Emergency USA
EMERGENCY USA is a USA based organization devoted to the promotion of a culture of solidarity, peace and respect for human rights.
EMERGENCY USA provides support to projects that offer free, high quality medical and surgical treatment for the victims of war and poverty.
News from the Field
EMERGENCY in Afghanistan:
Beyond an Ordinary Hospital
THE EXPERIENCE was indeed a rewarding one. I have just returned from Afghanistan where I was visiting EMERGENCY hospitals in Panjshir and Kabul.
The EMERGENCY hospital in Panjshir was built in one of Afghanistan’s mountainous territories in the village of Anabah: a remote and impoverished area. EMERGENCY maintains the only hospital in the area and provides excellent medical care while respecting the dignity of patients and the culture of the region. Panjshir, due to its vicinity to Kabul and its strategic value, was plagued by war during the past twenty-five years. It is located northeast of Kabul. The people of the area—mainly civilians—have suffered tremendously. In spite of the painful history of this region, when I arrived I was greeted at Lion's Gate, the entrance to the valley, by old and young faces, warm faces of children, some tired, some scared, but each person ever inspired and hospitable. At the EMERGENCY Panjshir hospital, I noticed first the sign “NO WEAPONS” painted in red letters on a white board and a little further on, I found the sign “WE TAKE CARE OF PATIENTS FREE OF CHARGE.”
As a physician I specialize in Obstetrics and Gynecology so I spent the majority of my visit in that department where I had the pleasure of meeting an international group of professionals: skilled and caring physicians, midwives, and nurses. The hospital has a first-class operating room, an immaculately clean delivery room, a welcoming and comfortable postpartum ward for new mothers, and a well-equipped nursery for newborns. I was particularly amazed to see the degree of careful attention to detail in this hospital since it is located in a remote and impoverished part of the country. In contrast, during my time in Kabul I visited some non- EMERGENCY maternity hospitals that were reportedly funded by millions of dollars. With frustration I observed that the hospitals were badly managed, and sadly in shambles. During my recent trip, as well as on a previous trip, I discussed this with authorities in Afghanistan and colleagues in the USA, informing them that the EMERGENCY hospitals provide ideal models of how to build and run a hospital and how to provide quality care to patients who need it.
As I spent time in the Obstetrics and Gynecology wards of the EMERGENCY hospitals, it gave me great joy to speak with women who had received prenatal care from the eighth or ninth week of pregnancy to the baby’s birth. They had enjoyed access to prenatal follow-ups, ultrasounds, nutrition consultations and were given advice about caring for a newborn. In this country 90 percent of pregnant women lack prenatal care partly due to culture but mainly due to decades of war resulting in the virtual absence of hospitals and clinics. The women I met at the EMERGENCY hospitals celebrated every aspect of their care and kept each appointment until delivery. As a result, each woman had a healthy pregnancy, and a healthy baby. In addition, I was encouraged to see ongoing training of national staff and midwives at the EMERGENCY hospitals. The valuable professional skills gained by the national staff will contribute to the growth of a healthcare system in Afghanistan’s future.
EMERGENCY serves several other villages in the area of Anabah with first aid and primary health centers where no other medical facilities exist. EMERGENCY provides medical care to the nomadic Kuchi people who migrate through the Panjshir valleys as they move to the high country for the summer and in my conversations with some of them I learned that they stay longer in the area in order to have prenatal care and have a delivery in the hospital. This is particularly unusual for Kuchis, since they have never had access to medical or prenatal care.
Every single pregnancy and birth is different. As an experienced physician practicing in the United States, in a state-of-the-art hospital, I have faced catastrophic obstetrical cases and have seen limits of our modern medical abilities tested by complex emergency cases. I also witnessed such cases in the EMERGENCY hospital in Panjshir and saw that they were taken care of effectively and efficiently. Unexpected cases arrive every day and night in the obstetrics floor there. One case was that of a young woman who was brought to the hospital one night during the eighth month of her first pregnancy. The day before she had been carrying bread from a bakery to her house through an area that had been inspected and declared free of mines. However, a mine had evaded detection by inspectors and as she stepped, she triggered an explosion and was severely injured. Her case demonstrates that even today roads remain littered with badly rusting tanks, obstacles, weapons and mines. When she arrived at the EMERGENCY hospital, she was taken immediately to surgery where the findings were grim: her uterus was perforated; her unborn baby did not survive, and her right leg had to be amputated below the knee. After her surgery as I sat near her bed, I could not then, and today still am not able to find an adequate word of comfort to offer her. A senseless landmine explosion had taken her leg and her baby. I am still haunted as I remember the pain she experienced in her loss while her mother sat nearby, speechless, pale and frozen. By saving her from certain death, the surgery provided by the EMERGENCY hospital communicated to her a message more powerful and hopeful than any of my words ever could in the face of such loss.
