HEEDA
  • About
    • Partners
    • Press
  • Programs
    • Light To Afghanistan
    • Warmth To Afghanistan
    • Education To Afghanistan
  • Leadership
    • Edris
    • Leeda
    • Waleed
    • Rowyda
    • Ghizal
    • Masoud
    • Allie
    • Volunteers >
      • Morcel Hamidy
      • Yagana Parwak
  • Blog
  • Donate
  • Contact

 

Friday in Kabul

10/9/2010

1 Comment

 
Picture
Picture
Friday is the official weekly holiday--the one-day weekend. Thursday night (considered 'Friday night') the city comes to life; music starts blaring out of every corner; hot coals cook kabobs on the sidewalks and are carried into the restaurants; hooka/sheesha and tea rooms are at every corner; but by the time Friday morning comes around, everything shuts down and the usually gridlocked streets are emptied of traffic. Everyone stays home. We learned this late and made plans to go out on the streets on Friday afternoon, but next week we'll know better.

We dressed in our best Afghan attire and left our apartment early in the afternoon, walked about half a mile down the street and caught a taxi on the main street. This was a first for us on this trip as on our work days we have a private driver. Our destination: the world famous CHICKEN STREET in Shar-e-now. The ease with which we caught a cab should have been a hint that this wouldn't be a very productive day. Meet our driver: Khalifa (picture above.) He has been a taxi driver in Kabul since the Prime Minister Dawod Khan was overthrown in the 1970's, followed by the Communist overtake, then the Russian invasion to support the weak Communist government, the subsequent fall of the Communists to the Reagan-backed Mujahideen (if you haven't seen Charlie Wilson's War, please go rent it tonight), through the Taliban, and now the Karzai administration. His final judgement is that there has been no functioning government since Prime Minister Dawod Khan.

Chicken Street was mostly deserted. Half the shops were closed and the usually bustling streets had few people roaming them, except for a few awkwardly placed students from the U.S. and us. The shops were all tourist-oriented with some carrying rare and antique guns and knives from all the provinces. Flower vases and plates frequently exhibited flags of the US and NATO nations along side the Afghan flag.

Tomorrow we visit a busy ICU with new ventilators and the Kabul's largest dedicated women's hospital that is a regional referral center for Obstetrical emergencies. We are hoping for a really enlightening interview with the director, but unfortunately we are not able to upload video due to the really slow internet speeds.

I'm sure we'll have plenty to talk about though.
Salam,
Picture
Edris Afzali
1 Comment

Anesthesia Absent

10/7/2010

0 Comments

 
Picture
The degree to which specialists are needed in treating emergently ill unstable patients is relative, though their contribution to definitive care is indisputable. It is my personal opinion that no services should be withheld if they benefit the immediate situation; that is as long as the doctor in attending has the competence to deliver.

After morning duties, I took the early part of the afternoon and visited the 'receiving' department of another local hospital. Their claim to fame is the triage of greater than 300 patients per day through this department. After going through the typical bounce through different offices, the 'communication director' personally escorted me to meet the Chair of the department. The department was relatively well lit and clean; it was a long hallway with individual rooms holding patients on single cots--most rooms without any other equipment in the room. There was a crowd of people around a room; most staring quietly; a few screaming, crying. The Chair walked out and greeted us, follow by a tray carrying all the requisite materials for intubation, and a few (reusable) needles. They had been waiting for anesthesia to intubate, but they never showed up. I didn't ask any further questions, but it was obvious an important step in this patient's management wasn't completed.

On another note check out Kabul early at sunrise from my balcony. It is amazingly green--the entire city. Apparently the local government underwent a massive tree planting campaign to replenish all that's been lost over decades of war. They pretty much made it a law to plant a tree, which was given to them. Aside from what you may read or hear on foreign news channels, I don't feel like I'm in a war zone.  A not to distant blog is going to focus on the Wedding Halls of Kabul... reminds me of Vegas. kinda.

