AFGHANISTAN. Inside the war

EMERGENCY ONG is an independent and neutral organisation founded in 1994 with two objectives: to guarantee free and high-quality health services to victims of war, landmines, and poverty and, at the same time, to promote a culture of peace, solidarity, and respect for human rights.

Since 1994, EMERGENCY has worked in 19 countries around the world, providing free medical care in accordance with its core principles: equality, quality and social responsibility.

Since 1994, EMERGENCY treated

+ 11,5

Million People


Person every minute


Countries we're working in

Our Principles

EMERGENCY believes that medical treatment is a fundamental human right and should be recognised assuch for every individual. EMERGENCY is guided by the following principles:


Obligation to provide medicalcare without political, ideologicalor religious discrimination


Autonomy of humanitarian aims fromany political, economic, military orother contexts or influences.


No involvement in conflict.


A conviction that human beings are equal in the face of suffering and that human life must be protected.


Afghanistan is in the headlines now that the withdrawal of international troops from one of the most strategically important corners of Asia has been announced.

For the benefit of those who do not remember, it may be worth casting our minds back to how this war started. In its resolution number 1368, approved the day after the attack on the Twin Towers in New York, the UN Security Council declared its ‘readiness to take all necessary steps to respond to the terrorist attacks of 11 September 2001, and to combat all forms of terrorism, in accordance with its responsibilities under the Charter of the UN.’ The UN called on all states ‘to bring to justice the perpetrators, organizers and sponsors’ of the attack. The resolution was ignored. The Council – the only international body with the right to resort to force – was not given the time to do anything.

The United States ignored the Council’s resolution and went ahead with a military plan of its own (and therefore in total violation of international law), as the decision to attack and occupy Afghanistan had already been taken back in autumn 2000, by the Clinton administration.

On 7 October 2001 the US Air Force began aerial bombardment. Officially, Afghanistan was attacked for giving support and succour to Osama Bin Laden’s war against the US. The War on Terror thus became in practice a war to destroy the regime of the Taliban, who had held sway since September 1996, and who had previously, for at least two years, been cosied up to by the Americans in the hope of a treaty. The regime in Kabul was granted formal recognition and financial support in exchange for control of future oil and gas lines by American multinationals. The pipes would run from Central Asia to meet the sea in Pakistan; Pakistan, which had given life to, armed and funded Taliban groups since 1994.

This stage was set for full-scale aggression against a whole country, in pursuit of a terrorist group.

Three months into 2002, the slaughter in Kabul and its environs alone had already claimed more civilians than were killed in New York. The places, the dates and the names of victims have been collected meticulously by Mark Harold, a professor at the University of New Hampshire. The information is less clear about the victims of the months and years that followed. Brown University’s ‘Costs of War’ documents approximately 241,000 people killed and hundreds of thousands more dead from starvation, disease and lack of essential services. In the past decade alone, the UN Assistance Mission in Afghanistan (UNAMA) has recorded the killing of 8,099 children and the wounding of 19,085, numbers which are certainly underestimates.

© Riccardo Venturi/Contrasto

I first met with war in Afghanistan in 1989, as a surgeon at the Red Cross hospital in Quetta. That was my first encounter with the Afghan people, who had been devastated by landmines and fighting between their pro-Soviet government and the mujahideen. There were farmers wounded while tending their crops, market sellers hit by bombs in the bazaar, women and children injured in their houses.

I came back in 1999 with EMERGENCY. We had already opened a hospital in the Panjshir valley, an area then controlled by General Massoud. In spring 2001 we opened a second, in Kabul, then a third in Lashkar-Gah, Helmand province, in 2004. In each of these hospitals I operated on men, women and children of all ages. In Afghanistan, as in every war that I have seen with my own eyes, nine in ten victims are always civilians. I lived in Afghanistan for seven years all told. I saw the wounding and the violence rise year after year, as corruption and insecurity gradually devoured the country.

20 years ago we were already saying this war would be a disaster for all. Now the results of the aggression are irrefutable; it has been a failure in every respect. With more than 241,000 victims and almost 5 million refugees, including both migrants and IDPs, today Afghanistan is a country walking into civil war. The international troops have been defeated and their authority and very presence are even weaker than they were in 2001. It is a country destroyed. So many of its people choose to flee, even if it means going through hell to get to Europe.

To fund all this, the United States has spent a total of 2 trillion dollars. An approximate but plausible estimate puts the average yearly cost of keeping an American soldier stationed in the country at 1 million dollars. As always, the big arms dealers – of which Lockheed Martin, Northrop Grumman and Boeing are only the biggest three – are very thankful; they are the ones making a profit out of this war.

EMERGENCY, meanwhile, has spent about 120 million euros in its over 20 years in Afghanistan. This money has come from individuals, institutions and, in the last few years, the Afghan government. We have used it to treat more than 7.5 million people, train new doctors and other medical workers, and given jobs to about 2,500 Afghans. All at roughly the cost of keeping a small contingent of soldiers in the country for a year. As always in life, you have to know where you stand. 

Gino Strada, surgeon and founder of EMERGENCY
(Text written on 3 August 2021)

EMERGENCY's Story in Afghanistan

December 1999
Opening of the first Surgical Centre for War Victims in Anabah, Panjshir Valley, in the north of the country
December 1999
Launch of the First Aid Post (FAP) and Primary Healthcare Centre (PHC) network. These are health clinics in inaccessible areas that guarantee first aid to patients and refer them, if necessary, to the three surgical hospitals. They are connected by a 24/7 ambulance service.

