Afghanistan: Tent clinic dispenses care to quake-hit Afghans

News and Press Release
Originally published
Seventeen months after an earthquake measuring 6.2 on the Richter scale struck the market town of Nahrin in northern Afghanistan, many of the mud-brick houses are still in ruins.
A walk along the dusty main street where the traders' stalls are stocked with fruit, vegetables and household goods gives little indication of the devastation that lies behind.

Whole areas of the town, which is situated on the treacherous switchback road from New Baghlan to Kabul, were devastated when the earthquake struck on 25 March 2002.

"Old Nahrin was close to the epicentre," explains Dr Juma Khan Khairzada, an International Federation health officer who arrived there within hours with an emergency medical team from the Afghan Red Crescent (ARCS) branch in Pul-i-Khumri. "We found the whole place flattened."

The quake struck around 7.30 pm. Many people were still out in their fields but others were indoors preparing the evening meal. Even conservative estimates put the number of people killed in the hundreds, with thousands injured. The ARCS emergency team treated almost two hundred victims, many of them with serious injuries, in the first few hours after their arrival.

Together with teams from the government's Ministry of Public Health (MoPH), the UN and many NGOs, the ARCS medics spent a month in Nahrin, tending to the victims and helping to distribute plastic sheeting, tents, blankets and other relief supplies.

They were joined in late April by a four-person delegation from the Japanese Red Cross, who brought with them a temporary health clinic, and set it up on the brown, windswept plain a few kilometres outside the devastated heart of the old town. Seventy five patients visited the 'Basic Health Unit' as the tented facility was called on the first day alone.

The ARCS medics worked alongside the Japanese team, and when the programme came to an end some months later, the tent clinic was handed over to ARCS, which has been running it ever since. Although it is intended to provide only basic care, the unit offers outpatients consultations, minor surgery and health education.

The place is popular, drawing up to 50 patients a day, despite the fact that there is a more sophisticated, Italian-financed hospital run by the MoPH in New Nahrin, and a clinic in the old town run by the Swedish Committee for Afghanistan.

One 38-year-old mother waiting in line with a painful wrist and shoulder spoke candidly about her choice. "I have tried the other places, but they didn't help," says Rahima. "Now I am putting my faith in the doctor here." The real reason may have had more to do with the fact that the services and medicines provided in the ARCS health facility are free.

Mujib Ahmad, 25, has been helping to run the clinic from the start. Hired by the Japanese Red Cross team as an assistant and translator during the quake's aftermath, he stayed on when the medical unit was transferred to ARCS, and received training as a health educator.

Today, he teaches basic hygiene to the clinic's patients using a picture book to illustrate his lectures, for the majority of them are illiterate.

"I say to them that as country people they have a friendship with animals," Mujib explains, using the same simple language as he would when talking to the patients. "I tell them that after tending to their flocks they should wash their hands before eating any food."

Mujib also has a strong message for the women, about one of his bugbears. Suspended on a string from the roof pole in the white medical tent where he conducts his sessions, dangles a bunch of babies' dummies. "The mothers resist when I tell them that dummies are not good for their babies' health," he confides. "But they let me take them away when I explain they can be dangerous and carry germs if they are not clean." Smiling broadly, he gives the offending items a dismissive flick, sending them spinning and bobbing on their string like some fancy pink, yellow and blue mobile.

Mujib Ahmad's colleague at the clinic is 28-year-old Dr. Najmudin Pajwak who, like his younger team mate, comes from the trading town of Pul-i-Khumri, 75 km away back along the bumpy dirt road beyond New Baghlan. But that's where the similarity ends. Whereas Dr Najmudin is quiet and tall, with black hair and beard, Mujib is tiny, quick to talk and even quicker to laugh.

A graduate of the medical college in northern Afghanistan's biggest city, Mazar-i-Sharif, Najmudin has been working in Nahrin for over a year. He and Mujib spend all but four days a month at the clinic, which is open six days a week. "But if someone arrives when it is closed, we are not going to turn them away," Najmudin says hastily. "Especially if they have walked for hours to get here, as many people do."

The two colleagues also make home visits to patients who are bedridden in and around Nahrin, and they turn out for emergencies at all hours of the day or night. "We are really on duty 24 hours a day!" says Mujib, proudly.

The clinic itself is one of 50 that the ARCS is running all over Afghanistan with support from the International Federation. They provide a vital, free service to the poorest of the poor, but their fate hangs in the balance. Under new government proposals to reorganize the health services into 'clusters' administered and run by designated NGOs in each province, the ARCS clinics, which are independent, risk being affected.

Dr Najmudin and Mujib try not to think of such an eventuality. "I am here to serve the people," says Mujib, speaking for both of them. "I enjoy my work and I want to stay. There is a lot to do."