Amid the changing political landscape, the freeze on international banking, an escalating humanitarian crisis and increased restrictions on women, EMERGENCY remains in Afghanistan and continues to provide free, high-quality care across the country.
Since August 2021, EMERGENCY has admitted more than 41,000 people to its four hospitals: two Surgical Centres in Kabul and Lashkar-Gah, and a Surgical and Paediatric Centre and a Maternity Centre in Anabah, in the Panjshir Valley. Its network of over 40 First Aid Posts and Primary Healthcare Centres – connecting rural and underserved parts of Afghanistan, including Kabul prisons, with routine health checks and essential first aid services – provided over 720,000 outpatient consultations.
EMERGENCY began working in Afghanistan in 1999 and has remained unflinching in its commitment to providing excellent medical care, treating more than 8.5 million Afghans since.
“I am thankful to EMERGENCY hospital,” says Ajmal, a patient admitted to the Surgical Centre in Kabul earlier this year after a serious road traffic accident. “Without EMERGENCY, I wouldn’t be here to tell my story.”
“Since August 2021, we have seen the health needs of Afghans change,” reports Stefano Sozza, EMERGENCY’s Country Director in Afghanistan. “We have widened admission criteria at our Surgical Centres, in particular in the Lashkar-Gah hospital, to include civilian trauma cases. This runs parallel to a clear change in the security conditions in the country.”
While the number of people arriving at EMERGENCY’s facilities with violent injuries is decreasing, the number of those who die because they cannot access treatment is rising.
“I couldn’t leave him alone. Public clinics are free in theory. But in practice, if you need medication you have to pay for it and I have no money. So I turned to EMERGENCY,” says Munir, whose 9-year-old son, Amir, was being treated at the Kabul Surgical Centre for injuries sustained in a landmine explosion. “I too would have had to go into debt. Where would I have found the money? I don’t know if Amir will talk again. But at least EMERGENCY gave him a chance.”
All of EMERGENCY’s services are completely free, creating a lifeline in a country where OCHA projects nearly 30 million need urgent humanitarian assistance to survive. As part of the organisation’s efforts to increase the long-term sustainability of its care, EMERGENCY prioritises training local colleagues: more than 97 per cent of EMERGENCY’s staff in the country are Afghan. EMERGENCY’s active residency programmes include surgery, anaesthesia, gynaecology and paediatrics.
“Nursing here is a sacred job: our patients are our relatives, our people,” comments Gulbudin, Head Nurse at the Surgical Centre in Lashkar-Gah. He has worked at the Centre since it opened in 2004. “I can only say that we work for EMERGENCY, because EMERGENCY works for our people.”
In the last two years, severe restrictions have been placed on women’s rights, including education and employment. There is currently an exemption in place for women working in health. EMERGENCY continues to train Afghan women, and has over 370 Afghan women on its staff; in particular, the Maternity Centre in Anabah is run entirely by women.
“In a country already struggling with very serious economic and humanitarian crises, denying girls education means depriving Afghanistan of future resources that could strengthen the economy, public health and stability,” says Sozza. “In the same way, prohibiting employment in NGOs reduces the possibility for vulnerable segments of the population to be reached and to have their needs and rights recognised. Our women colleagues continue to work with us, but we believe it is nevertheless essential that the authorities reconsider these decisions to allow women to continue contributing to the development of their country.”
Earlier this year, EMERGENCY published a report together with CRIMEDIM (Università del Piemonte Orientale), examining how access to care has changed since August 2021. While the security situation has improved, brain drain and inadequate, costly facilities have created major barriers. Over half of the 1,807 respondents reported having sacrificed buying food or clothing to pay for health services in the past year, and nearly 9 in 10 have been forced to borrow money to make these payments. More than one in five respondents had lost at least one family member or friend in the last year due to the inaccessibility of care.
Maternal health services were found to be particularly poor, with women dying in labour en route to hospital and many receiving no antenatal support until delivery.
You can access the full report, Access to Care in Afghanistan: Perspectives from Afghan People in 10 Provinces, here.
 OCHA, Aghanistan: Humanitarian Update, June 2023, https://www.unocha.org/publications/report/afghanistan/afghanistan-humanitarian-update-june-2023