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10-Year War Disfigures a Nation and Its People : Afghanistan: Amputees flood daily into Kabul for help. Many must wait months for artificial limbs.

TIMES STAFF WRITER

Roshan Gul and Anar Gul are not related by blood, only by tragedy.

They bear the same last name, and their villages were not so far apart in the days before both were bombed to rubble. Yet it took the same war that has been destroying their homeland to bring the two women together recently--at the Red Cross limb factory in Kabul, where they patiently waited for their new artificial legs.

The Guls are among the ranks of what experts say is Afghanistan’s fastest-growing population--war-wounded amputees who are perhaps the starkest metaphor for a civil conflict that continues to disfigure an entire nation.

Every day, amputees fill the urban bazaars of Kabul, hobbling around bomb craters and rocket holes on the capital’s ramshackle streets. At virtually every intersection in every city, they can be seen struggling through traffic and clinging to buses.

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After more than a decade of bombing runs, rocket and missile barrages and massive mine-seeding programs, these legless men, women and children--whose total is estimated at 100,000--represent what experts believe to be the world’s largest war amputee population. In fact, the number of amputees is so large that almost every shoe shop in Kabul has a section selling half-pairs only.

And the numbers may climb as Afghan refugees begin returning to their villages, which are still heavily mined.

“There is nowhere else in the world with a problem of these dimensions,” said Claude Alain-Amiet, the Red Cross orthopedist who built the state-of-the-art Kabul limb factory from scratch two years ago.

Anar and Roshan Gul are typical of the amputees.

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Anar, who still has the face of child, was 13 when she tripped a hidden land mine three years ago. Her right leg was blown off at the knee. Her parents had sent her to explore their family grazing land on the once-idyllic shores of Kabul’s Karga Lake after it was vacated by a military regiment.

Roshan, a 40-year-old whose face already is deeply lined, was home in her mud hut when her village, eight miles north of Kabul, was caught in an artillery barrage between government forces and the moujahedeen rebels. A rocket hit the hut, and the blizzard of shrapnel sheared off her right leg at the thigh. That was five years ago.

Finally, early last month, the two women found their separate ways to the Red Cross limb factory.

Amiet, the Swiss project director, already has worked with amputees for the Red Cross in Lebanon and Angola and contends that the fundamental problem in Afghanistan is underdevelopment, compounded by the sheer numbers.

Most of the amputees interviewed at the Red Cross center had lost their limbs at least two years earlier, an indication of the length of time it takes a wounded villager to reach the Kabul center.

Barbaric surgery practices, poor logistics and acute shortages of medicine have deepened the crisis, Amiet said. Now, he said, his factory is producing and fitting a record 105 custom-made artificial legs every month--and still there are 3,000 amputees on the waiting list, with each month of war adding scores more.

In Angola, he recalled, “the amputations were done better than here. When mine victims came in, the Cuban surgeons tried to save at least one of the legs. Here, they just cut them both. They just don’t care. So we have about 8% double amputees here.”

Lecturing Afghan war surgeons a year ago, a Red Cross surgeon, Dr. Kenneth Barent, spent nearly an hour detailing proper triage procedures that can prevent infections of war wounds, and he appealed to them to try save limbs rather than try to save time in the operating room.

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Still, legless civilians and soldiers alike continue to come in. First, they are fitted for a pair of crutches and are given a number on the waiting list; several months later, they get an appointment to begin the long process of fitting and manufacturing new legs.

At first glance, the scene in the center’s courtyard is depressing: Dozens of hobbling men, women and children; women like Anar and Roshan Gul sitting idly on the floor; old men stumbling as they try to walk again, and double amputees from isolated villages struggling with sophisticated wheelchairs.

But beneath the surface there is something different about these war wounded--something that Red Cross workers say is as extraordinary as their huge numbers.

“There is one thing that sets these amputees apart,” said one British physiotherapist at the center who has also worked with amputees in Cambodia and Lebanon. “With very few exceptions, they never seem to go through the stage of depression that most amputees experience. There’s just a whole different spirit in these people--stoic will to go on.”

Indeed, in interviews with more than a dozen legless, it was clear that they have retained their dignity and hope.

Mohammed Younis, for example, refused to give up when he stepped on a mine in Kunduz province four years ago. His face lit up with a proud, toothless grin through a yellowing beard as he rolled up his tattered trousers to show off an artificial leg that he made himself out of scrap metal and discarded bicycle parts.

Younis, 68, is a bicycle repair man by trade, so, he explained, he fixed his leg the same way he would a crumpled bike.

Raz and Lal Mohammed, 13-year-old cousins, are even more extraordinary, Red Cross workers said. Both boys lost both their legs a year ago when they stepped simultaneously on two land mines while walking to their uncle’s house.

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The boys have been walking on their new Red Cross legs for several months now and have become role models for other amputees, helping every day to run physiotherapy classes at the limb factory.

When asked what they want to do when they grow up, both respond, “I want to be a doctor.”

In the women’s dormitory at the factory, where Roshan and Anar Gul fill their time sewing prayer scarfs and chatting about their families, the same spirit came through.

“I am a seamstress by profession,” Roshan explained. “When my husband was alive, we had a fine field of crops. We had children. We had a life.

“Now, I’ve lost everything. No money; my husband is dead; my children are gone; my leg is cut, and I have forgotten everything because of this war,” she said. “But what I have lost, I have lost. I only pray that God will keep others from losing their lives, and that is what I live for--for those prayers.”

Anar, the 16-year-old, said she has the same prayer. But for her, the future appears to be more difficult. Perhaps it was her age; many Afghan girls are preparing for marriage at 16.

But when asked to tell her dreams for her life, a tear formed at the corner of Anar’s right eye.

Looking down, she said quietly, “Every night when I am sleeping, I dream that I have my leg back.”


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