An L.A. Doctor's Medical Corps Struggles to Heal the Wounds of the Afghan War
Five weeks later Simon knew he was facing a crisis of nearly hopeless proportions. Virtually every medical facility in Afghanistan outside the garrisoned cities had been bombed to rubble. Most of the country's estimated 1,500 physicians had been killed, imprisoned or driven into exile. Once-controlled diseases such as malaria had reappeared with a vengeance, and the mortality rate for children under 5 had rocketed to nearly one in three. "It wasn't just war wounds," Simon says now. "We treated 140 kids for diphtheria. I saw right away that one little clinic wasn't going to amount to much. Something more had to be done."
Over the next four years Simon mounted one of the largest "underground" medical efforts in the world. Today his Los Angeles-based International Medical Corps has 42 clinics in Afghanistan, with an annual budget of $2.5 million. Simon estimates that 50,000 patients a month are now being treated by IMC-trained Afghan medics in the rural clinics carved out of caves or hidden in bunkers. He expects the crushing patient load to increase dramatically if Soviet troops begin to pull out of Afghanistan as scheduled this spring. Few expect the withdrawal to bring the guerrilla war against the Kabul government to an end. But it will clear the way for some five million refugees now huddled on the borders in Pakistan and Iran to spill back into their ravaged villages. To meet this need, Simon hopes to open eight new clinics and enlist village women in a rudimentary rural health program. "He's a genuine humanitarian," says Rabbi Abraham Cooper of the Simon Wiesenthal Center in L.A.—part of the diverse network of American individuals and organizations that support the IMC. "He's one of the most remarkable people I know."
An associate professor of emergency medicine at UCLA, Simon grew up in a poor section of Detroit, the 13th of 16 children of a Lebanese immigrant. His father worked on an auto assembly line, and "My mother was illiterate," he says. "She never learned to speak English. So in a way I was constantly reminded how lucky I was to live in the U.S." Even as a boy, Simon says, he sent part of his car-wash earnings to Lebanese refugee organizations. "It was just something I felt I owed back to the Third World," he says.
In Afghanistan, though, Simon soon realized that his personal contribution would barely make a dent in the problem. "The need is so great over there that a few American volunteers couldn't really solve anything," he says. "The real problem for the Afghans is how to reconstruct their entire medical system." So, using the Pakistan border town of Peshawar as a base, Simon launched a program to produce a corps of native "medic-surgeons" capable of removing shrapnel, amputating limbs, setting bones and diagnosing and treating most common diseases. Trainees are selected from Afghan applicants; classes are taught by American doctors who donate three to 12 months of their time. So far, more than 100 medics have completed the course and reentered Afghanistan.
It is difficult for the IMC not to appear partisan since the medics, barred from government-controlled areas, operate only in territory held by the resistance. But Simon says, "For our doctors and medics, the role model is Albert Schweitzer, not Ronald Reagan." When the IMC was recently asked by the Agency for International Development to launch a program to treat wounded children in Nicaragua, the group agreed to go in only if it could treat victims from both sides of the conflict. "Our goal," says Simon, "is to provide help wherever the health care system has been destroyed."
Among Simon's first recruits in Afghanistan was Dost Mohammad, 38. Formerly an engineer at the gas fields in Shibarghan, near the Afghan border with the Soviet Union, Dost lost his job when a detachment of Red Army troops seized the facility. He went to Peshawar looking for work and was introduced to Simon by an exiled Afghan physician. "What really struck me most about Dost was his commitment," Simon says. Even before IMC began its formal classes, Simon began teaching Dost surgical techniques, using goats and chickens. After graduating with IMC's first class of 62 medics in 1986, Dost headed back into the war zone and set up shop near his home in eastern Afghanistan.
The fighting there, he discovered, has taken its toll in myriad ways. A small green plastic antipersonnel device, the PFM-1, which is dropped from Soviet planes and arms itself on the ground, has maimed countless children, who mistake the strangely shaped object for a toy. Then there are stress-related conditions like ulcers, which used to be virtually unknown in rural Afghanistan. "In the old days, everybody had something to do. He had a house, a family, food," says Dost. "Now there is the bombing, and everyone must flee. But then they just sit in the camps. Or they come back to more bombing and fighting." Adults are plagued by memory loss, hysteria, impotence; children suffer from depression and bed-wetting.
One of the most common complaints is total-body pain, which was once dismissed as hypochondriacal but is now regarded by IMC physicians as part of the psychological fallout of the eight-year war. "It is a very difficult problem," says Dost. "I will tell Bob Simon that we need more training."
Simon, who still spends a few weeks each year in Afghanistan, will no doubt find a way to provide it. "I'm lucky," he says. "Very few people in this world get the chance to really help other people when that help is critical."
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