Quetta is a difficult place to work. A lot of babies come to our hospital alive and, despite the best efforts of the team, leave dead. We have a neonatal intensive care unit and 30% of our tiny patients last month didn’t survive. It’s really difficult to deal with, especially those of us who are not accustomed to tiny babies dying.

We do the best we can, and have much more resources in this project that I’ve seen in many MSF locations, but we struggle, because our patients arrive with us late.

We offer free healthcare and that is uncommon, and can be distrusted. People can’t imagine that free care is good care. People are accustomed to getting antibiotics a lot and they are accustomed to getting injectable drugs a lot – apparently, even when they are not medically needed.

Patients often come to us when the private clinics are worried that they might die, or when the parents have ran out of money. They arrive in terrible states, having been injected with multiple heavy-duty antibiotics, sometimes with hospital acquired infections. They often arrive simply too late.

My job here, as project coordinator, is to try and maximize the impact we have with the resources available to us. I try to keep the team motivated and working cohesively.

With seven international and 253 local staff spread over Quetta Pediatric Hospital, Kuchlak Mother and Child centre and 4 other medical facilities, that’s a big team to keep pointing in the same direction, but I’m fortunate to have a good team and a team that is determined to do the best we can.

The mother and child centre has given over 45,000 outpatient consultations so far this year and we’ve vaccinated over 10,000 kids. All for free. Over 5,000 have been screened in our triage at the hospital and over 1,700 admitted.

I try to regularly chat to the Dads and check if they are happy with the service they received. They are. One had been to the mother and child centre eight times, bringing women to give birth (4,000 babies have been born in our Kuchlak centre this year), some travel from Afghanistan to get treatment here.

But for all those success, it is the kids who don’t make it that keep us awake at night.