Doubts...

Today I had a thought go through my mind in regards to the patients I am about to encounter in Afghanistan. What if I need a tool/test that is not available to diagnose a condition? Here in the ED, I have almost every imaginable test at my fingertip to use. These tests allow me to rule out many bad conditions thanks to CT, EKG's, or blood work. I wondered, would I be as effective of a doctor without them?

Those questions and doubt are the words of the enemy trying to discourage me and I won't have it! I had to talk myself out of that thought process and remind myself that I have completed medical school and residency and am a good doctor. The basics of medicine are somewhere in my head and just need to be recalled. Infectious diseases and basic OB care will be the majority of what we will see. I guess I hope there might be some trauma-related cases as well. I trust there will be lots I can do, even within the limits of the situation.

Below is the information describing my trips background, goals and mission. I think is does a good job of explaining many of the questions I have been asked about the trip.

Afghanistan - April 30th – May 14th 2010

Shattered by 22 years of USSR occupation, civil war, Taliban misrule and the US-led invasion in 2002 – Afghanistan is a country rebuilding from a countryside that was bombed and mined; loosing half the housing; most of the complex irrigation systems; a high proportion of the livestock were destroyed and millions of people were displaced in there own country. The entire country lacked infra structure and the ability to deal with the loss of all institutions including governmental agencies, schools and universities, police, transportation, a healthcare system, etc. Rebuilding the country is slowed by the lack of funds, lawlessness and fractionalization.

The character of the Afghan people is exemplified by a sense of pride, bravery, hospitality, generosity and loyalty. When invited to an Afghan home, a guest is treated with the utmost respect and honor. Afghans will share whatever they have with a friend.

Our national partners SOZO International have a wholistic outreach to empower the most disadvantaged individuals and communities by coordinating and implementing transformational development through healthcare, education, and economic initiatives.

This will be the eigth year that I have had the joy of leading a GHO team into Afghanistan. Many of the NGOs that were in Afghanistan five years ago have left in spite of the great need. It is clear that those who continue to serve and care for the least, the lost and the last are welcomed with open arms and will reap the harvest.

The decades of civil turmoil and war have, most obviously, left there mark on Afghan women and children:
• 1 of every 12 mothers die from a complication of childbirth.
• 1 of every 4 children die before they celebrate their 5th birthday.
• Life expectancy is 42 years – 35 of which are “healthy.”

We always have an urgent need in Afghanistan for females on our healthcare team physicians, PAs, NPs, dentists and nurses to supplement the males because if we do not have a good number of ladies on the team, the Afghan women will not be allowed to come to the clinics and then the children will not come. Afghan women culturally need to be treated by ladies for the most part.

Our efforts in Afghanistan over the past 8 years have been to provide emergency, ongoing relief, healthcare for the Internally Displaced People and train Afghan doctors as we come along side of our national partners in their great work. Helping and encouraging the communities like Istalif to heal itself and see them assume responsibility through wholistic, transformational development primarily through healthcare initiatives has been a real blessing. IDPs are refugees in there own country and we have had great joy in being able to help the people in Shaka Dara and Barek Aub as SOZO moves forward with permanent housing, education and economic initiative in partnership with these communities.