For six days in late May 2010, Emergency, an Italian NGO providing surgery and basic health care in Afghanistan since 1999, welcomed us to visit facilities they operate in the capital city of Kabul and in Panjshir, a neighboring province. We lived with their hospital staff at both places and accompanied them in their weekly trips to various FAPs (first aid posts) which the hospitals maintain in small outlying villages.
One morning, accompanying a field officer from the Kabul hospital, we pulled off of the main road and traveled over unpaved lanes, then walked a short distance to a shady grove outside a small Afghan village. Villagers, eager to welcome Emergency’s staff and drivers, served ripe mulberries and a salty cucumber yogurt drink. We sat in a circle, shaded by the trees. When breezes stirred the branches, we’d enjoy a momentary rain of mulberries, much to the amusement of little children nearby.
The five youngsters, ages 5 to 10, smiled shyly at us, shook our hands, and then joined their
older brother to systematically gather mulberries. Using a large
hoe, the older brother slammed the tree trunk. The children caught
the cascading mulberries in a plastic tarp. Then they sorted the fruits,
seeming to take discipline and routine for granted.
Earlier, Felippo, an Emergency
nurse in Panjshir, had told us about how hard life can be for Afghan
children in rural areas. “They never get a day off,” exclaimed
Felippo. “Never. If they attend school, and school is closed
for a day, the kids join workers in the fields.” Felippo, who has
been to Afghanistan for three six-month rotations, fantasizes about
building a theme park where kids could play and be entertained.
The majority of Afghanistan’s
agricultural laborers, both children and adults, face harsh realities.
Many villagers have little
access to health care or education. Diseases such as pneumonia,
gastroenteritis,
malaria, and malnourishment contribute toward the deaths of 850 Afghan
children every day.
In rural areas, a family
typically
has 10-15 children. Not all are expected to survive.
When a child is born, a ceremony to name the infant takes place several
months later because the child’s survival of the first months of life
is a cause for great relief and celebration.
Felippo’s supervisor, Micha,
the medical director at the Panjshir Hospital, explains that
malnutrition
is a social problem. “Mothers aren’t instructed about nutrition,”
she says. “Sometimes in large families, the 4-year-old is in charge
of the 1-year-old. Or the mother doesn’t breast feed during
the first month, the most crucial month. If fraternal twins
are born, the boy will be breast-fed, but not the girl.”
“They don’t come to the
hospital when symptoms of sickness appear,” Micha continues. “They
wait till a child is near death. Malnutrition is difficult to manage.
Children will become healthy, but the malnourishment recurs; it’s
often fatal.”
“Poor hygiene is another
serious problem, especially if families can’t provide clean water,”
Micha pointed out, “and, you see, this is also related to poverty.
Sometimes the children drink unclean water, causing gastroenteritis.”
Intent on helping solve these
basic problems, Emergency workers use the FAPs to educate people about
nutrition and basic hygiene. In winter months, the roads often
become impassable. In some places, Felippo hikes for two hours beyond
the point where a vehicle can’t continue, carrying medicine and supplies
in his backpack.
“Can you imagine,” asked
Felippo, “that last year, when I finished my term of service, in
January,
when it was my last visit to a first aid post that is furthest from
our hospital, people walked four hours in the snow to say goodbye to
me? Yes, I fell in love.”
It isn’t hard to imagine
why the staff feels so loyal to Emergency’s patients and to the
organization’s
goals.
Emergency is treating war victims as patients, and it won’t allow
police or military to enter the hospital carrying weapons. The
circumstances that occasion an injury or a wound never determine
whether or not the patient will be admitted. While neutral regarding
offering medical treatment, Emergency has been clearly partisan in its
rejection of all wars. Their literature and outreach clarifies that the
most important preventive measure to safeguard against war-related
wounds and injuries is the abolition of weapons.
In a pediatric ward at the
Emergency hospital in Kabul, doctors and nurses tend youngsters who’ve
mainly been hurt by landmines. Sometimes the boys go outside and sit
on the grass with older fellows. Many share in common the experience
of having lost limbs or fingers or toes to land mines or remote-controlled
explosions.
