Amid Afghanistan war, U.S. aid is there for an injured child

KABUL, Afghanistan — When he saw the flowing blood, Mohammed Anwar at first thought his son was dead. Five-year-old Muqadas had been shot in the head in June during a firefight between U.S. forces and Taliban insurgents in eastern Afghanistan.

But Anwar’s quick response not only saved his son’s life, it also secured modern medical treatment that has allowed Muqadas to resume a normal life.

Thousands of Afghan civilians are killed or maimed each year in warfare, and most are doomed to rudimentary medical care in this impoverished country. In Muqadas’ case, there was no hospital or clinic near his home, so Anwar drove to a U.S. military base about a mile from his remote village in Lowgar province. When gate guards saw his critically wounded son, they rushed him inside, where U.S. Army medics worked to stop the bleeding.

Within minutes, Anwar recalled, he and his son were placed aboard a medevac helicopter for a 10-minute flight to the American medical facility at Bagram air base near Kabul. There, emergency medical treatment saved the boy’s life.

The U.S. military specializes in treating serious wounds, including head and brain injuries caused by bullets or shrapnel. The Bagram hospital is staffed by specialists such as neurosurgeons, and has sophisticated medical equipment not available in Afghan hospitals.

Muqadas emerged from an eight-day coma partially paralyzed and with severe neurological damage. He was transferred to a medical program run by the U.S. Agency for International Development. Treated by Western and Afghan doctors and nurses, the boy has since learned to walk and talk normally.

Since December 2011, USAID’s Afghan Civilian Assistance Program has provided medical treatment for 180 Afghan patients. That’s a tiny fraction of the tens of thousands of Afghans wounded in fighting or by mines or roadside bombs since 2001, but for Muqadas, the care probably saved him from lifelong paralysis.

“He couldn’t walk; he could hardly open his eyes,” Anwar said in a Kabul civilian hospital ward where his son is undergoing outpatient physical therapy. He gestured toward the boy, who sat quietly in his lap. “And look at him now.”

Muqadas whispered to his father and smiled shyly. A plump boy with cropped black hair and a round face, he’s active and energetic and plays with other children. He is undergoing therapy for partial paralysis in his left foot, which causes a slight limp.

Three months ago, the boy was confined to a hospital bed. He had difficulty speaking, eating and drinking.

“He lay on the bed like a piece of meat,” said Dr. Abdul Shakur Furmoli, who has helped direct Muqadas’ care under the USAID program. “Now this child is 99% returned to his normal life. He has a small limp — that’s all — and we’re working to correct that.”

The assistance program, known as ACAP, is designed to treat Afghans wounded during combat between U.S. and coalition forces and insurgents, regardless of which side is directly responsible. (In its latest casualty report, the United Nations said that in 2011, at least 3,021 Afghans were killed and 4,507 wounded in war-related incidents, with insurgents responsible for 77% of the deaths.)

In Muqadas’ case, American officials at the ACAP program said they were unable to determine which side fired the bullet that struck the boy. Anwar said he didn’t know; he said his son was wounded after Taliban fighters fired on two U.S. helicopters.

The bullet remains embedded in the boy’s skull, left there by doctors at Bagram. Because Muqadas’ brain is healing, Furmoli said, there is no medical reason to risk surgery to remove the projectile.

Since his son was wounded, Anwar has left his job as a driver to devote himself to the boy’s care. The program has given him $225 to help pay for travel costs. He makes regular three-hour trips from his village to take Muqadas for physiotherapy treatment at the Kabul hospital.

Muqadas is unusual not only because he received American medical treatment, but also because his father took him to U.S. forces in the first place. Much more often, program officials said, it is they who seek out wounded Afghans after receiving reports of civilian casualties in clashes between coalition forces and insurgents.

Since 2007, more than 11,000 Afghan families affected by the war have also received non-medical assistance through the program: food, emergency supplies, livestock or help in starting a small business. Muqadas’ family, for instance, got help setting up a small grocery after he was shot.

The medical portion of the program is scheduled to end in September 2014. But USAID plans to continue many other programs that assist Afghan civilians well past 2014, said Kevin O’Loughlin, an agency spokesman in Kabul.

Anwar says he realizes that his son defied the odds in a country where dozens of civilians die unnecessarily of wounds each month, many from substandard medical care or no care at all. Even when Muqadas was in a coma at Bagram, Anwar said, American military doctors assured him his son would recover.

“Every day, they came to me and told me that one day he would be a normal little boy again,” he said.

He hasn’t yet told Muqadas that he has a bullet in his head. He said he told him he was hit by a rock.

The boy occasionally complains of headaches, Anwar said, but otherwise acts like any other 5-year-old boy. He seems grateful to be living an ordinary life except for his outpatient therapy.

“Every morning,” his father said, “he wakes up and kisses his own hand.”

david.zucchino@latimes.com