MSF international volunteers have now made their way back to three of the major towns in Afghanistan, Kabul, Herat and Mazar-i-Sharif, from where they had been forced to evacuate shortly after September 11th. The MSF teams, which include senior medical staff, are starting to make their assessments of the needs in the towns. They have also been re-united with the Afghan national staff, who kept so many of the medical projects running during the last two months.

In Kabul, the expatriate team of a doctor, nurse, logistician and administrator have visited the small hospital that MSF has supported in the town and the Dasht-i-Bakhshi clinic, which is still running well with 80 to 90 consultations per day. They are going to other health centers and helping with medical supplies where these are lacking. In Mazar, where the fighting in the town had been much heavier, the team found local doctors were treating a substantial number of civilian and military casualties but that, overall, medical facilities were coping.

MSF's international staff had crossed from the Turkmenistan border, where they had been working for the earliest opportunity to get back to the projects in that part of Afghanistan. They have also visited the MSF clinics in the town and among the displaced people's camps. In the paediatric ward of the town's hospital, MSF's staff are treating an average of 7-8 malnourished children per day, and around 470 people are getting special rations in the supplementary feeding centers.

The team is concerned that, as they travel out into the more isolated areas of the countryside, there may well be a heavier burden of malnourished people.

Extra MSF medical staff are on their way to the town, along with medical supplies. The expat team made up of Cuban surgeon, a New Zealand nurse and a British logistician, who have traveled from the Turkmen border to the town of Herat in the south west of Afghanistan, say that they had an emotional re-union with the national staff.

One of them had been injured in the fighting, along with over 80 other civilians. In the northern town of Taloqan, where an MSF doctor and nurse team made the dangerous journey over mined roads to rejoin the local Afghan staff, they found casualties coming in from the fighting still going on in nearby Kunduz province.

They also witnessed the remarkable capacity of the local staff to revive their original working practices, which had been banned during the last year of Taleban rule. MSF is trying to expand its work with international staff to cover all the country. It is doing this completely independently of the warring parties and is seeking out those most in need in the chaos of displacement and conflict. Other teams are struggling to continue their work in the refugee camps near the border with Iran, where the recent fighting has disrupted clinics.

In Pakistan, medical care and sanitation work is going on in the large Jalozai refugee camp. People moved from the poorly located Killi Faizo camp, near the southern town of Quetta, are also getting MSF medical care in the new site, Roghani 2.