The sound of crying and beeping medical devices fills the small room. Nurses rush from bed to bed, checking vital signs. Mothers push oxygen masks onto the faces of their children.

The emergency room doctor bursts through the swinging doors of the paediatric emergency room (ER) in Boost hospital in Helmand, Afghanistan.

“I have 17 patients waiting to be admitted, but nowhere to put them,” says Dr Ahmed*, a Médecins Sans Frontières (MSF) emergency room doctor.

It’s 6pm, and the night shift has only just begun. Every bed in the paediatric department is full; they are often shared by two patients, and the next wave of patients is already arriving.

“This is a crazy time for us. Day by day, more and more patients are coming,” says Dr Ahmed.

The number of children under five coming to the ER triage at Boost hospital has more than doubled since 2020, rising from 53,923 to 122,335 patients in 2024.

In April of this year, 13,738 children under five were seen in the ER at Boost hospital – the highest monthly number of ER consultations since at least 2020.