a severe head injury, he was comatose and from the start his survival was doubtful. Long story short: his family took him to a Neurosurgical centre in Pakistan when MSF could no longer help. Days later he returned but still needed some basic care and antibiotics, which MSF provided. He was discharged from MSF and walked out of the hospital with his family. I’m not saying that MSF saved his life nor that we can take full credit for the fortunate outcome; what I am saying is that it has been a privilege to be involved in his story. There are enough tragic stories in Kunduz, so when a case does turn out as well as Karim’s we are pleased (to say the least!)
The newest member of our Afghanistan blogging team, emergency doctor Stefan Kruger, talks about his favorite patient. Please leave your questions and comments for Stefan below his blog post. 
I leave with a strange feeling inside; this is something totally exceptional for me, to see a human body in this state [bones splintered, muscle crushed]. To understand the challenges faced by the surgeons and medical team with each case, to admire their skill, calmness and dedication to doing the best they possibly can for each and every patient. I take my hat off to them.
Biomedical engineer Ben King observes an amputation and discovers more about humanity than he expected.

Afghanistan: Mobile Care in Kabul

The population of Kabul has tripled over the last 10 years. Some people arrive after fleeing conflict-torn areas for the relative safety of the capital, while others, pushed by poverty, are simply trying to make a living. Returnees from Pakistan and other provinces of Afghanistan have also made their way back to the city. For those living in makeshift settlements and camps, the harsh winter makes an already difficult situation even harder. In January 2013, Doctors Without Borders/Médecins Sans Frontières (MSF) started running mobile clinics and nutritional screenings in six locations where hundreds of Afghans have settled.

Afghanistan: A Hospital in Helmand

Doctors Without Borders/Médecins Sans Frontières (MSF) is supporting the regional Boost Hospital in Lashkargah, the capital of Afghanistan’s Helmand Province. Our aim is to provide free, life-saving medical care in all areas, including maternity, pediatrics, surgery and emergency room service.

Photo: An MSF vehicle enters the front gate of the MSF trauma hospital in Kunduz, northern Afghanistan, November 29, 2011. Afghanistan 2011 © Michael Goldfarb MSF Treats Victims of Kunduz Bomb Blast Five people were dead on arrival and two others died during surgery. Of the 17 people treated by MSF, 11 suffered life-threatening injuries and were in critical condition. Almost all of the patients sustained blast-related injuries including fractures, head trauma, and abdominal and chest injuries requiring specialized trauma surgery. “People rushed to the hospital after the explosion, seeking information and inquiring about their families and relatives, which is understandable,” said Aurelien Marechal, MSF Field Coordinator in Kunduz. “However, the hospital grounds were crowded, so we had to temporarily close the entrance in order to give space to the medical staff to provide urgent treatment.” By launching a “multiple casualty plan,” which classifies patients according to the severity of their injuries, the medical team was able to identify and respond to the patients requiring immediate attention. MSF has been running the surgical hospital in Kunduz since August 2011, providing emergency surgery and follow-up treatment for people wounded in conflict and for those suffering from other life-threatening injuries. A total of 10,000 people were treated in 2012. In all locations where MSF works in Afghanistan, a strict no-weapons policy is implemented to ensure the safety and security of patients. “No matter what is going on outside its gates, the hospital needs to remain a safe place for doctors to work and patients to receive lifesaving treatment,” said Marechal.

Photo: An MSF vehicle enters the front gate of the MSF trauma hospital in Kunduz, northern Afghanistan, November 29, 2011. Afghanistan 2011 © Michael Goldfarb

MSF Treats Victims of Kunduz Bomb Blast

Five people were dead on arrival and two others died during surgery. Of the 17 people treated by MSF, 11 suffered life-threatening injuries and were in critical condition. Almost all of the patients sustained blast-related injuries including fractures, head trauma, and abdominal and chest injuries requiring specialized trauma surgery.

“People rushed to the hospital after the explosion, seeking information and inquiring about their families and relatives, which is understandable,” said Aurelien Marechal, MSF Field Coordinator in Kunduz. “However, the hospital grounds were crowded, so we had to temporarily close the entrance in order to give space to the medical staff to provide urgent treatment.”

By launching a “multiple casualty plan,” which classifies patients according to the severity of their injuries, the medical team was able to identify and respond to the patients requiring immediate attention.

MSF has been running the surgical hospital in Kunduz since August 2011, providing emergency surgery and follow-up treatment for people wounded in conflict and for those suffering from other life-threatening injuries. A total of 10,000 people were treated in 2012.

In all locations where MSF works in Afghanistan, a strict no-weapons policy is implemented to ensure the safety and security of patients.

