Provision of effective trauma care services to the conflict affected population through improved mass casualty management and emergency mental health service delivering capacities in high risk provinces This project will provide effective emergency and trauma care services to the population affected by conflict, through the activities that improve the mass casualty management capacity and emergency mental health care in the selected provinces. The activities under the projects are,

1- Establish seven Trauma Care Units (TCU) in Badghis, Sari-pul, Ghor, Uruzghan and Badakshan provincial/District hospitals (the tentative BOQ for a 20 bed TCU and improving TCU facilities in Uruzghan provincial hospital are attached). The activity will complement the Mass casualty management planning and implementation in the provinces and address the gaps of space, essential equipment and additional human resource for operationalize the TCUs in the selected hospitals and make them fully functional as referral hospitals by 2017. The hospitals selected for the project are under high risk for conflict and facing inadequate support from the national health budget. This was further evidenced by the mass casualty management capacity assessment made in Badghis, Badakshan and Uruzghan where they had limited space for triaging, emergency treatment and operating facilities (with one OT and two OT tables in Badghis and Uruzghan, two OTs and 2 tables in Badakshan).  An average of 17000 surgical interventions with 1000 weapons wounded cases have been reported from the five provinces. This activity would treat  at least 3000  major trauma cases per year including 1050 (35%) women and children. Overall 3 million people living in the five provinces would benefitted through the services. The minimum requred space, structure, HR, equipment and  supplies for the TCUs have been discussed in a Working group that included WHO, ICRC, MSF and EMERGENCY NGO. The activity will be implemented in collaboration with EPHS implementing partners and the MoPH. (WHO has already tested a similar project in Kunduz and initiated similar activities in kapisa and Faryab). 

2. Improve the emergency mental health care services through providing Psychological First Aid (PFA) in all conflict affected provinces through review and unify the available emergency mental health first aid training curriculum, guidelines and assessment formats as per the WHO recommendations, translate and print them and train 68 mental health staffs from all the provinces and 75 counselors from 5 high risk provinces that have been frequently affected by conflicts and mass casualty incidents. There will be at least 40 female staff gain advanced capacity to provide the emergency PFA services in their provinces. This activity would complement the mass casualty management program implemented over the last three years through prevention and healing of the mental trauma that could cause by the physical injuries and disability. 

3-Procurement and supply of Trauma Kits, Basic Health Kits and Supplementary Kits by  WHO would complement the trauma care and emergency health care services to be expanded in the six provinces (Badghis, Ghor, Saripul,Badakshan, Gazni and Urzghan) under CHF 2/2016 and serve 281400 individuals treated in emergency units of the six provincial/District hospitals. Among them around 211050 (75%) will be women, boys and girls (lt18 years). This kits will be prepositioned in the hospital as a buffer supply for the emergency mass casualty incidents including conflict related injuries, weapon wounded and major road traffic accidents that have been common in the recent past. Additional supplies will be provided to the provincial hospitals based on the need to replenish the stock.