Afghanistan is experiencing a long-lasting, extensive, and complex humanitarian crisis with a history of frequent natural and manmade disasters requiring humanitarian aid responses.
In August 2022, our team travelled to Kabul to provide Trauma and Emergency training for frontline health staff responders in Afghanistan. Read more about the programme and its impact below.
A healthcare system in crisis
Afghanistan is particularly prone to earthquakes, flooding, drought, landslides, and avalanches. In 2021 alone, a staggering 310,500 people needed emergency trauma care: making the need for effective, timely emergency and trauma care even more pertinent.
On 22 June 2022, the country suffered its deadliest earthquake in two decades. The powerful tremors hit remote parts of southeastern Afghanistan – flattening villages, causing thousands of casualties, and leaving many more homeless.
The disaster highlighted a substantial gap in national staff’s knowledge and skills in the emergency, trauma, and critical management of patients.
“Despite decades of international aid and investment, people in Afghanistan are still struggling to access basic and emergency medical care due to insecurity, distance, cost or the fact that many health facilities may have shortage or staff and equipment,” Ana Teresa Afonso, UK-Med’s Senior Health Advisor, explains.
“Now, entering the winter season, the living conditions will also become more challenging, and most people will continue to rely heavily on humanitarian assistance and prepared health services.”
Following a request for help from the IOM, we travelled to Kabul in August to provide Trauma and Emergency training for local health staff to deal with and manage traumatic events in preparation for future disasters.
Transforming a training centre into a simulated casualty zone
Setting off for Kabul from their home countries of Portugal and England on 13 August, Teresa (who is also a Registered Nurse) and Emergency Doctor Paul Ransom began delivering training straight away for 32 health staff.
The participants had travelled to Kabul from 12 different provinces in Afghanistan; mainly from rural hospitals and health centres that frequently face limited resources, reduced levels of specialities, and long, difficult journeys for patients and staff.
Paul Ransom and Teresa conducting training sessions for clinical staff in Afghanistan.
Over the week, the grounds of the training centre turned into a simulated casualty zone.
Teresa and Paul demonstrated how to provide life-saving interventions after traumatic injuries, initiate treatments, stabilise patients, and prepare them for a safe and effective transfer to a secondary health facility.
These skills can be the difference between life-or-death in a mass casualty disaster situation – particularly in rural areas where taking patients to a health facility can be long and arduous.
Around 70% of the training was delivered through practical sessions and scenario-based learning. Topics covered a wide range of situations, including burns and dressings, head trauma injuries, and simulations of mass incidents with many victims.
Halfway through the week-long training programme, an explosion struck a mosque not far from where the training had been conducted, tragically killing at least 21 people. The day-to-day reality of the dangers facing health staff working in Afghanistan became even more acute.
The training moved online for a day for safety, before continuing again with a mass casualty training simulation. A mix of medical doctors and nurses with different specialities worked together as they developed their skills caring for and stabilising patients in multi-trauma scenario involving many casualties.
A more prepared and confident team
All of the participants were positive about their learning experience: not only for practical medical and technical knowledge but equally on team working, keeping the team members and the scene safe, and how to apply leadership principle and skills in emergency situations.
“Most critically: the team felt better prepared to respond to trauma cases,” Teresa says. “At UK-Med, we make sure that all populations and communities, irrespective of their location in the world, have access to healthcare services that are better prepared and ready to respond to disasters and crisis when they occur.”
“We continue to work in different settings to build capacity of national frontline health care workers with the right skills and tools needed to save lives in early hours and days of an emergency response.”
Many thanks to all the participants and IOM Mission in Afghanistan for hosting UK-Med.