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Kabul Hospital Struggles to Serve Patients - 2002-02-16

More than two decades of war and oppression have left Afghanistan a devastated country lacking in just about every basic necessity. One of the sectors in dire need of reconstruction is the country's health care system.

Years of warfare have left their mark on every neighborhood of Kabul. Kart-Seih, in the west of the city, is no exception. Most everything has been reduced to rubble.

The Kart-Seih hospital is set up in one of the few intact residential buildings in the neighborhood. A narrow passageway and stairs lead to the wards. There is no heat, no reliable electricity or running water. It has only the most basic medical equipment and a chronic shortage of medicine; in fact, just about all it has in abundance is patients in need.

The hospital is operated by the ministry of public health, with the support of an international relief organization called Hope Worldwide. Dr. Mark Timlin heads the organization's projects here. He and his wife Vicki have been working in Afghanistan for the past year and a half. Every day Dr. Timlin makes the rounds with the local Afghan doctors.

One of the patients, a 75-year-old woman, is no stranger to the hospital. She is old, poor and chronically ill. And she keeps coming back.

"So, what is the matter with her, right, she has heart and chest problems combined. Is she better now? No, she's still sick. There are a lot of things she hasn't been treated for, maybe that she had 20, 30 years ago and so she has all these illnesses now that can't be treated now. You're just relieving some of the symptoms."

In another room is a mother with her young son, who is being treated for severe anemia. Nearby, in the men's ward, coughing patients huddle around small oil heaters.

Dr. Ghulam Habib has been working in the hospital for only a few weeks. He says, because of the poor conditions in the country, many Afghans suffer from upper respiratory ailments, such as pneumonia, asthma and chronic bronchitis. He says people are poor and cannot afford good food and therefore their bodies are weak and more susceptible to disease. Add to that the fact that people don't have proper heat in their homes nor proper clothing to protect them against the cold.

Many of the diseases here are brought on, or at least compounded, by poverty. But Vicki Timlin says there is also an urgent need for health education. "Basic things that we learn, like washing your hands before you eat and eating of different food groups and vegetables and fruits, they just don't know about and also if they're so poor they can't afford to get good vegetables ... and different things," she says. "So we've got to start with education as well and health education and we're doing that through the hospital."

The decades of war and poverty have taken a toll on Afghans in many ways. The average life expectancy is in the 40's, far below the average life span in any developed nation. And Afghanistan also has one of the highest infant mortality rates in the world. For Afghanistan to recover, rebuilding the health sector is a major priority.

Despite the difficult conditions, Mark Timlin has managed to remain optimistic about the hospital and about the future of Afghanistan. "Now there is some stability and we hope that will continue. You know 30 years ago Afghans would never have believed they'd be in the situation they are today and who knows in 30 years time Afghanistan will be developed and helping other countries," he says.

The Kart-Seih hospital is about to be closed down. The building is being rented to clients who are willing to pay more than the hospital can afford. But funds are available to begin renovation of a new site not far from here.

Work has already begun and once finished there will be more room for more patients and better facilities to treat them. The new hospital is scheduled to open in April.