A good day's work in Afghanistan

By Captain Hélène Le Scelleur
Deputy Commandant, Health Services Support Company, JTF-Afghanistan

At nine o’clock in the morning of January 15, 2008, we finally opened the doors of the District Joint Co-ordination Centre in Spin Boldak, ready to welcome everyone who wanted free medical care. This much-anticipated moment was the beginning of a Village Medical Outreach (VMO) visit, a project close to my heart since I first set foot on Afghan soil.

The need for health care is great in Kandahar Province, but Afghans have limited access to services. Security problems make development agencies hesitate to invest time and money in this area. To help bridge the gap, I proposed a VMO program to help people in desperate need of health services, although the Health Support Services Unit at Kandahar Airfield had not conducted one since July 2006.

I started by consulting important stakeholders, including the Director of Health for Kandahar Province, the representative of the Canadian International Development Agency and, finally, the sergeant-major of the Civil-Military Co-operation platoon in the Kandahar Provincial Reconstruction Team. This first stage was essential not only because it secured support for the project, but also — and more importantly — because it secured their agreement. Once permission was received and co-ordination established with everyone involved, I could get started on organizing the first free clinic, in the Spin Boldak sector.

Despite the popular belief that they are part of a “hearts and minds” campaign, VMO visits are actually conducted to gather and confirm information about the health of the population of a given area. Statistics and epidemiological studies are sadly out of date. A secondary goal is to find children who need specialized clinical care and to register them — through our CIMIC section — with Afghan Trust Funds Assistance, a granting organization that ensures children receive the care they need to recover fully.

Escorted by Reconnaissance Squadron (commanded by Major Pierre Huet), we drove from the forward operating base near Spin Boldak to the District Joint Co-ordination Centre, a convenient location for potential patients that was made available to us by the District Leader of Spin Boldak. With a platoon of infantry for perimeter security and two full medical teams (one male, one female), our clinic offered care to more than 260 patients, both children and adults, in six intense hours of clinical work.

The Canadian members of the male team were medical officer Captain Serge Blier, dental officer Captain Laurent Richard, dental assistant Master Corporal Alain Belhumeur, and an ambulance crew: medical technicians Master Corporal Patrick Perron and Corporal Rémy Dion, and driver Corporal Dany Corriveau, who helped out in the triage area taking vital signs. The male team also included a U.S. Army medical technician and, from the hospital in Spin Boldak, three doctors and two nurses who volunteered their services without pay. For female patients, we had nurse practitioner Major Lee-Ann Quinn, medical technician Corporal Julie Alain, and a midwife from Spin Boldak. RMS clerk Master Corporal Rémi Nay collated all the diagnoses and the prescriptions for each patient, and Master Warrant Officer Jacques Gauthier and Master Corporal Anouk Beauvais provided crucial advice on Afghan customs.

We saw people with a wide variety of troubles ranging from trivial to terrible: dehydration, malnutrition, musculo-skeletal problems, upper respiratory infections, cancer, congenital deformities. With no testing facilities or opportunity for follow-up we could give only primary care, referring the most serious cases to the hospital in Spin Boldak. Everyone was grateful for what we had to offer, even if it was just a listening ear. An embrace, a handshake, a smile from the children: all day that was what we got. For once in their lives, these people felt recognized, which matters when you’re sick.

At three o’clock, when the doors were shut, we told ourselves, “Mission accomplished!” All went well, adding a little glow to the growing collaboration between Afghan and Canadian medical teams. We returned to the forward operating base knowing that we had done a little good for Afghans living in difficult circumstances. No, we didn’t improve the general health of the population, but Rome wasn’t built in a day. In winning the trust of the Afghan people we will be able to introduce preventive measures along lines as simple as hygiene, which over the long term will help relieve Afghanistan of the burden of infectious disease.

We do not pretend to be the solution to the challenge of health care in Kandahar, but it’s a sure thing that action speaks louder than words.