Sylvia's Journal

We followed the visiting teams from the five other provinces (Jawzjan, Takhar, Badakhshan, Ghazni and Kabul) on their field trip to see how indicators for health services get collected and analyzed. Sara went with one group to a comprehensive health center (CHC) and I with the other to the District Hospital that is run by the Danish-Afghanistan Committee. Even if I had not known where the funding came from I could have figured it out from the small sketches of Copenhagen’s inner harbor and a rustic scene with a farmer.

Everywhere in the hospital I saw signs of our leadership program that has taken root here: it has led to team work where none existed before, joint and very systematic analyses of challenges and root causes and an abundance of graphs showing improvements over baselines taken months if not years ago.

I am told I am seeing some very successful students from the leadership program who have now become champions themselves. I watched the hospital director behave in ways that I don’t usually see in societies that are as hierarchical and gendered as Afghanistan. The director mostly listened and let his young female staff explain their vision, challenges and the graphs on the walls.

I used the time to sit with the women and ask what number baby they had in their arms – I can have such simple conversations in Dari now – and learned that many were baby number 2 (to women looking like small girls themselves) or baby nr. 9 or 10 to women who looked older than me but probably weren’t. I am now addressed as bibi-jon which is an endearing word for older women (dear granny). None believed I had no grandchildren.

One of these leadership champions, a young doctor working in another district was kidnapped two weeks ago and a ransom of 200.000 dollars demanded by the thugs who took him away from his family (under the guise of a medical emergency). About a year ago I handed this same doctor a poster which he had earned for his extraordinary work. Some people think that government officials are in on the plot – this is what President Karzai has to root out; but in the meantime there is the dilemma – nearby family want to pay of course as non payment may mean instant death. Who can afford this kind of money even in the US? And so family and friends go into debt from which there is no recovery. And payment of course means the crime gets repeated.

After lunch our guard Amidullah took Sara and me on a tour of Herat, first to the cistern that is an old architectural wonder with an enormous domed ceiling that has no support beams or anything like that – just bricks, each row slightly off center but not enough to collapse the dome.

After this we saw the gigantic minarets, 5 are still standing despite the many wars that have ravaged this city over hundreds of years. I couldn’t help consider these spires testimonials to the Y chromosome – they are rather phallic from a distance and still so close up.

While Sara went to see a colleague from her previous work life for dinner I joined a group of about 12 men, several of whom I didn’t know, all doctors, at the house of one of our Kabul staff who happened to attend to his sick mom. I was let in past the curtained off inner room to watch the cooking and preparation of the meal while mom was sitting coughing in a corner, another sick child near her and a bunch of sisters and wives were cooking a spectacular meal.

When the meal was served all the women scurried away, even sick grandma and I was once again with the men. We ate our meals in silence while watching a program about the production of Christmas ornaments somewhere in the US: blond women of a certain age delicately painting US Air force bomber planes on frosted glass balls with tiny paint brushes. When it was dessert time we were watching elephant polo in Nepal. I couldn’t have made it up if I had tried.

Sitting cross legged on thin mattresses for the duration of the meal is a bit of agony for me, especially when hemmed in by both sides. I was very grateful when the meal was over and we could return to the formal guest room with its western furniture. I watched with some jealousy how everyone, old and young, rose from their folded up position with great ease – I had to unfold myself very slowly and trying not to show any wincing. After that more tea, more nuts, more dried fruit and more Dari immersion until I anounced that my hard disk was full and I couolnd’t take in any more Dari. It was one very long Dari lesson today.

We always stay in the same hotel in Herat, a blue-glassed architectural-eyesore high rise that stands out in the neighborhood like a sore thumb. But the staff is nice and stable – each time I arrive here I see the same people and am greeted with more enthusiasm than the previous stay. We are practically old friends now.

The rooms are spacious and comfortable; now with the armoire I can actually hang my clothes. That the armoire is put right in front of the desk which has now become unusable is a minor irritation. It’s not that there weren’t any other places to put it and I try to imagine the reasoning that placed it in the most inconvenient spot.

The one thing that is a major irritation is the sheet arrangement. The bottom sheet of the bed is put on the mattress like a table cloth that is too small, it doesn’t cover the surface and edges of the mattress remain uncovered (who else slept on this I wondered). The sheet is more the size of a crib sheet than the full-size it should be. The rest of the bedding is do-it-yourself: a plastic bag on top of the bed has another sheet of the same size that therefore also cannot be tucked in. And finally there is the 15 kilo Chinese blanket that lies folded next to the plastic-wrapped top sheet at the foot of the bed.

Unlike the sheets, the blanket is made for a king size bed. It size and weight make it impossible to unfold with my one good arm as it is too heavy for my (still) injured and weak-muscled right arm. After trying for a while to spread the 15 kilo of dead weight over a slithering piece of cloth I gave up and slept in a jumble of mostly blanket and a little bit of sheet that’s always in the wrong place.

The label on the blanket says ‘handwash in warm water only’ and a stern warning to not dry clean. Given its dry weight I cannot imagine a human being hand washing this behemoth blanket (wringing not allowed luckily) and so I assume this blanket doesn’t get washed very much (this only bothers me the first night).

The pillow is another issue, a decorative affair with little things sewn around the edges that look like the ears on Halloween animal outfits. It too has only a sliver of a sheet wrapped around it by way of pillow case but ‘case’ is the wrong word as there is no encasing. Would they wash the decorative case after each use? I hate to ask because I can sort of predict the answer.

All of this is of course only a problem on the first night. After that I adapt and prove once more that we humans are, among many other things, endlessly adaptable and able to lower our standards if there are no obvious and immediate other options. It’s called accommodation, and probably a good thing.