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Journey to Afghanistan - Chapter 7, page 18

The Civilian Hospital

"We want to help where possible, but we also want to learn from you." This was our approach to the physicians in Afghanistan, and indeed it was very realistic. I felt the Afghan physicians appreciated it. On several occasions it was my privilege to make patient rounds in the Civilian Hospital in Mazar-i-Sharif. I did visit the military hospital once, but most of our interactions were at the civilian facility.

At that time the hospital was in large need of repair. Walls had cracks and peeling paint. A blanket was used for the exterior door in one place. Inside the beds and bedding were old and worn. There were few added niceties like chairs, bedside tables or lamps. But it was not trashy, it was being kept clean, and it became obvious that health-care workers were doing well with what was available.

The Civilian Hospital had three main buildings and some smaller ones. One appeared to be used primarily for orthopedics and surgery, another for gynecological problems and pediatrics and the larger building for internal medicine, some offices and separate rooms for men and women who needed to be seen on an emergency basis. A lady internist told us that during the time of the Taliban she could only work in the section for women and children. She was not allowed to care for men patients nor could men generally care for women. However, most women were not allowed to work outside the home. She felt fortunate.

As we walked up the front steps of the Internal Medicine building we saw a young girl struggling to get a glass of water at a hand pump near the base of the stairs. She would pull the pump handle down and hurry to reach the spout with her cup on the opposite side; always too late to catch the water. Jackie and I stopped a bit to help. While I worked the handle, the little girl collected her cup of water, gave us a shy smile, then hurried off.

After meeting and greeting Doctors Sadiqi and Yawsi and their entourage we proceeded down a large and very dimly lit hall toward the several separate rooms for men and women. I observed that often family members were there with the patients. In addition to several staff doctors, we were accompanied by young physicians who were in their residency training. It was routine for history and physical findings, much as we do during rounds in American hospitals. However, of particular note was that there was very scanty lab-work presented, simply, as I learned, because it was seldom available and therefore generally not done. The resident doctor would then present his or her differential diagnosis and what was being done. Doctor Yawsi and Sidiqi as well as others of the hospital staff would grill the young physician with great intensity. I found myself feeling sorry for the resident doctors. However, I also marveled at how well versed they were in western medicine. Most spoke English, at least to some extent. I was told that probably eighty percent of their schoolwork was done in English.

As we proceeded from bed to bed it fell my lot, as the eldest, to walk at the head of the group and even to ask the first questions, if I so wished.

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