“Of 500 patients who have come to the clinic since the morning, 200 have died” – that is the blunt assessment of Muhammad Gul, a staff member at a tiny clinic in Gyan, in eastern Afghanistan.
The facility has just five beds, but Tuesday’s earthquake left even these meagre resources unusable.
“All the clinic’s rooms have been destroyed,” Mr Gul told the BBC.
He said a helicopter had airlifted a handful of patients from the remote district in Paktika province to cities for treatment, and two doctors were manning a makeshift outdoor clinic to try to treat people who had nowhere else to go.
The generator supplying power has only a limited supply of fuel, and the help promised by other provinces has yet to materialise.
Meanwhile, casualties keep on arriving.
“There are dozens of people who need immediate medical help. I don’t think they will survive the night,” Mr Gul added.
The earthquake struck impoverished hilly areas with weak buildings, ill-equipped to handle the shock. Hundreds of houses have been destroyed and there have been landslides.
Gyan is one of the worst-hit areas. Many people remain trapped under the rubble.
International development agencies set up the clinic there a couple of years ago. It was meant to deal with minor health conditions and refer people to hospitals in major cities for more significant treatment. It had no accident and emergency department.
Since the hard-line Islamist Taliban took power across the country last August, many international aid agencies have left the country. The medical system has been dealing with severe shortages of supplies and staff.
When the Taliban’s acting district governor toured Gyan on Tuesday, people shouted at him, telling him to leave, a volunteer from a neighbouring district told the BBC.
“The Taliban are not capable of dealing with this disaster. There is no system in place,” the volunteer, who did not want to be named, said.
“And we cannot be hopeful for international help. The world has forgotten Afghanistan.”
Even before the Taliban takeover, the country’s emergency services in its larger towns and cities had limited capacity to respond to natural disasters. There were few aircraft and helicopters available.
According to Paktika’s medical authorities, there is a severe shortage of painkillers and antibiotics in the region.
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