Though the security situation in Hangu remains tense, Médecins Sans Frontières (MSF) continues to work inside the Hangu Tehsil Headquarters (THQ) hospital, where it has been since May 2010.

In 2011, MSF provided medical care to more than 20,088 patients in the emergency room and conducted 955 emergency surgeries in the hospital’s operating theater.

Throughout 2011, the MSF medical team also referred more than 452 patients to Peshawar for specialized surgical and medical care. From July to October—the rainy season—MSF treated 1,526 patients with acute watery diarrhea. In light of the area’s ongoing medical needs, MSF will continue to provide free emergency medical care in 2012.

MSF has also established a mass casualty preparedness plan in the hospital, in order to be able to quickly respond and provide emergency life-saving medical care to the victims of bomb blasts, clashes, and other trauma cases. Because of this preparedness plan, MSF was able to immediately perform emergency surgeries on four patients injured in a December 22 bomb blast near a private clinic in Hangu city. Two of these patients were referred to Peshawar for further specialized surgeries and medical treatment, where one of them eventually died. The other two patients are still hospitalized in THQ hospital.

In the hospital's Mother and Child Health Center (MCH), MSF has had one expatriate midwife assisting in handling complicated deliveries and providing training since May 2011, while the daily services inside the MCH are run by Ministry of Health (MOH) staff. So far, MSF has assisted more than 761 complicated deliveries free of charge.

According to one of the injured patients’ caretakers, “If this kind of emergency surgical care is not available here, I think my family members would not be able to survive.” All the services provided by MSF in the emergency room and surgical department are free of charge, which helps ensure that people have access to quality life-saving medical care. “I am only a driver and I cannot afford expensive treatment," one injured patient says. "But all the treatment, including food, is free of charge here. So for this, I am happy."

To ensure the safety of patients and medical staff, MSF has a strict “no weapons” policy inside the hospital. “The presence of anyone who is armed could turn the health facility into a target," says Abdelkader Tlidjane, MSF project coordinator in Hangu. "For the security of patients and medical staff, it’s crucial that all communities and authorities respect the neutrality of the health facility, making it a safe environment for all patients, and guaranteeing that all people have access to medical treatment, regardless of their political or other affiliations.”

He continued: “With the continuous acknowledgement and support from different communities and authorities, MSF is keen to continue our assistance in the THQ hospital, to ensure patients in the area can have access to emergency medical care."

MSF currently has about 130 international and Pakistani staff working in Hangu—including 61 staff in the emergency room and operating theater—and one expatriate midwife supporting the MOH staff of the MCH.

Since 1986, MSF has been working in Pakistan with Pakistani communities and Afghan refugees who have been affected by armed conflict, natural disasters, or a lack of access to medical care. MSF teams currently provide free emergency medical care in Kurram Agency in the Federally Administered Tribal Areas; in Hangu, Peshawar, Lower Dir and Malakand districts in Khyber Pakhtunkhwa province; and in Balochistan province.