Afghanistan has been struck by yet another disaster to add to the pressure already present in the country. On the night of March 25/26, a series of earthquakes, measuring up to six on the Richter scale, hit the Nahrin town and region in the Northern Province - a mountainous region, already difficult to access and with just three main roads. Two of these roads are now badly damaged, presenting immediate fundamental issues to the transport of aid supplies and personnel.

Nahrin was also near the front line in the long armed conflict against the Taleban that has dominated the country's recent history. This has left the region mined and so transport and movement is further restricted. International awareness of the country leapt with the recent Western military offensive against the Taleban but the reality is that the country, and its people, have been suffering from a steady and dramatic decline in their abilities to cope. Drought has been a near seasonal occurrence for the past four years.

Crops are failing and following year's harvest are immediately affected by the results of the current harvest. Malnutrition is on the rise and, in January this year, MSF identified a developing malnutrition situation in the Northern Province. Just recently, MSF had undertaken two measles vaccination campaigns in Ghorak and Khakrez in the Kandahar province (on the western region side of the country).

Our staff are also maintaining a careful watch over the population to identify any initial signs of outbreaks of other diseases that could threaten population - such as cholera, measles or meningitis. And still the issues for providing care to the Afghanistan people are increasing.

With the recent earthquakes, MSF has diverted aid from one emergency to another. Resources and staff that were initially intended for delivery to the Northern Province for the developing malnutrition crisis is now being delivered to the earthquake zone.

With the range of problems facing the country, the number of Afghan refugees outside the country and displaced inside are climbing. By late Spring 2001, Afghan refugees numbered 3.5 million. Internally displaced were at least 700,000. Of the displaced, the most common reason for moving elsewhere has been hunger, not conflict.

These figures are already dated and the numbers have risen. The humanitarian needs in Afghanistan are immense and this has been the case for years. MSF has been constantly active in Afghanistan for over 20 years providing medical care to the vulnerable populations there.

Due to the long presence and the widespread range of activity, MSF was present in the Northern Provinces when the earthquakes occurred. This presence allowed the organisation to mobilise staff and equipment rapidly and bring essential care in the immediate hours and days following.