07 May 2009

Returning to Emergency Hospital

Before I arrived in Kabul, I had been planning to visit the Emergency Hospital. Other than my imagination, two short trips to the Panjshir, and a weekend in Mazar-i-Sharif, Emergency was Afghanistan to me. I made early contact with Hamed and Shukoor. Hamed took me for a drive and dinner; Shukoor invited me to Hedayat's wife's Takhtjami. After ten days at Wazir Akbar Khan Hospital I was quite anxious to visit to prove to myself that a little effort, a bit of organization, and a hospital with a focused purpose could deliver decent trauma care.

I have always thought of the Emergency Hospitals as being clean, far cleaner than the provincial hospitals. Much of this is due to its signature white walls, the yearly application of a fresh coat of paint, the meticulous ward cleaning schedule, the gardens, and a functional laundry for which bloody sheets and bed clothes are an empty excuse. Few hospitals in the developing world are as sterile as hospitals in the U.S.; I can work around this if the hospital appears clean.

When I entered the guard house at the gate to await approval of my visit, I found Koko Jalil asleep on the couch. His distinctive white-gray beard and the tan pakol, pushed back Massoud style, haven't changed in three years.

Beautiful, blond Susanna rescued me from the Afghan administrator, who hadn't a clue as to my identity, and introduced me to the all-Italian international staff. All new and all, except the general surgeon, appearing very young. Marco's hug was as solid and warm as I remember. Strange that I so readily hug the Italians, yet with Americans I've known for years, it seems a stilted and unnatural maneuver. I was happy to talk with him and happy he was back in Afghanistan. He treats both Hamed and Shukoor as colleagues. Unprompted, they both told me how much they appreciate that he is working for them, for the Afghans, not just for Emergency.

Marco asked if I wanted to tour the hospital. I wanted nothing more than to be told about every patient in every ward and to pore over every x-ray. It was all so familiar, the clean white walls, everything in order. Even the OPD with three newly arrived patients was a study in order--no rushing, no senseless scurrying. This feeling of order, almost of refuge, that I get in Emergency Hospitals, is an idea I don't seem to be able to readily get across to non-medical people. Yet I've seen the recognition of this light up the faces of doctors or surgeons who have worked in the third world, when they walk into an Emergency Hospital compound. Even the Italian tourists in Cambodia who come for a tour when on vacation to Angor Wat and want to see where their money goes are generally appreciative, but have little clue as to how truly different these hospitals are from the normal chaos and are neither surprised nor comforted.

I was surprised that so many people recognized me and remembered my name. The young x-ray technician, smiled so openly that I felt immensely welcomed. I know the Afghans appear happy to see anyone they know from before, even if they disliked them immensely, but I took their smiles and greetings personally.

I like Marco's style. He is not fazed by anything. Every surgical problem is just that, not a casino, something to be dealt with. He seems to be running the hospital such as he ran it in the past--with a firm hand and a sense of order of what the resources--human and otherwise--can offer. He and I agree on many things. For a while it seems Emergency was operating on its own, almost pretending it was like the Vatican, not part of the country of residence. Marco realizes that the hospital has to be part of Afghanistan's big health picture. Maybe the picture is out of place on its present wall, but, still the organization must deal with the reality.

Hamed walked over from his flat to pick me up--the weather had turned nasty--windy and cold, the dust was atrocious and I was glad for a scarf to cover my nose and mouth. Hamed's sister, Nazifa, was busy cooking a feast--mantu, aushak, meat, salad, qabli palao. The mantu and aushak, both dumplings or ravioli, were the most tasty ones I've ever eaten. She had worked all afternoon to make the food and I watched her in the kitchen preparing the last bits. Afghan culinary techniques are time consuming, based on old ways of doing things, not changing as new instruments enter the market, though she did have a hand-cranked pasta maker to make the dough for the dumplings. I liked watching her, liked the way she cut the watermelon in great uneven pieces, but with such gusto.

04 May 2009

A Short walk in the Hindu Kush

Seven of us ex-pats working at Wazir Akbar Khan left the hospital early last Thursday afternoon for Istalif to spend the night in the mountains at The Lodge, (www.remotehydrolight.com).

