Afghan Hospitals Suffer and Weaken Under Militia Rule

The thinned ranks of female nurses toil in 24-hour shifts. Surgeons have been forbidden to operate on members of the opposite sex. To conform to Afghanistan’s new order of things, many of the male employees have stopped shaving.

“How I am supposed to operate with a beard down to here?” a doctor at Karte Se Surgical Hospital in western Kabul asked indignantly, chopping with his hand halfway down his chest.

In the last 10 days, under the rule of the fundamentalist Taliban militia, life has changed drastically here in the Afghan capital, but nowhere more so than at the city’s hospitals, already struggling to deal with the victims of this country’s long-running civil war.

Last week, a Taliban official gave specific assurances to reporters that female hospital employees would be allowed to go to their jobs despite the militia’s edict against women working. But at Karte Se, officials say they’ve been forced to make quasi-clandestine agreements with career bureaucrats at the Health Ministry. At the latter’s suggestion, only a third of the female nurses come to work on any given day so as to attract less attention as they are driven to and from the hospital.

So now, only 10 of the 30 female nurses dare report for duty each day at Karte Se. They gamely work for 24 hours straight, then, woozy with fatigue, shed their whites and put on black robes or other garments that cover them completely for the trip home. Ten other women succeed them for another 24-hour shift.

“We don’t know the reason any of this is happening,” Adela, 39, a surgical nurse, said in bewilderment one recent morning as she prepared to go home and sleep.

At Karte Se, a 300-bed hospital, only two of the seven female physiotherapists now come to work. An 18-year-old paraplegic, paralyzed by a gunshot wound to her spine, has developed bedsores because there are no longer enough staff members on duty to turn her regularly.

At Malalai, a maternity hospital where all the doctors are female, women in labor arrived one day last week to find no physicians or nurses on duty. After a hurried call to the Health Ministry, cars were dispatched to bring staff members surreptitiously to the hospital to conduct the deliveries.

In every area of Afghanistan they control, the Taliban have forbidden doctors to treat patients of the opposite sex. But in a poor country ravaged by more than a decade and a half of war, the harsh facts often do not square with the Talibs’ severe reading of Islamic doctrine.

For instance, at Karte Se, all nine senior surgeons are men and only one of their 14 juniors is a woman.

“In the operating theater, doing what they say is impossible. We just don’t have enough experienced [female] doctors,” said head nurse Sakhi Shafiq, who is letting his beard grow to conform to the Taliban dictate.

Karte Se’s new troubles are only a single piece in a mosaic of changes under the conquering Islamic militia that U.N. and international aid agency officials say are making their efforts to assist Afghanistan’s war-traumatized populace harder.

Some key programs have already been suspended because they depended largely or wholly on female staff--including one sponsored by the Office of the U.N. High Commissioner for Refugees that is employing 1,200 women to make 50,000 quilts, so that some of Kabul’s poorest residents have a better chance of surviving the fierce winter cold.

U.N. officials in Kabul have issued public warnings that if the Taliban maintain their ban on girls going to school and on women working, foreign aid donors may halt millions of dollars in critically needed development money for Afghanistan.

On Sunday, Mullah Mohammed Ghous, the country’s acting foreign minister, appealed for international aid to help rebuild the country.

“We are hoping that all countries will take part in the reconstruction of our country. The whole administrative system and public services in Afghanistan are paralyzed,” Ghous said. “If we don’t have cooperation and assistance from foreign countries, it will be very difficult for Afghanistan to stand on its own feet.”

Dr. Abdul Fatah Labid, Karte Se’s director, said he is overjoyed that peace has returned to Kabul but predicted an exodus of his staff along with the rest of the capital’s professional class if the Taliban don’t suspend their edicts.

“We don’t just need mullahs to push people to go to the mosque five times a day. We also need doctors, nurses, technicians, engineers,” said the 36-year-old surgeon, who has also begun letting his beard grow. “People think this state of affairs is temporary. Otherwise, the entire intelligentsia will leave Kabul for the north if it’s quiet there.”

Meanwhile, the staff at Karte Se, which receives medicine and other assistance from the International Committee of the Red Cross, is struggling valiantly to cope with what is only the latest in a series of ordeals.

In pitched fighting between rival Muslim forces in March, the hospital and the surrounding neighborhood changed hands four times in only four hours.

Now, Karte Se is also trying to cope with a new wave of patients injured by mines as they move back into their homes.

On average, the hospital gets seven such admissions a day. Recently, they have included a 10-year-old boy who threw a stone at a mine and was badly wounded by flying shrapnel and an 18-year-old man with a burned and blackened face who was blinded by a mine blast.

The nurses are paid a government salary of about $6 a month, as well as a supplement by the Red Cross. The Taliban may have forced the female nurses to change their work schedules, but their sense of duty and dedication to their jobs and patients seems unaffected.

“We don’t have the money to leave Afghanistan,” said Arifa, 34, a nurse with piercing dark eyes who borrowed a black Iranian-style chador from a friend so she could keep coming to work. “But our country is here. Our people are here. It is our duty to help them.”