Afghan Refugee Camps

My wife Najie and I really never thought about what we were doing as giving, at the time. Najie, a proud American citizen is originally from Afghanistan. As a teenager, she became a United Nations refugee along with three of her family members during the Soviet invasion of Afghanistan.

I am a Doctor of Public Health (epidemiologist) and I was working at The University of Texas Health Science Center at Houston at the time of this story. Currently, I am privileged to work for Dr. Kenneth Cooper as the Senior Research Fellow at the Cooper Institute in Dallas, Texas.

In June of 2001, Najie and I decided to use our personal time, skills, and limited money to perform a medical needs assessment in the Afghan refugee camps on the Afghan border in and around Peshawar, Pakistan. These are the same camps that the Taliban lived in as children.

We started collecting basic medical supplies from medical supply and pharmaceutical manufactures. The companies we solicited had little-to-no hesitation in giving. The problem soon became carrying the supplies and getting through foreign customs. The logistics were daunting. Initially, Pakistan would not issue visas because of the nature of the project and we had to remain in India for a few days. Flights from India to Pakistan were banned but later resumed and the visas were processed. We learned quickly not to ask why. The government wanted the refugees to leave Pakistan and if we were able to enhance services to them, then the theory was the refugees would want to remain in Pakistan. Our experience was much different.

We arrived at the camps August 2001 (we were all more innocent then). We teamed-up with the UNHCR and the local health authority. What we encountered is truly impossible to adequately describe. We worked at four different camps. Food supplies were inadequate. Each camp had four hand-pump type shallow water wells for approximately fifty-thousand refugees and no shelter other than U.N. tarps for tents. The temperature was 121 degrees our first day in the camp. Almost every mother we encountered had lost at least one child and it was not uncommon for families to have lost four children, either in the camp or prior to arrival. In front of visitors, the refugees were amazingly up beat and strong, this is a typical afghan trait but in our interviews, their despair was evident. As we found acute medical problems, we would refer them to a U.N. Basic Health Unit. For chronic illnesses, there was little chance of finding help.
Some of the findings from the assessment we provided to health authorities: Forty-eight percent did not get enough water to last all day, eighty percent did not get enough food or it was inedible, and forty percent had experienced the death of a child since arriving at the camp. We also identified the most prevalent diseases. We identified diseases in which the common treatments were not allowed in the country and initiated talks regarding policy.

We completed the health needs assessment and returned home just before September 11, 2001. We felt a great deal of despair and that our efforts were inadequate. Fortunately, the story does not end there. Immediately after September 11, we had no communication with our contacts in the camps. People there were as frightened as Americans were. Then four months later, I received an email from the director of the local health authority for the refugees. He was requesting me to return and present my findings and assist him in persuading the Governor of the province to fund at least some of the healthcare for the refugees. I traveled alone on this trip because of the prevailing danger in the area. One of the Afghan doctors told me when I arrived, it is always good to be an American but this is not a good time to be standing too close to one.

In all of the analyses, it was evident that women and children should be the primary focus of services. They were and still are the most vulnerable population in the country. The Governor of the Northwest Frontier Province provided some money and an old abandoned bank building to serve as a women and children’s hospital. While this was somewhat uplifting, many of the refugees were retuning home, where they were only becoming refugees in their own country. The director asked me to go to two more camps on this trip and provide a health needs assessment, one near Tora Bora, Afghanistan and another on the border. The irony is thousands of refugees were traveling in great peril to get back to Afghanistan, while thousands of others traveled in equal peril to leave Afghanistan.

In 2005, I was asked to come back and lecture regarding this project at the University of Health Science in Lahore, Pakistan and meet with the Governor of the Punjab province regarding a public health system there, where none currently exists.

When I read this, I find it amazing that Najie and I, who consider ourselves low profile people with a relatively simple lifestyle could have become involved with such a piece of history. Did we give? Maybe a little of ourselves. We found giving to be very contagious and with contagion comes exponential growth. Did we change the world? No, but we changed a tiny piece of it, mainly ourselves but as I look at the world map in my office, it appears that the earth is just tiny pieces having congruent needs, a need to give and a need for help.

We are currently exploring the possibility of going to Cambodia in 2008.