When the Islamic Emirate of Afghanistan, also known as the Taliban, entered the capital, Kabul, and took over power on 15 August 2021, foreign development funding was cut overnight. Afghan assets held in the US and in some other foreign countries were frozen and many international organisations left the country. This added more pressure to an already fragile, over-burdened public health system, making it increasingly difficult for people to obtain healthcare.  

Although the security situation improved in 2022, and it generally became easier for people to travel to health facilities, many Afghans still faced huge challenges in accessing care. In a broken economy, many could not afford hospital visits, while for women, there were the additional barriers of the limitations placed on their freedom of movement, access to education and work. Consequently, many people delayed seeking assistance until they had no other option.       

In 2022, we saw an increase in the number of people coming to our facilities, possibly due to the lack of free, local medical services and the fact that travel was safer. We ran seven projects in seven provinces, maintaining a strong focus on providing specialised healthcare. MSF also carried out an emergency response after a 5.9 magnitude earthquake hit Paktika and Khost provinces on 22 June. Our teams provided medical and logistical materials to the affected area, and set up outpatient and inpatient clinics for women and children, as well as for patients with trauma injuries or acute watery diarrhoea. 

Lashkar Gah 
MSF supports the 340-bed Boost hospital in Lashkar Gah, Helmand province, offering a wide range of medical services, including maternal and paediatric healthcare and surgery. In 2022, there was a 32 per cent increase in patients admitted to the hospital compared to the previous year. This increase can be attributed primarily to the fact that many health facilities in remote districts of Helmand suspended or limited their activities due to a lack of funding, medical supplies and qualified healthcare workers. Many people were forced to travel to Lashkar Gah to receive care as a result.  

Kunduz 
MSF’s Kunduz trauma centre has an emergency room, intensive care unit (ICU), inpatient and outpatient departments, and two operating theatres. The majority of admissions to the centre are for trauma incurred in accidents, but we also provide care to people with violence-related injuries, such as explosions.  

Our team in Kunduz reported that seriously injured patients sometimes took more than seven hours to reach the centre. Such long delays can be very detrimental to patient outcomes, and speak not only to the limited referral and trauma care services in Kunduz, but also to poor road infrastructure in rural communities.  

In November, MSF opened a heath post in Chardara district, to respond to gaps in local healthcare, including nutrition support and routine vaccination services. 

Kabul 
In the capital, we supported Maiwand teaching hospital by carrying out renovation work on the paediatric department and opening two new facilities: a 28-bed measles ward in February and a 34-bed inpatient therapeutic feeding centre (ITFC) in July.  

We continued our collaboration with the Afghan Midwives Association’s pilot project by providing funding and technical support for deliveries, ante- and postnatal care, and family planning.

Khost 
In Khost, MSF runs a dedicated hospital offering neonatal and maternal care, with a special focus on complicated deliveries. The hospital has a 60-bed maternity unit, a 28-bed neonatal unit and two operating theatres.  

In 2022, we also supported eight local health centres across the province, providing medicines and funding for additional midwives, so that women with no risk factors for obstetric complications could give birth closer to home. In addition, MSF donated medicines and other supplies to Khost provincial hospital. 

Kandahar 
We have been treating both drug-sensitive and drug-resistant forms of tuberculosis (TB) in Kandahar since 2016. Our hospital has a laboratory, an outpatient clinic and a 24-bed inpatient department for patients with drug-resistant TB (DR-TB) and other illnesses, and for those who develop severe side-effects after taking DR-TB medication. To respond to elevated levels of malnutrition in the province, we also opened a 40-bed ITFC in 2022. 

Herat 
In Herat regional hospital, MSF supports the paediatric department’s triage, emergency room, ICU, ITFC and hospitalisation ward. Over the course of 2022, we screened and admitted thousands of patients for emergency care. The main reasons for admission were infections of the central nervous system, such as meningitis, and for septic shock, sepsis and pneumonia.  

The total number of admissions to the hospital’s ITFC increased by 42 per cent in 2022 compared to 2021. Almost 50 per cent of patients were younger than six months old. Meanwhile, in camps for displaced people, we treated pregnant and lactating women, and children with moderate acute malnutrition, as well as providing general healthcare, in Kahdestan outpatient clinic.  

Bamyan 
In March, MSF started a new project in Bamyan province to support the provincial hospital with staff, donations of medications, isolation ward management, and capacity building for measles case management and the COVID-19 response.   

 We also completed the first phase of an assessment in three districts – Shibar, Saighan and Yakawlang – and the construction of eight community health facilities in Sar-e-Tarnook, Baghalak, Dar-e-Ali, Band-e-Amir, Pusht-e-Waz, Amrut, Baghak, and Jalmish.