Life you just can’t make up…

In addition to meetings and surveys and project analysis and set-up, we’ve also had quite a few adventures in the past 24 hours. Politics have stalled the bridge building process across the Kabul River to the Kuchi village that Sister City/Rotary/Mindtel have been assisting for the past few years, and so makeshift rafts (inner tubes with rope and some wood) are still the way to get across. The plan was to donate some rubber rafts to replace these and then head over for a visit. Reality, on the other hand… presented quite a different experience…

First, we got hung up on a rock in our SUV in the middle of the river. After 10 minutes of attempting to get the car off the rock, and realizing it wasn’t going to happen anytime soon, Dave decided to inflate the raft – on the roof of the car through the sunroof using the foot pump with his hands. Part of the crowd gathered on the near shore of the river came out to assist and try to push us off again – no luck so we got into the raft. (I have to say chivalry is not dead as Meggin and I were the first in, and we were oh-so-carefully handed into the raft – actually quite charming and we were grateful as the water temperature is near freezing.) With Dave and I paddling and Meggin carefully photo documenting we pushed ourselves off and over the rocks and through the rapids – trying to maintain some semblance of control and not tip over. I can only imagine what the picture of this looked like to the villagers! Thankfully, they are friends, and were just excited to have us make it over rather than laughing at us – although I REALLY need to learn Pashto because there was quite a lot of smiling and pointing as we climbed out of the raft – particularly by the boys. (They did, however, immediately jump into the raft (way more than it should really hold) and started paddling around. Albeit, one boy asked Dave – why’d you bring us this cheap thing? We need a wood bottom one. LOL. Point taken and sorry was the best luggage would allow!)

Due to the elapsed time and the pure spectacle we created, there was now quite a crowd gathered to welcome us. The kids know one word in English – “Picture”. With multiple cameras and willing “shooters” – they were in absolute heaven. They’ve become quite the little posers, I must say. Finally we had to begin the hike up to the village, and we did so to the chant of “Picture, Picture” the entire way. The kids are endearing and the parade up the hill with all their brightly colored clothes and beautiful, dirty faces was full of laughter.

Upon arrival at the village there were more pictures (naturally), and then Dave went to go talk to the elders about the situation with the wells. Meggin and I were surrounded as the women came out to talk to us (again, gotta learn Pashto…) and we were invited into one of the huts. While we sat on their carpet, we were surrounded by more than 30 women in children in a semi-circle around us (in a not large space I might add) they asked for our socks. After handing them over, however, a fight broke out among some of the children over the INDIVIDUAL socks, so the eldest woman gestured for us to take them back. So, now we are of course on a sock mission – among other things… For starters, the village has never seen a doctor or dentist. There seems to be some sort of spreading fungus on the kids and lice were literally jumping off their heads.

As we rejoined Dave and the men, and were invited in for chai, we learned that due to flooding they had lost their access to fresh water several months ago. As I drank my second cup of tea, not wanting to be rude as they generously gave us the only gift they had to offer – sugar, I was gently reminded by others in our party that the water we were drinking was the contaminated, barely filtered river water. I needed a stronger immune system anyway… As for them, it is just unacceptable and a complete travesty that they don’t have access to clean water. We found out that it is $500 to put in a new bore hole and give them access. Needless to say this WILL happen in the next couple of days.

This morning, our adventures continued as we made our way to the Public Health Hospital to add a more reliable relay for the sat comms hosted at the Taj and providing access to the hospital. Ryan is of course our comms/sat/tech guru (who is my hero as well after fixing my computer twice in as many days), but no way us non-techies (e.g. Meggin and I) were going to be left behind as we climbed to the top of the water tower. After admiring the FabFi antennas (Google it) at the top that have been providing the link to date, we stopped to look out at the view from this incredible vantage point – snow capped mountains surrounding the valley, bustling activity on the streets below… Tomorrow morning Pete and Ryan will return to complete the last step to get the antenna up and running. For now, as I sit at the Taj writing this, I am just thankful beyond words to be back here, for our friends new and old, for all we have accomplished, and simply for the day.

"Never doubt that a small group of thoughtful committed citizens can change the world. Indeed, it is the only thing that ever has." ~ Margaret Mead

We arrived in Jalalabad three days ago and have managed to visit the three primary hospitals we had on our agenda. The Teaching Hospital (see entry below with the IV bags hanging from trees, etc.) was our first stop. I’m sad to say that not much (if anything) has changed in 6 months. The smells are still rancid and basic supplies (clean water, soap) are in short supply. As promised many months ago we had planned to fix their “broken” anesthesia machine. Turns out, that the machine had never been taken off the pallet (bolts rusted on) and by simply plugging it in – it worked. However, no one is trained to use it, so instead it sits there while they use a bag-valve mask (BVM) to administer anesthesia – which we might add is not constant and patients frequently wake up in the middle of surgery. In so many ways everything comes back to training and dedicated PEOPLE to make it happen – the technology and equipment pieces are the easy pieces. The human factor is the imperative as Dr. Dave Warner likes to say.

