Week 14--Afghanis I Have Known

I was going to write a long entry about all the Afghanis I know and work with here at FOB Salerno and in Khowst. However, as I gathered information and talked to my Afghan friends I realized that the last thing they want is their name and/or picture posted on the internet. The same technology we use to keep in touch and share our lives with friends and family, the insurgents use to target the Afghans who work with the Coalition Forces. I'm sad to say that I personally know of many, here and in Iraq, who have been killed just for working with the US Army.

So, I'll tell this story without pictures or names. In a place where suicide bombers and assisinations are common, it's just too dangerous to do it any other way.

Here in Afghanistan I work with Afghanis every day. It's one of the most rewarding parts of my job. I've changed since my tour in Iraq, so I have a more objective view of my "terps", as they are called here.
So far I have found the them to be smart, reliable and hard working. The ones who work with us here on the FOB are now familiar with American culture and idiosyncrasies. The ones we work with outside the FOB are curious and reserved, but interested in learning more about America and Americans.

Most of our patients are Afghani. It's probably split almost evenly; soldiers and civilians. The Afghan Army Soldiers are, as you imagine, tough fighters. But what I didn't expect is their "esprit de corps". Just like US Soldiers, when they wake up after surgery their first question is, "when can I go back to my unit?". Just like US Soldiers, their commanders and leaders call to check on them and visit them in the hospital. They seem to be loyal; to Afghanistan, the army and their unit. The way ahead for us is making their Army self sufficient. There can be no freedom or progress without security. We are doing our part by ensuring they get excellent trauma care when they are wounded or injured.

The other half of our patients are civilians; both elective cases and trauma. The elective cases are the best; we relieve suffering, improve quality of life and train the Afghan healthcare providers all at the same time. The Afghani doctors, nurses and medics with whom we work provide much of the care to our afghani patients. In this way we increase their capabilities and set them on a path to independence in the health sector.
The trauma cases are not as nice, but sometimes very rewarding. Afghanistan is a violent, dangerous place and trauma is common. Just this last weekend the news reported two bombings in Khowst. Most of the patients are treated at local hospitals, but sometimes we can assist them if the number of injuries or the nature of the injuries exceed their capabilities. In many cases we are able to save lives and ease suffering after senseless, violent attacks. And no matter the outcome, I have received nothing but thanks and gratitude from patients and families of patients for the treatment and care we provided.

Our Afghani staff consists of doctors, nurses and medics. They work with us in all aspects of patient care. We could not do our job without them. As a miniumum, they translate between English and Pashto. Often they provide patient care alongside US providers. Of course, many of them would love to travel to the US to study or live, but they also retain a hope for their country, a hope for the future and a hope for their children. Like security, healthcare is essential for this country to move forward and improve.

The Afghanis I deal with "outside the wire" are totally different. They are understandably guarded, since they never know who is watching or listening. But still, I find them interested in all things American and optimistic about the future. Khowst Province is poor, and it has seen decades of continuous conflict, but it is undergoing a transformation. New schools, new homes, new roads, new hospitals and clinics are all easy to see. Afghanis still shop and travel, marry and have children, all with one eye on the past and one eye on the future.

One important note: I rarely deal with any Afghani women. I've worked with one female Afghani doctor and I routinely see female Afghani patients in the clinic and on the ward. But in all instances, they remain quiet and as covered as possible, even during a physical exam, even in a patient bed on the ward. I remember one trip into Khowst where we entered a courtyard, accompanied by our Afghani host, where several women were waiting, uncovered. They paused just long enough to watch us enter the courtyard, then covered their heads and faces and exited the courtyard as quickly as possible. On another occassion I was talking to a doctor as he conducted some patient teaching with a female patient in the clinic. The patient sat on the bed, completely covered from head to toe, with her husband beside her, while the doctor relayed his instructions and recommendations through the interpreter. It's just another part of living and working here in the Islamic Republic of Afghanistan. It's just another reason to rely on our interpreters and Afghani healthcare providers when we are treating and dealing with Afghani patients.

Overall, this is a great job. It's easy to get depressed; the days are long and work never stops and I miss my family. But it's also easy to see the progress we are making and the lives we are changing. The American people should be proud of the job the Soldiers, Sailors, Airmen and Marines are doing here and all over the world. The represent the best of America, and they do it under less than ideal circumstances.

Thank you and may God Bless You.

Until next time....