Sylvia's Journal

We had not really planned to check the emergency health system quite the way that we did early this morning. An upset stomach turned nasty and at 5 AM Axel was in such a bad shape that a doctor was needed. This was a new experience and one we had not sufficiently researched while he was healthy.

The dispatcher, whose English is OK but not enough for emergencies like that, did not have the necessary information, or, if he had, didn’t know it. I called one of my Afghan staff who is a doctor and asked if he knew of a good doctor classmate or friend who could come to the house and administer IV fluids? He counseled me to dress the patient while he’d call the dispatcher and get a car over to take us to the nearest emergency room. I saw Axel cringe. Here hospitals are not really the place to go to when what you need is expert care.

Luck, or rather bad luck had it that just when we arrived at the main road, at 5:30 AM, Parliament, which is in our neighborhood, came back from recess. A long line of cars and police cars with flashing blue lights and tons of heavily armed men guarded all roads within a quarter mile of the parliament buildings.

Even sick people were not let through and we bumped over unpaved back roads to the entrance of the Cure Hospital which I had always supposed what the place for foreigners to go to. But when we arrived the entire hospital was dark and the reception area without any signs of life. There is no such thing as night duty – something we take for granted in the US or Europe.

After some time we spotted a sleeping boy. We woke him but he refused to find us a doctor because we did not have a contract. Phone calls with one of our own doctors made no difference and we hoisted Axel back in the car and drove, once again via bumpy back roads to the next hospital, Istiqlal, which had the lights on and people walking about.

Our driver disappeared inside and came out after about 10 minutes with a doctor on duty. He checked Axel’s vital signs (OK) and ordered an ECG and gave the driver a prescription for various drugs. With IV fluids in third place I decided it was time to call my colleague Steve to get someone who knew about medicine to oversee the treatment plan. And so Steve was awakened and summoned to Axel’s bed.

1 liter of IV fluids later (I always go home when the bottle is empty, quipped Axel, noticeably better) he was released. I asked where to settle the bill but there was no bill; compliments of the government of Afghanistan. This is the irony: the Afghan government is feverishly trying to show its population that ‘government works for them.’ It did for us.

The IV fluids were probably a gift from the Italian government; the medicines were our own to purchase but Steve decided Axel did not need these. Prescribing drugs, preferably antibiotics, is expected from doctors. Steve used all his tact to counter the doctor’s orders, who gave in and cancelled the prescriptions and then asked for a job.

It took us another hour to inch our way back home through the congested back roads. Steve walked ahead of us to a pharmacy to buy a bunch of Oral Rehydration Solution packets (10 cents each) so we could complete the entire treatment of fluid replenishment (3 liters) and keep a small stock for future GI mishaps.

And so, instead of our Saturday plans of shopping and a visit to the bird bazaar I got to contemplate hospital emergency care in Kabul city, something that is badly needed and that we are working on with US taxpayers’ dollars.