Scarred by war, sapped by illness

Victims: Afghans gather each morning, seeking a doctor's care. But the hospital is unsanitary and short of drugs, and curable diseases go untreated.

October 17, 2001|By Douglas Birch | Douglas Birch,SUN FOREIGN STAFF

CHARIKAR, Afghanistan - In the hallway of the hospital here, yesterday's casualties of Afghanistan's two decades of warfare squatted in wait for treatment.

Twelve-year-old Hangama, a pale, listless girl clinging to her mother, had typhoid fever. Plump, bleary-eyed Ataq, 5, had leishmaniasis, a debilitating parasitic disease spread by the bite of a sandfly. Another boy had tuberculosis. A 7-year-old girl suffered from chronic diarrhea.

Most of the scores of people who gather here each morning bear no bullet wounds. But they suffer and sometimes die from measles, polio or other diseases that could be easily prevented or cured if clashing armies had not destroyed many of the region's hospitals, frightened off many of its doctors, and made it virtually impossible to stock drugs and medical supplies.

"The cause of this," said Dr. Muhammed Qasem, the hospital's deputy director, "is war."

Charikar Hospital has seen a lot of war. Built in 1937 during the reign of Afghanistan's now- exiled king, Zahir Shah, the hospital once had an elegance lent by high ceilings, tile floors and arched porches. It now is a shambles. It has been bombed, sprayed with gunfire, looted and rocketed, as recently as two weeks ago.

Last year, rockets destroyed the electrical generators and medical refrigerators. There is no electricity, no running water, no X-ray machines and few drugs. The wards are lighted by lanterns and warmed by wood stoves.

The operating room has an oil-powered steam sterilizer and a rust-covered operating table. There is no ventilator to keep patients breathing, just a hand-squeezed leather bag fitted with a plastic mask. The room looks far from sterile. "Sometimes we wash it," a surgeon said.

Some civilian patients are indirect victims of the seesaw battles between the Northern Alliance and the Taliban regime. The sides face off across the Shomali Plain, an intensively farmed patchwork of bean fields, apple orchards and rice paddies. Farmers and their families either work the land or starve - and encounter land mines, small-arms fire and artillery.

The hospital's director, Dr. Saidi Qasim, offered tea and caramel candy yesterday to Northern Alliance officials, but the officials turned down his plea for money. "They say if they have any excess, they can help us," he said.

A half-dozen international aid organizations work in the area, 30 miles north of Kabul, and a medical charity helps pay the salaries of Charikar's doctors. But that barely keeps the hospital's doors open.

The aid organizations say they are stretched too thin to support every Afghan hospital. And they are reluctant to stock front-line hospitals such as Charikar with drugs and supplies, only to see them destroyed by gunfire.

"They brought us a few drops of medicine," Qasim said.

Staff members buy their supplies at the bazaar, and sometimes buy drugs for patients, too. But most patients must pay for their own medicine, meaning many must do without.

Sidiqua, who like many Afghans has only one name, said her son Ataq has suffered leishmaniasis for four years. "We didn't treat him because we couldn't afford medicine," she said.

Some of Charikar's doctors suffer from the same diseases as their patients. Two doctors rolled up their sleeves to show the pale scars left by the leishmaniasis parasite.

"We can cure ourselves because we are doctors," said Dr. Zalmai Neda. "The people here, they can't cure themselves."

Many patients are refugees either from the fighting or Taliban rule. Hangama's mother, Tourpiaka, 38, decided her family had suffered enough under the Taliban in Kabul. She was forced to quit teaching and couldn't venture from home alone without being harassed by the Taliban's vice and virtue police. She, her husband and their three sons and two daughters fled north about six months ago to territory controlled by the Northern Alliance.

Her children are often sick. A baby has diarrhea. A 7-year-old daughter has a sore throat. Hangama woke up a few days ago with a headache that grew worse. Yesterday, Tourpiaka took her to Charikar Hospital, where Dr. Neda said it was typhoid.

If the family could afford medicine, the girl could be cured. But they have no money; the family lives in part of a bombed-out building and survives through the charity of relatives and friends.

"We have no jobs, no money," Tourpiaka said, ignoring the automatic weapons fire in the distance. "We live as guests here."

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