Today, the network consists of 44 First Aid Posts and Primary Healthcare Centres in 31 districts across the country.

March 2001
Launch of a social project to support widowed women in the Panjshir Valley
April 2001
Opening of the second Surgical Centre for War Victims in Kabul.
May 2001
Start of operations in Sheberghan prison, where over 1,200 political prisoners were held. This was the start of a wider programme to provide healthcare for inmates in the country’s largest prisons.
April 2002
Faced with a reduction in the number of patients- and therefore war victims- in the Panjshir Valley, the hospital expanded its admission criteria to include trauma, general surgery, internal medicine and paediatrics.
June 2003
Maternity and Paediatric Centre opened in Anabah, Panjshir Valley.


Summer 2003
Construction of a new Intensive Care and Resuscitation Unit in Kabul. It is the first completely free ward of its kind in Afghanistan.
September 2004
Opening of the third Surgical Centre for War Victims in Lashkar-Gah, Helmand Province, in the south of the country.

The hospital is dedicated to Tiziano Terzani, an Italian “journalist, global citizen, war writer and promoter of peace.”

April 2007
Temporary closure of EMERGENCY’s hospitals following the arrest of a staff member who had supported the release of journalist Daniele Mastrogiacomo.

The colleague was subsequently freed and acquitted of all charges.

April 2010
Arrest of three EMERGENCY workers on false charges at the Lashkar-Gah Surgical Centre.

A petition in their support was signed by 400,000 people in 4 days. After 9 days, they are freed and recognised as ‘completely innocent’.

From July 2011
Recognition of EMERGENCY’s hospitals as Training Centres for Surgical, Gynaecological and Paediatric residents by the Afghan Ministry of Health.
December 2016
Inauguration of the new Maternity Centre in Anabah, Panjshir Valley.
From 2017 to 2020
The hospital is dedicated to Valeria Solesin, who was killed in the attack on the Bataclan in Paris on 13 November 2015. To this day, the Centre remains the only free, specialist facility of its kind in the area.

Expansion of hospitals in Kabul and Lashkar-Gah to meet increased needs.

January 2018
On 27 January, staff in Kabul manage the largest mass casualty ever, with 119 injured people hospitalised.

2018 is also the year with the highest number (31) of mass casualties.

All facilities were adapted to prevent Covid-19 infection. No EMERGENCY hospital ever closed, even during the peak months of the epidemic.
From December 1999 to June 2021, approximately 70,000 war-wounded patients were admitted to EMERGENCY’s three surgical hospitals.

Surgical And Paediatric Centre – Anabah. Since 1999


Surgical Centre: Accident & Emergency room, 2 operating theatres, sterilisation, intensive care, physiotherapy, 4 wards (2 for women and 2 for children), laboratory, blood bank, pharmacy,  technical and cleaning services shared with Paediatric and Maternity Centre.

Paediatric Centre: Accident & Emergency room, outpatient clinic, 2 wards, observation room, isolation room, dispensary, guesthouse for national trainee staff.

Surgical Centre for War Victims- Kabul. Since 2001

Beds- 377 Local Staff

Accident & Emergency, clinics, 3 operating theatres, sterilisation, intensive care, sub-intensive care, 6 wards (1 of them specifically for women and children), physiotherapy, laboratory and blood bank, radiology, CT, pharmacy, classrooms, technical and cleaning services.

Maternity Centre – Anabah. Since 2003

99 Beds – 173 Local Staff

Obstetrical and gynaecological emergency room, outpatient clinic with ultrasound service, labour room, waiting room for scheduled examinations, 4 outpatient clinics, 4 single delivery rooms, 1 post-partum room, 2 operating theatres, neonatology department with NICU (Neonatal Intensive care unit (NICU), intensive care unit and post-natal ward, obstetrical ward, gynaecological ward, technical and auxiliary services shared with the and auxiliary services shared with the Surgical and Paediatric Centre.

Surgical Centre for War Victims – Lashkar-Gah. Since September 2004.


Accident & Emergency, 3 operating theatres, sterilisation, intensive care, 5 wards (one for children and women only), physiotherapy, radiology, laboratory, blood bank, pharmacy, classrooms, teaching room, technical and cleaning services.

First Aid Posts (FAPs) and Primary Healthcare Clinics (PHCs). Since 1999.


LOCATIONS: Maydan Shar, Sheikhabad, Mirbachakot, Tagab,Chark, Pul-e-Alam, Barakibarak, Ghazni, Andar, Gardez,Ghorband, Mehterlam, Abdara, Anabah, Changaram, Dara,Darband, Dasht-e-Rawat, Hesarak, Khinch, Paryan, SangiKhan, Shutul, Anjuman, Gulbahar, Kapisa, Koklamy, Oraty,Pul-e-Sayyad, Said Khil, Grishk, Sangin, Marjia, Musa Qala,Garmsir, Nad Ali, Shoraki.


The data collected in recent years by EMERGENCY and UNAMA, the United Nations Assistance Mission in Afghanistan, show an increase in civilian casualties compared to the early years of the war. From 2013 to 2020, there were 136 mass casualties in Kabul, plus 14 in 2021. The effectiveness of EMERGENCY's intervention also increased, thanks to the expansion of its network of First Aid Posts.