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The neglect of Kabul's disabled war veterans

From flesh-eating mice to unhealthy food, war-disabled Afghans complain of poor health care.

Last updated: 04 Jan 2014 14:03
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An estimated hundreds of thousands of Afghans suffer from disabilities after decades of war [AFP]

Kabul, Afghanistan - When Gholam Muhammad first heard faint rustling sounds under his hospital bed he passed it off as a dream.

As the night went on, the noises seemed to be getting closer, and when he opened his eyes before dawn, he could not believe what he saw. "The bedsheets were stained red. When I removed the blanket I saw a mouse chewing at one of my legs," the paralysed war veteran said.

For residents at Kabul's Disabled Rehabilitation Hospital, Gholam Muhammad's wounds serve as one of the most extreme examples of neglect patients say they face in the hospital.

His case was not an isolated incident. At least one other patient had also complained of having his body gnawed at by mice. That patient later died of kidney failure.

Though official statistics on disability in Afghanistan are non-existent, there are an estimated 400,000 to 655,930 disabled people, according to World Bank and Handicap International reports, many with wounds sustained during three decades of conflict. 

Eighteen long-term patients at the rehabilitation hospital told Al Jazeera that Kabul's only government-run facility for the disabled treats them with indifference. Flesh-eating mice are merely one example of their neglect. Patients point to bottles of drinking water stored under their beds since the hospital water began to exude a strange odour.

"Until last year, it had a urine smell to it. This year, the odour has lessened, but the taste is still the same," said Mohammad Amin, one of the long-term patients.

For a hospital that has had at least three patients die of kidney complications in a four-year span, the questionable water quickly set off alarm bells.

Unheard and uncared for

Lab results in 2012 showed that the hospital's water supply had been contaminated by the nearby Kabul River, a dried-up waterway that has become an urban dumping ground. "They are only doing what is best for their pockets, not the nation," said Mohammad Amin, who serves as an intermediary between patients and hospital officials.

In a small, cramped room where exposed electrical wires run along the white-and-yellow dirt-stained walls, Mohammad Amin said all of the patients feel uncared for.

One of my kidneys has already stopped functioning and the other one seems less active.

- Gholam Muhammad, patient

In a hospital where the still under-construction bathrooms are also used for trash storage, patients claim their meals have created further medical complications for the bedridden and paralysed. 

Several patients speaking to Al Jazeera complained about the hospital's unappetising menu, which has remained unchanged for more than four years. The daily ritual of chickpeas and boiled eggs have caused "kidney problems for the paralysed, who are unable to do any physical activities", they said. 

Gholam Muhammad, who hails from the southwestern province of Helmand, said he fears the combination of discomforting food and unsanitary water may have already left a lasting impact on his body. 

"One of my kidneys has already stopped functioning and the other one seems less active," he said weeks after seeing a fellow patient die from kidney complications.

When he approached hospital directors to demand better food, Mohammad Amin was told that budget constraints made the request impossible to fulfill. Currently, the Ministry of Public Health provides the hospital with 70 afghanis ($1.24) for each patient's daily meal allowance.

But Amin said hospital officials are not doing enough to make the most of the budget, pointing out that the hospital pays 9 afghanis ($0.16) for each egg when the market value is just 6 afghanis ($0.11) - a result he claims stems from a corrupt bidding process. "They gather three or four invoices from different merchants, but the bidding process is in their hands. If it was a real bidding process, why would they pay more than market value?"

A request for comment from the Ministry of Public Health was not answered by publication time.

With only 1 percent of next year's national budget allocated to healthcare, Mohammad Amin places little faith in the hospital's promise that in 2014 the daily allowance will increase to 150 afghanis ($2.68) per patient. 

Because 64 percent of the national budget comes from foreign aid, patients say they fear the uncertain fate of a Bilateral Security Agreement with the United States - the largest foreign aid contributor -  could see further reductions in government assistance to the disabled in subsequent years. 

'Pride of our nation'

Din Mohammad Darwesh, the hospital's director, called Afghanistan's disabled veterans "the pride of our nation" for the role they played in the war against the Soviet Union's occupation from 1979-88. Darwesh agreed the government is not doing enough for the disabled. "The government makes repeated promises on paper, but fails to deliver on them," he told Al Jazeera. 

Afghans face uncertainty in new year

Despite financial constraints and lack of government cooperation, the hospital still strives to provide patients with the best care possible, Darwesh said. "Neither the government nor international organisations have helped us, but still we managed to see 1,414 [short-term] patients so far this year, and more than 35,000 since this building was transformed from a basement to a hospital 10 years ago."

Hospital officials told Al Jazeera they maintain a ratio of one doctor for every four beds. At night, 18 doctors, nurses and pharmacists are on shift. 

But Mohammad Amin said that even with these staff levels, problems remain. "The staff come here like it's a guest house. Every night there is a list of 10 or 12 doctors and nurses on duty, but you won't see more than two or three in person. It's all on paper and nothing more," he claimed.

Several patients highlighted examples of the lack of care they receive. Paralysis makes patients more susceptible to skin breakdown, and bed sores are a common occurrence in the hospital, said Amin. At least four patients suffered from bed sores in 2013 because they were not turned over at regular intervals, he said.

Looking elsewhere

All this has led patients to look elsewhere for treatment, most notably at the International Red Cross hospital in west Kabul.

For Gholam Muhammad, however, the realities of his disability have hampered his chances of treatment at the highly regarded institution. To be transferred to the ICRC hospital, Gholam Muhammad would first have to register in his home province of Helmand. Aside from the threat of the Taliban, who line the road to Helmand, Gholam Muhammad must also contend with the pain of a days-long bus ride.

"How can I lie down in an overcrowded bus? There's no way. I'd need to go by ambulance or helicopter, but there are none," he said. 

 

Obaid Ali is a researcher at the Afghanistan Analysts Network, where he has written extensively about the disabled.

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Source:
Al Jazeera
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