http://www.nytimes.com/2016/10/07/world/asia/kunduz-afghanistan-hospital.html 2016-10-06 21:30:50 A Few Medics Hold the Line in Kunduz, Their Hospital Also a Casualty Under fire for four days, Afghan hospital staff members are short on food and medicine as Taliban and Afghan forces fight for the city. === KABUL, Afghanistan — When the But they were also aware of the risk. Exactly a year ago, after the insurgents last overran the city, many doctors and nurses just like them Marzia Salam Yaftali, the head doctor at the 200-bed government hospital, said her colleagues on duty on Monday morning thought that it was probably a small group of Four days later, Kunduz is still an urban war zone, with the The city is without electricity and running water, and shops and private clinics remain closed. Many desperate residents are reporting food shortages, with the price of a loaf of bread increasing fivefold. The situation is so tense that many of those responsible for emergency assistance have fled to safer places. “Working in Kunduz is impossible — there is no condition for activities. It is a complete war zone, and we are just worried about our own lives,” said Khudabaksh Nazari, head of the Red Crescent charity in the province. The condition of those who fled to neighboring provinces also remains dire, with the government and aid agencies already stretched by the more than 277,000 others internally displaced by fighting across the country so far this year, as well as the roughly 6,000 refugees who are returning from Pakistan every day. “Many families were unable to bring their possessions with them and are in a precarious position,” said Dominic Parker, Head of the United Nations Office for the Coordination of Humanitarian Affairs in Afghanistan. “We have had reports that some families have been forced to sleep out in the open and many have few food supplies.” About two thirds of the members of the medical staff at the hospital in Kunduz have fled the city, Dr. Yaftali said. Only about two dozen doctors and nurses continue to work, and there’s been little break for them. They have treated about 250 people since the beginning of the fighting and are running short on medicine, she said. Food is short, and they are down to rice and onions to feed the remaining staff members and patients. While much of the staff had stayed at work through the first two days of fighting, the mortar shells that struck the hospital on Wednesday were the last straw for many. Taliban and Afghan forces have also clashed at the entrance of the hospital. “Since 10 a.m. this morning, the hospital can only provide emergency services,” Dr. Yaftali said in a phone interview on Thursday. “We had insisted that the doctors stay at the hospital, but after the firing on the hospital yesterday, we regretted insisting.” Sayed Delawar Khan, a 42-year-old nurse who left work on Thursday afternoon to move his family out of the city, described the stark choice they faced. “I have six children, the oldest one is 11 years old,” said Mr. Khan, who said he had worked at the hospital for 20 years. “Taliban have threatened residents of the area where my house is located to leave their homes, so I left the hospital to take my family to Shahrak.” With his family out of Kunduz and in another province, Mr. Khan said he would go back to the hospital: “I have a commitment there.” Mr. Khan described the fighting in the city this time as more intense than last year’s siege. “There were around six or seven patients left in beds — most of the other patients have escaped,” he said. Fighting across several parts of the city, focused around the main government buildings that the authorities are trying to hold onto, has also meant the wounded have to take further risks to access the little medical help that remains. Mr. Khan described the case of five people in one family who were wounded, probably by a mortar strike. A sixth family member suffered injuries as he was trying to bring them to the hospital. Victims described having to live with shrapnel and bleeding wounds for now. Abdul Majid said he was wounded when a rocket landed near Cinema Square in the city on Thursday morning. Shrapnel was embedded in his face. When relatives took him to the hospital, they found it in chaos. Part of the compound was damaged by mortar shells, and the patients had been wheeled to the corridors out of fear of window glass’ breaking in further strikes, he said. “There were no doctors on duty. The nurses did a wound dressing and gave me some tablets,” Mr. Majid said. “They were not able to remove the shrapnel — they told me I should wait for treatment until the situation improves.” One family’s losses were described by a doctor at the hospital who did not want to be named, but the account was also confirmed by Mr. Khan, the nurse. Around noon on Wednesday, the hospital received three wounded sisters. A mortar shell had hit their home, killing their mother. While two of the girls survived, one of them, 18, died of shrapnel wounds to her legs and abdomen around 6 p.m. Relatives called a motorized rickshaw to the hospital gate. As they were loading the girl’s body to transfer her home, intense fighting started again. The relatives rushed back to take cover in the hospital, the medical staff members said. The girl’s body remained on the street all night.