Canadian and American Medics Risk Life - To Save Lives in Panjawai, Afghanistan

(By: Robert J.Galbraith, in Panjawai, Afghanistan)

The month-old baby lies in his adopted mothers arms crying non-stop from hunger pangs, his tongue darting in and out of his mouth, like a snake smelling the air for its next meal. It is such a pathetic and heart-wrenching site, but not an unusual site, for the doctors and medics of the Village Medical Operation (VMO), who risk their lives to save lives, in the small though extremely violent town of Panjawia, Afghanistan.

This emaciated, hollow-faced infant boy (who's mother died during his birth), is just one of over a hundred-and-fifty patients who will be seen today by two doctors and three medics (one American and four Canadians), those who attend to the maladies of the walking-wounded. The VMO is an American-led operation, with a Canadian contribution of doctors, medics and medicine.

The poorest of the poor, these ailing locals arrive by donkey cart, walk and hobble, to this free, one-day clinic.

"The purpose of the VMO is to take us out to the towns and create relationships with the Afghan people, and while we're providing a service they require, we know we can't replace the medical system, but we can help to develop it," says Captain Colleen Forestier, the Senior Medical Authority, and doctor with the Provincial Reconstruction Team (PRT), based in Kandahar, Afghanistan. "Our presence allows them (the sick) to see us in a way that otherwise they may not, a service on the ground, asking about their needs and how they are doing."

Looking over the young victim of advanced malnutrition (whose femur is just thicker than that of a mans thumb, and who's vertebrae stick out like the ridges of a dragons back), Dr. Forestier works without flinching or showing emotion, as she and medic, Corporal Amy Pennington, of Edmonton, go about their seemingly endless tasks of caring for the female ill.

Two doors down, Doctor Joel Dean, a Captain with the 173rd United States Airborne, and a resident of New Hampshire, is busy analyzing male patients with medics, Corporal Paul Franklin, of Edmonton, and Sergeant Bill Burfitt, of Grand Bank, Newfoundland.

It is a different patient with a different ailment, but it shows the range of challenges the medical team face. "I have a fire in my penis," says a middle-aged man, who avoids making eye contact with the doctor, perhaps due to embarrassment or shyness, or both. Dr. Dean gives the man the medication Cipro, for a possible urinary track infection.

At the same time, in another corner of the same plain room (adorned with the automatic rifles, bullet-proof helmets and fragmentation jackets, which are always in reach of the soldier-medics), the always-smiling Corporal Franklin, is analyzing two young boys and their grandfather. "There is a cold running through their family. So I gave them cold syrup. It's a good old Western medicine!" At the same time he gives them all a three weeks supply of multi-vitamins to take home.

His next patient is a pleasant old man of about 75 years, he has a dirty white handkerchief wrapped over his head, covering the area of his left eye. The Corporal takes off the bandage, exposing a deep concave socket, where the old man's left eye used to reside. "I had a cataract operation in Pakistan," explains the turbaned, white-bearded elder. "But after a while, I came back to Afghanistan and it started to hurt - so they took the eye out," he explained, while not showing a hint of anger nor remorse in his voice or face.

"The socket shows no signs of swelling, and it doesn't smell of infection, so I'll give him a tube of Polysporin to apply to the socket and wrap it with clean bandages," explains Corporal Franklin. In a matter of a few minutes, the old man is walking out of the room with a broad smile on his face, and a fresh dressing, but not before shaking the hand of everyone in the room.

Back at the women's examination room (the same kind of dirty, dusty room that the men medics and Doctor Dean are working out of. The kind of environment that most Canadians would faint at upon seeing, if led into such a room by a doctors in one of our clinics), Dr. Forestier is looking-over two young boys, aged 7 and 8-years-old. The interpreter explains, through the children's' mother that, "one has diarrhea, and one is constipated." The doctor asks, "are they eating lots of fruits and vegetables?" The mother replies, "They have lots of vegetables but don't like them. We are very poor and most times we can't afford meat."

Asking the mother about the importance of this day clinic to the local townsfolk, she replies, "it's really important to have these clinics. I have visited here once before and the medication helped me, and thanks for your cooperation," she says. "There is another local clinic here, but the medicine they gave me is weak, and didn't help. Our clinic is not as effective." The mother has a chronic upset stomach and is pregnant. She is given an iron supplement, pain medication, and medicine for an upset stomach. The two children are a given a de-wormer formula and multi-vitamins.

Medic, Bill Burfitt explains that today alone, he saw three leishmaniasis (a parasitic disease transmitted by sand flies) cases and numerous Tuberculosis cases. "Tuberculosis is a very common problem here," he says.

Working in Kandahar Province, is a very difficult and dangerous place to conduct any sort of business, medical or otherwise. Life expectancy for Afghanis is a challenge enough, without doctors and medics being blown-up or shot-up while they try to go about their dedicated business of helping the weak, diseased and infirm.

"Just three weeks ago, 3 Afghan doctors and a nurse were ambushed and killed in a nearby district of Panjawai, as they drove to a clinic. Where we were working today, was very close to that area," says Captain Forestier, a resident of Edmonton. "They all worked for the Afghanistan Health and Development Service."

As a result, some of the clinics (there are five within the Province of Kandahar) were closed, leaving many civilians without any opportunity for medical assistance.

Twenty-four-hours prior to the MVO teams arrival in Panjawai, the Afghan National Police discovered a huge weapons cache in an abandoned building. It included, 16 landmines, six hand grenades, numerous boxes of heavy and light ammunition and hundreds of handguns. But to make matters even worse, the threat of death or injury inflicted by roadside bombs, or IED's (Improvised Explosive Devises), just adds to the gauntlet of challenges that our Coalition doctors, medics and support staff face on an almost daily basis.

In fact, on the return trip to Kandahar from Panjawai, a 45 minute harrowing drive through some of the most dangerous territory in this entire country, an IED exploded less than a kilometre from the PRT, where the medics and doctors mentioned above are based. The explosion injured 3 members of the Afghan National Police, and was easily heard by all in the PRT. And there have been other recent incidents within a stones-throw from this small base of 250 Canadians.

In this country of misery and never-ending conflict, the probability of dying before reaching your fifth birthday, is 250 deaths per 1000 live births. In Canada it is10 deaths per 1000 live births (from 1997 statistics). Adding to this culture of life and death is the stunning fact that the infant mortality rate per 1000 live births is 165 in Afghanistan (also from the 1997 stastistics).

It would appear that Afghanistan is not a country that fosters life, but rather, takes it away in the most brutal of ways. But Doctor Forestier and her team just brush-off the danger, like the talcum-powder-sand that chronically sticks to their clothing. "What we really are attempting to address is support and development of what is already here. So that in 5 or 10 years down the road, they (the Afghan people) have a better system. We achieve nothing -- if we don't achieve that!"

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