Nima Elbagir guest blogs from Kandahar hospital, Afghanistan.

When the Obama administrations’ then nominee for the top job in Afghanistan General Stanley McChrystal faced the Senate Armed Services committee in early June his message was unequivocal – civilian casualties were the major operational issue.

“This is a critical point. It may be the critical point. This is a struggle for the support of the Afghan people.”

Just under a fortnight later the British launched Operation Panther’s Claw in the North of Helmand, quickly followed by the US’s Operation Strike of the Sword to the south. Both designed to clean out the Taliban stronghold that Helmand had become.

A month into Panther’s claw we travelled to Mirwais Hospital in Kandahar City.

With only 350 beds it serves Afghanistan’s five southern regions – a population of nearly four million. It’s the only hospital in the South with the Surgical facilities to treat trauma victims. And it’s where those caught in the operations against the Taliban in Helmand have been coming.

My cameraman Jake and I are both based in Kabul so we’re used to hearing the figures on civilian casualties. We went into Mirwais knowing the figures keep rising, we knew this was looking to be the deadliest summer for civilian’s since the conflict began.

But what the statistics conspire to obscure are the numbers of civilians who die because of the war but aren’t felled by a bullet or a bomb.

Although whether McChrystal and the coalition like it, nearly two months after that Senate hearing, most of the patients operated on at Mirwais were there because of bullets and bombs.

On our first day we were taken round by a man who’d lost his grand-daughter in a coalition air strike on his village. Lying next to his bereaved son was another man, naked with his exposed back covered in shrapnel scars. He’d lost his cousin and nephew in another aerial strike on the same night.

And then there was the young man who’d lost his whole family in a US mortar strike.

We spent our first few days in a daze filming a litany of coalition casualties.

None believed they were the unfortunate victims of mistakes or miscalculations – one man told us, “the Americans do not recognise their friends from their enemies.”

But what was unexpected was the children, the dozens and dozens of children, who came in every day.

Unicef rates Afghanistan as having the second highest infant mortality rate in the world and the insecurity plays an ever greater role.

Staff and parents at Mirwais both told us the choice is simple – wait, praying for a window of calm or risk the journey to the hospital through the violence. Wait and risk your child’s life. Go and risk everything.

We stayed in Kandahar with the International Committee of the Red Cross who support Mirwais. They have the largest expatriate post in Kandahar, an incredibly lonely position to be in. The work they do is incredible.

Unlike many other Hospital’s in Afghanistan the generator’s never run out of fuel and the medicines are to international standard.

The ICRC trained surgeons are running at capacity, they carry out 700 surgeries a month, of which 600 are on war wounded. And over the next few weeks they are erecting operating theatre tents on the hospital’s grounds to deal with the continuing influx.

Even coming from Kabul, believing that you know a little of the situation on the ground, that you’ve heard the stories elsewhere. You are still unprepared for what you see here.

Victims of aerial bombardment and cross fire, victims of living too near coalition bases or walking down roads the Taliban don’t want built.

Victims of living their life in the middle of a war.