The exuberant, spring-green of the Shomali Plain north of Kabul was surrounded by mountains of cold, pure white lofty peaks. Having only passed through this area in the fall and winter when the landscape was a contracted dry monochrome, I was surprised at the inviting lushness, the expansive openness. But spring is fleeting in Afghanistan, and all will soon desiccate and melt into shades of brown.

About 40 kms north of Kabul we turned west toward the mountains, traveling a rutted dirt road alongside walled fields; walled living compounds, some looking quite prosperous with a fresh, outer layer of mud, dung, and straw; and walled vineyards. Many of the walls had been damaged during the Taliban wars and remain unrepaired. Others have fallen under the weight of weather and time. Walls define Afghanistan's cultural architecture; falling from walls and collapsing walls define common Afghan orthopaedic injuries.

Besides green, the fields and walls were dotted with the orange of single poppies and the blue-purple of a 6 petaled delicate, open-cupped flower. Young boys wantonly pull them up from the fields to sell along the road to Afghan tourists.

The road followed the plain for about 4 kms then climbed into the mountains, through picturesque villages of huddled mud houses, reminiscent of Italian hill towns in appearance and raison d'ĂȘtre. Orchards of blossoming apricot and almond, interspersed with groves of willowy poplars, balanced the horizontal green of terraced fields. Redbud, in thick bushy form, with branches lavishly covered in pink-red buds, lined the road and dotted the hillsides. Yellow gorse-like shrubs complemented this exquisite medieval pastoral picture.

The track through the villages or hamlets was flanked on both sides by the high, windowless walls of fortified houses or the shorter walls of terraced fields and meticulously tended small groves of mature walnut and mulberry trees in various stages of early leafing. Each switchback we traversed, skirted a stream of rushing water or an irrigation canal, opening to a clearing where people and animals could rest in the cool shade. Magnificent spreading chenars (oriental sycamores) graced shadowed glades. A short alley of deodars in one picnic area gave an idea of the more abundant beauty that in the past lured the wealthy of Kabul to Istalif as a summer refuge.

We stopped at the village at the end of the road, Mazar-e-Mitalam, 6 km from Istalif Bazaar to began the 2 km walk to the lodge. While parking the vehicle an official approached the members of the group requesting a clinic. The nearest medical clinic is a long walk and gives limited care. We had not advertised ourselves as other than ex-pats on a weekend outing, yet it was assumed we had the power to DO something.

The sound of water was the background music to the walk, but my thoughts were crowded with the most wonderful realization that I was walking unescorted, among Afghans who were going about their daily work. I was part of the picture, walking with a purpose to a destination. Though we all have different ideas of Afghanistan, the one of mud and rock architecture perched on the side of mountains, a rushing river below, intense blue sky supported by snow-white peaks, and red-cheeked children herding baby goats, is, I believe, universal. I was finally in the "real" Afghanistan--rooted in a distant Kiplingesque past, traversed on foot, interpreted in free-form. I never thought I would have the chance for such an unfettered short walk in the Hindu Kush.

It was a glorious walk along the chaotic Istalif River, the mica and pyrite of the wet rock glistening in the sun. A chenar at a bend in the river fluttered with strips of glittery cloth in supplication. For what? I assume the usual: fertility, protection from the vicissitudes of poverty, maybe a medical clinic.

After an hour and half dawdling walk with no photo-op left untaken, we entered the small garden of the unpretentious lodge. Two large sleeping rooms strewn with thin mattresses and bolsters around their periphery occupied the top floor with a small kitchen between. Three unisex hot-water shower; seated, flush toilet; and sink enclosures satisfied all other needs on the first floor. I sat on the roof listening to the river, absorbing the view of mountains, snow, green terraced fields tucked into every crevice high above, when the smell of sautéing garlic rose from the kitchen, followed by fragrant cinnamon and the yeasty smell of bread fresh from the oven. What a welcome!

The seven of us polished off the chicken, rice, and bread about sunset then some of us watched the stars from the roof and talked. Light from the quarter moon obscured the stellar display, so I woke at 02:30 to view the Milky Way and was rewarded with the head of Scorpio rising over the southeast mountains--the first sighting of my favorite summer constellation. I rose to sunshine at 05:30 and did a full workout of tai chi on the roof as the morning warmed.

