KABUL (Reuters) - That Afghan toddler Abuzar survived a bullet fragment to the head during a Taliban attack in Kabul last week is astonishing.
The two-year-old, his head heavily bandaged, has emerged from a coma, and the sight of him chuckling during hospital visits from his aunt give doctors hope he can make a full recovery. He may now go to Canada to live with an uncle.
That is where the good news ends.
The boy’s mother, father and two sisters died in the brazen raid on the luxury Serena hotel, and at the Italian-run hospital where Abuzar is being treated, medical staff are planning to expand the facilities to cope with an expected rise in violence.
The militant Islamist Taliban movement has declared war on the April 5 presidential election, and it may also be emboldened by the withdrawal of many foreign troops stationed in Afghanistan by the end of the year.
“We are here to be surgeons of war,” said Luca Radaelli, a doctor at the surgical center in Kabul run by an Italian non-governmental group called Emergency, where admissions have soared 36 percent so far this year.
“Our plan is to expand and build on the facilities we have present in Afghanistan,” he added.
Little Abuzar is patient number 28,378 at Emergency’s surgical center in Kabul, which has been open since 2001 and is one of just three of its kind in the country.
His father Sardar Ahmad, a prominent journalist with the AFP news agency, died in the attack along with his wife, two daughters and five others.
Abuzar did not have far to travel to get to the Emergency clinic, increasing his chances of survival.
For seven-month-old baby Mohammadullah, the prognosis was less certain as he underwent intensive care for a life-threatening bullet wound to his tiny body.
He came from Ghazni, around 120 km southwest of Kabul, and journeys to Emergency’s clinics across Afghanistan made by foot, donkey, ambulance or car can be fraught with danger.
“We are trying to rescue him in every possible way,” said Radaelli.
With more than 40 clinics around the country, Emergency casts a wide net over a nation ravaged by war. It has its own fleet of ambulances to shuttle patients to its main hospitals.
Emergency treats all patients for free regardless of which side they have been fighting for in Afghanistan’s insurgency, and sometimes enemy combatants find themselves lying on hospital beds side-by-side.
”We only ask three questions,“ said Radaelli: ”‘What is your injury?', ‘How long ago did it happen?’ and ‘Where are you from?’
“They respect the rules. As long as they are patients, nothing happens inside the hospital.”
The recent flood of patients has put significant pressure on Emergency doctors, who fight to keep at least 20 percent of their beds free to be able to respond to a crisis.
Sometimes even that is not enough, and a tent outside is used to cope with larger attacks, when as many as 50 patients have arrived at one time.
The government has only recently recognised traumatology as a medical field in its own right, largely due to pressure by the Italian group that now trains surgeons wishing to qualify.
Seven Afghan doctors have passed since the training programme started in 2011.
One of the Afghan traumatologists at the hospital vowed to stay in Kabul even if the conflict did escalate.
“For a person with no resources, it’s better to leave. But people need my experience,” said Hedayatullah Abdul Ghafar.
Emergency’s experience of a rising number of patients echoes a UN report on civilian casualties last year that recorded a 14 percent increase on 2012, putting the total figure at the highest since 2009.
The United Nations found women and children bore the brunt of the increase, with the number killed or injured in the conflict up by more than a third from 2012.
Editing by Maria Golovnina and Mike Collett-White