MSF Afghanistan: Life-saving care for little lives in northern Afghanistan

MSF teams are witnessing the urgent need for comprehensive support – ranging from improved healthcare infrastructure to better-trained medical professionals – to reduce preventable deaths and enhance people’s overall health. At the same time, the socio-economic and cultural barriers that restrict families’ access to care must be addressed.

“The first time my son Umar* got measles, he had a very high fever,” says Umar’s mother, Farzana Ismail. “He couldn’t even open his eyes and kept crying the whole time. His condition was really bad. For five days after the measles appeared, his eyes stayed shut — he just cried constantly. When the measles finally went away, he developed pneumonia, and it got worse.

We spent about 10,000 to 15,000 Afghani (approx. 150 -225 USD) on his treatment in Maymana city and another 3,000 Afghani (approx. 45 USD) in Mazar-i-Sharif city. But since we have brought him here in the children’s ward of the MSF-supported hospital in Mazar-i-Sharif, all treatments are free.”

Barriers to Healthcare Access: Infrastructure and Economic Challenges

“At first, I took my daughter Asma* to private doctors in Dawlatabad and then Maymana city,” says Ayesha*, Asma’s mother. “Then I took her to Andkhoy, she didn’t get better and then from there, I brought her to Abu Ali Sina Hospital in Mazar-i-Sharif City. The medicines would help her feel better for a few days, but then she would get sick again. Some doctors said she had a stomach problem. Others said she was anemic. We have spent around 5,000 to 6,000 Afghani (approx. 75 – 90 USD) on her treatment.”

Throughout the region, many healthcare facilities are either under-resourced, understaffed, or geographically inaccessible to communities, particularly those living in remote areas. In Balkh, the limited number of functioning medical centres are overwhelmed with patients, resulting in overcrowded wards, long waiting times and overburdened staff.

The situation is particularly dire for people coming from rural districts surrounding Mazar-i-Sharif, where health services have been suspended or stopped due to funding cuts. At the same time, families have to travel long distances on poorly maintained roads to reach functioning healthcare centers, paying transportation fees they can barely afford. This burden disproportionately affects women in labor, patients with chronic conditions and children with acute illnesses.

These groups often require timely and specialized care, but the lack of an efficient referral system complicates their access to higher levels of treatment. In Balkh, however, referral systems are often dysfunctional. Many healthcare providers lack the resources or knowledge to properly refer patients to secondary and tertiary care centers. The challenges are compounded by transportation difficulties and insecurity in certain regions, further delaying or obstructing the transfer of patients to specialized facilities.

These gaps in the healthcare system increase the risk of preventable illness and death. High infant and child mortality rates, driven by preventable diseases like pneumonia, diarrhea and malnutrition, underscore the need for better healthcare access.

MSF’s lifesaving medical care at Abu Ali Sina Hospital in Mazar-i-Sharif

In August 2023, MSF began supporting Abu Ali Sina hospital in Mazar-i-Sharif-city in collaboration with the Ministry of Health (MoH), MSF teams are working to strengthen the hospital’s capacity to deliver specialized care for children. This includes supporting the paediatric intensive care unit (PICU), the neonatal intensive care unit (NICU), the measles isolation room and the emergency room, which provides lifesaving treatment for children up to 14 years old. These efforts aim to strengthen the quality of critical and emergency care for young patients and ultimately reduce child and newborn mortality in the region.

MSF provides continuous support to the PICU, NICU and neonate wards while ensuring emergency-preparedness measures. Following the earthquake on 3rd November 2025, which affected the city of Mazar-i-Sharif , in collaboration with MoH, MSF activated its emergency response plan and made donations of medical supplies for the communities and critical medical supplies to Abu Ali Sina Regional Hospital, ensuring timely and effective treatment for injured patients.

Over the period of two years since the initiation of the project, MSF teams have observed a significant influx of patients at the facility, with an average of around 3,000 children triaged each week. Upon arrival, patients are classified according to the severity of their condition using a color-coded triage system: red for critical cases, yellow for moderate, and green for mild. Children and newborns – indicating those in serious condition receives immediate life-saving interventions and moderate cases get prompt evaluation and urgent treatment. Patients classified as yellow or green are referred to the Department of Health for follow-up care.

The NICU has a capacity of 154 beds, while the PICU has 38 beds. In addition, the measles isolation room has a capacity of 28 beds. Due to the overwhelming number of admissions, it is common to see more than one child sharing a single bed, as space constraints leave no other option to ensure all patients receive timely care.

We see how quickly children’s conditions can deteriorate when they arrive late or when families can’t afford treatment elsewhere. Many of our young patients come to us in critical condition — with measles, pneumonia or severe malnutrition. In October alone, our team admitted a total of 1211patients to the PICU and NICU, and 95 patients to the measles isolation unit. They have been treating wide range of medical conditions, including measles, neonatal sepsis, tuberculosis and other severe infectious and respiratory diseases.

Since 2023, MSF teams have triaged 366,002 patients and provided care for more than 8,477 paediatric patients aged 14 and below, 17,853 neonates in the intensive care units, 6,417 patients in the measles isolation room, and consulted 122,143 cases in the emergency room.

When children are admitted for treatment, their family members – most often their mothers – stay with them in the hospital to provide care and emotional support. MSF teams actively engage with caregivers through regular health education activities, including both individual and group sessions. This helps families better understand their child’s condition, treatment process, and key practices for maintaining hygiene and preventing infections.

MSF also provides psychosocial and mental health support to families, recognizing the emotional strain and anxiety that often accompany a child’s hospitalization. Dedicated counsellors and mental health staff offer sessions to help families cope with stress and build resilience during their stay.