Oatmeal, eggs, toast, and tea prepared us for an 8:00 hiking departure. My idea was a nice ramble in the hills, an alpine frolic. I soon realized I was in for a much different outing. After crossing the river we worked our way up through a green, irrigated valley plaited with water channels among terraced fields and groves of poplars. Tom led the way, picking our path over boulders, up and down, along scree and dirt, and around huge overhanging outcrops. Up we climbed, past the running water into a landscape of brittle dryness.

Wild mint and penny royal grew along the streams and when crushed underfoot gave off a heady fragrance. I found a small patch of tiny-flowered ground orchids. At the high, drier elevations, small yellow tulips, fritillaries, ranunculus, yellow "star lilies," the furry basal rosettes of mullein, and the red, phallic shoots of a spurge emerging from a bulbous root grew among the rocks. Bordering a boggy rivulet at snow line, a profusion of 3" high pink primulas grew in a patch of mossy grass, looking like a Persian carpet. Each stage of the climb brought us better views of the mountains, a greater expanse of snow, and best: the feeling of solitary achievement.

After a snowball fight we descended an adjacent canyon, gingerly picking our way on the steep slope to the stream that led us back to the river and the lodge. Seven hours of very unexpected climbing and worse--descending--had extracted all my energy.

I had not conquered any peaks, made no daring ice field traverses, or braved avalanches. I was scratched, pricked with thorns, sunburned, and exhausted. Yet walking out of the valley I felt a sense of belonging, as if I had earned my temporary presence in this strange and beguiling country, simply by walking in it.

29 April 2009

Spring unfolding

Spring unfolds in Montana in a most painful, start-stop fickle manner over many months. I am sure the reality is no different in Afghanistan, though perhaps commencing a bit earlier and holding back its glories less petulantly. Since I arrived about ten days ago spring has been most generous. The grass in our personal and the hospital compounds has visibly greened and I can measure the new red-growth of the rose bushes. A type of lilac with single pale lavender blossoms throws out great plumy spikes from eight-foot tall bushes lining the short walk between the house and the hospital. The leaves are not the typical spade-shape, and the lilac fragrance is over-laid with a clove scent. Coming and going I cannot help the Foltz tendency for stealing flowers. Every morning a handful go to the hospital's office and every afternoon a handful return with me to my rooms.

A bush of salt-cedar, or tamarisk, is in tight blossom. I'm sure its cousins along the Yellowstone have yet to make a showing. Honeysuckle spirals in confusion over some make-shift trellises. In a few weeks they will thrum with insects.

I have said little about the place I'm living. The rooms of the apartment are laid out single file, along a short entrance hall: bedroom, kitchen, bathroom and study. All windows face west, but from 04:45 first light until sunset, all the rooms except the bathroom are flooded with light. The best word to describe it is comfortable, though I'm not sure others would use that the defining characteristic. It gives me what I want and more than what I need. I rearranged the furniture in the study so that I have a long "runway" to do tai chi, all the while looking at the snow-topped mountains--a most magnificent sight, the heights close at hand, just beyond the dusty bowl of the city.

From the study and while I write, I have a good view of the hill Tom and I climbed last Friday morning. There are always people walking its paths and usually a car creeping along the narrow bumpy road. Sometimes I see strings of runners/joggers. The best for me are the ones walking or playing along the crest. Their silhouettes are more stark than the forms trudging along the hillside. It is a hill where people live and use at their own; a part of their lives, not an obstruction.

28 April 2009

The Takhtjami --The party to celebrate the bride coming to her new home

The Takhtjami

Hedayat's wedding earlier in the week necessitated another family party on Friday, the takhtjami, and his brother Shukoor invited me to join. (Both brothers are surgeons at Emergency hospital) I couldn't pass it up as an anthropological experience. Shukoor arrived at the compound with his younger brother, Engineer Hamed, as driver in a borrowed car with two beautiful curly-headed 3 year old boys (Sassoon and Siawash) asleep in the back seat. The family's compound lies beyond the airport, I believe to the northwest, but early on I lost my orientation.

Coming to the compound, I would have never guessed from the outside that inside were 50-60. No parked cars, no people milling around, nothing stirring. I finally met Shukoor's wife, though still do not know her name. I'm only told, "This is my wife." It is not an introduction, rather a statement. Hedayat looked very scrubbed--well shaved, nice hair cut, and wearing a beautifully embroidered kamis, totally roped into this extravagance. I.e. the whole affair is not in his character. His new wife, also without a name, is a tall, willowy, beautiful girl, and sister to Shukoor's wife. The elaborate wedding may very well be in her character.

