As well as Lashkargah provincial hospital in Helmand, we are also starting to work in a hospital east of Kabul in a town whose population has mushroomed with the arrival of Afghan returnees from Pakistan, and displaced people fleeing the war in the eastern provinces of Afghanistan. Despite the needs and low health service coverage, this area has so far been neglected by aid agencies because it is not a priority in counter-insurgency aid policies. Much funding is set aside for large infrastructure projects in Kabul, but few international funds are made available for immediate assistance.

Exterior view of the Ahmed Shah Baba Hospital in Eastern Kabul. [© Erwin Vantland /MSF]

A nurse vaccinates a child in Ahmed Shah Baba Hospital in Eastern Kabul. [© Erwin Vantland /MSF]

We have medical teams of Afghan and foreign staff now working in both hospitals, where our aim is to provide quality, life-saving, and absolutely free medical care with effective drugs, in all areas including maternity, paediatrics, surgery and emergency rooms. The collaboration with the resident medical staff to agree on best practice is key. To get these medical services running 24 hours a day rather than for a few hours in the morning is a priority. MSF will seek to extend its support to hospitals and rural health centres in other provinces in 2010, but in such a dangerous environment progress will be slow.

A father and his son are waiting their turn in the emergency ward of the Ahmed Shah Baba Hospital in Eastern Kabul. [© Erwin Vantland /MSF]

Today in Afghanistan, there are not enough organisations independently assessing the needs of people and responding in war affected areas. In a province like Helmand, access to care is extremely limited. Evidently, the delivery of aid for political rather than humanitarian objectives has its limitations; it can fill hospital basements with expensive medical machinery but not fill beds with the patients in need of treatment coming from all sides of the conflict.