Background

In 2004, EMERGENCY opened its Surgical Centre for War Victims in Lashkar-Gah. Named after the Italian journalist and pacifist Tiziano Terzani, the centre is the only free specialist facility in an area – Helmand province – where fighting between the Afghan National Army and the Taliban; International Security Assistance Force (ISAF) airstrikes; and antipersonnel landmines remain a severe threat to civilians.

 

In 2015 the fighting intensified, particularly in the Babaji, Nadali, Marjah, and Sangin areas. As such, Helmand Province is one of the country’s most volatile. For more than ten years the Afghan National Army and international coalition forces have been fighting to reclaim territory held by the Taliban. Helmand produces more opium than any other province and fighting is mostly concentrated in the north, around Musa Qala, Naw Zad, and Kajaki, where the Taliban seeks to maintain control of opium production. The spread of fighting has made it exceptionally difficult to provide medical care to those in these remote regions.

Security conditions continue to deteriorate. 2016 saw a 20% rise in the number of patients admitted. To account for this, in the same year we expanded the hospital to increase bed capacity from 70 to 96 beds. We created a new physiotherapy department and a room for dressings and follow-up care.

Current levels of violence are the most severe EMERGENCY has witnessed, and the number of casualties visiting the hospital in Lashkar-Gah is constantly on the rise. 2017 saw 3,961 people admitted to the centre. An average of 24 victims of war were seen each day throughout the year. One in every three patients was under the age of eighteen. In 2019, we received more than 1,000 child patients, 260 of them under five years old. As of June 2020, the centre has conducted 171,849 outpatient consultations; admitted 46,747 patients; and performed 64,179 surgical procedures since opening in 2004.

Network of Aid

In order to provide immediate assistance to those in need, we established six First Aid Posts (FAPs) in the remote districts neighbouring Lashkar-Gah. Currently, FAPs operate in the villages of Grishk, Garmsir, Marjia, Sangin, Musa Qala, and Urmuz. In these facilities, our local nurses provide crucial first aid to patients. If deemed necessary, patients are stabilised and then transferred to our hospital in Lashkar-Gah by ambulances which operate 24/7.

 

In May 2016, we reluctantly closed our First Aid Post in Sangin due to security concerns. It was impossible to reopen the facility in 2017 due to the fighting still afflicting the region. Finally, reopening became a reality: in October 2018 we managed to open a new First Aid Post in Sangin that will guarantee easier access to treatment for those living in the area.

 

Education

As with many EMERGENCY facilities, the Afghan Ministry of Health has officially recognised the Lashkar-Gah Surgical Centre as a training facility for emergency surgery and traumatology. In 2017, six local surgeons completed their training and specialisation at the hospital. A core component of EMERGENCY’s work – in all its hospitals and medical facilities – is close partnership with, and training of, local medical professionals and ancillary staff. At present, 283 local staff members and medical professionals work at the Lashkar-Gah Surgical Centre.

Civilian Casualties

There are four girls, a little boy, and a woman. The man accompanying them says that their home was struck during a counter-Taliban offensive, most likely an attempt to push back the group, which have been edging closer to the city for days.

Sat on benches outside the A&E Department are another child and an infant, covered by the dust into which their home has been transformed. Fortunately they are unhurt, but frightened and hungry. For days their family has not been able to find enough food.

A few hours later, at 5am, 26 patients arrive together, all suffering from firearm or shrapnel wounds. It took them many hours to get to our hospital.

In Lashkar-Gah, each day involves a constant flow of arriving patients. We are here to guarantee treatment to whoever needs it. But the hope remains that the entire population of Helmand can return back to their homes, without risk of injury from a projectile, bomb, or mine – without the risk of becoming yet more ‘collateral damage’.

The Lashkar-Gah Surgical Centre features in the Vice News documentary ‘What We’re Leaving Behind’