The International Committee of the Red Cross are reporting that even before the initiation of Operation Moshtarak an increase in Afghan casualties is being seen in the affected areas of Helmand Province.
"The current upsurge in military operations in Helmand, particularly in the districts of Marjah, Nadali, Sangin, Nari Saraj and Lashkar Gah, has resulted in a marked increase in the number of casualties requiring emergency medical treatment.
...Over the past few weeks, staff working at the ICRC's first-aid post in Marjah have been seeing increasing numbers of war casualties, although not as many as might be expected given the scale of the fighting. Civilians and injured fighters are finding it more and more difficult to go to places where they can obtain urgently needed medical care, owing to mounting security problems and numerous roadblocks and checkpoints throughout Helmand province. It is especially difficult for people coming from rural areas to reach Helmand's capital, Lashkar Gah, where there are two hospitals. Those who do manage to reach a medical facility often succeed in doing so only after long delays.
The ICRC reminds the Afghan security forces, the international forces and the armed opposition that the sick and wounded – whether they be civilians or fighters, regardless of which side they are on – must be cared for with the least possible delay, in accordance with international humanitarian law. No distinction must be made among them on any grounds other than medical ones."