Doctor Doctor:
I speak English, you may have noticed, not expert, not Stephen Fry, but better than Stephen somebody else who I am struggling to think of. I am frequently asked for the definition of this and the spelling of that in Afghanistan, but it's not life or death stuff.
However there is one area of frequent enquiry that streams my way, where I feel that I am not ideally qualified to comment. Doctors in Afghanistan are at best soothsayers, at worse fraudsters. There is a road that I regularly drive down in Kabul, and along one side is a block of apartments, perhaps 500 yards long and three stories high, and on each door and balcony is a painted signboard with the words 'Doctor Abdullah's Surgery' or 'Mr Farsi's Chemist'. Each has a pile of letters after their name that would make Professor Steven Hawking's blush. Personally I wouldn't visit a single one of them if I had so much as mosquito bite. I reckon in little more than a week I could set up business there and offer 'breast implants and other augmentation procedures' and my waiting room would be full of the disadvantaged and deformed. It is the Harley Street of Kabul without the cache.
These doctors prescribe drugs whose relation to the symptoms they are meant to cure is tenuous at best. So I am often asked to countenance the efficacy of these items, and a steady knock knock at my door has passed an idle seven months. And here is my favourite. 'My father is dying of cancer, the doctor has prescribed these, can you check if they are safe and whether they will work?' Of all the roles I imagined I might take when I arrived here, I never considered Oncology, 'arbiter of life and death'. So you scan the instruction leaflet, trawl the internet, and in no time at all you discover it's a prescription for some completely unrelated condition, like Piles, and these poor unwitting people have just wasted $50 they didn't have to save their dying father from sitting on a cushion.
As always it's the children who suffer the most
No Drugs Please:
When various friends texted me over the last few days to suggest drinks, I declined due to massive near-death ill health. Concern was ripe and offers of help flooded in from literally no one - I was touched. They all, however, said "best you get some antibiotics, things can quickly turn nasty in this country, westerners have died tragically because of the mix of virus, pollution and no health system." And it's true, it is a toxic concoction. I was just fine, and I held off medication in the arrogant belief that my immune system would win through against an insurgent army of Talib bacteria. And I was right. However my desire to desist from pill popping was more due to the providence of the old amoxicillin, and not my belief in my personal inner strength.
And here is why. There are only two places that you can safely get antibiotics in Kabul. They are brought in independently by western NGO's, are fully tested and guaranteed (and you will need to sell a kidney to pay for it). Everything else is unscrupulously manufactured in Pakistan by evil deviant dealers intent on profit. If you are ill in Afghanistan doctors will prescribe you four different antibiotics to take at the same time, in the hope that one will be legitimate. However, if by fluke they are all legitimate then you can suffer damage to your internal organs.
You really do run the gauntlet in this place. For the billions invested in this country in 11 years, none of it goes into health and medicine, none of it. 500,000 women and children a year die in childbirth here, yep you heard me. That's a couple of Tsunamis and throw in the World Trade Centers for good measure. A silent statistic of stoicism and stupidity, and utter sadness.
Two years ago I visited an Afghan hospital and followed a surgeon on his rounds. I watched as they performed surgery on men who had lost half their leg in motorcycle accidents and car crashes. I am going to describe the anesthetic now, hold on to your hats, don't spill your tea. They rolled up a rag, stuffed it into the patients mouth, and they bit as hard as they could, whilst they poured beakers of burning iodine on the bloodied gaping wounds. It wasn't for the squeamish I can tell you, and it has made me somewhat averse to having my legs blown off. When the patient came to, in typical Afghan manner, they would stretch out an arm, shake me by the hand and say 'Hi I'm Abdul'. I would have turned the surgeons lights out for good.
All of this is why I decided to get better all by myself, and why I sleep 23 hours a day and never leave the house. And I am determined not to get pregnant too!
Ill health is a hobby here, sometimes on an epic scale
All images and words © martin middlebrook 2012
To find out more about the life of a working photojournalist go to http://www.martinmiddlebrook.com/martin_middlebrook_ezine.html