Hospitals Offer Little Relief

When I first became ill in May, I sought treatment from nearly every well-known doctor in the capital. Each one handed me a prescription slip, and each slip had no less than 5 items on it.

But I wasn't getting any better.

My body was racked with pain, especially in my stomach. I couldn't keep any food down, and the pain kept me awake all night. My weight dropped from 60 to 50 kilogrammes.

On May 25, when my condition took a turn for the worse, I checked into the state-run infectious-diseases hospital in Kabul city. None of the doctors were able to diagnose my illness, and I was referred to a private clinic for a medical exam and diagnostic tests.

There, I tested positive for typhoid, so I went back to the hospital for treatment.

On my first day there I was administered an intravenous serum in the corridor of the hospital. The wards were overcrowded and no vacant beds were available.

The next day, I was transferred to the typhoid ward, where all the patients were attached to IV drips. I could smell fresh sweat as I climbed into my hospital cot; its previous occupant had been discharged only a half-hour before.

Reluctantly, I lay on my bed.

A doctor who examined me gave me a prescription for about 60 US dollars worth of drugs. I sent my 15-year-old brother, who was caring for me, out to buy the medicines the doctor had ordered.

By the time he returned in about an hour, I’d decided that I could no longer stand the bed’s stench. I asked him to fetch me a clean blanket, pillow and mattress.

Later than night, when the night-duty nurse arrived, I realised that foul odours weren’t limited to my bedding. His white lab coat smelled even worse than my cot had. In fact, I had first mistaken him for a hospital janitor.

This nurse then gave me an ominous warning. "Brother,” he said, “if you can afford to go to Pakistan it will be better, because you can find better doctors and medicines. You will catch more diseases here."

On the following day, someone entered without putting on a white lab coat. I thought at first he was a relative or a friend looking after one the patients, but after a few minutes he started measuring doses of medicine and administering injections to patients.

When I asked what he was doing, he said, "I have a friend on the staff here who lets me inject people and give them IVs. I plan to be a doctor someday, so I want to practice before going to medical school."

After about three days, another nurse in a nice, clean lab coat came in carrying a box with some cotton and syringes.

He would use the same syringe on each patient, replacing only the needle. I asked him, "Are you sure that won't transfer disease from one person to another?"

"Keep quiet, patients don't speak," he replied.

Five nights later, a patient with meningitis had a seizure and screamed for one hour. His father, who was taking care of him, was unable to get him a doctor.

After an hour a doctor finally arrived and administered a serum.

Tajmir, the patient's father, said, "I had heard that nurses were [only] supposed to inject the patients and give them infusions, but nowadays they write prescriptions too."

He then added, "A nurse wrote me out a prescription and told me I could only find this medicine in a certain pharmacy in Kart-e-Parwan, and that it would cost me about 50 dollars. I don't know whether this is a business or butchery."

One incident was unforgettable. A 50-year-old man from Bamyan province was brought into the infectious diseases ward by his 22-year-old son. The man remained in the hospital for two days. When he started to show some signs of recovery, the doctor discharged him - in order to send him to a private clinic run by the doctor.

The old man had been diagnosed with jaundice and typhoid. "I have been paying for treatment myself for seven months, and have spent about 1,800 dollars. I have some land and will have to sell it so I can recover," he told me.

A 33-year-old resident of Paktia province, who was taking care of his 12-year-old brother Basi, complained that the staff required bribes.

"My brother has been hospitalised for 15 days, and the nurses and orderlies always let me visit him because I buy them kebabs and candies," he said. "And every day I pay 50 afganis [a little over a dollar] to the doorman to let me in to visit my brother for one hour. Otherwise, I have to stay till 3.30 am."

Another person slept in the same bed with his sick brother.

"It is less expensive to stay with my brother, so I pay to the orderlies about 2 to 3 dollars," he explained. "I know this place is full of contagious diseases, but I don't have anywhere else to stay."

Nazir, who was hospitalised for 5 days, said, "If I were rich, I would have gone abroad for my treatment."

Alidad, a 55-year-old resident of Hazarajat, told his 25-year-old son, "Take me back home to die, otherwise it will be too difficult to carry my body"

Complaining of the greasy hospital food, he asked God to grant him death.

Each afternoon we got three apples and one teaspoon of condensed milk. Each patient got one egg per morning. During the day, the flies and mosquitoes would settle in. Whenever someone peeled a piece of fruit, they would attract swarms of flies.

Patients' relatives were allowed to visit at 3.30 pm. Out in the yard, they would discuss if there were any free hospitals with better doctors in Kabul. Some talked about going to Pakistan; others discussed going to private clinics.

Many patients would ask their relatives if they could get any of the doctors in this hospital to pay better attention to them.

Three patients died on August 18, Afghanistan's independence day. The medical staff had taken the day off.

One was a 22-year-old girl. From my hospital bed, I could see her mother crying in front of the hospital. She said that her daughter was supposed to get married in two months.

Two male patients also died. I saw them wheel the gurneys past the door of the hospital ward.

I left the infectious diseases hospital shortly after that. I went to the Egyptian field hospital at Bagram, where they gave me pills for stomach ache.

Since I still wasn't recovering, a member of my family said I should get an amulet to ward off the illness. I went to see seven different mullahs, who put various charms on me and gave me amulets to wear.

Finally, a co-worker took me to the hospital run by the International Security Assistance Force, the NATO-led peacekeeping contingent in Kabul.

We waited two hours outside the gate. They searched me for weapons before I entered the compound. A German physician, Dr Faust, checked my prescriptions. When he looked at the list of 47 different medications, he smiled and simply shook his head.

Shahabuddin Tarakhil is an IWPR reporter in Kabul. He is now recovering.