Médecins Sans Frontières reported Tuesday that while fighting has been intense since May in Helmand province, clashes between the Afghan security forces and the Taliban have intensified in recent weeks and spread to more urban areas such as the provincial capital of Lashkargah city.

“There has been relentless gunfire, airstrikes and mortars in densely populated areas. Houses are being bombed, and many people are suffering severe injuries,” says Sarah Leahy, coordinator of the MSF Helmand project.

“Fighting within the city makes it harder for us to respond; our staff are part of the community and they, like many people, are afraid to leave their homes. It’s just far too dangerous and life is at a standstill,” says Leahy.

“Some of our colleagues are staying overnight in the hospital as it’s safer, but also so they can keep on treating patients. The situation has been dire for months but now it is even worse.”

Despite the challenges, the MSF-supported Boost hospital remains operational and has seen a marked increase in trauma needs over the past week.

“In just one day we performed 10 surgeries on people injured by violence, which is unheard of for us as we are not Lashkargah’s main provider of trauma care,” says Leahy. “Before last week we were operating on average on two war-wounded people per day.”

The main trauma centre in the city is run by another organisation, and is also under immense pressure; the people they cannot admit are sent to MSF for care, the statement read.

Between 29 and 31 July alone, MSF treated 70 war-wounded patients. In total from 3 May until 31 July, we have treated 482 war-wounded people, nearly all (92 per cent) for injuries caused by shells and bullets, and around a quarter (26 per cent) aged under 18. The patients seen by MSF are just a fraction of the total number injured by the violence, the organization reported.

MSF also said the conflict is stopping people from seeking medical attention when ill.

“The conflict leads people to think 10 times about whether they really want to make the journey. They delay until they can’t wait anymore, when their relatives haven’t opened their eyes for two or three days, have shallow breathing and are unresponsive. From a medical perspective, that’s almost too late.”

Even amongst MSF staff, the impact of the fighting is clearly visible. “Healthcare staff are exhausted. The work itself, seeing all these patients, is hugely difficult. And then on top of that, people have to deal a lot with outside pressures and worries,” says an MSF doctor.

Our teams continue to provide much-needed healthcare in Boost hospital, while continuing to run projects in four other locations around the country; Herat, Kandahar, Khost and Kunduz.