After entering the house I peered into the room with all the women--at least 50 of them sitting on the floor pillows around the perimeter of a large room sun-lit from three sides. They looked rather intimidating and I think the male members of the family, wanting to spare me from being plunged into their midst, led me into a private room where Shukoor and his family sleep. We talked a bit; I met a sister and other brothers and parents. I gave Shukoor the copy of A Leg to Stand On, which he was most happy to receive. Later in the afternoon he told me he was so very, very happy with the book. He pointed to a part about him, saying his father read this and for the first time looked at Shukoor as being other than a jokester. That his son was recorded in a book was something special.

When I finally joined to women in their room to eat lunch, Shukoor said they were all his close relatives. He wanted me to sit at a set of raised seats at one end, a seat of honor, but I wanted to be down with the women, not some object of consideration. On the floor with the women is where the anthropological aspect comes in. I scrunched in among some and of course picked a spot between a couple of girls who didn't speak any English. It was all rather guarded with everyone stealing glances at me and when caught out, returning an embarrassed smile. The children didn't turn from their steadied staring. None of us knew exactly how to respond to each other, so we smiled a lot.

After eating qabli palao, (rice with raisons and carrots) and the rice and fruit skin filled floor cloths were removed, some of the teenagers with a bit of school-English scooted close, forming a semi-circle that expanded into a warm, close girl-knot. It started as an approach-avoidance affair of them moving to me, asking my name, touching my hand, forgetting the English words they wanted, retreating, with another filling her place, asking my name again--as if it might have changed and the second interrogation would bring out the correct response. The reality is that that is the substance of the first lesson of every language class and like good students we were starting at lesson one. After proving that I was not a monster and was quite ready to talk and answer appropriately, we ventured onto lesson two. This involved family. If I am married and how many siblings and children I have. No one asks about Kara the dog. A picture of her would not elicit any warm responses. Within 10 minutes everyone had asked me my name at least once.

Shukoor and Hedayat's sister led the dancing. A few years ago, when going through the long list of his siblings and what each did, he told me this sister was like a nun. The idea of life-long celibacy seemed radically against the tradition of family held by both the Afghan religion and culture. He clarified, saying she did not want to marry. Since then I had pictured her as the consummate aunt, a most auspicious position in some ways. Especially in a large family an unmarried sister has a place in the family--the joy of being surrounded by children but without the chore of a husband. My interpretation is that within the family she is more an individual. I liked this sister, (again, I was given no name.) She and some other women came into the women's room with a huge tambourine singing a song of short repetitive verses. It sounded tribal, but why I use that description, I can't say, except that it was not very melodic to my ears and the words were known and sung by all the women at a wedding party in Afghanistan. The sister started to dance, alone, the typical woman's dance of a few simple steps, arms raised so hands were at at head height, sinuously rotating the wrists to the beat of the tambourine and clapping.

A plump middle-aged woman, in more sedate and westernized, but still well-covering clothes, stood up to sing. Probably a love song. Isn't that what one should sing at a wedding? When she finished another woman danced. It wasn't the young women who danced, rather the older and middle-aged ones. Everyone looked at me with wondering glances to see if I would join in. Of course. It was what they wanted, what I wanted, and made me part of the group. The laughter and clapping encouraged me into more western movements, prancing around the hot room, looking most out of place in my stodgy-colored Lands End knits against the colorful shimmering textures and sparkle of Afghan female finery. In the same manner I had been invited to dance--the one dancing, bending down and extending her arms for me to join--I invited some of the older ones, with tattoos and plain clothes to dance with me. This brought great howls of laughter. The women covered their faces with their chadors, as they warded me off. Of course I had asked the ones whose husbands were strict and didn't like their wives to dance, even at weddings. When I sat down, a young girl with a diamond in an eye-tooth said their husbands were "taliban." (I asked Shukoor about the facial tattoos, thinking it meant the women were Koochis, but he said it was only an old fashioned beautifying mark.)

