"The intensification of the conflict urgently demands enhanced precautions by all parties – the Afghan national security forces, the international military forces and the armed opposition," said Jacques de Maio, the ICRC's head of operations for South Asia. "More must be done to minimize the war's impact on civilians not only in combat zones, where fighters and civilians must be distinguished at all times, but also far from the battlefield – even there, respect and security for medical and health workers must be restored."

At Mirwais Hospital in Kandahar, the only referral hospital for some 3.5 million people, between 500 and 700 war-related operations are now being performed each month by ICRC and local surgeons. "And they are the lucky ones: many other wounded and sick people simply do not have access to any treatment," said Reto Stocker, head of the ICRC delegation in Kabul. "Medical facilities and first-aid posts are often not spared the effects of the fighting – occasionally, they are even directly targeted. When ambulances are blocked and sometimes shot at, it becomes impossible to evacuate casualties. Medical workers venturing into remote areas do so at the risk of their lives."

International humanitarian law stipulates that the sick and wounded – whether they be civilians or fighters, regardless of which side they are on – must be cared for with the least possible delay and must not be subject to any form of discrimination. The parties to the conflict must at all times respect and protect medical personnel, vehicles and facilities, and must facilitate the rapid passage of medical assistance to those in need.

The ICRC has been working in Afghanistan since 1979 and currently employs 1,600 staff throughout the country.

Facts and figures:

• A total of 2,112 weapon-wounded patients were admitted to Mirwais Hospital in 2009, an increase of more than 25 per cent compared with 2008 when 1,598 weapon-wounded patients were admitted.

• In August 2009 alone, 331 weapon-wounded patients were admitted to Mirwais Hospital, more than a twofold increase over August 2008 when 149 weapon-wounded patients were admitted.

• Weapon-wounded patients often require multiple surgical procedures, resulting in an increased workload for hospital staff and longer admission times for patients.