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