Most of the women were dressed in shimmering shalwar-kamis, of colorful diaphanous materials, spangled and beaded, made up with lots of face paint. Even the young girls, tarted-up maybe for the first time with an amateurish trial of eye shadow and lipstick, were decorously smudged and smeared. Shukoor's wife called me out from the room and gave me a pink beaded/embroidered tunic and a pink scarf with silver threads. Shukoor had asked if I had Afghan clothes and I thought he meant if I had clothes to modestly cover myself. He had bought these for me so I wouldn't feel out of place. The outfit helped to make me part of the party. I'm sure my un-made-up face was a drab affront to the carefully and gaudily made-up women. The girl sitting beside me reached into her purse and in great flourish applied her lipstick to me.

(I just read in the book about Afghan culture for Westerns, that, "It is important for women attending an engagement or wedding party to wear dressy outfits make from shiny, silky or velvety fabrics. Wear a different outfit on each day of the celebrations. Cotton clothes are not appropriate."!)

The many children, tearing about in their own groups, but also very much a part of the scene were dressed in the most incongruous outfits: a flashy, sequined blouse topping a pair of oversized jeans and little high heels on a 4 year old--a real mix and match assortment I found most wonderful. These were second hand clothes, high-end Salvation Army and Good Will treasures. The more I think about the combinations and the way they were worn, I realize that I would have chosen the same thing at age four or six.

Among the 50 women and girls I was the only one wearing glasses. How strange.

I watched some of the video of the actual wedding. This was a very grand affair, with huge amounts of money spent for clothes. The male parts of the video showed older men at the contract-signing (the neka) dressed in chapans, karakal caps, turbans, or in western suits and ties. The younger men were in shiny, metallic-colored suits or suit jackets, often too large and ill-fitting, which made them as flashy as the women. They wore long, pointy toed shoes often topped by tattered jeans, or one of the "newer" jean styles of permanent creases, patched over rips--very fashionable. They occupied their own section of the wedding hall, their dancing rather uncontrolled, but with no sexual innuendo, since they weren't dancing with or for women--just for themselves. They were a combination of West Side Story hoodlums and 14th C. grandees thumbing their noses at sumptuary laws.

It became very hot in the woman's room and I transferred to a cooler room, which soon filled with people--the girls pouring over the album of wedding pictures. One of Shukoor's boys and another of the same age came into the room dragged by their mothers, dripping wet with bits of food clinging to their hair and bodies. They had decided to go swimming in the bath-tub sized basin where the plates were being washed. The boys were screaming and very unhappy at being taken from their fun.

I can see that growing up in such an extended family compound could be very reassuring for a child. There is always someone to talk to you, hold you, wipe your tears, save you from drowning. Your mother scolds you, and in response you march off to your aunt or uncle who open their arms and think you are a very clever darling.

25 April 2009

first few days in Kabul

26 April

Dr. Zirkle once told me that at SIGN conferences he concentrates on making only certain, limited points about the nail. I made some non-SIGN power point presentations to give to the doctors--flashy extravaganzas. They would work for the Filipinos and the East Africans--the Anglophone docs who have been using English since kindergarten. Here it isn't going to work, and in Mazar, it will be more difficult. I will have to change tactics.

Though there are problems with getting the older surgeons to think in terms of SIGN, the younger ones have been the engine behind its use at Wazir Akbar Khan Hospital. Dr. Ayyub said that with SIGN there are fewer non-unions and broken plates. The fact that Ayyub used this as criteria of success, made me realize he understands the goal. He also knows how to keep his cool.

