

Over 40 years of conflict and instability have left Afghanistan’s economy and infrastructure in ruins and millions dependent on humanitarian assistance. The international medical humanitarian organization Médecins Sans Frontières (MSF) finds that Afghans today still struggle to get access to healthcare due to pervasive violence, widespread poverty, and a weak public health system. Morbidity and mortality rates remain high. This briefing paper features the stories of patients, their caretakers, and our staff in Herat and Helmand provinces to illustrate the many obstacles people face in their efforts to get medical care.
While international attention has recently focused on the potential impact of a peace agreement between the United States and the Islamic Emirate of Afghanistan (IEA, also known as the Taliban) and the anticipated resumption of intra-Afghan talks, it remains too early to know whether these developments will translate into meaningful peace on the ground. A sustained reduction in violence going forward would certainly provide much-needed relief—as civilian deaths and injuries due to armed conflict almost doubled between 2009 and 2019, with a record-high death toll in 2018.
Summary of key findings
Based on MSF survey results from Herat regional hospital in Herat province and medical data collected at Boost hospital in Lashkar Gah, Helmand province. See Methodology section.
HERAT REGIONAL HOSPITAL
41% of caretakers and patients surveyed stated that a family member, friend, or neighbor had died in the past two years due to lack of access to medical care.
Postponing medical care due to financial pressure is a dangerous coping strategy adopted by 89% of patients and caretakers surveyed; 43% stated they had postponed medical care more than three times over the past two years.
BOOST HOSPITAL
During the first six months of 2019, 44% of the children who died within 24 hours of arrival in the pediatric intensive care unit (PICU) had arrived too late and at a very advanced stage of illness.
Of 3,680 measles cases treated in the first seven months of 2018, 48% were admitted to the isolation ward due to severe complications.