Bost Hospital Lashkar Gah


Book Reviewer
Saw this - thought it might be of interest:


Reconstruction Team install life-saving equipment into Helmand hospital
The main hospital in Helmand province turned on its first life-saving oxygen system this week which, donated by the Estonian Government, was installed by the Provincial Reconstruction Team.

The Provincial Reconstruction Team (PRT) in Helmand supports development programmes alongside local Afghan authorities. It is made up of military and civilian personnel from Britain and other countries.

The donation and installation of the $100,000 life support system, which provides oxygen to support twenty patients in Bost Hospital in Lashkar Gah, was managed by Anu Raisma, an Estonian with 25 years' nursing experience.

Ms Raisma, who works in the PRT, said:

"It is good to know that this new system will be saving lives, especially those of infants. In Estonia, the UK or America things change very slowly. But here you see great improvements like this happen in only a few months."

A British Medical Support Officer from the RAF, Flight Lieutenant Lisa Higham, has been working with Ms Raisma on the project. She said:

"The conditions in the hospital are far short of those back at home in Oxfordshire, but having worked in Kosovo earlier this year I had a good idea what to expect.

"The new oxygen system is going to have a really positive impact. I'm looking forward to our next project to help improve medical services in Helmand, probably working with local community clinics."

Bost Hospital receives patients with serious conditions referred from across Helmand, a province with a population of nearly a million people.

After the return of democratic government in 2002 the hospital was suffering from over a decade of neglect. However, with the support of international donors, the local Department of Health has rebuilt it to provide an essential medical service.

In the past two years UK and Estonia, working through the Provincial Reconstruction Team, has supported Bost Hospital by installing water, electric and sewage systems at a cost of $250,000, and donating $1.25m of medical equipment.

As a result of initiatives like these across Afghanistan the percentage of the population with access to healthcare has risen from 9% in 2002 to over 82% now.
(odd..... my copy of 'Hello Exclam' didn't feature this story?)

Le Chevre
I hope the hospital has also been provided with an appropriate maintenance and servicing contract, or trained electro-medical technicians to ensure the system is kept functional.
I hope the hospital has been provided with appropriate patrols to make sure they don't sell it out the back door like they probably do with drugs, works and anything else not bolted down.

By the way, OP I hadn't noticed your username when I created my account. I'm not trying to clone you or owt, but if you'd like, I'll create a different account to use...?


Book Reviewer
NVG_Goatman said:
By the way, OP I hadn't noticed your username when I created my account. I'm not trying to clone you or owt, but if you'd like, I'll create a different account to use...?
I'll assume OP = Original Poster :)

Bonjour Night Vision Goggled Goatperson,
Your choice bud - no strong feelings either way .......I've been on this Board since 2004 so people are used to seeing this might get some weird PMs though!

" Oi, Goaty - where's that tenner I lent you? AND it's your round! "

(oh and the Adminisphere will also track your posts just to see if they can nail another scrotum to the totem....depending on whether you are still serving this may or may not be a consideration .....up to you ?)

Good to hear a few other reports about the CIVIL side of what's been going on for the last five years in AFG, from all sorts of angles: it's something that the UK media haven't really been able to focus on with anything other than the usual flyby 'balanced' reporting e.g

" Here in Nanga Parabat, a new school has just opened, a clinic funded by W.H.O has brought primary healthcare within reach of the 1,000 inhabitants for the first time in history and a waterpump operating on a solar energy source has been installed by a Lithuanian NGO.......however women still don't have the vote and I can't get a skinny latte for all the money in the world.......the quality of the local hash is AMAZIN' though - and I got a LOVELY ethnic Bazooki scarf for absolute pennies..........Daisy Bleugh, for CBBC, uh.... Afghanistarrrn"
Le Chevre

Just to let you know that the staff at the hospital were trained in the maintenance of the machine, and the local engineer who fitted it (under the supervision of the STRE) will service it when needed.
Has the Italian NGO "Emergency" pulled out of LKG then?

