Peshawar, Pakistan — ``We've never had so many women and children as in the past year, '' Franoise Ruffinen, chief delegate of the International Committee of the Red Cross, giving a tour of its crowded war casualty hospital in Peshawar. ``Last night, seven women and 12 children were brought in.'' For a reporter covering the Afghan conflict, visits to this Northwest Frontier hospital provide a tragic but necessary insight into gauging the brutality and intensity of the war against the Soviets. Victims include guerrilla fighters as well as civilians, carried in for treatment by camel, horse, vehicle, and on foot from the border regions of Afghanistan and beyond.
``We were completely overrun during the summer. . . . We had to set up a secondary hospital tent just to cope,'' added Ms. Ruffinen.
This reporter has witnessed such scenes during the past six years both inside and outside Afghanistan. Still, the quiet suffering is no easier to behold: the nine-year-old girl with 70 percent of her body burned during a Soviet aerial bombardment; a mother, little boys, old men, whose limbs were blown away by mines or bombs.
For the 6 to 8 million Afghans living in areas not controlled by the Soviet occupation forces, the Red Cross clinics, although based in Pakistan, represent the only sophisticated form of treatment for war injured.
Nevertheless, cross-border relief to the interior ranging from food supplies to basic health care and education is beginning to improve. For one thing, Afghan resistance organizations, now aware that they are facing a long war, are making more concerted efforts to coordinate assistance that will enable their people to survive in the years ahead.
At the international level various voluntary agencies have been furnishing limited humanitarian assistance inside the country, mainly medical and food relief, for a number of years. Yet it is only in the past 18 months that the world, notably the United States, seems to have awakened to the need for more concerted action to counter Moscow's war of attrition against civilians.
President Reagan, in a statement Friday -- marking the sixth anniversary of the Soviet invasion -- said, ``The United States stands squarely on the side of the people of Afghanistan and will continue its support of their historic struggle in the cause of liberty.''
Resistance representatives stress that the guerrillas are ``quite capable'' of fighting on their own, but that civilians should be given the means to sruvive the hardships of war: medical supplies, schools, books, agricultural assistance, clothing, and famine relief.
Certainly the most important recent development has been the advent of large-scale US funding for cross-border relief -- an estimated $48 million or more over the next two years, including at least $10 million for transportation and non-miltary activities.
The US Agency for International Development (AID) in Islamabad has refused to comment publicly on how these funds are to be spent. But according to Western sources they will be channelled toward health, education, and other forms of humanitarian aid inside Afghanistan.
Though welcome, this surge of aid has caused European and other Western relief representatives to express concern about the way the US intends to distribute it. Too much sudden aid, they feel, could prove detrimental to the resistance cause and lead to further corruption, even disunity among the parties. Peshawar already hosts many international relief agencies, all intent on running their own humanitarian projects.
``We can only hope that the Americans will exercise caution,'' said Anders Fange of a Swedish aid committee.
Observers also feel that AID is proving too dependent on the Pakistani government. Unlike other agencies with humanitarian experience in Afghanistan, the US seems to be leaning on the exiled political parties in Peshawar rather than on the more closely involved resistance commanders in Afghanistan.
``The Americans just don't understand the complexities of the Afghan situation,'' noted one Western observer. ``It's taken them years to get involved and now they suddenly know it better than anyone else.''
Other sources, however, maintain that the private agencies haven't considered the scope of what the Americans are contemplating. ``It's a matter of thinking expansively,'' commented one.
According to these sources, AID plans to operate through a proposed Pakistani organization which will coordinate relief through the seven Afghan political parties recognized by the government. While the parties generally represent most ethnic groups, the Shiite Hazara minority (one-sixth of the country's population) has not been included in the US relief strategy.
The Pakistanis are known to favor the more fundamentalist Pushtun-dominated Afghan groups, notably Hekmatyar Gulbuddin's Hezb-e Inqilab-e Islam-e faction. Hekmatyar is viewed by many informed observers as the most controversial and ruthless of the Peshawar leaders.
Private relief agencies are worried that Pakistan could eventually curtail their ties with the interior and oblige them to work under Pakistani control. ``In the beginning,'' said American Steve Keller of the International Rescue Committee, ``the idea was to cut out the Peshawar leaders. But the US has now surrendered to the Pakistanis on every point.''
US officials in Washington and Islamabad apparently favor backing Hekmatyar. Similarly, some refer to the Afghan struggle as a ``Pathan-run war'' even though the resistance is made up of a patchwork of guerrilla fronts representating different tribal and ethnic groups. While some of its top chiefs are indeed Pushtun (Pathan), other highly reputed leaders such as Tajik commander Ahmed Shah Massoud of the Panjshair or Hazara Sayid Jaghlan of Ghazni are not. Next: Interview with a top guerrilla commander