“No matter what is going on outside its gates, the hospital needs to remain a safe place for doctors to work and patients to receive lifesaving treatment,” said Marechal.

We don’t take sides; we care for people on all sides of this war. For neighbors shot for cutting down a tree; for children shot for being in the wrong place at the wrong time; for people injured by a blast while going down the street for bread; for entire families who have had grenades thrown at them.
MSF Nurse Brett Adamson, on treating victims of the war in Afghanistan.
Photo: The grounds the MSF hospital in Kunduz, Afghanistan, seen at dusk. Afghanistan 2012 © Michael Goldfarb Letter from North Afghanistan: “This Is Life and Death Under a Magnifying Glass” Nurse Brett Adamson recently completed a six-month mission in Kunduz,Afghanistan, where Doctors Without Borders/Médecins Sans Frontières (MSF) runs a hospital providing emergency surgery to people with life-threatening injuries. Below is some of what he wrote while he was there: Today we watched a child die. We had done all that we could, but there are always limits. He was hit by a speeding motorcycle, cracking his skull. The child was hooked up to a ventilation machine. We have four in our intensive care unit and they have saved many lives—of people hurt in bomb blasts, wounded by gun shots, or with head traumas. We kept the child alive to see if he might recover—buying time for healing, for the family to pray, for us to hope. Unfortunately he didn’t make it, but thankfully the majority do. This child was hit by a speeding motorcycle. His family is present when I turn off the ventilator and pull the tube from his lips to see if he can breathe on his own. We have talked with them many times about his extremely poor chances of survival. If a child stops breathing, we know the bleeding or swelling inside the head has progressed to the point that almost all brain function has been lost. The boy cannot keep breathing on his own. His bed is surrounded by people—his family, two doctors, a nurse, the nurse from the morning shift who has stayed on—all eager to do anything possible for the dying child. The child is gasping for breath, so we relieve his distress with drugs; a push on a syringe eases his suffering. Family members hold his hand, a nurse washes his face. This is life and death under a magnifying glass. The boy gasps occasionally and again we settle him, his heart rate nearly stopping between each gasp. Family members ritually trickle a tiny amount of water into his lips. We suction his mouth and we comfort the family. Eventually he slips away. We wash him, dress him, tie his jaw closed and his toes together, and wrap him in a clean sheet. A brother sheds tears. The family wants to take him now. The father thanks us for our efforts, wraps his child in a blanket and carries him outside to an old station wagon borrowed from a friend. I hold his child for him as he climbs into the back. I pass him the child and he cradles him and they drive away to their home in the mountains. We clean the bed, clean the equipment and attend to the other patients. Then we make up the bed with fresh sheets, and within a couple of hours it is filled with someone new. 

Photo: The grounds the MSF hospital in Kunduz, Afghanistan, seen at dusk. Afghanistan 2012 © Michael Goldfarb

Letter from North Afghanistan: “This Is Life and Death Under a Magnifying Glass”

Nurse Brett Adamson recently completed a six-month mission in Kunduz,Afghanistan, where Doctors Without Borders/Médecins Sans Frontières (MSF) runs a hospital providing emergency surgery to people with life-threatening injuries. Below is some of what he wrote while he was there:


Today we watched a child die. We had done all that we could, but there are always limits. He was hit by a speeding motorcycle, cracking his skull.

The child was hooked up to a ventilation machine. We have four in our intensive care unit and they have saved many lives—of people hurt in bomb blasts, wounded by gun shots, or with head traumas. We kept the child alive to see if he might recover—buying time for healing, for the family to pray, for us to hope. Unfortunately he didn’t make it, but thankfully the majority do.

This child was hit by a speeding motorcycle. His family is present when I turn off the ventilator and pull the tube from his lips to see if he can breathe on his own. We have talked with them many times about his extremely poor chances of survival. If a child stops breathing, we know the bleeding or swelling inside the head has progressed to the point that almost all brain function has been lost.

The boy cannot keep breathing on his own. His bed is surrounded by people—his family, two doctors, a nurse, the nurse from the morning shift who has stayed on—all eager to do anything possible for the dying child. The child is gasping for breath, so we relieve his distress with drugs; a push on a syringe eases his suffering. Family members hold his hand, a nurse washes his face.

This is life and death under a magnifying glass. The boy gasps occasionally and again we settle him, his heart rate nearly stopping between each gasp. Family members ritually trickle a tiny amount of water into his lips. We suction his mouth and we comfort the family. Eventually he slips away.

We wash him, dress him, tie his jaw closed and his toes together, and wrap him in a clean sheet. A brother sheds tears.

