The overcrowded wards of Mirwais hospital show the real cost of the war in Afghanistan.

Patients have travelled to Mirwais from across southern Afghanistan for treatment, from inside Kandahar and from neighbouring Helmand, where fighting between Taliban militants and Afghan and international forces is at its most fierce.

Mirwais is the only hospital that covers the five southern provinces that is equipped to carry out major surgical procedures.

The hospital wards are overflowing, new operating theatres are needed and supplies of blood are desperately low. The doctors work long hours and struggle to provide care with limited resources.

As well as civilians the doctors and nurses treat Taliban fighters, some of whom are under arrest.

The medical staff work without protection and many fear for their own safety. Doctors say they can no longer send ambulances and medics out on emergency calls.

"It is dangerous for us to go outside the hospital," Dr Sharifa told us.

"We lost two doctors who were on their way to a border district to vaccinate children. The car they were travelling in was targeted and two of our very experienced doctors were killed."
 

MILITARY & AID SPENDING IN AFGHANISTAN $100 million a day spent by US forces in Afghanistan $7 million a day spent on Afghan development Source: ACBAR, 2001-2008

International assistance
 

Mirwais hospital is supported by the Red Cross who provide money together with international doctors and nurses to train the staff and help treat patients.

But some Afghan doctors accuse the west of not helping enough.

"Foreigners should spend more money on healthcare in Afghanistan rather than so much on military expenses," Dr Ghullam Mohammad, a surgeon at Mirwais hospital told us.

Patients travel for hours, sometimes days, to come to the hospital for treatment.

Many say they have been injured as a result of ground or air attacks by foreign forces. Nato says their troops do what they can to prevent civilian casualties and that they investigate incidents and pay compensation.

Some of the injured have been harmed by booby traps left behind by the Taliban, others are the victims of the growing lawlessness linked to the drugs trade that has a strangle hold in Helmand province.

 

Child mortality

 

The Red Cross provide resources to train staff and treat patients

Unicef figures from 2006 estimate that 165 of every 1000 babies born in Afghanistan die before they reach their first birthday.

A midwife at Mirwais hospital explained that there are many reasons why high numbers of mothers and babies die during labour:

"…sometimes it's because of such long distances to the hospital. Sometimes it's because of cultural issues - men don't want the pregnant woman to go into hospital until they go into shock."

There are problems too for other patients.

Afghans rarely donate blood and supplies in the hospital are critically low.

AFGHAN CIVILIAN DEATHS 2118 Afghan civilians killed in fighting 1160 killed by insurgent forces 552 killed by US or NATO airstrikes Source: UN Commission for Human Rights (figures for 2008)

Blood donors often have to be found and paid directly by the patients. With 42% of Afghans living on less than a dollar a day (according to United Nations figures), it is not surprising that people on low pay offer to sell their blood to people in need of transfusions to make some extra money.

The war in Afghanistan is now seven years old. Billions of dollars of aid money has been spent in the country. People continue to be killed and injured in the fighting.

Many of them will come to Mirwais hospital where the medical staff will do what they can to help.