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From Afghanistan to Cambodia: mined lives

12-09-2003 Featureby Alberto Cairo

For the past 13 years Italian physiotherapist Alberto Cairo has offered hope and care to war amputees and the disabled of Afghanistan. In charge of the ICRC's orthopaedic programme, he leads a dedicated team fitting hundreds of artificial limbs each month. He wrote this article after a recent visit to Cambodia.


My job is making arms and legs. I work in Kabul for the International Red Cross, with around a hundred Afghans, physiotherapists and prosthesists. A hundred – big number, it makes quite an impression. But in fact there are only barely enough of us, and we’re always in a rush, trying to keep everyone happy. Two years ago, when the Taliban were driven out, people said with relief “No more fighting, it’s peace now. They won’t be long clearing the mines, and there’ll be no more wounded. About time too”. Instead, in 2002 there were over a thousand new amputees – and this year, we’re still here.

To improve the prostheses we make, the Red Cross is sending us to see the work they do in Cambodia, another country with mines everywhere. None of us has ever been there, and we’re impatient and curious.

At the crossroads a girl and a man, both on crutches, are forced back each time by the cars... 

The farewells of the departing Afghans are long-drawn-out and rather theatrical. “We’re only going to be away for ten days,” I remind them, to hurry them up. Kabul airport isn’t far, but with all the traffic it’s better not to delay. I was right. Motor vehicles and bicycles everywhere, policemen waving their arms and blowing their whistles, pedestrians popping up on all sides, while the women with burqas are a danger to themselves and to everyone else, with that mask in front of their eyes. At the Bibì Marù crossroads a girl and a man, both on crutches, are trying to cross but are forced back each time by the cars. The policeman, in the shade, is smoking a cigarette and thinking his own thoughts.

We let them cross. They turn around, surprised. The man recognizes us, and smiles, and the girl salutes us too. They are Zia Gul and her father. Zia Gul was in the orthopaedic centre a few weeks ago. She was limping heavily. As she had lost quite a bit of weight, her prosthesis was too big for her and needed to be replaced. “Adjust it any old way”, she asked us, “I’ll see to it later on, I haven’t time now. I’m missing work.” We know her story. She comes from the Bamian area. She belongs to the Hazara ethnic group, with oriental features. They are farmers, and poor, and they have a hard life: a little land, a few sheep, a donkey and a cow, bought at a cost of who knows how many sacrifices.

Ten years ago, Zia Gul was in the pasture with her small sister when a mine exploded. A second one, put there deliberately to wound whoever came running to help, blew her father’s legs off. Together they come to us for their prostheses, together they go home a gain. But the father can no longer till the fields, in the mountains. In order to survive, they sell everything and move to Kabul. The mother does laundry in rich people’s houses, the sons gather wood and leaves to make fires, the father and the little girls make carpets. Work is irregular, and they don’t eat every day. There is no time for school. They dream about Bamian: “We used to be happy at home”.

 At the knee and foot factory  

Cambodia is beautiful, with water everywhere. People have lovely smiles, their movements are swift and graceful. In Phnom Penh we visit the knee and foot factory. All shapes and sizes, made in large quantities and distributed to all the orthopaedic centres in the country. They don’t see patients here, it’s only a workshop – like a medicines company, with no sick people. We find the amputees – many, many of them – in Battambang, up in the north. Almost all of them are there thanks to a mine.

It’s a big centre, and well organized. The plaster room, machines, work tables, casts, dormitories for those who have travelled a long way. In the physiotherapy unit there’s a lot of flexing and stretching, massaging and bandaging, pulling on weights, walking to get used to new legs, going up and down stairs, pedalling. It looks like our place in Kabul, only with all Hazara patients.

The little girl is eight or nine years old – in her lifetime, she’s going to need forty more prostheses... 

In one corner, a little girl and a man have their backs to us. She’s missing one leg, the man both of his, from the knee down. It must be t heir first prostheses, because they’re having difficulty moving around. He’s fixing her hair slide for her, they’re talking in low voices, who knows what they’re saying to one another. “They were walking at the edge of the wood, in a place where there was thought to be no danger. The first mine wounded him, the other got the girl when she was trying to help him”, we’re told. “They’re farmers, they come from a village where there’s at least one amputee in every family.” In about ten days their legs will be ready.

The little girl is eight or nine years old – in her lifetime, she’s going to need forty more prostheses. What will they do in the village? School is far away, and for someone who has two prostheses the rice fields and mud are no joke. Maybe they’ll have to come into the city to look for work, whatever they can find to keep them going. It’s impossible not to think of Zia Gul and her father. She was the same age when she came to us, with nearly the same story.

They’re all alike. Injustice, violence against people who have nothing whatsoever to do with war or tactics. In such a paradise of plants and flowers, the offence seems even greater. Having come from dry, rocky Afghanistan, we had been taken in by all that luxuriant green. In Cambodia, where the war has been over for years, there are still fresh victims. And there will be more. Wars never end in a hurry. And when there are mines too, it takes decades.