- Edris Afzali
0 Comments

Tea with the Health Minister

10/6/2010

0 Comments

 
Picture
This was our second day in Kabul, but our first day working exclusively on our project. The bureaucracy here can be debilitating if you don't have the right contacts. Everyone is the boss; everyone is trying to push their weight around. We started out the morning chasing bureaucratic channels at the "400-bed" military hospital in the heart of Kabul. This hospital was built 3 decades ago and is relatively well-funded. It has an 'emergency department' that is divided into two sections: the trauma unit and the general medicine unit. These two departments provide relatively basic services and generally rely on in-house specialists for treatment (i.e. Anesthesia for intubation.) Patients that are deemed more "acutely ill" are transferred straight to the 3rd floor ICU department that is staffed by surgeons.

With our 14-page survey in hand, we were ping-ponged through various secretarial offices so we can be referred to the appropriate department head that can allow us access to physicians that staff the 'ED'. We were told more than once to come back tomorrow, but luckily found the office of the ED chief. His attitude was the exact opposite: He sat in his office with us and discussed extensively our project, its implementation, and we arranged for a return visit to spend the day with his staff physicians and to observed the department. He had called for tea but...

We were already en route to the Ministry of Public Health. Dr. Sadruddin Sahar, the Deputy Ministry pictured second from left, was very amicable and will surely prove to be quite instrumental in the coming days. He had his own deputy from the Foreign Relations office draft a letter, addressed to the directors of each hospital we plan to visit, giving his own full support for our work and requesting their full cooperation. Then we had tea. I'm hoping we'll be spending more time drinking tea and less time chasing bureaucrats.

- Edris Afzali
0 Comments

Project Overview

10/5/2010

0 Comments

 
Picture
Welcome.
​
Thank you for visiting our Blog. You are here because you already know us or you've been referred by someone else because you share our interest. Please feel free to forward this URL to anyone who you feel may benefit, contribute, advise, or simply like to read about our experience. Lets begin with a brief description of our project and a very brief foray into why we believe our work is not only important to Afghanistan itself, but for the developing world at large and health care delivery as a whole.
 
Project: An Assessment of Emergency and Acute Care in Afghanistan in the Current Conflict Setting.

Afghanistan’s healthcare has suffered tremendously after decades of war and civil unrest. The country is currently entrenched in an insurgency that is fueled by social problems- including lack of access to basic healthcare services. The current US strategy of Counter Insurgency and State Building seeks to diminish these gaps in an effort to curb terrorism and promote sustainable peace and growth. ​One of the key focal points is that of actual health care delivery. Afghanistan has the some of the world’s worst health indicators and recognized as such, the major donor organizations such as USAID and the World Bank implemented what is known as the Basic Package of Health Services (BPHS). The BPHS seeks to address key areas such as mass vaccinations, infectious diseases such as HIV/TB and Malaria, and Maternal and child mortality.

We are currently in Kabul, spending our days in clinics and intermittently implementing our project.
Our goal is to use an evidence based approach to help identify gaps at the initial phase of patient interaction. Local physicians and healthcare workers have no formal training in Emergency Medicine and each hospital has a unique approach to the triage of patients--with or without receiving initial evaluation. Our work will seek to assess the capacity of Primary as well as Local Healthcare Providers’ to deliver acute resuscitation and stabilization as well as their capacity to transfer to definitive care through a series of surveys, small group discussions with physicians and nurses that staff these emergency departments, as well as personal observation.

As previously mentioned, the BPHS addresses some basic healthcare needs of Afghans. The BPHS is unique in that it is the first of its kind being implemented in a conflict region and has the philosophy of delivering healthcare as a human right. We hope that our work in Emergency Medicine can compliment the goals of BPHS, and expand to other regions of the health sector and eventually other countries.

- Edris Afzali
0 Comments

    Archives

    December 2016
    October 2010

    Categories

    All

    RSS Feed

HEEDA
HEALTH, EDUCATION & ECONOMIC DEVELOPMENT IN AFGHANISTAN

HEEDA's mission is to promote the means of sustainable progress for the people of Afghanistan through innovative health, education and economic development.
  • About
    • Partners
    • Press
  • Programs
    • Light To Afghanistan
    • Warmth To Afghanistan
    • Education To Afghanistan
  • Leadership
    • Edris
    • Leeda
    • Waleed
    • Rowyda
    • Ghizal
    • Masoud
    • Allie
    • Volunteers >
      • Morcel Hamidy
      • Yagana Parwak
  • Blog
  • Donate
  • Contact