Following an explosion at midday Thursday in Mingora, the main city of Swat district in Khyber Pakhtunkhwa province, Pakistan, medical staff from the emergency organization Médecins Sans Frontières (MSF) and Pakistan’s Ministry of Health treated 58 injured people, some of whom were seriously wounded. “Soon after the blast occurred we started to receive a steady flow of people at the emergency room of Saidu Group Teaching Hospital. We’ve seen 58 patients, including women and children. Most are now in a stable state, but two patients are still in critical condition,” said Sonoko Shidehara, a doctor working with MSF in Swat. Emergency preparedness is crucial for an adequate response to events like this, so hospital staff are being trained to implement triage and mass casualty plans which enable the sorting of injured people into groups according to their needs. “This means that we can first give immediate and urgent medical care to those most seriously wounded,” explained Dr. Shidehara. “People arrived with severe head traumas, chest injuries and serious shrapnel related wounds in their arms and legs.” “The explosion occurred at a busy time of the day, and afterwards, crowds rushed to the hospital to see what happened and to check on family and friends. When people gather in the emergency room, this compromises the space we need to carry out urgent medical activities. However, through the cooperation of those around, we did manage to keep only patients and medical staff inside the ER,” said Josep Prior, MSF field coordinator in Swat. After a one year absence, MSF recently returned to Swat to address specific medical needs identified in the casualty department of this hospital. Working together with staff from the Ministry of Health, MSF teams are now boosting work in the emergency room by providing medical personnel, regular trainings, specialized emergency equipment, and life-saving drugs all free of charge. As a medical organization focused on providing emergency medical care, MSF is not involved in any efforts to rebuild Swat, nor is it part of any military or political strategy. To maintain its independence, MSF chooses to rely solely on private donations, and does not accept funding from any government for its work in Pakistan. To be able to provide life-saving assistance to patients in need, MSF urges all members of the community, political parties, armed forces and armed opposition to respect the neutrality of health facilities.