One afternoon, we sat in the hospital garden listening to the director
of an Afghanistan human rights NGO talk about plans for President Hamid
Karzai’s peace jirga, scheduled to begin on June 2, in
a tent outside of Kabul. Sixteen hundred people are expected to attend. We
watched boys and young men assemble in a circle, all wearing thin
hospital
gowns, most with bandaged limbs and some having suffered amputations.
They were each from different regions and likely held quite divergent
views… a jirga of sorts.
Esmatullah, 7, came
to the hospital a month ago because of a mine injury. He is from the
Paktika province. “He has never cried, not once,” said Anil,
the hospital’s physical therapist. “Not while dressings were being
changed, not during physical therapy. He’s a real Pashtun.” Esmatullah
beamed when Anil patted him on the head.
Anidullah, 11, suffered
a bullet injury. He was studying inside the mosque, in his town
in the Ghazni province, when a battle erupted between U.S. and Taliban
fighters. He doesn’t know which side hit him.
Nur Said, a teenager, lost
one eye and has only one finger on his right hand. He is learning to
feed himself. An unexploded device exploded when he picked it
up. Sometimes the children try to open up the unexploded devices
and take out the brass so that they can sell it.
A young man, 21, was
injured
when he was a driver for U.S. forces. He said that the U.S. convoys
have GPS systems for the front car and the back car in each convoy.
He was driving a Land Cruiser, in the middle of a U.S. military convoy,
without the benefit of a GPS.
“I could tell a lot of
stories,”
he says. “Some people were killed for no reason.”
After he was injured, the U.S.
forces brought him by helicopter to Emergency’s hospital in Lashkar
Gah, where treatment, as in all Emergency facilities, is free of charge.
Emergency staff then brought him to Kabul for surgery. The U.S. hasn’t
offered this young man any compensation or assistance for future
rehabilitation.
He’s anxious not to talk more about his case for fear of being harmed.
But asked what he would do
if U.S. forces attacked his family, he said he would fight. “I
would react against them if they killed my family. If I lose my
family, I don’t want the life.”
Unlike ourselves on this visit,
the Emergency staff doesn’t ask many questions about what brought
patients to their hospital. Their all-consuming task is to help them
leave, healed and, as much as possible, physically rehabilitated.
Still, they can’t help but
feel frustrations over problems that could be solved if the Westerners
who have come to Afghanistan would establish priorities more sympathetic
to human needs.
“The price of fuel for one
of the U.S. warplanes roaring overhead, on a routine flight between
Bagram and Kabul, could allow many creative choices if it were made
available to an Afghan village,” said Noor Akbari, an analyst
working for the Ministry of Agriculture. “Villagers could build a
health center, buy a communally owned pump, get assistance to spray
the trees, hire a midwife, or organize agronomy training and literacy
programs.”
Anil suggests that the concrete used for protective blocks surrounding U.S. bases and checkpoints could build as many as 10 dams to provide electricity for people.
Felippo notes that the Italian government spends $1 million every day to maintain Italy’s military presence in Afghanistan. “What could we do with just one day of their funds?” asks Felippo. “We could build another hospital.”
As the eight-year long war
drags on, claiming more victims every day, the U.S. develops
increasingly
sophisticated means of surveillance, laser-guided bombing, and robotic
weaponry. Meanwhile, Taliban bomb-makers develop their expertise
and teach new recruits to make and plant explosives. “In 2007 there
were 2,600 attacks, in Afghanistan, using homemade bombs. In January
alone, in 2010, there were 1,000 bomb attacks,” according to a May
30 report in the Sunday Times.
“Over the past three years the U.S. military has pumped more than
£10 billion into research and technology designed to detect and
neutralize the IEDs [improvised explosive devices] that cost the
Taliban just £20 to make.”
If we want Afghans to reject the Taliban’s brand of weapon development and attacks, we in the U.S. need to show our own determination to foster the works of mercy rather than the works of war. The Emergency hospital staff, unarmed and courageous, provides a fine example.
