KABUL, Afghanistan – It is a place as necessary as it is tragic: a fortified hospital in the center of Kabul, brimming with broken bones and bullet-battered children, those who have lost limbs and loved ones in the bloodshed that has gripped Afghanistan.
But since Aug. 15 – the day that the Taliban surged through the gates of the capital to hoist their white-and-black flag in the presidential palace – Kabul’s intensive care hospital dedicated to treating the war-wounded has noticed a marked shift in the nature of admissions.
“There has been a noticeable change in the injuries,” Alberto Zanin, the medical coordinator of the Italy-based NGO EMERGENCY, tells me from the small walled garden in the center of the hospital – a grassy pocket of paradise inside the pandemonium. “There used to be many IEDs, bombs and explosions targeting around the city. Now, things are different.”
Zanin pledges that a strange sort of “peace” washed over the beleaguered city in the initial weeks after the Taliban takeover. After all, the group – which had long carried out targeted attacks that routinely shook Kabul – had won. Yet the relative placidity marked a far cry from 2020 and the first half of 2021 when war-related violence soared to new heights.
One of the most prominent problems EMERGENCY has encountered since the Taliban takeover is the group’s celebratory shooting in the air. On Friday, the rapid gunfire injured 12 – two of them children. One of the injured children, around 7 years old, was admitted with a bullet to the back of the head, and the other boy – age unknown – was hit in the chest. Both are fighting for their lives.
After complaints to the Public Health Ministry, Taliban authorities announced a public ban on such behaviors.
But despite last month’s seemingly peaceful power shift – given that President Ashraf Ghani fled, thus allowing the Taliban to enter without resistance – the confusion and chaos of that first day provided a platform of underlying anarchy that Zanin described as being something akin to “disaster.”
“There was a lot of troublemakers, a lot of criminals taking advantage of the situation,” he explains. “People getting injured in the overall crime or by unknown attackers.”
A 35-year-old businessman, Haji Hamyoon, suffered a bullet straight into his stomach on his way to work on that Sunday afternoon as the Taliban entered the city.
“My oxygen was very small and I thought I would die,” he says softly, glancing into the blinding daylight in the sheltered courtyard beside his ward. “But 24 days I am here, and in maybe 10 days my wife will have our first baby and I need to be well for that. I want the fighting to stop and to live again.”
EMERGENCY’s medical clinics in other Afghan provinces have also experienced a kind of quietude since the Taliban took the helm, Zanin said. For one, their facility in Lashkargah – a province that became so rife with battles that staff was forced to sleep inside for three weeks straight as rockets and shells crashed around them – now has the space to admit patients from road traffic accidents. That is something they have not been able to do in years.
The relative halt in the bloodshed was splintered on Aug. 27 when ISIS exploited the turbulent US departure scenes around Kabul’s Hamid Karzai International Airport (HKIA) with a coordinated suicide attack that claimed the lives of more than 160 people – including 13 American troops.
One of EMERGENCY’s employees lost almost his entire family – some five members – in the airport gate blast. Sixteen Afghans were pronounced dead on arrival, and four died in the ensuing hours. But there are dozens of wounded now left to grapple with burns, implanted shrapnel in their frames and faces, and adjusting to life as paraplegics.
There were other fatalities not directly connected to the blast, too.
In one case, EMERGENCY tended to a disabled, deaf man who happened to be driving in the vicinity shortly after the explosion. Unfortunately, he did not hear the Taliban’s stringent instructions to stop at a checkpoint and they subsequently opened fire. He succumbed to his injuries on arrival at the hospital.
The halls and quiet wards of EMERGENCY, founded in 2000 under the first Taliban rule in Afghanistan, are an amalgam of fear, misery, and triumph. A child who sustained a head injury in a blast calls out to his mother in wincing confusion and yelps like a wounded animal, and a blinded man reaches out into nothingness – exposing arms healed with deep layers of pink.
Another young person, with a hollowed chest and protruding cheekbones, vacillates between anguish and laughter. His name is Abdul, and he thinks he is about 14 or 15, although EMERGENCY staff predicts his actual age is probably closer to 18. Only there is no official birth record, and it is likely that nobody will ever really know. Abdul lost both his legs days ago to a landmine in Logar province, yet he smiles and folds his fragile body into prayer, accepting his new reality with a beleaguered shrug.
Yet several other young men – all in their twenties – tell me they were shot in disputes with people they knew near their homes on the edges of the city over the past two weeks, highlighting the area’s maneuver away from war and into an uptick of violence and crime.
Sadly, some patients are haunted by having become burdens on their already low-income families. They worry that they can no longer provide and will require medical attention and constant, financially-draining help for the rest of their lives.
Nonetheless, the will to survive is unmistakable. EMERGENCY’s patient admittance ratio remains the same: roughly 30 percent women and 70 percent males. Of that, around a quarter are children.
But in addition to the ceaseless conflicts and clashes that permeated in the Taliban’s push to power over the past eighteen months, the EMERGENCY staff was also forced to contend with the COVID-19 pandemic, which Zanin characterized as a “nightmare.” The Delta variant prompted a second wave of infections earlier this year; however, with the arrival of vaccines, first from India and more recently, Johnson & Johnson, the medical staff says that the situation is now mostly under control.
In fact, it is rarely mentioned by those on the ground in the embattled nation who have had to survive a war of a much of visible kind.
The last parcel of the two-decade war protracts inside the Panjshir Valley some 80 miles north of the capital. EMERGENCY operates a state-of-the-art maternity ward, poised on a hill in and around the snow-capped mountains and deep gushing valleys. Still, deep concerns have been raised in recent days that the new government has instituted a medical and humanitarian blockade. However, Zanin notes that as of Monday, buses filled with patients restarted to and from the white-and-red clinic and he remains confident that they have the supplies to last for about four to five months even with a blockade as conflicting information over how much control the Taliban has continues.
“We are always prepared for situations like these,” he says. “But we have never had to deal with this in Panjshir before.”
Although communications in the isolated province are down, the partner hospitals currently communicate with one another twice a day via satellite.
And even inside the city, there is certainly no rest for the weary.
As I venture out into the midday sunshine, the haunting quiet – not to be mistaken for serenity – is fractured by the loud and seemingly endless barrage of bullets being fired directly on the streets inside. Even when you think it has stopped, the battery begins again.
“They are trying to get rid of the protestors outside,” one local staff member exclaims as we move away from the glass windows and into the center garden, which just earlier that morning had appeared to be that oasis amid the madness. “It is many women upset, so they are marching to the White House!”
The irony of his words – somewhat twisted in translation but referring to the nearby presidential palace – is not lost. Hundreds of young Afghans, men and women and small children, carried signs and chanted the word “freedom” repeatedly. Just over a week after the US left, and many feel as though they had nothing left to lose. Many feel let down by the nation that for two decades urged them to claim equal rights.
Only that fight not to lose all they have gained was countered by the Taliban shooting into the scorching air as a dispersal tactic.
“Six admissions,” Zanin wrote to me later in a text, emphasizing that they weren’t a result of the bullets but other injuries related to the commotion.
Even with small moments of reprieve like in the days after the fall of one government and the rise of the next, it is the sort of work that never ends.
“What you can see here, you just cannot see in Europe,” Zanin says, his eyes scanning the sky as if lost in thought. “You stay here, and everyone becomes a member of your family. Your life adapts. It’s very difficult to go home – what do I do there? My possibilities to help are all here.”