One patient on the ward with a fractured femur had a carnelian bead on a string tied around his right wrist--to protect him from bad sounds and encourage healing. I wonder if it is like protection against the evil eye, but in this case, against evil sounds.
Hamed walked over from Emergency after work to visit with me. I had thought he had driven, but after searching in the parking area, found him at the front entrance of the hospital. One of the guards had commented on a small chain he was wearing on his pants and Hamed gave it to him. He laughed about this request for baksheesh. I guess when it is present at all times, it only makes sense that one learns to live with it. I find this sort of corruption quite disabling
He offered to take me out that evening and I took him up on his offer. A pleasure dive in Kabul is an oxymoron. The roads are only a pocked excuse, the traffic is aggressive, the thick pall of dust--especially at the end of the day--makes it impossible to see, and if I'm honest, there is nothing of beauty to see. But during 6 months with Emergency I went out so seldom, that the idea that I can get out now is rather exhilarating. We drove across town, up onto a hill with a mausoleum being built for Zahir Shah and his father. One existed before, but it was destroyed in the civil war. He took me past the Bala Hissar, but it was too dark to walk around the ruins.
When I asked Hamed about the hospital, he said it had been pretty quiet over winter, but now with the recent rains they are seeing more children with landmine and other ordnance injuries. They were also seeing more stab wounds. This, to him, was a positive sign of increasing stability. People are afraid to carry guns, and had reverted to a slightly less lethal form of expressing their frustration.
When we talked about general changes in the country he said 10 years ago, people were all poor, pretty much on the same level, but now there is a huge difference with the two ends of the spectrum increasingly further apart and far more people at the very poor end. He said the doctors are also a problem. There are too many of them, they order unnecessary medicines, perform unnecessary surgery. When they see a patient they look first in the pocket and then at the face. Patients view doctors not as people who help, but as predatory, criminal. The sorts of kudus that more well-to-do doctors get, taking care of wealthy patients don't belong to the doctors at Emergency, since the hospital takes only the poor. Hamed realizes that in the Emergency system doctors miss out on follow-up since the patients aren't theirs, (he put it in different, more Afghan terms, saying he does not have a chance to become famous.) People don't know his work, the patients don't know his name and so there is no recognition, which is most important here. The upside is that the poor receive proper care and there is no corruption.

Thursday evening during dinner out I met Christina, a woman who is in Kabul working with an NGO teaching skills to deaf women. Some of these skills are cosmetology. I asked if "the beauty school" was still functioning and she hesitated. It seems that after the Beauty School of Kabul was published, Deborah Rodriguez, the author, was banned from the country. Someone thought the book detrimental to Afghanistan's image.

The Norwegian woman who wrote The Bookseller of Kabul is also banned from the country. She portrayed a rather seedy situation that was quite damaging to the image of Afghan men among Westerners. The Afghan actors in The Kite Runner are also banned because of the portrayal of sodomy in the movie. I wonder if the author is also banned. He is an Afghan-American man and not a foreign woman. I find all this banning a backward and unproductive way to mold peoples' images of the country. Prohibition only heightens the appetite. It also shows fear of different ideas and a bullying mentality.

Tom Kraner, the general surgeon, agreed to walk up the hill/mountain west of the hospital Friday morning. There are so many things I never experienced when I was in Afghanistan before and now I have the freedom to do them. I wanted to go at 05:00. It is light then, the best light of the day. He would have sprung for that hour except he was worried that there might not be enough people. Security requires some people to be present, but not too many. It's a delicate balance, something one senses. There have been kidnappings in the past, but things are quiet now.

The path, which I can see from my apartment, used to be accessible from a back gate to the hospital, but this has been cemented shut, so one must walk about a km out side the hospital compound and around Indira Gandhi Children's Hospital to access it. Tom knew a short cut climbing up over the hospital's walls, walking along the top and jumping into a ditch, saving 20 minutes. It was like being a little kid and finally allowed to go out and play with the big ones. He's a tall, fit guy with long legs. I felt like a dashhound beside a great dane and that at 6000'.

The 360° view from the top was marred even at 06:15 by a low level brown haze. It will only get worse as the temperature rises. A Soviet-built swimming pool sits at the top. The talibs used to take people up here and shoot them; the bullet holes in the pool are now patched up. The snow mountains to the west were quite magnificent. On the east, below the hill is a newly laid out municipal public park--laid out in Persian fashion with square plots separated by rows of trees. I wonder if it is done like that so each family coming for a picnic has their own square. The west slopes and valley of the hill are covered with graves. Cemeteries are by rule free of landmines, a nice place for picnics.

A man walking with 3 children called out a greeting in English. He's a translator for the US military. I found out listening to Tom and the man, Fazli, that the US has a program in which certain people working for them, especially for the military, can apply for a US visa after 4 years of work. It's a protection program since many have dangerous jobs. Fazli complained about the Pakistanis coming into Afghanistan. He said "terrorist," but from the Afghans the word often sounds like "tourist." He said the Afghans needed a stronger government. Afghans respond to strength, they respect and appreciate it, even when it stops them from doing what they want to do. They respect the limits even when they are always working to destroy them.

