New Report Reveals Woeful State of Afghanistan’s Health Care

2 minute read
Pediatric nurse Isabelle Arnould examines a baby in the neonatal ward at the MSF Maternity Hospital in Khost.
Pediatric nurse Isabelle Arnould examines a baby in the neonatal ward at the MSF Maternity Hospital in Khost.Andrea Bruce—Noor Images for MSF
By Andrew Katz

As the almost 13-year-occupation of Afghanistan by foreign troops draws to an end, a new report by Médecins Sans Frontières highlights jarring shortcomings in the public health system they’ll be leaving behind. These pictures, by documentary photographers Andrea Bruce and Mikhail Galustov, both of whom have spent years covering the war’s toll on the innocent, are paired with the aid group’s findings.

The report released Tuesday concludes that access to basic or emergency medical care remains hard to reach—or beyond grasp—for many Afghans despite years of Western involvement and billions of dollars in humanitarian assistance. Aid workers interviewed hundreds of hospital patients over the course of six months in Helmand, Kabul, Khost and Kunduz provinces. The results of their survey strike a blow to “prevailing narratives of progress,” says MSF, as battles with the Taliban rage and international aid dries up.

Some clinics lack qualified staff, specific medicines and even electricity, MSF was told. One-fifth of patients interviewed said a family member or close friend had died in the past year due to a lack of access to proper care. Among the main barriers for reaching treatment were high costs and lack of money, long distances and the armed conflict. “The fighting doesn’t stop when there are injured people, so we can’t get them to a doctor. So we wait, and then they die, and the fighting continues,” said one man, a 25-year-old principal in the northern Baghlan Province. “Even if you are able to move with your wounded, you still have to get through roadblocks, checkpoints, questioning and harassment before you can reach the hospital.” Forty percent of interviewees who reached the hospitals said they encountered those hardships, among others.

MSF does note that the number of health facilities has risen “considerably” over the past decade and that national statistics claim more than 57 percent of people now live within an hour’s walk of a public health facility—up from nine percent in 2001—but that’s just about all the good news that there is. With this report and accompanying photographs, the organization calls on international donors, other aid groups and the Afghan government to begin filling in the gaps and meeting the needs of a population wracked by decades of war before the situation gets any worse. —Andrew Katz

A camp for the internally displaced is located on the western outskirts of Kabul. Thousands of people live in the camp, most are from Helmand or Kandahar where they have fled their homes due to heavy fighting. This baby was born inside a mud and tent home inside the camp. The mother has continued to bleed for a week since the birth and says she can't stand.
A camp for the internally displaced is located on the western outskirts of Kabul. Thousands of people live in the camp, most are from Helmand or Kandahar where they have fled their homes due to heavy fighting. This baby was born inside a mud and tent home inside the camp. Andrea Bruce—Noor Images for MSF
Women wait for services at the Ahmed Shah Baba Hospital in Kabul. Over 600 patients come through the hospital a day.
Women wait for services at the Ahmed Shah Baba Hospital in Kabul. Over 600 patients come through the hospital a day.Andrea Bruce—Noor Images for MSF
In Kabul, women going through labor are helped by midwives at the Ahmed Shah Baba Hospital, which is known for its maternity care. Midwife Iline Ceelen comforts a woman going through labor who is around 13 years old. The Ahmed Shah Baba Hospital sees, on average, 900 to 1000 births a month.
In Kabul, women going through labor are helped by midwives at the Ahmed Shah Baba Hospital, which is known for its maternity care. Midwife Iline Ceelen comforts a woman going through labor who is around 13 years old. The Ahmed Shah Baba Hospital sees, on average, 900 to 1000 births a month.Andrea Bruce—Noor Images for MSF
Pediatric nurse Isabelle Arnould examines a baby in the neonatal ward at the MSF Maternity Hospital in Khost.
Pediatric nurse Isabelle Arnould examines a baby in the neonatal ward at the MSF Maternity Hospital in Khost.Andrea Bruce—Noor Images for MSF
The MSF mobile clinic arrives at the village of Spinar Poza just east of Kabul.
The MSF mobile clinic arrives at the village of Spinar Poza just east of Kabul.Andrea Bruce—Noor Images for MSF
Children come for vaccinations and other care at the MSF mobile clinic in the village of Spina Poza just east of Kabul.
Children come for vaccinations and other care at the MSF mobile clinic in the village of Spina Poza just east of Kabul.Andrea Bruce—Noor Images for MSF
Scene outside of a local pharmacy in Kunduz city, Northern Afghanistan.
Scene outside of a local pharmacy in Kunduz city, Northern Afghanistan.Mikhail Galustov for MSF
Patients and visitors gather at the door of OPD at Boost Hospital in Lashkar Gah, Helmand province, Southern Afghanistan. The provincial hospital, supported by MSF, is one of only two functioning referral hospitals in southern Afghanistan. Helmand is one of the most conflict-affected provinces in the country.
Patients and visitors gather at the door of OPD at Boost Hospital in Lashkar Gah, Helmand province, Southern Afghanistan. The provincial hospital, supported by MSF, is one of only two functioning referral hospitals in southern Afghanistan. Helmand is one of the most conflict-affected provinces in the country.Mikhail Galustov for MSF
Visitors queue at the IPD of Boost Hospital in Lashkar Gah, Helmand province, Southern Afghanistan.
Visitors queue at the IPD of Boost Hospital in Lashkar Gah, Helmand province, Southern Afghanistan.Mikhail Galustov for MSF
OPD patients wait for appointments outside at the Kunduz Trauma Centre in Kunduz, Northern Afghanistan.
OPD patients wait for appointments outside at the Kunduz Trauma Centre in Kunduz, Northern Afghanistan.Mikhail Galustov for MSF
MSF doctor treats a female patient at the OPD of Kunduz Trauma Center in Kunduz, Northern Afghanistan.
MSF doctor treats a female patient at the OPD of Kunduz Trauma Center in Kunduz, Northern Afghanistan.Mikhail Galustov for MSF
Doctors examine a head trauma patient at the ICU of Kunduz Trauma Center in Kunduz, Northern Afghanistan.
Doctors examine a head trauma patient at the ICU of Kunduz Trauma Center in Kunduz, Northern Afghanistan.Mikhail Galustov for MSF

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