EMERGENCY in Kabul has a tremendous number of trauma cases that arise from a variety of causes. It is located in a busy section of the city. The hospital is again meticulously clean, with dedicated and skilled international staff. This is the only hospital in the country with six beds in a first-class intensive care unit, and at this point the only CT SCAN in the country. I happened to meet a family that brought a relative to the hospital with a life-threatening gunshot wound to the head. Their injured family member underwent a 12-hour operation by a neurosurgeon, and survived.
The life-supporting medical care doesn’t stop after the patient leaves the operating room table. At EMERGENCY, care is continued with excellent postoperative treatments. Sometimes children have to stay in the hospital for several months. EMERGENCY provides physical therapy, a rehabilitation program, and a playroom for children, and even a classroom with books in the native language. Teachers read and write with patients as they recover. For some amputees after recovery, EMERGENCY even provides social services and opportunities for employment
Among many wonderful and memorable experiences I had during my trip was an afternoon spent with a group of women ages seventeen to sixty as they wove carpets as part of social program of EMERGENCY s hospital in Anabah, Panjshir valley. In the room where the women worked, the essential elements of calm and safety that these women experienced were a beautiful contrast to the violence and struggle that they had each experienced. We talked for a good many hours, and slowly and tentatively they opened up to me in their own way. They talked to each other and to me bravely of their grief, pain, the war and the hurt. Their voices were resonant and comforting to each other and in the midst of it all, they laughed and they told their happy stories too. We all laughed together at times, just like all happy people in the world laugh. The redemptive power of that laughter spoke for itself while their artistic expression as they wove those beautiful carpets was made precious by the touch of their care-worn hands. Some of them were just learning this skill, showing creative drive and human dignity preserved. That was a lesson to me: no matter what circumstances they had gone through, they were discovering hope there, and it was palpable. We lifted each other’s spirits with hugs and kisses and a shared human experience, and that is how I lift this human village. No matter how much I write I will still feel inadequate to complete this message. There are so many stories, some painful some delightful.
I am thankful to those who help me to be a small part of this grand organization EMERGENCY that gives high quality medical care to patients in the most difficult situations and consistently recognizes the dignity, life and humanity of each individual. You would do no less, if you saw what I saw. Please help; keep safe the gnarled and nimble hands that weave the many-colored tapestries. Regarding support of this organization, my message is simply “Do it and the time is now.”
Sincerely,
Dr. Nafisa Abdullah
July 2006
Surgery and Obstetrics in the Panjshir Hospital
In 1999, an old police barracks in Anabah, in the Panjshir valley, was transformed into a surgical center for war victims. The conflict at the time was between the Taliban and Mujaheddin. The wounded were victims injured not only by rockets and bullets, but also by land mines spread and left behind by the Soviets in the aftermath of a silent war that continued to be waged against them. It was a war declared over, officially, but it kept generating victims, mostly civilians. The surgery center was always filled.
The following year, the initial first aid post (FAP) was opened in order to address the needs of the population living in isolated villages, with minimal means of communication, located in the mountainous terrain. At first. the wounded -- often in desperate condition -- would arrive at the new hospital after traveling for as long as two weeks. Today, patients are easily and rapidly transferred free of charge in EMERGENCY’s ambulances. Over the years, after the conflict between the Mujaheddin and Taliban ended, the center’s activities have broadened and increased in order to respond to the needs of the population.
The Anabah surgery center has become the hospital of reference for the whole valley in general surgery, pediatrics, obstetrics and gynecology ... it is medical care for peace. The network of FAPs has also expanded with the opening of outpatient departments that provide primary health care. Today there are 17 FAPs and primary health care centers in the Panjshir region and along the Salang Pass that refer patients to the surgery center. The most recently opened FAP is in Adbara, on the other side of the river opposite Anabah.
Cecilia Strada
Translated by: Cecilia Gragnani