Coalition gives Afghans health care

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KHOST, Afghanistan — As Afghanistan struggles to create a functioning health care system after 23 years of war, military hospitals and mobile clinics run by coalition forces are the only hope for thousands of Afghans of getting adequate medical care.

The Soviet occupation from 1979 to 1989, the civil war that followed it, and the subsequent medieval rule by Taliban militias destroyed what little health care infrastructure existed in the country before the Soviet invasion, and uprooted most doctors and nurses.

According to the 2004 United Nations Human Development Report, there were only 210 health facilities with beds to hospitalize patients in the entire country last year. There are only 0.32 hospital beds per 1,000 people, compared to 2.7 beds on average in other developing countries.

There is only one doctor per 10,000 people, against an average 11 doctors per 10,000 people in other developing countries.

And while humanitarian agencies like Doctors Without Borders fill some of the void in Kabul, most provinces are still considered too dangerous for them.

Most health care providers are located in large cities like Kabul, Herat, Kandahar, Mazar-e-Sharif and Nangahar, while more than 70 percent of Afghans live in rural areas.

Some provincial capitals like Khost have private and public hospitals run by local doctors — usually small, dilapidated and fly-infested structures with antiquated equipment donated by charities. Very few of these have the facilities to handle life-threatening diseases or traumas.

So when Almarsha, a 10-year-old boy from a small village near the border with Pakistan, set off a land mine while gathering firewood, his relatives took him directly to the U.S. military hospital at Camp Salerno, a two-hour drive from the boy's village.

"The last thing I remember before the explosion was that I was reaching for a branch of deadwood on the ground," Almarsha said, standing in line for a follow-up visit at a clinic organized by U.S. medics just outside Camp Salerno. "There was a big flash and then my hand started hurting a lot."

Col. David Barber, the commander of the 249th General Hospital at Camp Salerno and an orthopedic surgeon who operated on Almarsha, said the land mine mangled the boy's right wrist.