Afghans Face a Loss of Health Care

"If something goes wrong, there will be a very, very negative impact on health care in this area," Naseem said. "At the moment, our health facilities are open. But the time may come when we will not be able to supply drugs, and the services will collapse."

Even before the kidnappings, health facilities in the area were showing signs of strain.

While up to 80 percent of Afghans have access to basic health care, about 70 percent -- 22 million people -- lack a nearby hospital capable of treating more serious conditions.

That's why the health facility in the Shinwar district, a rural outpost an hour's drive from Jalalabad amid corn and poppy fields, has become so popular. The campus of spare concrete buildings looks rudimentary from the outside, but the two surgeons inside -- along with a pediatrician and a gynecologist -- are enough to draw patients from 50 miles away along rough mountain roads. Many die making the journey.

The facility is equipped to receive 1,800 patients a month; these days, it gets 6,000. Lately, more and more of them are war wounded.

On March 4, a patient arrived at the clinic with a gunshot wound to the neck. A second showed up minutes later with a bullet hole in his jaw. Over the next several hours, 21 additional trauma patients arrived -- victims of an attack by U.S. Marines that the military later called "a mistake" and apologized for.

The staff was overwhelmed. Anyone in the area who knew basic lifesaving skills was brought in to help. The local pharmacy was emptied of medication. Patients who were not in imminent danger had to give up their beds.

"If two or three trauma patients come in at once, we can cover that very well," said Aman Gul Amani, a doctor and the hospital manager. "But 23 is too much."

Similar mass-casualty events have been reported across Afghanistan in recent weeks. According to an Associated Press estimate, NATO and U.S.-led forces have killed 203 civilians this year; Taliban fighters have killed 178 civilians. Hundreds more people have been wounded.

NATO and U.S.-led forces say that they do everything they can to provide care to civilians and that they routinely offer medical evacuations by helicopter or plane.

But the areas where airstrikes occur are often exceptionally remote, and some are even beyond the reach of international forces.

Such was the case this month in the southern province of Uruzgan. There, 120 people were wounded and more than 60 killed over three days of intense clashes between NATO and Taliban forces.

Jan Mohammed, who is in his late 50s, was asleep at 4 a.m. in the Uruzgan district of Chowreh when a bomb tore through his home. Lying amid the wreckage, he could see the bodies of his wife, children and grandchildren. Overall, 22 members of his family were killed.

He was barely alive himself, with severe bleeding from his arm, abdomen and legs. For four hours, he lay there, desperately hoping for help. It finally arrived, but not in the form of an ambulance or military convoy. Instead, it was his neighbor, who put together a makeshift rescue squad to ferry the injured on the treacherous two-hour journey to the nearest medical facility.

"The hospitals didn't help us. The government didn't help us. The foreign people didn't help us," said Mohammed, breathing heavily through tears. "Only my neighbor came to help me."