Learning to Walk Again From Experts in Taking the First Step

In the gloom of the men’s ward stood Farid Aqa, hobbling on a damaged leg. At his elbow was Said Musa, a physical therapist, both legs securely planted as he led 13-year-old Farid through exercises.

The boy’s left leg had been blown off by a land mine. So had the left leg of his therapist. The boy struggled to walk on a new prosthesis. The therapist walked with grace and precision on his artificial leg.

And that, essentially, is the difference between the staff and the patients at the ICRC Orthopedic Center of Kabul.

Eighty percent of the patients are land mine victims. Eighty-five percent of the staff members are amputees too, mostly because of land mine wounds that first brought them to the center.

New patients come to be fitted for prostheses, and to learn to walk and function in society as effortlessly as the therapists who teach them. Their plastic legs and arms, and their wheelchairs and crutches, are made in the center by former patients disabled or disfigured by land mines.

There they are in the dimly lighted machine shop, young men and old men missing an eye, a hand, a leg, two legs. They mold hot plastic into artificial arms and legs, fashion rubber from old Russian tanks into orthopedic shoe heels, and turn old bicycle tires into wheelchair wheels.

Their patients keep coming, dozens more every week, their limbs blown off in a country that is one of the most heavily mined in the world. The center, run by the International Committee of the Red Cross, has treated 26,000 amputees and churned out 39,000 prostheses since opening in 1988.

Dashing from room to room on two good legs, greeting staff and patients in Dari and English and a smattering of Italian, is Alberto Cairo, the center’s charismatic director. Cairo, a slender Italian lawyer with a manic personality, seems to be everywhere at once, cracking jokes with the men, teasing the women, hugging the children.

Cairo is the force behind the center, having arrived in Kabul in 1990 to revitalize the operation and gradually expand it. He has survived half a dozen governments, from the Communists to warring moujahedeen to the Taliban.

“No matter which regime is in power, our patients need the same kind of help,” Cairo said one morning, moving between the wards in a white smock with “Alberto” written in red marker on a piece of masking tape over the breast pocket.

It was a busy morning. In the machine shops, men bent over lathes, breathing in the sharp odor of hot plastic seeping from the ovens. Cairo spotted a big, bearded worker with a missing leg and shouted: “Watch that one--he’s Al Qaeda!” The big man laughed and continued his work at the lathe, but not before threatening to smack the director with a half-completed leg.

Cairo, who says he quit his law practice to earn a degree in physical therapy, cajoles and admonishes his patients. “I tell them to stop thinking about what they have lost,” he said, “and to think only about what is now possible.”

Without the center, many of the amputees would have been left by family members to sit alone at home day and night, or to crawl in the street to beg. Cairo searches the streets for amputee beggars, hauling them in for prostheses and therapy. Sometimes he spots them months later, back to begging, their artificial legs carefully hidden away.

Since 1995, the center has extended its services beyond land mine victims to assist all disabled people--those with polio, spinal injuries, birth defects, cerebral palsy, and victims of falls and car accidents. Men and women are admitted equally.

During the Taliban era, Cairo said, the center was inspected almost daily by Talibs who measured the beards of male staffers and made certain that men and women were strictly segregated. The Taliban insisted that women receive therapy only from women, though Cairo said several Talibs secretly begged him to come to their homes to help their disabled wives or sisters.

The Talibs also demanded that Cairo remove the red cross he wears on his lapel, saying it was a banned Christian symbol. He refused, he said, and the Talibs cursed him and called him kafir, an apostate, but finally relented.

Today, the center sends male and female amputee staffers on home visits to amputee patients. It provides vocational training and operates a job center that it says has provided more than 200 patients with jobs at Western aid organizations.

The center’s micro-credit office provides $100 loans to patients to help them start small retail businesses. Said Mujtaba, who lost a leg to a land mine, is the micro-credit director. He rides a bicycle 25 to 30 miles a day, he said, checking up on clients and making sure that loan recipients repay in 18 months, no interest.

The center also trains teachers who provide home lessons to amputee children. About 35% of the country’s land mine victims are younger than 14, Cairo said.

One of the teachers is Obaidullah Mihr, a former soldier who lost his left leg to a land mine. Five days a week, Mihr rides his bicycle 12 miles through Kabul’s choking morning traffic to the mud hut of Mohammed Ashraf, a slender boy of 16 whose legs were paralyzed by a rocket attack when he was 7.

The youth sat on his bed one morning as Mihr, wearing his army fatigue jacket, taught him an hourlong lesson in 16th century Afghan history. Ashraf said he wants to earn a degree, improve his English and get a job as a computer programmer.

Cairo often teases the boy about his desire to one day live in America. “I tell him America is a terrible, wicked place,” the director said. “I don’t want him to leave. I would miss him too much.”

Cairo, who is single, said his patients are his family. “I give them so little. They give me so much. I’m a very privileged man, eh?” he said.

Outside the men’s therapeutic ward, Cairo stood watching as men and boys with missing legs and feet learned to walk with prostheses. It was difficult work. They had to walk on concrete, up a stairway, across a wooden platform, down a muddy dirt path and, worst of all, along a pathway of stones and pebbles. Many of the amputees stumbled or fell, but the therapists caught them, bracing themselves on their own prostheses.

Nearby were two bicycle frames with the wheels raised. There, the amputees learn to ride bicycles, the most common form of transportation in Kabul, the Afghan capital.

Inside, the floor of the men’s ward was littered with artificial legs. The patients had put them aside as they rested on benches, raising the stumps of their legs to warm them beside kerosene stoves glowing in the chilly room.

There was Abdul Wasay, a boy of 13 who looked no older than 10, whose legs were blown off by a land mine near the Kabul airport. Next to him was Said Mirza Ali, a bony man of 65 who was twice cursed. He had lost three fingers and a thumb to a Russian mine 16 years ago, he said. And last year, he said, he was shot by the Taliban in northern Afghanistan and had his wounded leg amputated after an agonizing nine-hour car ride to a hospital in Kabul.

Outside the women’s ward was Sahar Gul, a 2-year-old wearing a red dress. Her legs withered by polio, she took tiny steps with specially made mini-crutches and leg braces from the center, her father supporting her as she inched across the walkway.

On and on the amputees walked, 250 to 300 of them in all, up and back, up and back, their therapists beside them.

“Some say this is such a sad place,” Cairo said, watching them come and go in the shadows of the ward. “I say, no, no, this is a very, very happy place. This is where life begins again.”