In 2005 the Bost Hospital was a terrible place and everyone (including wounded Talib, I'm sorry to say) went to Emergency. Of course under the Hipocratic oath, blah, blah, blah, they couldn't refuse to treat them but there was a bit of a fuss one day when the septics tried to arrest someone in the hospital.
TFMH said:

Just to let you know that the staff at the hospital were trained in the maintenance of the machine, and the local engineer who fitted it (under the supervision of the STRE) will service it when needed.
Good. It may still be useable this time next year.
The Italian Emergency Hospital is still there but MSF are due to take over the running of the Bost Hospital at some point soon.

Bost is still a long way off what we would expect in the UK, but things are improving.


Book Reviewer
Probably from the strain of resisting the urge to clobber the tw4t in the turban behind them .....

Update from MSF : SOURCE

Bost Hospital in Lashkar Gah is one of the key health facilities in the south of Afghanistan, a region that is severely affected by ongoing conflict. Though the building is in good shape and medical staff is available, the hospital receives little support and cannot deliver basic secondary health services. Medecins Sans Frontieres plans to revitalise the hospital so that it can provide a comprehensive package of medical care, including emergency medicine, surgery, infectious diseases management and reproductive health care.

More recent news follows.
TFMH said:
The Italian Emergency Hospital is still there but MSF are due to take over the running of the Bost Hospital at some point soon.
A medical colleague sent me this:

Médecins Sans Frontières has started to work again in Afghanistan after an absence of five years. MSF’s General Director Christopher Stokes, has extensive work experience in the country and he has recently been back to take stock of the MSF projects.
In this article, he explains why it is crucial for MSF to base its activities in the country on three pillars; providing free medical care, not accepting funds from governments and keeping all weapons out of the hospitals.

Afghanistan has some of the worst health indicators in the world. In a province like Helmand, the noise of war is heard around the clock as helicopters take off in the night, and gunfire and rockets are audible in the distance. In this context, ordinary health problems become medical emergencies because movement from villages to towns is very dangerous, and in many places simply impossible.
MSF has just started working in the only public general hospital still functioning in Helmand, in the provincial capital Lashkar Gah. This is a hospital that has, over the last few years, been the recipient of a great deal of overseas aid. Yet when I walked through the different wards, what I found most striking was the absence of patients. Generally only a third of beds are occupied. On the morning of our visit, we counted 40 patients for 124 beds.
Why so few patients? In truth, the medical services provided in this hospital have been patchy at best. Most of the medical staff only work in the mornings - in the afternoons they leave to work in their private clinics. Medical practice in the hospital is out-of-date; drugs are routinely over-prescribed - at times seven different antibiotics are prescribed when one would suffice. Then there is the cost of the medications – whilst the consultation may be free, patients are nearly always sent out to private pharmacies to buy drugs. The cost of these can be prohibitive for poor families, particularly when you add in the cost they incurred travelling to the hospital in the first place. Even if they have the means, the drugs they do manage to buy can be of low quality or even counterfeit.
While the hospital may not be operating to its capacity, it is nevertheless full of donations of sophisticated medical equipment. Digital x-ray machines from Europe and China, laboratory machines, surgical equipment and scialytic lamps - many still unpacked - are piled up in the basement. They were donated by governments, through the provincial reconstruction teams of the International Security Assistance Force (ISAF) or via direct bilateral aid. Usually with little explanation or instruction.
Whilst I was there, a child with measles was brought in. His mother told us there were at least eight more children with similar symptoms in her village. Measles is a highly contagious disease that can be fatal if untreated. Her child suffered from complications and needed oxygen to get through the night. However, the only functional oxygen machine was in the medical ward where the presence of other children led to a dangerous risk of cross infection. Nevertheless, this is where he was brought. Meanwhile we counted at least six mobile oxygen generators gathering dust in the basement!

