“It happened in the end of August. The Taliban and government forces were fighting. A rocket hit our house. I don’t know from which belligerent side it came from,” said 44-year-old Nur Habib from Shahr-e-Kuna area in the vicinity of Pul-e-Khumri, the provincial capital of the northern province of Baghlan. The rocket that exploded on Nur Habib’s front yard injured him and six members of his family. All of the seven victims were civilians. Three of them suffered minor injuries and were treated at a hospital in Pul-e-Khumri, while the other four – Nur Habib and his son and wife and wife’s sister – were seriously wounded and had to be transferred to the better-equipped Emergency Hospital in Kabul.

Nur Habib, father of six, a painter by profession, was the most severely injured. Both the tibia and fibula in his left leg were fractured, while one bone was fractured in his right leg. “Before I came here, I spent a night at the hospital in Pul-e-Khumri. The doctors in Pul-e-Khumri suggested amputating my legs. I refused to allow them to do that. I decided to come to Kabul,” recalled Nur Habib, lying in his hospital bed with both of his legs wrapped up in plaster.

The doctors treating him in Kabul said that he will fully recover. He will be able to walk again using both of his legs.

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According to data collected by the United Nation Assistance Mission in Afghanistan (UNAMA), the number of civilian casualties has been steadily increasing over the past six years. In 2009, when UNAMA started documenting civilian casualties in Afghanistan, they recorded 3556 war-related injured civilians. In 2015, the number of injured civilians was 7457, which represented a nine percent increase from 2014.

“I first came here in 2009. It’s hard seeing how the security situation is going from bad to worse. You never know what’s going to happen. There is no feeling of security. The feeling is that at any moment something can happen,” said Sara Salvigni, the medical coordinator at the Emergency Hospital in Kabul. She confirmed that the number of war victims treated at the hospital continued to increase this year. “In the first quarter of this year, we received 25 percent more patients than in the same period of last year,” she said.

With three hospitals and dozens of small clinics across the country, Emergency, an international non-governmental organization based in Italy, remains the largest provider of free medical assistance to war victims in Afghanistan. In order to assist an increasing number of patients, the Kabul hospital opened last year three new operation theaters, operating 24/7, and an additional wing with 20 new beds, thus increasing the number of beds to 120 in total. When incidents with mass casualties occur, they also use the laundry room and physiotherapy room, in order to gain enough space for about 20 beds. “This usually happens once or twice a month,” said Salvigni. One of the bloodiest attacks this year happened in late July, when a suicide bomber of the Islamic State – Khorasan, the Afghan branch of the Syria-based Islamic State, blew himself up at a demonstration in Kabul, killing 80 people and injuring more than 230. “About 50 people were transferred here. About 40 of them were severely injured and had to be hospitalized, while 10 people had superficial wounds,” recalled Salvigni.

The Emergency hospital in Kabul primarily treats patients from nearby provinces such as Wardak, Logar, Parwan and Ghazni. But ever since the U.S. military air strike that demolished the Doctors Without Borders Hospital in Kunduz City in October 2015, an increasing number of war-related injured civilians started coming to Kabul from the northeastern provinces. Without the Doctors Without Borders trauma center in Kunduz city, which was the only trauma center in the northeast of the country, civilians with serious injuries now have to make the 330-kilometers long journey to Kabul, if they want to receive proper medical treatment. “Many hospitals were closed in Kunduz. When the road is open, people come here for treatment. Sometimes they need two or three days to reach our hospital,” said Salvigni.

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Aga Jan, 28, is a truck driver from Chelam village in Jani Khel district in the eastern province of Paktia. In late August, the Taliban launched an operation in which they tried to take control of the Jani Khel district. During the fighting, a mortar shell hit Aga Jan’s house, allegedly fired by the government forces. “I was at home. I was standing outside my house when the mortar shell hit me,” said Aga Jan, who has two wives and four children – three sons and a daughter. After he got injured, they first transferred him to Gardez city, the provincial capital of Paktia, from where they took him to the Emergency Hospital in Kabul.

The surgeons could not save his severely injured right arm, which has been amputated below the elbow, but they could successfully treat the wounds caused by pieces of shrapnel that hit him in his legs and abdomen. “I was the only one in my family who got injured in that incident. This was the first time that something like this happened,” said Aga Jan, sitting on his hospital bed. The doctors said that he needed two or three weeks more to heal the wounds.

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About 85 percent of patients treated by Emergency are male. About a third of the patients are under 18 years old. “The most common are bullet injuries. About 50 percent of our patients have bullet injures,” said Salvigni. The second most common type of injury – about 30 percent – are shell injuries, which include injuries incurred in suicide attacks, air strikes, roadside bombs and rocket attacks. About 10 percent of the patients were wounded in landmine explosions, while the rest of them were stabbed.

Over the past two decades, the staff at Emergency worked hard to remain neutral in the conflicts that plagued the country. At their hospitals and clinics, they treat civilians and members of all belligerent parties. When they receive patients, they only ask them questions strictly related to the treatment. They ask patients where they come from, what kind of injury they suffered, and when they got injured. By staying neutral, Emergency staff are able to operate across both Taliban-controlled and government-controlled areas. “Everybody knows us. All belligerent sides allow us to pass through their checkpoints. The Taliban know we treat all patients. They respect us because we treat all patients,” said Salvigni.

In this period of time, the main problem they have to face are road blocks. “Sometimes there are road blocks even around Kabul. In such cases, it takes a lot of time to reach the hospital,” said Salvigni. In addition, ambulances cannot reach their destinations when the roads leading there are mined.