After sixteen years, MSF hands over emergency services in Chaman, Pakistan

08 Feb 2024

After sixteen years, Médecins Sans Frontières (MSF) is handing over its emergency room (ER) services at the district Headquarters (DHQ) hospital to the medical authorities in Chaman, a town 130 kilometers north of Quetta, Pakistan, on the border between Balochistan and Afghanistan.

The ER was initially established in 2007 to ensure emergency care for conflict-related trauma patients and mass casualties. In 2023 alone, the facility treated over 11,000 people. However, since 2021, the majority of trauma cases that presented at the ER have been injuries sustained in accidents such as road crashes for which services are available in other public health facilities in Chaman. 
 

Many years of dedicated support to the Emergency Room at the DHQ Hospital, and a close collaboration with the Ministry of Health (MoH) team have led to significant achievements. While MSF acknowledges that the demand for emergency health services persists, it also believes that this is the right time to transfer the overall management responsibility to the Ministry of Health team.

Xu Weibing
MSF head of mission

"As an emergency humanitarian organisation, MSF chooses where to work based on the most pressing needs. Following this principle, the organisation has now completed the transition of responsibilities of ER services to the MoH. The MSF is nonetheless prepared to assist local health authorities in case of an emergency and will continue offering training on mass casualty preparedness in Chaman”, Xu Weibing, MSF head of mission explains.

The facility served 112,448 patients at the outpatient department (OPD) from 2012 to 2023. Among them were 98,037 trauma patients, 3,925 OPD cases who were referred to the Ministry of Health for further care, and MSF nurses provided wound dressings to over 110,000 patients.

Emergency room in Chaman

The MSF emergency room in Chaman, 130 kilometers north of Quetta, on the border of Balochistan and Afghanistan © MSF/Gul Nayab

What assistance has the emergency room provided?

Sher Bahar Khan is an emergency nurse who has been working in the ER room since 2016. He explains, "in our time here, we've had to handle various situations in the ER, from responding to mass influxes of patients following violent incidents to managing a surge in accident-related injuries. The kind of cases we treat here are the result of intercommunal clashes, burns, bomb blasts, traffic accidents, suicide cases, and we also received a number of patients from Afghanistan in very bad condition."

"I remember when, following a clash between the military forces and armed groups, 32 severely injured patients were brought to our facility. As professionals, we had to deal with such incidents," Sher recalls. "I was fixing a bandage on the leg of an injured person, when I noticed another person motioning for me just by moving his eyes. Both his legs and arms were badly injured, and he could barely talk: 'I am the only son of my parents, please save me’ he said. I did what I could and then referred him to Quetta. After two months, he came looking for me.  He walked up to me, hugged me and said: 'You have saved my life.' This kind of experience is immensely rewarding,” he said.

"We treated many patients and served the community, and the community trusts us. On many occasions, we worked 24-hour shifts to respond to a mass casualty influx following violent clashes. Once stabilized, patients would be rushed to the hospital in Quetta,” he says. "One night at 3 o'clock, I was the only one on duty; seven patients from Afghanistan were brought in. One man’s body was riddled with bullets. I quickly provided emergency treatment to him and referred him to Quetta, and then attended to all the other injured people as well,” Sher Bahar says. 

Throughout the 16 years of activity in Chaman, MSF has been strengthening the skills and competencies of the ER team and providing technical support to ensure the best quality of care.

We are well trained medical professionals; MSF offered great learning opportunities. Senior staff used to come on a regular basis to train us and prepare us to manage difficult situations.

Sher Bahar Khan
Emergency nurse

"Though working with severely injured patients is challenging, as a professional, you learn to deal with it. What I found difficult was getting caught in the conflict. Sometimes, 20 to 30 armed men would show up with the patient and would want to interfere with the treatment," Sher Bahar says.

What health services will MSF provide in the region now?

As one of the largest healthcare providers in Balochistan, MSF remains committed to providing free-of-charge, quality health services. In collaboration with the Ministry of Health, MSF medical teams will continue delivering a range of health services at the district headquarters (DHQ) hospital in Chaman including a 24-hour delivery room with surgical capabilities for complicated deliveries, a dedicated pediatric inpatient ward, a neonatal unit with referrals to Quetta, and therapeutic feeding programs for malnourished children under five years.

Mother and child healthcare and medical nutrition care are also provided in two other MSF facilities in Quetta and Dera Murad Jamali.

 

Doctors Without Borders/Médecins Sans Frontières (MSF) is an international medical emergency organisation that delivers healthcare to people affected by armed conflict, epidemics, natural disasters, and exclusion from healthcare. It initiates medical projects based on the specific identified needs of people and their ability to access health services. MSF has been working in Pakistan since 1986.