In Herat in May, we saw an increase in cases of malnutrition and acute watery diarrhoea. The MSF ITFC at Herat Regional Hospital (HRH) treats severely malnourished children who have an additional medical complication. In May, 374 children were admitted to the ITFC, more than double the number admitted in April (174). This was largely due to the increase in acute watery diarrhoea cases. Our ITFC now has 86 beds and we have also repurposed an isolation tent to add an extra 20 beds for children with malnutrition who also have acute watery diarrhoea. We therefore currently have 106 beds dedicated to children with severe acute malnutrition with complications but throughout the month there were regularly more severely malnourished children admitted than available beds. At the start of May we established an ambulatory therapeutic feeding centre (ATFC) in HRH, which provides outpatient treatment for malnutrition, by the end of the month over 100 children were enrolled in the programme.

MSF has been supporting the paediatric department at HRH since December 2021, supporting the emergency room, intensive care unit and step down unit (part of the inpatient department which provides care to patients who don’t require as regular monitoring as in an ICU but are not yet considered stable enough for normal care). In May, MSF medical staff triaged over 18,900 children at HRH’s paediatric department, around 80% of these were green (less severe) cases not requiring admission to the ER. There were 393 patients admitted to the paediatric intensive care unit, with the most common causes of admission being suspected central nervous system infection, septic shock and respiratory failure.

The 60 bed measles ward at HRH that MSF opened in March, continues to treat patients, but fewer than earlier in the year. In May there were 739 measles patients received in triage, 40 percent fewer than in April. There were 292 patients admitted to the measles ward, 50 percent fewer than in April.

We triaged 2,345 suspected COVID-19 cases at HRH, with severe and critical patients comprising just 3.6 percent of all cases. In June, we handed over the COVID-19 treatment centre in Gazer Gah to the Ministry of Public Health. The centre will be used as a ward for infectious diseases.

At the Kahdestan clinic, where we provide outpatient treatment for children and pregnant and lactating women, MSF carried out over 1,800 outpatient department consultations. We saw over 650 cases of diarrhoea, a 40 percent increase compared to April. Our ambulatory therapeutic feeding centre had 114 children and 577 pregnant and lactating women enrolled at the end of the month. There were 238 antenatal, 144 family planning and 35 postnatal consultations at the clinic in May.