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Afghanistan: time out in Kabul

22-05-2009 Feature

When the sadness of life that is so often manifest on Kabul’s dusty streets becomes overwhelming, there is no better place to go than the ICRC Orthopaedic Centre in Ali Abad on the city's outskirts, as ICRC communication coordinator Jessica Barry found out.


  Idris in the physiotherapy practice room. Faridoon is on the left.    

Those who have never visited the spacious compound of the ICRC Orthopaedic Centre in Kabul could be forgiven for thinking a centre for the physically disabled a strange place in which to raise ones spirits, but they would be mistaken.

Sitting one recent afternoon on a garden bench, near a line of white-sheeted hospital beds whose occupants were sunning themselves in the soft spring light, it struck this visitor that here was a place not only of shared suffering, but of shared hope. Here, every man, woman and child share not only a common burden of disability, but a belief in the process that is underway to help them overcome it.

Take, for example, 12-year-old Idris Nawrozi, a spina bifida child, the eldest of four siblings. Idris had been romping in the physiotherapy practice room earlier in the afternoon, chasing a small yellow ball, when he saw his friend and mentor, Faridoon, enter. He rushed over to say hello. “Idris is first in his class in school,” remarked Faridoon (29), an ICRC-trained physiotherapist, who is himself disabled.

Today, Idris can walk and play, which would not have been possible had not a family friend told his parents about the ICRC’s Orthopaedic Centre and encouraged them to take their son for a consultation. Following surgery, and rehabilitation over three years, Idris can now walk unaided and take the bus to school. But his uncle still has to carry him up and down the hill outside his house, steep slopes being too difficult for him to manage. Crucially, Idris is also getting an education, both at normal school and at the Orthopaedic Centre. He has a passion for languages.

“Disability on the one hand brings deformity and physical problems,” explained Faridoon when Idris gambolled off again bouncing his yellow ball. “And on the other, it brings psychological challenges. That is why we encourage our patients to keep themselves busy, and to study. It’s a psychological support that will help them through life. "


Elsewhere in the large, airy practice room, seven-year-old Naghmah, a solemn child with fairish hair, was trying out her prosthesis for the first time. Injured in an accident with a motorbike a year earlier, her father, Sadar, had only now brought his daughter to Kabul from their farm in Baghlan for treatment. After spending the last 12 months on crutches, Naghmah was now taking her first awkward steps on her new leg.

  Naghmah, a solemn seven-year-old, lost her leg in a traffic accident.    

“It will take about two weeks before she is ready to go home,” said Faridoon. “She will then need to come back every three months to have the prosthesis checked. And it will have to be changed regularly as she grows.”

A delighted Sadar remarked, “Her mother will be the happiest woman alive when she sees her walking again.”

The ICRC's Orthopaedic Centre in Kabul was opened in1988. Since then a further f ive centres have been established around Afghanistan. At first, the programme was intended only for landmine victims and other war-wounded patients. But over the years people with a whole range of disabilities – including club feet, polio and paralysis from spinal chord injuries – have been admitted. Not the least of the Centre’s many programmes is one for children with cerebral palsy. There are some 9,000 youngsters on the register.

Nine-year-old Enamullah was in the middle of his session in the cerebral palsy exercise room when Faridoon entered. His father, Haji Asadullah, a businessman who had brought his son to Kabul that day from their home in Ghazni, stood watching him laboriously fitting plastic pegs into a wooden peg board. The father’s full grey beard and black striped turban gave him a majestic air.


For children with cerebral palsy – a physical condition that affects movement as a result of damage to the motor control centres of the brain – it is vital that parents encourage their offspring to do their exercises regularly at home. Too proud to take on that duty himself, Asadullah nevertheless appreciates why it is important. “I teach my wife and daughter the exercises I am given for my son to practice,” he said. “They take care of him.”

Improvement, if slow, is surely there. “It would have been difficult for Enamullah to do those kind of detailed activities at the beginning,” observed Faridoon, pointing to the now completed peg board. “We can also help him to walk better, and not to fall. "

  Cerebral palsy affects a child's movement as a result of brain injury. Enamullah has trouble walking.    

And he added thoughtfully, “We can improve his life but we can’t repair it.”

It is perhaps this finding of solutions to what would seem insoluble difficulties that makes the Orthopaedic Centre such an inspiring place to spend an afternoon. But there is other magic there, also. The place is a haven of quiet amidst a chaos of traffic. The compound, unlike much of Kabul, is not surrounded by concrete blast walls but with a simple green iron railing. Guards stand at the gate and search every visitor for weapons, which are banned. Cars are also controlled. The guards smile.

Just before the warmth of the afternoon began to fade and the patients lying in their hospital beds were wheeled back inside, a man wearing a traditional shirt and trousers known as a shalwar kameez approached a friend lying prone on a mattress. No words were exchanged between them, just gestures. Thumbs up. Thumbs down. Then thumbs cautiously up again… a clasping of hands, a farewell greeting, and th e two parted.

It was such a simple moment, but it summed up all that is good about the work that is going on in Ali Abad. It spoke of compassion and caring. It spoke of friendship and community. It said to the patient – a young man with extraordinary blue eyes – you are not alone.

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