LEIGH SALES, PRESENTER: Here is a story about the widening war in Afghanistan.

More than 300 foreign soldiers have been killed since January, making 2009 the deadliest year since operations began eight years ago. The war's also taking an increasingly heavy toll on civilians.

More than 1,000 have died this year, many of them children. On Friday, six civilians were among 54 people killed in a NATO air strike on two fuel tankers hijacked by the Taliban.

NATO's currently investigating the incident, but it's reignited concern among ordinary Afghans about civilian casualties.

For a frontline view, the ABC's South Asia correspondent Sally Sara spent 24 hours in the emergency room of one of the busiest combat hospitals in Afghanistan.

But first a warning: this report contains material which some viewers may find distressing.

SALLY SARA, REPORTER: It sits only metres away from one of the busiest runways in the world. The Role Three hospital in Kandahar looks non-descript from the outside, but inside it contains state-of-the-art medical facilities.

The staff are bracing themselves for another busy night. 14 patients are scheduled to arrive, including US soldiers hit by a suicide bomb and children with shrapnel wounds from another blast.

MARC DAUPHIN, OFFICER-IN-CHARGE: Lost his eyes, lost a leg, lost a hand. This one shot in the foot. This one shot in the head.

SALLY SARA: Do you normally keep a track on your hand?

MARC DAUPHIN: Well, they don't issue us with pads, you know. It's the Canadian Government ... (Laughs).

SALLY SARA: The officer-in-charge is Canadian Major Marc Dauphin. He's been a trauma doctor for more than 30 years and has no desire to quit.

MARC DAUPHIN: I'm an old guy; I should be retired now, and I spend my time in Afghanistan doing this crazy work. So, you have to do it for the love of your brothers in arms and to try and help the people here.

SALLY SARA: The Role Three hospital is staffed by more than 100 doctors, nurses and medics from around the world. Although it's a military hospital, almost half the patients here are civilians.

11-year-old Abdul has been severely injured by an improvised explosive device, or IED - a homemade bomb laid by the Taliban.

PHILIPPE PARENT, TRAUMA DOCTOR: Half of his jaw was taken off, I didn't see his ear. It didn't seem to touch his brain, but you never know with IED blasts; they get frags everywhere.

SALLY SARA: Doctors scan Abdul's head looking for shrapnel and bleeding. The explosion was so powerful it killed his brother instantly, but doctors are hoping that Abdul's jaw and not his brain has taken the force of the blast.

PHILIPPE PARENT: If his brain is not affected, his prospects are quite good. We have (inaudible) facial surgery over here, so they're very good at reconstruction. The rest of his body seemed to be alright.

SALLY SARA: Although Abdul's face is still covered in the dirt from the explosion, his outlook is promising. It's some much-needed good news on a grim night.

This is where the civilian cost of the war is counted. Mortuary workers have just taken out the body of a 10-year-old boy who was killed in a mine explosion this morning.

He was so small that the body bag was folded in half like a suit pack, and that's how his life was carried out from this hospital.

The dead boy's baby sister has stitches in her head, her tiny feet are bandaged. The boy's brother lays bewildered, his arm amputated. Anxious relatives don't want their faces shown; they're frightened the Taliban will kill them if they speak out.

They've lost so much, but fear they could lose more. The suffering of the children leaves Major Dauphin barely able to speak.

MARC DAUPHIN: It's a war. Women and children always pay. That's what's worse. That's all.

SALLY SARA: Although the hospital looks after civilians, its priority is the military. The staff treat Coalition and Afghan soldiers and Taliban insurgents.

ACCURSIA BALDASSANO, CRITICAL CARE NURSE: I try not to relate it too much, because then it becomes too personal. So, you know, we just do our best to take care of them all. At the end of the day, if you've done your best, that's all we can do.

SALLY SARA: US Navy critical care nurse Lieutenant Accursia Baldassano doesn't wear her real name on her uniform; she has a nickname instead.

The medical staff protect their identities when they're treating Taliban patients because of fears of possible reprisal attacks against their families. For many of the doctors, caring for the enemy stirs up conflicting emotions.

PHILIPPE PARENT: I just don't understand their cause. I mean, we're in two different worlds and those people seem to be living 1,000 years before what we're doing right no.

So they're on their own planet, their own world and I just can't understand this.


SALLY SARA: The medicos are not insulated from the dangers of war. Even the severely injured are checked in case they have been booby trapped by the Taliban.

But for 11-year-old Abdul, there's a long journey ahead. He's been in surgery for several hours. He has 55 stitches on the side of his face, but his condition has improved and he appears to be out of danger.

PHILIPPE PARENT: He should be waking up today and I think he had a CV scan this morning, which I assume was probably normal because he's doing better, and he will be transferred to the ward today.

So tonight we'll probably be eating on his own and going home tomorrow.

SALLY SARA: The next day, Abdul is doing well and breathing on his own. The doctors say he's stable. But less than an hour after we filmed these pictures he suffered a massive brain haemorrhage.

Abdul died the following morning. Hospital staff found his father just in time so he could hold his son's hand.

KRISTINE DESJARDINE, CRITICAL CARE NURSE: He was explaining to me he had four children - two daughters.

And he said, "Can you please try everything to do - to save my son. This is my last son. This is my only hope." So he was quite sad.

SALLY SARA: Abdul's father lost his second son in two days. Abdul's empty bed will soon be filled by another patient fighting for life and another family will be plunged into uncertainty.

MARC DAUPHIN: We cannot feel the pain that these people have. We can try to imagine it, but we can't feel it.

LEIGH SALES: Sally Sara reporting there from Kandahar.

Tags: unrest-conflict-and-war, afghanistan
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