Dasht-e-Barchi: can it ever be a safe place again?
By 2017 Zelman Cowen John Monash Scholar Dr Katherine Franklin
I found out about the attack on the MSF hospital in Dasht-e-Barchi in the most mundane of ways – a WhatsApp message – a screenshot of a Twitter post, sent to me by Jacqui, my MSF sister. I met her during my stint in the project four years ago and I continue to talk with her daily.
I watched from the other side of the world in real time. The attackers targeted pregnant and new mothers deliberately and systematically. I was terrified for the MSF staff, the babies and the mothers.
What I keep on coming back to is how sad I am for what we had built. Six years ago, MSF opened the 55-bed maternity hospital in Dasht-e-Barchi. In 2019, MSF had seven projects in six provinces of the country and undertook more than 100,000 outpatient consultations, assisted more than 60,000 deliveries and performed almost 10,000 surgical interventions. This year, hospital staff have supported 5,401 deliveries in Dasht-e-Barchi alone.
There are four images from the hospital in Dasht-e-Barchi that I can’t get out of my mind. They may seem mundane, but they were a part of my daily life for seven months, and they are some of my strongest memories of what we built as a team before the attack.
The first is the door to our hospital. Excited during my first assignment, I took photos of the MSF stickers plastered across the door to send back home – I was so proud. As days in Afghanistan became my new norm, the door represented the start of my morning. Having travelled through the bright and busy markets of Dasht-e-Barchi, we would climb out of our van with colourful headscarves tucked, calling out in a hurry, checking to see who had the keys, and more importantly who would do the honours of opening the door!
The door was simple: adorned with the signature MSF and “no arms” logos, it was plastic framed with big glass windows. It was reinforced with a padlocked, barred door. The padlock would always get stuck and the bolt was difficult to slide.
We were so limited in our resources that later I would come to use that door as a makeshift lightbox, holding X-ray films of sick babies up to it. X-rays were always an event in Dasht-e-Barchi, which involved carrying a baby across the stone carpark to the hospital next door. The x-rays were then developed in front of an old bar heater in the office of an ancient, Russian-speaking man, who would ply me with tea and regale me with stories.
The door was the start and the end to our day, but it meant so much more. The same stickers, the same plastic white frames, the same pink surround. But now, after the attack, it is riddled with bullet holes. Looking at this new picture of the door, I am afraid to think about how the bullets spraying across the glass must have sounded to the patients and staff inside, and what they must have done. The simple yet harmonious refuge that we built for mothers to deliver their precious new babies has been annihilated. I wonder – can it ever be a safe place again?
The second image that runs through my mind is the carpark. It’s the same carpark we carefully crossed to get babies to X-rays. It was also the carpark we dashed across in the rain after greeting our guards every morning. It was the carpark that the drivers sat in, quietly waiting at 2am after they had driven me to check on a baby struggling to breathe. It was the carpark where we set up cushions and rugs with our staff for an Iftar dinner, the evening meal signifying the end of the daily Ramadan fast, sharing plates of food as well as stories and perspectives. The staff who laughed and joked freely that night were the same staff who were there when our hospital was attacked. The first photo of the carpark I saw after the attack looked so familiar, and I was confused. I remembered a scene of friendship and healing. The carpark that I saw in the photo was destroyed, littered with burned-out cars.
Photo prior to the attack
The next photos were from inside our hospital, most of which are too awful to ever share publicly. Since I was receiving them in real time via Messenger, these photos were how I learned that the staff I care about so much were still alive.
The photos were shocking. They were photos of the inside of our hospital. There is one of our delivery room, the place where expectant mothers, often four to a room, would labour. This was the same room where I stood with the MSF paediatricians and helped new babies take their first breaths. There are photos of our inpatient wards, where there were often two new mothers per bed. These new mothers would regularly depart six hours after delivering their babies. There was a photo of the neonatal ward, a place where the sick babies were carefully fed, monitored and given some of the best care I have seen in an MSF project.
In the photos after the attack, the beds looked the same, the cots unchanged. However, they weren’t lined up in perfect symmetry the way they always were in our hospital. There was blood on the floor; streaks shockingly marking where people looked to have been dragged. There were bullet holes everywhere, walls crumbling into dust and daylight shining through.
The last photo is one I found looking back through my old photos. It’s an image of the door of one of our safe rooms – solid, inches thick, made of metal. It swings closed slowly, designed to safely lock staff inside in the event of catastrophe.
This is the photo that bothers me the most. It’s just a door, but all I can imagine is the terror. I imagine trying to get mothers, babies and staff in there while guns were aimed at them. I see the hand on the handle, swinging it closed as quickly as possible. I imagine the bolt sliding home. The one thought I have over and over again is how terrifying it must have been for our staff. It is a safe room, but how safe could it really be? Safe enough for four hours of bullets and grenades?
Afterwards, our local staff wrote to me, but never of their terror. Instead they told me, “I’m sorry Dr Katherine. We could not save all the mothers and babies”.
As a result of the attack in Dasht-e-Barchi, 24 people were killed and at least 20 more injured, a large majority of them patients. Fifteen women were killed, five of them in the delivery room with their unborn babies. Among the dead were two young boys and an Afghan midwife working with MSF. Two newborn babies were wounded, one of whom was transferred to another hospital for emergency surgery after being shot in the leg, as well as three MSF staff members
Katherine has a Bachelor of Behavioural Science with First Class Honours from La Trobe University, and an MBBS from The University of Melbourne with First Class Honours. She is an advanced paediatric trainee and published author who has volunteered extensively overseas. She has worked with Medecins San Frontieres in Afghanistan, South Sudan and Iraq, supervising paediatric and neonatal projects. Katherine used her John Monash Scholarship to complete a Master's in International Public Health (Hons.) and a Diploma of Tropical Medicine and Hygiene (Hons.) at Oxford University. As part of her Masters, she completed an Internship at the World Health Organisation in Geneva. After completing her Masters, Katherine returned to Iraq to work for MSF and volunteered at a children's hospital in Laos. Katherine is currently continuing her paediatric training at the Royal Children’s Hospital in Melbourne.