The child is a victim of this conflict and his plight encapsulates this war. He contracted an easily preventable communicable disease, simply because he lives in a war torn region where vaccination coverage is scarce. The child's mother had no choice; she took a risk by coming to Lashkargah, but she had to wait until it was almost too late. Even after eight years of donations from governments and ‘dumping’ of medical equipment, the hospital is still not ready to receive patients and treat them properly.

Earlier a pregnant woman who was injured in an explosion finally made it to Lashkar Gah 48 hours later. Her unborn baby was also wounded in the blast. The mother survived the delivery although her uterus had been perforated. But her baby died from sepsis. Had she been able to reach a hospital faster, perhaps both lives could have been saved.

After nearly five years of absence, following the murders of five of our colleagues in 2004, the return of MSF is cautious, balancing risks against needs. Our sole objective is to assist those most in medical need, to help as many people as possible to survive the conflict. In order to be accepted by all parties involved in a conflict, a private medical-humanitarian organisation should demonstrate, and clearly communicate, complete impartiality and independence. For MSF this means, for instance, that we choose not to accept any funds from any governments for our work in Afghanistan or Pakistan and we reject any attempt from other forces to control or direct us.

The once clear distinction between armies, reconstruction and development activities and humanitarians has become very confused; at present all assistance actions, including hearts and minds initiatives implemented by armed forces, are labelled ‘humanitarian’. The key difference is that strictly humanitarian organisations such as MSF work to provide immediate life-saving care on the basis of medical needs alone, with no other objectives. There is a practical need for clear distinctions to be made. Why? Because humanitarian organisations such as MSF should seek to help populations in need no matter where in the country they live or what battles are being fought there. An organisation (of whatever political complexion) that aligns itself with one side through funding or otherwise, simply will not and cannot do this. Second, choosing sides often requires relying on armed protection and that can make the organisation or the medical facility they support a military target.

Currently, there are many medical centres in Helmand that have been physically rehabilitated by ISAF and which are patrolled by NATO and Afghan troops. They are viewed as military targets by armed opposition groups. Meanwhile, clinics run by local independent NGOs, which are often intentionally left in a state of disrepair to avoid association with ISAF-supported health facilities, have come under attack by ISAF forces mistaking them for opposition hideouts. The result is that clinics themselves have become a battleground, putting patients in danger and making them more reluctant to seek healthcare.

Central to restarting our work in Afghanistan has been the demilitarisation of hospitals through the enforcement of a strict no-gun policy in the health centres where we work. We are asking all parties - the police, the coalition forces, and the armed opposition - to leave their guns at the gate.

As well as Lashkar Gah provincial hospital in Helmand, we are also starting to work in a hospital east of Kabul in a town whose population has mushroomed with the arrival of Afghan returnees from Pakistan and displaced people fleeing the war in the eastern provinces of Afghanistan. Despite the needs and low health service coverage, this area has so far been neglected by aid agencies because it is not a priority in counter-insurgency aid policies. Much funding is set aside for large infrastructure projects in Kabul, but few international funds are made available for immediate assistance.

We have medical teams of Afghan and foreign staff now working in both hospitals, where our aim is to provide quality, life-saving, and absolutely free medical care with effective drugs, in all areas including maternity, paediatrics, surgery and emergency rooms The collaboration with the resident medical staff to agree on best practice is key. To get these medical services running 24 hours a day rather than for a few hours in the morning is a priority. MSF will seek to extend its support to hospitals and rural health centres in other provinces in 2010, but in such a dangerous environment progress will be slow.

Today in Afghanistan, there are not enough organisations independently assessing the needs of people and responding in war affected areas. In a province like Helmand, getting healthcare is extremely difficult. Evidently, the delivery of aid for political rather than humanitarian objectives has its limitations; it can fill hospital basements with expensive medical machinery but not fill beds with the patients in need of treatment coming from all sides of the conflict.
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