Adonis Diaries

Medical missions in Afghanistan. How civilian casualties are treated?

Tuesday, July 5, 2011.

I am in neurosurgery mission at the pediatric medical Institute for Afghan children of Kabul. Usually, I perform 30 operations in my frequent visits to Afghanistan.

Six years ago, I diagnosed cancer cases in 4 patients within my three-week stay. This rate has increased sharply: I am facing 4 cancer cases every day, and many deformed babies.

A 18 year-old boy is suffering of a Schismatic syndrome. I had ordered a scanner in urgency 3 days ago, and still no news.

Another kid, 10 of age, has a cardiac malfunction of tetralogy of Fallot type, and I also diagnosed an abscess in the brain between the frontal and temporal lobes.

There are no rooms in the intensive care unit.

I consulted with the competent anesthetic Charlotte for the next morning set of surgical operations.

At about 5 pm, the scanner revealed that the boy requires an operation very quickly in order to remove a craniopharyngione cyst.  The boy had lost his right eye, and the acuity of his left eye is declining due to hormonal perturbation.

The boy had lost both his parents during the civil war and was barely surviving on small jobs in the province of Takhar, 600 km from Kabul.

The operation is delicate, but sending this patient to India or Pakistan would cost $8,000. I have limited equipment that I brought with me from France, and I can make do thanks to competent anesthetics and surgeons in the staff.

I prescribed a MRI and got involved to get results today: I am leaving back to France within a couple of days.

The department of radiology demanded $160 for the MRI and the boy and his cousin had to try securing financial aid from social services, even when the cost was reduced to $100.

I managed to contact the boy and convinced the admission to perform the MRI gratis.

It is 9 pm and the boy is in front of the closed doors of admission. Another round of negotiation and explanation.

Kate, the association director, agreed to take care of all the expenses of the surgery.

It is 10 pm. The pieces of the puzzles are falling nicely in place and I recuperate a couple of instrument from my brother’s home.

Midnight, I get a call from the boy’s cousin: No blood in the blood bank. I think that it is feasible to do the surgery without additional blood.

A couple of hours nap and I am up at 6 am. Six other surgeons are observing this rare operation.

The microscope is showing signs of weakness and I used a magnifying glass. The intervention is a success.

I had a light breakfast and started my next surgery on the kid.

At 3:30 pm I check on my first patient in reanimation: He is awaken and doing fine. The working day was supposed to finish at 7:30 pm.

My brother is throwing a farewell party for me, and I see the invitees with half closed eyes.

Afghanistan was bombed in 2002 with 3,000 tons of depleted uranium (DU), 60% as active as the enriched uranium used in nuclear power plants. The dust of DU, if inhaled or digested, disturb the process of the formation of the embryo through cellular splitting and division.

The new-born suffers terrible malformation: No head, no eyes, no hands, no legs, no nose, no lungs…The DU particles attack the brain, the nerve cells, the thyroid, the lymphatic ganglion…

Six years ago, I used to witness 3 cases of cancer during my 3-week stay. Currently, I have to deal with 4 cases every day.

In Iraq, new-born with no eyes have increased 250,000 times the normal occurrence.

Note: This story was taken from “The Devastation” by the French/Afghanistan neurosurgeon Ahmad Ashraf