During the year, there was a gradual but stable increase in the number of patients coming to MSF facilities in Afghanistan, largely due to the improved security situation, which made it easier for people to travel. However, many Afghans continue to face huge challenges in accessing care.

In a broken economy, many cannot afford medical assistance. The public health system in Afghanistan has also been under-resourced, under-funded and over-burdened for years, and remains unable to meet people’s needs.       

In 2023, MSF teams in Afghanistan witnessed very high bed occupancy rates, reaching 130 per cent to 200 per cent in most facilities.

We ran nine projects in eight provinces, maintaining a strong focus on emergency care, surgery, and mother and child health. We also carried out an emergency response in October, after four 6.3 magnitude earthquakes hit Herat province, killing more than 2,000 people and displacing over 250,000. We donated emergency kits and helped treat the wounded at Herat regional hospital, the main treatment facility for earthquake victims.  

The situation for women did not improve in 2023. In late December 2022, following the decision by the Islamic Emirate of Afghanistan, also known as the Taliban, to ban women from working for NGOs and to limit their access to higher education opportunities, MSF condemned the gradual erasure of women and girls from public life in the country. In April, the ban was expanded to women working for the UN. In order for essential services to be available to everyone, there must be no constraints on who can deliver them. Women must be allowed to work, and to train as medical professionals.

Bamyan
In December 2022, MSF started a community healthcare programme in Bamyan, delivering healthcare services to remote and underserved districts in the province. We initially focused on mother and child healthcare, including obstetric and gynaecological consultations, support for non-complicated deliveries, and outpatient services for children under five. We also worked to boost the provincial hospital’s capacity for treating measles and COVID-19 patients, a short-term project that has since ended.

In 2023, we saw significant needs for general outpatient services, prompting us to expand our services. We also began administering routine vaccinations to protect children from preventable diseases.

Helmand
MSF supports Boost provincial hospital in Lashkar Gah, offering a wide range of medical services, including emergency, paediatric, neonatal and maternity care, surgery, and internal medicine.  

Our teams continued to witness the negative impact of poor access to health services in Helmand, with many patients travelling long distances from other provinces to reach the facility, sometimes arriving very late and in a critical condition.

Herat
In Herat province, we work in the paediatric department at the regional hospital, supporting triage, the emergency room, both inpatient and outpatient therapeutic feeding centres, the paediatric intensive care unit, and an intermediate care unit. During 2023, our teams admitted a high number of severely ill children to these units.

Our teams also run an outpatient clinic in Kahdestan, in Injeel district, where we offer care for pregnant and lactating women and treatment for children with moderate acute malnutrition, as well as general health services.  

Kabul
In 2023, we continued to treat patients with measles at Maiwand teaching hospital, but our main focus during the year was malnutrition. Our team increased the feeding centre’s bed capacity from 34 to 47 – the maximum the space would allow. Due to space constraints and a growing demand for inpatient care, MSF ended activities at the hospital on 26 December, with a plan to relocate to another, larger facility in the capital.  

We also maintained our assistance to the Afghan Midwives Association’s pilot project by offering funding and technical support for deliveries, ante- and postnatal care, and family planning.

Kandahar
In Kandahar, we run a comprehensive tuberculosis (TB) programme, providing diagnosis and treatment for both drug-resistant and drug-sensitive forms of the disease. 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.

In addition, we run a paediatric nutrition programme with inpatient and outpatient departments.

Khost
In Khost, our 83-bed maternity hospital provides comprehensive emergency obstetric and neonatal care and a safe space for mothers with high-risk pregnancies and obstetric complications to deliver in.

We also support eight health centres across the province, donating medicines and funding for additional midwives, so that women with no risk factors for obstetric complications can give birth closer to home. In addition, we donate medicines and other supplies to Khost provincial hospital.

Kunduz
MSF’s Kunduz trauma centre has an emergency room, an intensive care unit, inpatient and outpatient departments and operating theatres. The majority of admissions to the centre are for people injured in accidents, but we also treat patients with violence-related trauma. In early 2023, we introduced an antibiotic stewardship programme to monitor and treat infections, seeking to reduce the prevalence of antimicrobial resistance against first-line treatments in the community.

In Chardara, on the outskirts of the city, we run an outpatient health post, where our teams stabilise trauma patients, provide routine vaccinations and general consultations for children under five, and offer nutrition support.

Mazar-i-Sharif
In August, we started activities in the paediatric department of Mazar-i-Sharif regional hospital in Balkh province. Our teams support the paediatric emergency room and run the neonatal ward and neonatal intensive care unit. We see thousands of critically ill children in the emergency room each month, and admit hundreds of newborns to the neonatal intensive care unit.