Disaster Services

Yes­ter­day Megan and I taught CPR to a group of Uni­ver­si­ty Stu­dents who have tak­en it upon them­selves to form a Dis­as­ter Response team and are try­ing to amass skills and knowl­edge that will be of use to them and their com­mu­ni­ties. One of the boys, Hameed, is part of our infor­mal “geek squad” at the Taj and wrote the pre­vi­ous post on this blog. Of the four he was the only one who spoke ful­ly flu­ent Eng­lish. Two could get by in Eng­lish and the fourth spoke none, although he was flu­ent in Pash­to, Dari, Urdu and Russ­ian. Many Afghans in this area can speak and read (if they are lit­er­ate)  Pash­to, Dari and Urdu. If they are in their for­ties or fifties, they can get by in Russ­ian. The younger gen­er­a­tion tends to know dab­bling of Eng­lish. Pash­to is the main spo­ken lan­guage but Dari seeps in from the West, Urdu from the East, and West­ern Lan­guages trick­le in through the occu­py­ing armies sta­tioned here.

The class was punc­tu­at­ed by Hameed’s rapid fire trans­la­tion, side con­ver­sa­tions in Pash­to, and the boys wrestling match­es as they were a lit­tle over­en­thu­si­as­tic when prac­tic­ing the Heim­lich maneu­ver on one anoth­er. The best part of the class was the myr­i­ad of ques­tions the boys had, indi­cat­ing both a sin­cere desire to learn skills applic­a­ble to dis­as­ters they had wit­nessed first hand, as well as expos­ing deep seat­ed cul­tur­al dif­fi­cul­ties that nev­er arose in my numer­ous First Aid re-cer­ti­fi­ca­tion classes.

Noorah­mad probed about how to clear water from a person’s lungs, the mem­o­ries of last year’s flood­ing and earth­quake still penetrating.

They asked about the spread of infec­tion and how they were sup­posed to avoid get­ting dis­eases when sweep­ing a victim’s mouth clean or pro­vid­ing res­cue breath­ing. (The next step of prepa­ra­tion involves each of them assem­bling a med­kit, com­plete with lots of latex gloves).

Through Hameed’s trans­la­tion, Najib explained to me that he was from a very rur­al area where there were no trained med­ical per­son­al in any kind of prox­im­i­ty. He want­ed advice for preg­nant women that he could bring back to the vil­lage and dis­perse. Accord­ing to the UN, Afghanistan has the sec­ond high­est infant mor­tal­i­ty rate in the world, topped only by Seir­ra Leone. It is the only non-African coun­try in the top twen­ty-five. Access to infor­ma­tion on preg­nan­cy and birthing, let alone trained med­ical work­ers, is slim at best. Even where there are med­ical facil­i­ties, mis­in­for­ma­tion abounds. I was shocked to find out last night that the direc­tor of the Neona­tal ward at the Pub­lic Hos­pi­tal in Jalal­abad has nev­er seen a live birth.

Rah­mat raised his hand and said “In our cul­ture we are not sup­posed to touch women. What should we do if it is a woman who is not breathing?”Although sur­pris­ing to my west­ern sen­si­bil­i­ties, the ques­tion is of utmost impor­tance. Most women in Jalal­abad still wear their burqas in pub­lic. Although Afghan soci­ety is extreme­ly phys­i­cal, it is so in a ful­ly seg­re­gat­ed way. Men and boys are always play wrestling, hug­ging, and walk­ing with their arms around each oth­er, but the two sex­es nev­er touch in pub­lic.  Mean­while, in the pri­va­cy of the university’s two-month-old women’s dorm, I chat­ted with half a dozen teenage col­lege girls play wrestling in their own way- hug­ging, pok­ing and slap­ping. Still, one girl there was mar­ried and five months preg­nant yet her hus­band lived across cam­pus in a men’s dorm. There was no place they could live togeth­er with­in the orbit of the school.

Even in a life or death sit­u­a­tion, where a women would die if she were not giv­en a few breaths of oxy­gen, there is a hes­i­ta­tion if it is the right thing to do. The ques­tion was not uncar­ing, quite the oppo­site, but it reflect­ed the extreme chasm between men and women which will take more than an effec­tive counter-insur­gency force and an army of preda­tor drones to solve. In the end, if these boys ever have to per­form life sav­ing aid they will have to make those deci­sions for themselves.