Afghanistan: ICRC steps up efforts to help the sick and wounded

25-05-2010 Operational Update

Fighting, mines and road blocks are preventing many people in the conflict-affected areas of Afghanistan from getting to hospital. The ICRC is reacting by training local surgeons in war surgery skills and giving basic first-aid training to people directly involved in the fighting.

  ©ICRC/J. Powell/v-p-af-e-01561    
  Operating theatre, Mirwais Hospital, Kandahar. The hospital has extremely high emergency surgery rates, with two beds being used concurrently.    

  ©ICRC/J. Powell/v-p-af-e-01587    
  ICRC rehabilitation centre, Kabul. A patient exercises with dumbbells in the training room.    

  Humanitarian situation  

The armed conflict is taking a heavy toll on health services around the country. Even basic first aid is often lacking, let alone advanced war surgery. And when health care is available, it is not always easy to get it. The recent offensive in Marjah, Helmand, is a case in point.

" Even after the fighting is over in a particular area, we're having difficulty transporting patients to doctors. Mines, checkpoints and general insecurity stop us getting through safely, " reported an Afghan Red Crescent Society volunteer providing community-based first aid.

According to a taxi driver who regularly takes sick and wounded patients from the Sangin district of Helmand to the ICRC-supported Mirwais hospital in Kandahar, " road blocks, fighting and insecurity are endangering the lives of the sick and injured, because it often takes us six or seven hours to get people to hospital instead of two. "

  Caring for the sick and wounded  

The ICRC's response includes training local doctors to deal with weapon wounds. In April, forty-two surgeons and other doctors from across the country participated in a three-day war surgery workshop conducted by the ICRC's chief surgeon Marco Baldan, an internationally recognized expert in the field of weapon-related injuries. Worryingly, many participants confirmed a trend noticed at Mirwais hospital in Kandahar, namely that there has been a substantial increase in the number of patients injured by improvised explosive devices and other weapons.

The ICRC also provided basic first-aid training and first-aid kits to arms carriers and to civilians living in conflict areas. In April, it reached over 100 Afghan security forces personnel, over 70 members of the armed opposition, taxi drivers involved in the transport of wounded people, first-aiders and its own staff. In addition, 28 medical staff underwent training in the use of specialized ICRC supplies for the treatment of patients with weapon wounds.

The ICRC-supported Sheberghan Hospital in the north of Afghanistan and Mirwais Regional Hospital in Kandahar treated nearly 3,500 inpatients and some 20,000 outpatients between them. Surgeons performed almost 1,000 operations. Both hospitals are run by the Ministry of Public Health with substantial support from the ICRC, which has deployed 18 expatriate doctors, nurses and administrators to assist and train staff at Mirwais Hospital. The organization has also been providing technical and financial support for ten basic health clinics run by the Afghan Red Crescent. Finally, the ICRC treated over 400 patients at seven first-aid posts in the southern and central regions.

  Limb-fitting and physical rehabilitation  

The ICRC has been involved in limb-fitting and rehabilitation activities in Afghanistan for over 20 years. Increasingly, the organization has also been supporting the social reintegration of disabled people, ranging from landmine victims to those with a motor impairment. It runs prosthetic/orthotic centres in Kabul, Mazar-i-Sharif, Herat, Gulbahar, Faizabad and Jalalabad, plus a home-care service offering medical, economic and social support for patients with spinal cord injuries and their families.

In April, the six ICRC centres:

  • registered 670 new patients, including 87 amputees;

  • assisted some 6,500 patients;

  • fitted nearly 1,120 prostheses and orthotic devices;

  • held over 17,000 physiotherapy sessions;

  • granted micro-credit loans to 48 patients to help them start their own small businesses;

  • provided vocational training for 241 patients, of whom 35 who completed their training in April;

  • conducted 700 home visits to patients with spinal cord injuries.

  Visiting places of detention and restoring family links  

The ICRC regularly visits places of detention run by the NATO-led International Security Assistance Force, the US forces and the Afghan authorities. The aim is to monitor conditions of detention and the treatment of detainees. Last year, it also began visiting people detained by the armed opposition.

The ICRC helps family members separated by conflict to stay in touch with one another, and supports families seeking missing relatives.

During April, ICRC staff:

  • monitored the cases of 742 detainees, visiting 78 of them for the first time;

  • paid the cost of transportation for 18 ex-detainees to return to their home villages;

  • collected 184 Red Cross messages and distributed 211, mostly between detainees and their families, with the support of the Afghan Red Crescent;

  • facilitated 184 video telephone calls between families and relatives held in the US-run Parwan detention facility at Bagram airfield;

  • provided transportation and other support to enable the families of 74 detainees held in the Parwan facility to visit their relatives in person.

  Water and sanitation  

ICRC water engineers are wor king closely with local water boards on urban and rural programmes. The organization promotes hygiene awareness in religious schools and detention centres, and with families in their homes.

During April, the ICRC:

  • continued to work on four projects that will supply water for some 90,000 people in Herat, Jalalabad, and Kandahar;

  • held hygiene-promotion sessions for nearly 9,000 people in the cities of Kabul, Bamyan, Kapisa, Herat, Farah, Jalalabad, Kandahar and Balkh (Mazar);

  • worked on improving water supply and sanitary conditions for more than 2,850 inmates in five provincial prisons;

  • carried out work to provide safe water for over 42,500 people in the provinces of Bamyan, Herat, Farah, and Kandahar;

  • continued renovation work at Mirwais Hospital in Kandahar.

  Food and seed  

The ICRC distributed rice, beans, ghee, sugar, salt and tea to around 835 people who had fled their homes because of conflict or natural disaster in seven southern, northern and western provinces. In addition, the organization distributed two tonnes of sesame seed and 20 tonnes of fertilizer to 792 farming households in the west and 15,500 pistachio seedlings to 2,765 households in the north.

  Promoting international humanitarian law  

Reminding parties to a conflict of their obligation to protect civilians is a fundamental part of the ICRC's efforts to promote compliance with international humanitarian law worldwide. The organization also promotes knowledge of international humanitarian law amongst civil society, government bodies and the armed forces.

During April, the ICRC held:

  • information sessions on international humanitarian law for the Afghan National Police and National Army, attended by some 160 personnel;

  • briefings for community elders, members of religious circles, university students, and members of the Afghan Red Crescent, attended by 408 people in all.

Afghanistan is the ICRC's biggest operation worldwide. The organization has 140 international and 1,540 national staff based in its main delegation in Kabul and in five sub-delegations and ten offices countrywide.

  For further information, please contact:
  Bijan Frederic Farnoudi, ICRC Kabul, tel: +93 700 282 719
  Christian Cardon, ICRC Geneva, tel: +41 22 730 2426