Till the Last Bird Sings: A Graphic Novel About Access to Care in Afghanistan

Afghanistan has almost vanished from the media since the withdrawal of international troops in 2021 despite suffering one of the most serious humanitarian crises in the world, which has had unprecedented social, economic and health repercussions.

Extreme poverty is widespread, compounded by natural disasters. Meanwhile, EMERGENCY’s surgical hospitals continue to admit patients with violent trauma from bullets, stabbings, landmines and explosive devices. Afghanistan is among the top countries contaminated by ordnance, the remnants of war intentionally left behind to devastate communities long after direct conflict ends.

Through the drawings of La Tram and the words of Francesca Romana Torre, who visited our projects in Afghanistan together in July 2023, we want to shine a light on some of the issues the Afghan people currently face, from the vantage point of our hospitals and healthcare centres.

“How has Afghanistan changed since 15 August 2021? We wanted to answer that question from the point of view of the staff and patients at EMERGENCY’s hospitals, health centres and First Aid Posts. It’s a partial view, but a thorough one, revealing the changes in a society that is experiencing a period without direct conflict for the first time in decades. The narratives of different characters who cross the country during a working day intertwine to show the mark the organisation has made on access to care and protecting health as a human right.

We do not know what the future will hold for Afghanistan, but we wanted to capture the present with a story made up of extraordinary little moments, accompanied by the singing of goldfinches: a traditional metaphor for a people who endure in spirit and celebrate their innate poetry in spite of the enormity of their situation and the vulnerability of everyday life.”

Francesca Romana Torre and La Tram

A Graphic Novel on Access to Care

Till the Last Bird Sings is inspired by EMERGENCY’s report “Access to Care in Afghanistan: Perspectives from Afghan People in 10 Provinces”, through which we sought to take a snapshot of the healthcare situation in the country, using research we carried out in ten of the Afghan provinces where we work.

Gathered from patients, caregivers, EMERGENCY’s own medical staff and those at Afghan public hospitals, the findings show the extreme difficulties for Afghans to access and afford care in the country. More than one in every five respondents had lost at least one family member or friend in the past year due to the inaccessibility of care.


After spending some years in the audio-visual field, writing several full-length films and the documentary Vicine about the Lucha y Siesta women’s shelter, Francesca Torre began working as a proof-reader at Panini Comics. In 2020, as editor of the comics section of the website Stay Nerd, she wrote an article about sexual harassment in the Italian comic book business, followed by co-founding the collective “Moleste” in October of the same year. She also curated the introductory events for Arf! Festival’s “Women in Comics” show at the Palazzo Merulana in Rome. In 2021, she was one of the contributors to the anthology Fai rumore and coordinated the publishing for Il Castoro Editore. Currently, Torre is on the editorial board of the magazine Smack!, which focuses on comics and gender equality. In 2024 her graphic novel “L’età verde” will be published by Castoro Editore.

Margherita Tramutoli – La Tram – has a degree in International Relations and a diploma in Comic drawing and colouring. She started as an aid worker and graphic designer for non-profit organisations, then went on to put her concern for social issues into comics and illustration. Her work includes “Bandierine-Tutta una storia di resistenze” (Barta Edizioni, texts by Tuono Pettinato), “Post Pink-Antologia di fumetto femminista” (Feltrinelli), “Sister Resist” (Beccogiallo), “Il mostruoso femminile” (Tlon) and “La prima bomba” (Feltrinelli, texts by Marzo Rizzo). She has worked with Jacobin, Linus, L’Espresso, Il Corriere della Sera, Sonzogno, Salani and La Revue Dessinée Italia. La Tram is one of the founders of “Moleste,” the collective for gender equality in the comic book business, which produced the anthology “Fai rumore” (Il Castoro Editore), with a story written by Francesca Torre. She teaches colour theory at The Sign: Comics&Arts Academy in Florence.


EMERGENCY NGO is an independent non-governmental organisation that provides free, high-quality medical and surgical treatment to victims of war, landmines and poverty. It promotes a culture of peace, solidarity and respect for human rights.

Since 1994, EMERGENCY has worked in 20 countries around the world, providing free medical care in accordance with its core principles: equality, quality and social responsibility. EMERGENCY has been present in Afghanistan since 1999, treating over 8.5 million people.

This graphic novel was made possible thanks to humanitarian funding from the European Union.


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