Looking Back to Afghanistan 2008 - Part 2

Hello everyone. Happy Monday! Another week has come and gone. I'm now well into the middle third of my deployment as I previously stated. Honestly, the long hours are kicking my butt right now. There are no days off here. I must persevere. Maybe I can look back to 2008 to help me get through this.

As I alluded to in my last post, there were many lessons learned at Camp Alamo in 2008. Right off the bat it was obvious that Afghanistan is a third world country. The poverty is shocking. The lack of what we consider to be basic necessities is striking. The first thing I noticed at the Afghan base was that there was no soap. Yeah, that's right there was not a bar of soap, a container of liquid soap, or a bottle of hand sanitizer anywhere in sight. This included the barracks, the dining facilities, the clinic, and even the head general's bathroom right outside his office. The bottom line is that soap is not a normal thing in this society. It's that simple. I was horrified. For six months I did everything that I could to get soap all over that base. I failed. It was not for lack of trying. There were forces so far out of my control that it made it nearly impossible. The bottom line is that I first had to convince the Afghans that soap was an important thing. The doctors and the medics understood it. The army recruits did not. Most of them were peasants. We sent out an order for 10,000 cases of soap for the Kabul Military Training Center. It never came. Why? Quite frankly, the person at the other end of this order probably threw the order away. After all, if that entire base never had soap before, then why would they need it now? I could have easily written a letter to Proctor and Gamble to get a ton of soap. But, that would be a temporary solution. And, in this war temporary solutions are pointless. Changes and improvements need to be sustainable. We failed on soap, but we did make some progress on needles. When I arrived at the Military Entrance Processing Station (MEPS) Clinic, hypodermic needles and syringes were being thrown directly into the garbage. American tax dollars were paying for all Afghan army recruits to get 6 vaccinations upon entry into the Afghan National Army (ANA). Those needles went into a garbage can and were mixed in with garbage from all over base. I was disgusted by this. One day, a garbage worked stepped on a needle and developed a raging infection. He almost lost his leg. Something needed to be done. With the help of my colleague Major Ron Greenaway and one of our interpreters, 500 red plastic buckets were purchased. We began using those as sharps containers. We effectively eliminated this work place hazard. It was probably our biggest success in my time there.

The most enlightening and fulfilling aspect of my job as an Afghan trainer was getting to know the Afghan doctors. I worked with 9 Afghan doctors and physician assistants. A few of them were very smart and talented. A few had potential. Several of them had no business being in medicine. Nevertheless, I spent hours getting to know them. We talked about their lives. We talked about their medical training. We talked about their opinions on the war. What I learned is that the average Afghan lives a life of fear. They are afraid of violence from the terrorists and the Taliban all day every day. They fear for the safety of their families. The fact that they were members of the ANA was a secret outside the gates of the base. Wearing an army uniform casually in the streets of Kabul is a death wish. Maybe that has improved in the last 2 years, but I doubt it. The Afghans value family a great deal. A normal greeting is to say hello then immediately ask how their family is doing. They would always ask me how my family was doing. Most of them live with or near their extended families. Marriages are arranged. My friend Yama got engaged while I was there. I asked him how he could deal with an arranged marriage. He simply said that he trusted his family 100% to find the right person for him. I thought that was pretty cool, especially since I am a single guy with many ridiculous experiences in the dating world! One other thing that we talked about at length was religion. Yeah that's right, I even broached this controversial subject with my Afghan friends. They were all muslims of course. I was there during the muslim holy month of ramadan. Things basically shut down for 4 weeks. It's not that much different than our holiday season when you think about it. Muslims of course have many different customs that Christians. But, I think that the values taught in their religion are pretty similar to what I learned growing up catholic. They believe in regular prayer and are more disciplined at doing this than most Christians. I think the most important thing that I learned is that only a very small percentage of muslims are extremists that make up terrorist cells. This is not ground breaking information, but it was important to for me to confirm this first hand. In the end, I make some good friends. I truly do consider Dr. Yama, Dr. Zaman, Dr.Farid, Dr. Masood, etc good friends. It's unfortunate that I will probably never see any of them again.

Well, I must get going back to work. A ward full of patients is waiting for me. This morning alone we admitted 10 patients all before 10 in the morning. We are busy to say the least and this will likely continue through the spring and summer. So, when the going gets tough, I can look back at my previous deployment knowing full well that I can make it through this just like I did in 2008.