Afghanistan: Higher casualties from intensifying fighting in Helmand

The current upsurge in military operations in Helmand, particularly in the districts of Marjah, Nadali, Sangin, Nari Saraj and Lashkar Gah, has resulted in a marked increase in the number of casualties requiring emergency medical treatment. 

Over the past few weeks, staff working at the ICRC's first-aid post in Marjah have been seeing increasing numbers of war casualties, although not as many as might be expected given the scale of the fighting.

Civilians and injured fighters are finding it more and more difficult to go to places where they can obtain urgently needed medical care, owing to mounting security problems and numerous roadblocks and checkpoints throughout Helmand province. It is especially difficult for people coming from rural areas to reach Helmand's capital, Lashkar Gah, where there are two hospitals. Those who do manage to reach a medical facility often succeed in doing so only after long delays. 

The ICRC reminds the Afghan security forces, the international forces and the armed opposition that the sick and wounded – whether they be civilians or fighters, regardless of which side they are on – must be cared for with the least possible delay, in accordance with international humanitarian law. No distinction must be made among them on any grounds other than medical ones. 

The ICRC is currently sending to its first-aid post in Marjah two additional medical kits containing all items required for the basic treatment of wounded people. Each kit contains enough supplies to treat some 30 severely wounded or up to 300 moderately wounded patients. The parties to the conflict have been advised of the location of the first-aid post. Like any other health-care facility used solely for its intended medical purpose, the post and the patients travelling to and from it are protected under international humanitarian law. Patients, whether civilians or injured fighters, must be allowed to enter and leave it freely. The first-aid post itself and the health staff working there must be respected and protected and their activities must not be unnecessarily impeded. 

In its capacity as a neutral intermediary between all parties to the conflict, the ICRC retrieves the mortal remains of fallen fighters and returns them to relatives. 

The ICRC has for many years provided emergency food and shelter for families whose homes have been destroyed in the fighting, and will continue to do so. It is not currently possible to count the number of people who have left Marjah, since many have moved in with relatives or rented houses in nearby towns. 

General context in January and early February 

The lack of security remains a major concern for ordinary Afghans. In January and February attacks have taken place in Kabul and in Lashkar Gah, the capital of Helmand province. The fact that medical facilities and first-aid posts are often not spared the effects of the fighting – occasionally, they are even directly targeted – is particularly alarming. Evacuating casualties is becoming increasingly difficult in an environment in which ambulances are blocked and sometimes shot at. As the ICRC's head of delegation, Reto Stocker, pointed out: "Medical workers venturing into remote areas do so at the risk of their lives." 

Focus on health care 

At the request of the Ministry of Public Health, the ICRC donated medical supplies to Wazir Akbar Khan and Aliabad hospitals in Kabul. The organization also provided technical and financial support for 10 basic health clinics run by the Afghan Red Crescent. With ICRC support, volunteers provided local communities with information on safe water, hygiene, birth spacing, immunization and the dangers of mines. 

ICRC-supported hospitals run by the health ministry in Kandahar and Shiberghan (Jawzjan province) saw a total of 3,023 inpatients and 18,159 outpatients. Surgeons in the two hospitals performed 945 operations. 

In addition: 

- the eight ICRC first-aid posts in the south and central regions received 814 patients; 
- two kits for treating war-wounded patients were pre-positioned at the Ministry of Public Health in Kabul for emergency use during mass-casualty incidents; 
- the ICRC provided drugs and various non-medical supplies for the 10 Afghan Red Crescent clinics it is supporting.