DON'T FORGET OUR PROMISE TO AFGHANS.
Member of the Executive committee, AMAA
Date:
From:nhuf@ix.netcom.com
To:stanisai@aol.com
The viewpoint section.
This past April, I decided to return to my war-torn homeland to see the conditions there firsthand. What I saw saddened me.
Despite promises by the international community to help
reconstruct
As a visiting physician and an expatriate, I felt
compelled to use my skills during my four week "vacation" to help
women and children in need of medical assistance in the city. I chose to work
with female doctors in the department of obstetrics and gynecology at the
This hospital, I was told, had been visited six months
earlier by representatives from the U.S. Department of Health and Human Services
who promised that it would become one of the most modern women and children's
medical facilities anywhere. So on April 21st, I was honored to be present when
officials from the Afghan Department of Public Health, the U.S. embassy, the
U.S. Department of Health and Human Services and a host of dignitaries came for
a ribbon cutting ceremony and tour of the hospital.
What I saw in the hospital, where I was to begin work
within two days, however, showed me that ribbon cuttings and visits by
dignitaries are not the solution to the health care problems of the Afghan
people. A spruced up facility for one day does not make the cut in the long run.
The quality of
Forty-eight hours later, I began work in my tiny corner
of this hospital and was confronted with the real condition of Afghan medicine.
The delivery
rate for newborns was 55 to 80 per day. There were times
when 20 to 30 women were in active labor, some with high risk and complicated
pregnancies, giving birth with very little care, some on cold and naked steel
delivery room tables of which there were few. Others, with sad and wizened
faces, lay on the cement floor or with one or two of their countrywomen on a
flat cushion, wrapped only in their shawls. These were the lucky ones.
I say this because the vast majority of Afghan women
receive no prenatal care. Also, most deliveries still occur at home because
women may be unable to get to a hospital or may not have the permission of a
male family member to "go out." As a consequence, the mortality rate
for mothers and their infants is unacceptably high by any standard.
What I saw in the operating room was equally disturbing.
It was not unusual during a major operation for my scrub nurse to tell me
"I'm sorry, there are no more sutures." Patients coming to this
hospital often had to bring sutures, blood and antibiotics for their own
surgeries. If the supply of sutures was depleted in the middle of an operation,
the patient's relatives would be sent out to buy more, if they had the money.
Electric power was also a frequent problem. This
"model" hospital did not even have a back up generator, so surgery
sometimes had to be performed by candlelight when the antiquated power grid in
Why should we care about this situation? In many ways,
it is a simple matter of integrity. As part of the war on terrorism,
The sorry state of the medical system is just one
example of the neglect by the international community that I observed during my
tenure. Yes, some small progress has been made, but in my view, it would be a
big mistake to let this incremental
approach continue, if the world wants a stable and peaceful
Having been there in person, all of what I observed and
experienced has motivated me to do my best to bring the world's attention back
to this seemingly faraway, but hugely important country.
Anyone who saw the suffering and chaos that I did could
do no less.
Nafisa Abdullah, M.D., practices Obstetrics and
Gynecology at the
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