The family wants to take him now. The father thanks us for our efforts, wraps his child in a blanket and carries him outside to an old station wagon borrowed from a friend. I hold his child for him as he climbs into the back. I pass him the child and he cradles him and they drive away to their home in the mountains.

We clean the bed, clean the equipment and attend to the other patients. Then we make up the bed with fresh sheets, and within a couple of hours it is filled with someone new. 

MSF.TV - Delivering Aid in Armed Conflicts.

When working in war-torn areas, it’s often challenging to differentiate military aid and humanitarian aid. Intentions are blurred as military groups provide food and clinics for their own political gain. Where do armies end, and humanitarians begin? Watch this thought-provoking animated video to see how MSF is able to support clinics in warzones while remaining weapons-free.

Photo: Newborn babies at the MSF maternity hospital in eastern Khost Province. Afghanistan 2012 © Hilde Cortier/MSF MSF to Resume Medical Activities in Khost, Afghanistan We’re resuming medical activities in our maternity hospital in Khost Province, Afghanistan, which were suspended following an explosion in the hospital in April.  “We are reopening the hospital because of the overwhelming messages of support for MSF we received from the community, and because of reassurances that our patients and medical staff will be safe inside the hospital,” said Benoit De Gryse, MSF’s country representative in Afghanistan.

Photo: Newborn babies at the MSF maternity hospital in eastern Khost Province. Afghanistan 2012 © Hilde Cortier/MSF

MSF to Resume Medical Activities in Khost, Afghanistan

We’re resuming medical activities in our maternity hospital in Khost Province, Afghanistan, which were suspended following an explosion in the hospital in April. 

“We are reopening the hospital because of the overwhelming messages of support for MSF we received from the community, and because of reassurances that our patients and medical staff will be safe inside the hospital,” said Benoit De Gryse, MSF’s country representative in Afghanistan.

Photo: Ali* was injured when a discarded detonator he found exploded in his face. He was successfully treated at Doctors Without Borders’ Kunduz trauma hospital. Afghanistan 2011 © Michael Goldfarb/MSF Martin John Jarmin III, Field Surgeon, Afghanistan “As in any urban area, we see a lot of road accidents and civilian gunshot injuries at the new 70- bed Doctors Without Borders surgical hospital in Kunduz. Yet, while it is relatively safer here these days, remnants of war—like stray bullets or rockets— continue to put people’s lives at risk.  One day, a family rushed in with their 14-year-old son. Ali* had been playing with friends in a field when they found something they said looked like a battery. It was probably a bomb detonator, because it exploded when they touched the two wires that were sticking out of it. Ali had shrapnel in his face and serious injuries to his hands and arms. He was lucky and will recover. The blast permanently blinded his brother.  Prior to our arrival in August 2011, the 250,000 people living in Kunduz had no access to adequate trauma care. The Doctors Without Borders trauma center is equipped with an emergency room, two operating theaters, and an intensive care unit. Once word spread that we’re here, more and more people began coming to us for care. Many patients tell us they used to go all the way to Pakistan to get specialized care.  Since there is not really a good hospital in this part of the country, we are filling a very real need. We always tell people that it doesn’t matter where you came from or who you are, we will treat you.” More on our work in Afghanistan. * Patient’s name has been changed.

Photo: Ali* was injured when a discarded detonator he found exploded in his face. He was successfully treated at Doctors Without Borders’ Kunduz trauma hospital. Afghanistan 2011 © Michael Goldfarb/MSF

Martin John Jarmin III, Field Surgeon, Afghanistan

“As in any urban area, we see a lot of road accidents and civilian gunshot injuries at the new 70- bed Doctors Without Borders surgical hospital in Kunduz. Yet, while it is relatively safer here these days, remnants of war—like stray bullets or rockets— continue to put people’s lives at risk. 

One day, a family rushed in with their 14-year-old son. Ali* had been playing with friends in a field when they found something they said looked like a battery. It was probably a bomb detonator, because it exploded when they touched the two wires that were sticking out of it. Ali had shrapnel in his face and serious injuries to his hands and arms. He was lucky and will recover. The blast permanently blinded his brother. 

Prior to our arrival in August 2011, the 250,000 people living in Kunduz had no access to adequate trauma care. The Doctors Without Borders trauma center is equipped with an emergency room, two operating theaters, and an intensive care unit. Once word spread that we’re here, more and more people began coming to us for care. Many patients tell us they used to go all the way to Pakistan to get specialized care. 

Since there is not really a good hospital in this part of the country, we are filling a very real need. We always tell people that it doesn’t matter where you came from or who you are, we will treat you.”

More on our work in Afghanistan.

* Patient’s name has been changed.