Afghan National Army counts cost of war

Kabul's 400-bed hospital has treated the wounded from Afghanistan's wars for 30 years since it was built during the Soviet occupation.

Its sunlit wards, overlooking a small park, are now filled with men wounded in fighting against the Taliban.

Nasir Ahmed had both his legs amputated high in the thigh. He received these appalling injuries in Kandahar, stepping on a mine after he followed other soldiers jumping over a wall.

He has not been able to walk with the only prosthetic limbs available here, so will be flown to Turkey for further treatment. His morale remains high. He was engaged before he was wounded, and said his fiancee still wants to get married.

"She is proud of me for losing my limbs for my country and our people. Thank God I am alive. I joined the army to serve my country."

He was the only breadwinner in his family, in a country where employment in the military is one of the few growth industries.

Afghan government forces - in the police, army and other services - are close to the size of around 350,000 that Nato hopes to have built by the time they finally end their combat mission next year.

The force has been built from a very low base, and is growing both in numbers and ability, "getting good enough" in the words of the International Security Assistance Force (Isaf) commander General Joseph Dunford, speaking to the BBC earlier this week.

Five years ago there were three times as many international troops as Afghan troops on the ground, now the ratio is the other way round.

Next week, Afghan government forces will take the combat lead across the whole country for the first time, a significant milestone in the country's road towards sovereignty after the US-led invasion in 2001.

Between then and the end of the Nato combat mission in December 2014, international troops will have a supporting role, responding when called on.

The last districts to be handed over to Afghan combat lead are mostly in the east in the mountainous frontier provinces south of the Khyber Pass that the US have nicknamed "P2K" - Paktiya, Paktika and Khost.

During a recent reporting assignment in that area, I saw far more competent Afghan forces than I have witnessed before.

They had high morale, good equipment, were using GPS and other modern equipment with confidence and had the ability to call in accurate artillery strikes from several kilometres away.

This could make all the difference as they operate on their own - replacing the Nato air support that they have relied on up to now. It will be some time before the Afghan forces are equipped with significant air power.

The growing competence is seen in the response to several recent attacks on the Afghan capital, Kabul.

In two of the attacks in the last month, militants seized buildings and needed to be confronted. Newly trained rapid reaction police acted swiftly to retake control. Civilian casualties have been very low.

But the pressures on these forces are substantial. As well as death and injury, the Afghan police and army are losing thousands to desertion, at an attrition rate that requires them to sign up 50,000 new recruits every year to replace those lost.

This is "unsustainable", according to Gen Nick Carter, the deputy commander of Isaf and most senior British general in the country. He said it was essential that Afghan forces give their troops more time off and better training opportunities.

Gen Carter called on Afghanistan to support its armed forces better, concerned that those doing the fighting are remote from the daily lives of the country. He said that Afghan forces are "bleeding for the population, the population needs to lean in to support them".

But not all of the population support the government.

This complex campaign is not only being fought between the Afghan Taliban and the alliance of the international coalition and government forces.

In the east, Pakistani-backed militant groups are more prominent this year, in the north-east Uzbek Islamists are fighting, and there is a nexus between criminal and drug gangs.

Families carrying away coffins from the military hospital - a sad steady stream - are offered Afghan flags to honour the fact their loved ones died for their country.

But many prefer a simple drape of funeral black, as they are driving through areas where being identified as a military family would risk reprisals.

Last year about 10 times as many Afghan security force members as Isaf troops were killed. This year the difference is even higher.

There are several reasons for the far higher rate of Afghan casualties, connected to their own competence, the strength of the insurgency and their ability to treat casualties quickly.

Gen Carter said that one of the key assets which international forces will continue to provide until the end of 2014 is helicopter support to evacuate casualties.

In the hospital, a typical casualty, Shah Rassul, was recovering from the 10th operation to try to save his leg, shattered in an attack on his base in Helmand two years ago.

While surrounded for four months, 30 of his Afghan comrades and two British soldiers were killed.

Now the British are not in that base.

There are in fact only 13 British bases left in Afghanistan, as international troops withdraw from the field, leaving Afghan forces to lead the fight and bear the cost.