We walked down the hill, passed a small neighborhood bakery, a "shop" about 2 meters wide. I wasn't hungry, but couldn't pass up the smell and the thought of hot fresh bread. I ate my "flap" as we walked along the non-descript dusty streets. I gave the remaining naan to Margaret for her breakfast.

24 April 2009

On the way to Kabul

24 April 2009

Dubai Airport terminal 2 is only marginally better than when I last experienced it in the fall of 2005. It remains the quarantine terminal. The preponderance of men--both westerners, primarily engineers and security types, and Central Asians in shiny suits with unhealthy paunches, and common stubble-- give it an unbalanced energy. The Western men are largish, independent-types, well off, but not flashy, the type who venture out to grab the iffy, but lucrative deal or the hundred other "things" obtainable only far from home. The Central Asians seem weighted in a fateful destiny and the debilitating effects of tobacco and ill living.

Considering the shiny, glassbling of the new Terminal 3, the quarantine terminal is a very poor cousin. The most incongruent aspect is that as soon as one passes from the general entrance into the restricted ticketing counters, one must negotiate a quarter mile of movable, gated switchbacks traversing the entire area of the otherwise huge, empty hall before reaching the luggage scanners. The snaking path could easily accommodate 600 people with baggage. But there is no one in the line, and no one has bothered to move the gates to accommodate this wasteful expenditure of energy. The same sort of maze confronts the traveler approaching passport control. Though not exactly the same humbling procession as the supplicant approaching the gates of Nineveh, it seems to operate on the same level of intimidation.

The accomodating Filipino at the Kam Airlines counter gave me seat 9A--the most perfect seat available for an economy ticket. Positioned before the wing and facing NW, away from the sun, and toward the mountains, I again had the sense of coming into the country with oriental fairy tale suspense and anticipation.

Clouds covered the interior of the Hindu Kush, heaped up against the valley walls, mixed in whiteness with the snow. West of Kabul, we dove into the clouds, circled to the north and completed our final approached to the west. Much is green in the undisturbed villages around the city laid out in rigid squares. Nomad tents and brown and black goats. Puddles from an early morning rain glaze the runway; glossy blue-black magpies hop around on the grass. While taxiing, Afghan men walk around the plane, the female attendant is ignored. It is a land of men, not laws.

Our flight has been enlivened by the addition of the Afghan Cricket Team, returning from their recent series of international games in South Africa. They did not win the championship, but neither did they disgrace themselves. The game is new to the country, having been added to the national sports lineup after refugees learned it in Pakistan. (So I assume most are Pashtun). They were honored back as quite the heroes, representing Afghanistan to the world in their green blazers with embroidered pocket patches.

Waiting at the luggage carousel I chanced on another world-classifying scheme: the number of suitcases passing on the conveyer reinforced with rope. Third world airports cater to fewer passengers traveling with cardboard boxes, but not all have graduated to complete reliance on manufactured zippers and nylon straps, allowing them to discard the security of tidy equator-defining wrappings of rope. I don't remember ever seeing rope in Billings; Dubai was pretty unroped, yet Kabul remains rope heaven.

My apartment at the Loma Linda University compound attached to Wazir Akbar Khan Hospital (WAKH) is simple, clean, and the sort of place I like. The IT technician has actually made the wireless connection my computer work. The people sharing the compound are very agreeable and all work at the hospital.

WAKH is typical of public health hospitals in the developing world, with different odors, huge numbers of people milling. I was given a quick tour and some counsel by Dr. Tom, the general surgeon who has been working here for a few years.

19 April 2009

Viewing the Pierre Bonnard exhibit at the Metropolitan Museum I felt as if I was being offered a chair at a simple European repast. Fruit of the most luscious texture filled the tables, sometimes accompanied by a basket of bread, a bottle of wine, or a pot of tea. This was fruit that begged to be eaten, the intense colors promising flavor no Dutch still life perfection could deliver. I did not know all the fruits' names; some of the colors were unrecognizable. Was papaya available in France in 1929? Bonnard painted the illusion of fruit in all its old testament desirability. Even the shallow bowl of brilliant red sour cherries looked to be brimming with sweetness.

The second course of the artistic feast took place in the museum's ancient Middle East exhibit. The unfolding of each successive empire, each ruler, and each set of all-powerful gods gave meaning to the reality of impermanency. A fitting prelude to Afghanistan.