Dr. Erlend Grønningen, native of Trondheim in Norway, is the doctor in charge of the DWB ward at the Boost hospital in Lashkar Gah, in the province of Helmand (Afghanistan). He arrived to Afghanistan in April this year and worked primarily on the diagnosis and treatment of tuberculosis (TB). This is Dr. Grønningen’s second mission with DWB, since he worked with the organization in South Sudan in 2014. Upon his return to Norway, Grønningen worked and studied pulmonary medicine.
He is one of the many “doctors without borders” who risk their lives to save other people. They are not warriors, but “angels” who leave their homes to rescue those who suffer, people who have been abandoned to their own devices because of the war. Yet, we can see a paradox here: assistance is hardest to obtain in places where it is needed the most. Roads are closed, communication is difficult. At times, it is impossible to help. And we are not talking only about those injured while fighting, but also about ‘regular’ patients; all too often, we forget that those immersed in the horror of war, are still human beings with all their limitations, including diseases. Dr. Grønningen explained that the conflict in the districts around Lashkar Gah does not allow people to reach the hospital.
“Over the past few weeks, fights in the Helmand province have intensified and got closer, closer than usually, to the capital Lashkar Gah. The conflict is everywhere around the city, despite the lower number of clashes in recent days, but we have noticed a significant drop in the number of admissions to the Boost hospital, a facility with 300 beds that, jointly run by us and by the Afghan Ministry of Public Health. The hospital is usually overcrowded with patients, but lately we have noticed that fewer people come to the emergency room.”
“For our team – he says – it is really frustrating to see how the conflict directly affects the population’s ability to access medical care. Beds in our pediatric ward and in the intensive nutritional rehabilitation center (ITFC) have been almost always full of lively children and young patients, often two for every a bed, who received treatments from malnutrition or other serious diseases. These departments are inexplicably quiet now and many beds are free. Empty beds are the face of war.”
Since the fighting calmed down last week, “we have noticed that children’s ward and ITFC returned to their normal rhythms of work, but the number of hospital admissions is still unstable; it keeps varying every day.”
About a week ago, a 15-year-old girl arrived from the Nawa district with meningitis – a more serious condition that requires immediate medical attention. “Her parents told us that had been ill at least for a week. They knew it was serious and wanted to take her to the hospital right away, but it was impossible. The Nawa district is very close but fighting has intensified lately. We admitted her while knowing that it was probably too late. Twenty-four hours after the beginning of the treatments, she fell into a coma and died”.
“We also had a 7–year-old boy – he goes on -, who had arrived with a severe respiratory crisis. His family told us that he had had those symptoms for twelve days. We visited him and found a tension pneumothorax. It is essentially an accumulation of trapped air in the thoracic cavity, in the wrong place, caused by a lung injury or trauma. If not treated promptly and adequately, it can be deadly: the lung gets squeezed and collapses. We put him a chest drain and his condition improved shortly later, although he is going to need a chest tube for a longer period, until his lung does not re-expand entirely”.
A chest X-ray showed that he suffers from pulmonary tuberculosis, a significant public health problem in Helmand. “We started a treatment for tuberculosis and he recovered immediately, just enough to wander around the hospital like any other curious 7-year-old child. Yet, movement cause him pain. Thus, a medical examination showed that his left hip was dislocated. He had had a car accident 12 days earlier, when he had injured his lung and hip. His hip – the doctor concluded – was put back in place and is currently in traction, while he is hospitalized in the intensive care unit run by Doctors Without Borders”.
The story of this boy shows that even when the case is severe and the patient reaches the hospital late, there is still hope; but too many people do not make it. The damage caused by the bombs are not only those caused when a person is struck. But nobody knows it…