MSF/Ben KingMSF staff
prepare for the rush of patients at a mobile clinic in Kabul.
30 August 2013 - Mina, 25,
has brought her young children to get vaccinated at Médecins Sans Frontières
(MSF) new mobile clinic in the outskirts of the city of Kabul, Afghanistan. The mother of six walked an hour
from her village to get to the site in Buthkhak where the MSF team provides
preventive health services each week for the neighbouring communities. “We only
have private doctors in our village and it costs quite a lot of money for us to
go to see them,” she says.
Kabul has an estimated population of more than five million,
having tripled over the last ten years. These new residents are a varied mix of
internally displaced persons fleeing conflict in more insecure regions of the
country, economic migrants seeking better opportunities in the city, returnees
from refugee camps in Pakistan, families without land, and members of long marginalised
minority groups who struggle to find a place within mainstream Afghan society.
Many of them live in the outskirts of the city and are confronted with very
poor access to healthcare services.
Reaching out to isolated
communities
Since April this year, MSF
has been conducting preventive mobile clinics in ten locations in the suburban
areas of Kabul, in order to reach out to these isolated communities. The
clinic focuses on women and children under the age of two; almost 2900 patients
have been seen since the start of the activities. The team provides pre- and
postnatal care and family planning for women, as well as vaccination and
malnutrition screening for children. Since there is a high incidence of
tuberculosis in the country, patients with the disease are also encouraged to
bring their family members to the clinic for screening.
“The feeling is quite strange,”
says Lajos Jecs, MSF nurse who leads the mobile clinic team. “Even though we
are in Kabul, in the capital, it looks like we are really very far from
the city. The preventive care approach is important as there are a lot of
Afghan women who don’t know about the need for antenatal checkup. “There is no
health education for them at all. A lot of mothers don’t know how to breastfeed
their babies and so we see a lot of malnourished children.”
Patients who need a follow
up examination or treatment are referred to the Ahmad Shah Baba District Hospital,
located in eastern Kabul, where MSF has been working with the Afghan Ministry of
Public Health since 2009.
Going beyond hospital walls
“While we are treating an
increasing number of patients in Ahmad Shah Baba and our other hospitals in
Helmand, Kunduz and Khost, we know that many more people cannot even make it to
the hospitals or other health structures because of distance, insecurity or the
cost of transport,” says Benoit De Gryse, country representative for MSF in
Afghanistan. “That’s why we want to go beyond our hospital walls and reach out
to some of these isolated communities.”
The mobile clinics in Kabul are the first step, but De Gryse acknowledges that this
was not a simple undertaking. “The negotiation process for launching the mobile
clinics took quite some time. We had to talk to different community and
religious leaders and explain the preventive mobile clinic concept to them.
Since then however, we have gained a lot of trust from them. They help us
promote and explain the mobile clinics to their communities and we even use
their houses to see patients.
“Another challenge is to
ensure the security of our staff as well as our patients when we reach out to
these areas. That is why the acceptance from the community is critical.”