It’s so true. We have the potential resources and ability to install a large telemedicine network here, but there are basic training elements that are lacking and must be met first. So we draw up plans, revise them, and revise them again and again – trying to find a solution that can be sustainable in the long term even if we are not involved. Initially we’ll focus on training because there is such a vital need by establishing a Telemedicine and Medical Distance Education Center. We have a site, excitement about the idea, and it looks like the funding to make it happen within the next 6 months.

At the Jalalabad Public Hospital today, too, we saw a “friend” (no names) from our last trip here who recently was almost prey to a suicide bomber attack. We see a slight resignation in him now versus the near boundless energy from before the attack, the elections and political wrangling and change of the past several months, yet there still remains hope and a light in his eyes and a determined resolve to help his people.

All the kids tug at our hearts everyday as we see them in the halls of the hospitals and the banks of the river, but there was something equally powerful and moving sitting across the conference table today looking at this powerful man oh so humbly and graciously—with no pretension—express his appreciation for the fact that we came back, ask us to not leave and help him to help his people. We are humbled to be around such incredible people who do so much for little more than love. It is a lesson also in resilience – quitting is not on option…

Afghanistan Return - Fall 2009

Compared with our last trip here to Afghanistan in March, which can only be described as a whirlwind, this trip, which began on November 6, has been at a totally different pace—Slower and quieter, but still powerful. A lot has changed in six months, and certainly the media has done a “great” job of sensationalizing some of the security and political issues, but there is still an amazing hope and energy that is palpable, and I would be sadly remiss if I didn’t mention it and try to convince others to feel it and care about it, too.

We spent several days in Kabul on this trip due to travel issues, but everything happens for a reason and I’m so happy we did. Having not spent much time in Kabul previously, it was a whole new adventure – from the tranquil serenity of our guest house to the bustling and crazy traffic that rivals anything LA or New York can throw at it – just add some donkey carts, bicycles and lanes that aren’t really lanes so much as “guidelines” – to the French restaurant tucked away off dirt side streets with good friends. At one point, we set out to pick up our air tickets from the UN travel office thinking it would be 45 minutes max roundtrip and over 3 hours later we had success. Little bit of lost driver time in there, too, but the upside was that we (Meggin & I) got to see parts of Kabul we’d never seen before. Also, got to ride in the back of the car (trunk really), as in true Afghan style, we crammed 8 people into a car meant for 5. All part of the adventure.

That’s kind of been the flow of this whole trip – start with a plan, have it change, redirect, etc. and go with it – which is often far better than the original plan. We were able to meet again with Afshar Hospital, which is now open and functioning – great to see the changes and the use of the facility. Our meeting was delayed by a couple of days as they prepared for and then conducted their first outreach clinic on the outskirts of town along the Jalalabad-Kabul road. They saw over 200 patients (men, women, children) in the space of 4 hours – impressive to say the least. We brought along a 3.5 MHz portable USB ultrasound, which we donated and they will use for their upcoming clinic this weekend and in the weeks that follow. While we were there, their IT Tech was able to load it onto one of their laptops (after first conducting a virus check of our ultrasound AND the laptop!), so it is ready to go and they were excited to use it. There is just such a great feeling about being able to give something that you KNOW will be put to good use and immediately.

Our next stop was the privately funded and run Acomet Hospital – associated with Kabul Medical University. Another great facility – and completely dedicated to a qualitative standard of care. They offer no patronage, rather services are provided on a first come-first serve (or urgent need) basis – period. The two brothers that run it are incredible. We’ve now had the good fortune to meet both, and their dedication (which includes living at the hospital), energy, and commitment to forward progress and quality are truly inspiring. As but one small example, in a couple of weeks the 64-slice CT (impressive technology) they ordered will arrive at the hospital. We were able to donate a Medweb server and get it up and running for their Radiology Department. After our return from Jalalabad, we’ll head back to the hospital and Meggin and Ryan will provide some additional training and ensure they know where to go for support.

As I sit here in the sun in Jalalabad reflecting back on the week, I just can’t help but smile. It’s REALLY good to be back here in Afghanistan.
Up next… Our Jalalabad adventures… including today’s planned excursion in a couple of hours which involves rafting across the Kabul River to visit the Kuchi village…