The rotors of attack helicopters and artillery fire echo across the Kunduz plain in northern Afghanistan.
On the outskirts of the provincial capital Kunduz, government forces attempt to repel Taliban assaults and the city's trauma centre is always full.
Trapped in the middle of this forgotten conflict far from Kabul, the inhabitants of the province have borne the brunt of the fighting.
In recent weeks, the Taliban have advanced on Kunduz, battling against the army, police and local tribal militias known as "Arbaki".
At a time when NATO troops are preparing to leave the country by the end of the year, militant attacks on the strategic city have taken a dramatic turn.
Since early summer the hostilities have left dozens dead. The hundreds wounded have been admitted to the trauma centre run by Doctors Without Borders (MSF), the only one in the region able to treat the most severe cases.
In the intensive care ward doctors keep a close eye on five-year-old Somit, who is semi-conscious with a bandage around his head.
"An anti-aircraft grenade landed on our house and four of the children were wounded," said his uncle Mirwais sitting at the boy's bedside.
The three older children escaped with light injuries but Somit had shrapnel embedded in his skull.
The family had to walk from the neighbouring district of Chahar Dara, a Taliban stronghold, with the wounded children.
After crossing a river by barge, they had to call out to a nearby police post telling them not to shoot and allow them to take the children to hospital.
Among the non-combatants, women and children are the worst affected by the fighting.
- Taliban focus -
Qurban Gul, 25, was hit by a stray bullet in her arm and right side when she left her house in Chahar Dara. Her family had to find a car to take her the 16 kilometres to hospital.
"Everybody was afraid to drive us because of the ongoing fighting," explained her mother-in-law, which meant the family had to pay a high price to take her to hospital.
Islamist fighters control several Pashtun-majority districts in the immediate vicinity of the city.
"Kunduz is a strategic province and has always been the focus of the Taliban operations in the north," provincial governor Ghulam Sakhi Baghlani told AFP.
With all the country's main ethnic groups represented in Kunduz, the province is often likened to a "small Afghanistan", with a population comprising of Pashtuns (34 percent), Uzbeks (27 percent), Tajiks (20 percent) and Turkmens (9.4 percent).
And this mosaic has often seen inter-ethnic tensions over control of the province which is crossed by the strategic trade route north to Tajikistan.
And getting access to medical help is a serious problem amid the fighting, explained a relative of Salahuddin, 18, who suffered a gunshot wound in his leg.
"We faced a lot of problems to come to the hospital because of the road. And there was fighting around. Too much fighting -- we had to wait for one day in Dashte Archi (a Taliban stronghold) before we could come to the Kunduz hospital in a private ambulance," he said.
"We know that in conflict zones, sometimes people cannot come (...) People are afraid to come, of being arrested or worse being killed," said MSF project coordinator Elias Abi Aad.
"We would like to find a way to facilitate access because it is our mandate. Our mandate is to reduce mortality in the region," he said, referring to a project to set up "outposts" in combat zones that would be responsible for stabilising the wounded before sending them to hospital.
To do this, MSF maintains contact with various local factions, including the Taliban. "We're talking to everybody," he said.
And hospital staff, Afghan or foreign, do not differentiate between civilians, security forces and the Taliban, as Hafizullah, a member of an "armed opposition group" seeks care alongside his "enemy" Afghan policeman Noorullah.
The rotors of attack helicopters and artillery fire echo across the Kunduz plain in northern Afghanistan.
On the outskirts of the provincial capital Kunduz, government forces attempt to repel Taliban assaults and the city’s trauma centre is always full.
Trapped in the middle of this forgotten conflict far from Kabul, the inhabitants of the province have borne the brunt of the fighting.
In recent weeks, the Taliban have advanced on Kunduz, battling against the army, police and local tribal militias known as “Arbaki”.
At a time when NATO troops are preparing to leave the country by the end of the year, militant attacks on the strategic city have taken a dramatic turn.
Since early summer the hostilities have left dozens dead. The hundreds wounded have been admitted to the trauma centre run by Doctors Without Borders (MSF), the only one in the region able to treat the most severe cases.
In the intensive care ward doctors keep a close eye on five-year-old Somit, who is semi-conscious with a bandage around his head.
“An anti-aircraft grenade landed on our house and four of the children were wounded,” said his uncle Mirwais sitting at the boy’s bedside.
The three older children escaped with light injuries but Somit had shrapnel embedded in his skull.
The family had to walk from the neighbouring district of Chahar Dara, a Taliban stronghold, with the wounded children.
After crossing a river by barge, they had to call out to a nearby police post telling them not to shoot and allow them to take the children to hospital.
Among the non-combatants, women and children are the worst affected by the fighting.
– Taliban focus –
Qurban Gul, 25, was hit by a stray bullet in her arm and right side when she left her house in Chahar Dara. Her family had to find a car to take her the 16 kilometres to hospital.
“Everybody was afraid to drive us because of the ongoing fighting,” explained her mother-in-law, which meant the family had to pay a high price to take her to hospital.
Islamist fighters control several Pashtun-majority districts in the immediate vicinity of the city.
“Kunduz is a strategic province and has always been the focus of the Taliban operations in the north,” provincial governor Ghulam Sakhi Baghlani told AFP.
With all the country’s main ethnic groups represented in Kunduz, the province is often likened to a “small Afghanistan”, with a population comprising of Pashtuns (34 percent), Uzbeks (27 percent), Tajiks (20 percent) and Turkmens (9.4 percent).
And this mosaic has often seen inter-ethnic tensions over control of the province which is crossed by the strategic trade route north to Tajikistan.
And getting access to medical help is a serious problem amid the fighting, explained a relative of Salahuddin, 18, who suffered a gunshot wound in his leg.
“We faced a lot of problems to come to the hospital because of the road. And there was fighting around. Too much fighting — we had to wait for one day in Dashte Archi (a Taliban stronghold) before we could come to the Kunduz hospital in a private ambulance,” he said.
“We know that in conflict zones, sometimes people cannot come (…) People are afraid to come, of being arrested or worse being killed,” said MSF project coordinator Elias Abi Aad.
“We would like to find a way to facilitate access because it is our mandate. Our mandate is to reduce mortality in the region,” he said, referring to a project to set up “outposts” in combat zones that would be responsible for stabilising the wounded before sending them to hospital.
To do this, MSF maintains contact with various local factions, including the Taliban. “We’re talking to everybody,” he said.
And hospital staff, Afghan or foreign, do not differentiate between civilians, security forces and the Taliban, as Hafizullah, a member of an “armed opposition group” seeks care alongside his “enemy” Afghan policeman Noorullah.
