Background

EMERGENCY has been working in Afghanistan since 2000, when the organisation began renovating and expanding a former nursery school in the centre of the capital city, Kabul. The nursery had been destroyed by a rocket, in an incident which killed five children. In April 2001, this structure re-opened as a Surgical Centre for Victims of War and Landmines, and was expanded in 2015 to improve the facilities and increase the number of beds.

 

The centre houses an impressive number of facilities, including three operating theatres; an intensive care unit; an A&E; outpatient clinics; a laboratory and blood bank; a radiology department; and equipment for physiotherapy and CT scans. The centre also specialises in trauma surgery. Since July 2010, however, the admissions criteria have been restricted to war surgery only, in order to cope with the influx of war-related admissions.

Although the NATO ISAF (International Security Assistance Force) mission officially ceased in December of 2014, intense fighting continues across the country. Conflict is becoming increasingly urbanised, and in recent years Kabul has become even more unstable. Suicide attacks and armed assaults are a regular occurrence. In the first six months of 2017, according to UN data, civilian casualties in the capital increased by 26% from the year prior. The data gathered at our hospital reflects this trend. 2016 saw a record number of admissions: 4,182. This figure rose again in 2017, during which time the hospital handled an unprecedented number of admissions: 4,532 patients. Of these, around 1,554 were transferred to the hospital from our network of First Aid Posts (FAPs) in neighbouring provinces, using our 24-hour ambulance service. In 2017, we performed an average of 17 surgical operations every day.

 

As the number of wounded continues to rise, EMERGENCY’s Kabul Surgical Centre remains the only free specialist hospital for war surgery in the capital and surrounding provinces. Over the course of 2017, our staff dealt with 17 mass casualties, providing emergency medical care for 370 patients. On 31 May, we experienced our most serious mass casualty to date. At 8:30am, a truck bomb exploded in the embassy district, killing dozens and wounding hundreds. Within a few hours, our staff had admitted 76 patients.

The New Facility

Driven by the consistent rise in patient numbers, in 2015 we expanded the facility in Kabul: building a new operating block with 3 surgical theatres; reorganising the intensive care and step-down units; and increasing the number of inpatient beds to 120. Even while the renovation work was in progress, the hospital continued to ensure treatment for the wounded, seeing a total of 12,057 patients over the course of the year. The renovation was completed in 2016. In 2019 alone, there were more than 3,700 admissions to the hospital, and a third of them were children. As of June 2020, the Surgical Centre has admitted 57,819 patients, carried out 139,952 outpatient consultations, and performed 78,769 operations since opening in 2001. 

 

Education

The Kabul Surgical Centre operates in line with EMERGENCY’s ethos of working to provide sustainable healthcare through the training of local staff, who can subsequently operate autonomously upon EMERGENCY’s departure. The Kabul hospital is officially recognised by the Afghan Ministry of Health as a centre for specialist training in emergency surgery and traumatology. In 2017 the facility was home to nine trainee specialists, three of whom had completed their academic studies.

Additionally, over the past year we designed and ran courses for doctors and nurses from public hospitals on dealing with trauma and mass casualties. At the request of the World Health Organisation, and in collaboration with the Afghan Ministry of Health, we trained 250 people, helping to strengthen the national healthcare system’s emergency response capacity.

As of 2019, the Kabul Surgical Centre employs 352 national staff and medical professionals.