The team is also responsible for implementing infection prevention and control (IPC) measures across the hospital to ensure a safe and hygienic environment for patients and staff. As part of these efforts, MSF constructed a fully equipped laundry facility at Abu Ali Sina hospital to strengthen IPC practices and reduce the risk of hospital-acquired infections.

In recent months, the combined effects of reduced funding and a growing influx of patients have put a strain on remaining health services. Although MSF is not directly impacted by the funding cuts, thanks to our independent funding model. MSF teams remain committed to delivering lifesaving care and advocating for sustained funding and support to ensure that patients receive the treatment they need. Continued investment by humanitarian organization and international institutions is essential to maintain service quality, protect healthcare workers from burnout and safeguard the health of children.

Patient testimonies

*Names changed to protect identities

Farzana’s Journey: A Mother’s Struggle to Save Her Child

Farzana, 30, from Faryab province, northern Afghanistan, arrived at the MSF-supported Paediatric Intensive Care Unit at Abo Ali Sina Hospital in Mazar-i-Sharif, Balkh province, with her four-month-old son, Umar. Their journey had been long, filled with uncertainty, and marked by desperate attempts to find the right medical help.

"My son was sick, and I first took him to the hospital in Maymana city of Faryab province, where he stayed for six days. He had measles, which eventually improved, but then he developed pneumonia. They couldn’t help us, so we moved to a private hospital in Mazar-i-Sharif. But they couldn’t help either, and that’s when we came to this hospital," Farzana recounts.

The constant moving from one hospital to another took a toll on Umar’s health. Farzana describes how his condition worsened as they searched for care. By the time they arrived at Abo Ali Sina Hospital, Umar’s situation was dire.

"By the time we brought him here, he was in a very bad state. His skin had turned blue, and he couldn’t breathe. He was almost dead. He had stopped breathing, and the doctors immediately put him on oxygen. His chest was rising and falling heavily. He was in such a bad state that I thought he wouldn’t survive," Farzana recalls.

At that point, Farzana felt utterly helpless. The weight of the situation hit her hard, and she even fainted from the stress.

"I felt terrible. I didn’t know what to do. When I looked at him, I thought he wouldn’t recover. Both my husband and I were in a very bad emotional state. We had no hope because two hospitals had already turned us away," says the mother of Umar.

However, after 23 days at the hospital, Umar’s condition has improved. Initially requiring 17 litres of oxygen just to breathe, he now only needs 2 litres.

"Now, he is doing better. His color has returned, and he can drink milk from his mouth, something he couldn’t do before," Farzana says with a sigh of relief. The emotion in her voice reflects the immense relief she feels as her son begins to recover.

Looking at Umar, now showing signs of improvement, Farzana feels hope again.

"Now that my baby is getting better, I feel happy again. I am very grateful to the doctors and nurses. They really worked hard to save him," says Farzana.

For patients in critical condition, an effective and well-coordinated referral mechanism is crucial to ensure timely access to higher levels of care. However, in Balkh province the referral pathways are often weak or dysfunctional. Many healthcare facilities lack the necessary resources, transportation, or communication systems to properly refer patients to secondary and tertiary hospitals, which can delay lifesaving treatment.

Asma recovering from Critical Condition

Ayesha, 25 years old, from Dawlatabad district in Faryab province, arrived at an MSF-supported health facility in Mazar-i-Sharif with her one-year-old daughter, Asma. The young mother’s journey to find proper care for her child was long and filled with uncertainty.

When Asma first became ill, her mother shares that her symptoms were worrying. She began vomiting and developed diarrhea. Soon after, her legs became swollen, and she showed signs of severe anemia.

“At first, I took her to private doctors in Dawlatabad and then to Maymana city. Then I took her to Andkhoy, another district in Faryab province. The medicines would help her feel better for a few days, but then she would get sick again. Some doctors said she had a stomach problem. Others said she was anemic, and no one was sure what disease it is. We have spent around 5,000–6,000 Afghani (approx. 75 -90 USD) on her treatment,” Ayesha recalls.

Despite her efforts, Asma’s condition continued to worsen. What began as mild symptoms soon turned into something far more serious. She developed persistent vomiting, bloody stools, and signs of shock. Each referral brought a new diagnosis from measles to anemia but no lasting improvement. From Andkhoy, Faryab province, Ayesha and her daughter were referred to Sheberghan, Jowzjan province and from there, they were advised to continue to Mazar-i-Sharif, Balkh province — a difficult journey for any family, but especially for one with a critically ill child.

“When Asma arrived at the MSF-supported facility, her condition was extremely serious”. describes Dr Sayed Mohammad Ali, MSF Medical Doctor. “The patient came from Faryab province in very poor condition near shock, with severe impairment and signs of bleeding. She had bloody vomiting (hematemesis) and tarry stools (melena), along with bruising all over her body. We stabilized her hemodynamically and began supportive treatment.”

Without proper guidance or structured referral between health facilities, Ayesha was forced to move from one doctor to another, trying to find answers. This delay in reaching specialized care worsened her daughter’s condition and put Asma’s life at greater risk. A functional referral pathway ensuring timely transfer from primary to advanced healthcare centers could have helped her receive appropriate treatment much earlier and possibly prevented her condition from becoming so severe.

“The laboratory tests revealed that Asma’s cholesterol and triglyceride levels were alarmingly high her triglycerides exceeded 1,200, while the normal level is below 200. The medical team continues to monitor her closely as they work toward a final diagnosis. For now, her condition is stable”. Says Dr Mohammad.

Despite the exhaustion of repeated hospital visits and financial strain, Ayesha’s focus remains steadfastly on her daughter’s recovery. “All I care about is that my daughter gets well,” she says quietly, holding Asma close.