Overheard in an Afghan Clinic

As the Afghan medical system progresses towards self-sustainment, the rules have changed for me a little.  I'm not allowed to treat patients as their doctor, but I can help in other ways.  So on Saturday I asked the Afghan doctor what I could do to help him get through all 60 patients he had to see that day.  He asked me to prepare little bags of common medications for him. 

There is no pharmacy in the clinic. Medications are kept on the shelves in his 4ft x 8ft office, which you can see in the background.  I took this picture to show that some Afghans have red hair, fair skin, and blue eyes, like this little boy and his sister enjoying lollipops.

As I'm preparing the packets, two young girls are waiting for their brother to be seen by the doctor.  They are watching me curiously, so I smile at them at say "Salaam."  A combination of Afghan culture and my being very manly and intimidating causes them to look away shyly.  I don't need a translator to understand their conversation:

Why is that American dude wearing a red cross and a gun at the same time? 

Shh!  Don't stare at him, it's rude.

I wasn't staring...[looks away, ten seconds later]

I said stop staring!

I wasn't!  [ten seconds later] "What?  I was looking at...something else..."

  I would guess they are about 8 and 12 years old.  Sometime around age 12 or so, Afghan girls stop playing with boys and begin covering their faces around men.

The bench in the background was being used by an American humanitarian worker to interview patients in the clinic to get an idea of what the local medical needs are.    I can't help but listen to the translator's words, since we are all in one small room.  Here is an example of one of the interviews, I thought you all might be interested in the answers as well:

How old are you?

-Probably more than 30 (most Afghans do not track their age into adulthood)

Why did you come to the clinic today?

-To get medicine for my child.  He has a fever and is coughing.

If you couldn't come here, where would you go?

-I couldn't afford to get medicines any place else.  They are free here, so I come here.

Isn't there some way to get medicines?

-If I had to, I would talk to all the women in my village and ask them to share their medicine with me (this is good-hearted but problematic from a medical standpoint.  Painkillers, antibiotics, antacids are all just "American medicines" that are often handed out to one's circle of friends upon stepping out of the clinic)

Did your children get vaccines?

-Yes.  At a free clinic like this one.  (This answer made me happy.  I know some of you anti-vaccinators are disappointed :) )

Do you work outside of the home?

-Yes, when there is work I do as much as I can to earn money.  I clean houses, wash dishes, and prepare food as a day laborer.  But it is rare to be able to find work.

Did you go to school?

-No, there are no schools for the Hazari.  (Hazari are an ethnic tribe, traditionally farmers anand day laborers, on the fringes of civilization because of their Asian ancestry.  My interpreter, who is Tajik, later told me, "you will never find in all of Afghanistan a Hazari begging for handouts.  They are hard, hard workers and always find jobs)

What do you usually eat for food?

-Whatever we can.  If there are beans, we eat beans.  Sometimes there are potatoes or squash.  We eat whatever is there at the time.

How old were you when you got married?

-About 15

How old were you when you had your first child?

-The same

Did you and you husband plan the children, or did they just come naturally? (This struck both me and the interpreter as a silly question.  I assumed she was required to follow a standard questionnaire)

-Of course they just came naturally

How many children did you give birth to?

-Seven

Did any of them die because of sickness?

-[sobbing]

(I was taught in my "cultural awareness" class that Afghan parents are accustomed to losing children and it doesn't bother them as much as it bothers us.  As a parent of four children, one whom was born too early to survive, this struck me as garbage the moment I heard it.  I was also taught that I should keep my distance from women and not interact with them directly.  Well, I guess that's two things I disagree with.  I knew it would be wrong to put my arm around her, but I had to at least give her a tissue.)

-Yes, I lost two children. [sobbing].  Please don't ask me their ages.

From here, the interviewer could tell it was time to stop the survey, and the conversation turned to lighter things like her beautifully embroidered housecoat and the handsomeness of her sons.  Soon her turn to see the doctor arrived, and her sons got medicines and lollipops as well as some winter clothes.  So when people ask me, "don't you worry about people coming to the clinic just so they can get free stuff and sell it!?"  I think of people like this lady, just doing what she can to take care of her sons.  I know she loves them as much as I love mine.

  Thanks for all of the donations, we gave away a lot today.