Two of my teammates and I at our table at the Bagram Health Fair yesterday. 

My new best friend Major Eden, the Combat Stress Dog

This morning was such a great experience. After I got off shift, I went to the gym and then went to the hospital to make the rounds and drop off invitations to our Memorial Day event.

I went first to the ICU and visited with the patients in the American bay. There was a positively horrific ambush within the last few weeks and several of the wounded went through the Craig hospital at Bagram. Only one is still here, injured from a dismounted IED. Everyday I've visited him I've held his hand and encouraged him to fight and be strong. He is in a drug induced coma with full body paralysis, but I can't help but believe that maybe he knows we are there visiting him. And I fully believe that someone suffering from his injuries would not want to be alone in the ICU.

After the ICU, I made my way to the Ward which contain patients who are not as serious as the ICU. The guys in the Ward are usually awake and eager for conversation and today was no exception. A lot of the guys in the Ward want to talk about why they are in the hospital and their stories and injuries just make you shake your head. One guy was trying to make sense of his experience being hit by an IED and the ground shaking underneath him. All I can hope to do is provide them with a willing listener, because I certainly will never be able to relate to anything they have been through.

Next it was on to the Warrior Restoration Clinic, where the Combat Stress dog lives. I invited all the staff to our event (the Combat Stress dog being the guest of honor after all!) and then I spent the next 30 mins on the floor playing with the pup, a gorgeous Red lab named Maj Eden.

And finally, it was off to the Vet clinic to play with some more puppies... except the Vet clinic primarily see the working dogs - bomb sniffers, narcotics dogs and attack dogs. Today they had Tessa in the clinic, a narcotics and attack dog, who in a nervous frenzy had basically chewed her tail off. She is a German Shepherd and because of her injuries the vets were forced to take the majority of her tail off. Because of her training however, she was also muzzled and sedated for her check up, trained to attack anyone who is not her handler.

The vets allowed to me to sit in on the visits and pet the sedated Tessa (not quite as enjoyable as the blind adoration of the combat stress dog, but it's Afghanistan after all, I will take what I can get! ;-) 

Photo of a Women's Health Education day at the Korean Hospital

 

Myself and the amazing ladies at the Korean Hospital working on Health Education with the Afghan women

 

I wanted share a really interesting cultural clash that occurred today at the Korean Hospital. An Afghan woman was schedule for surgery with the American OBGYN that I often sit in with during consultations. The woman was to have checked in for her surgery on Tuesday night and then it was to take place at 9am today, Wednesday.

I had some responsibilities at the US Hospital this morning and as such didn't make it over to the Egyptian Hospital until after 11am. When I arrived, I didn't really have any specific plans because normally on Wednesdays I sit with the OBGYN but today she was supposed to be in surgery. However, when the Korean staff saw me they asked if I wanted to join the American OBBYN. Confused I went to the OBGYN clinic and it turns out the woman never reported for her surgery the night before and they lost the Operating Room to other surgeries after 9am.

What was so interesting however, was that the woman showed up around 11:30am without excuse or cause for concern saying she has arrived for her surgery. When the hospital staff attempted to explain to her that she had not checked in for surgery the night before and they had lost the operating room because she arrived 3 hours late, she failed to understand why she could not still have the surgery. She remained confused and frustrated, continuing to explain that she was here now for her surgery and why could we not proceed?

This story is representative of the incredibly different sense of time and communication that exist between our two cultures. Time in Afghanistan is not a construct like it is in the West. One of the most common expressions you here in Afghanistan regarding time is "Inshallah" - God willing. In other words, if God wills you to be on time, than you will be there, but if something else comes up or you are delayed, it is God's will. This is also combined with the fact that communication in the Afghan culture tends to be very indirect, it is how Afghans maintain good relationships. So, the average person finds it hard to be told "no" or "maybe" to a request and the average person finds it hard to say "no" or "maybe" to any request.

As an example, I found this blurb of advice on the Internet about how to say no in Afghan culture:

The Three Step Rule for Effective Cross Cultural Communication:
I suggest one communication strategy is to follow the three step rule when making a request.
The first step is:
1. When we make a request and get the initial reply, "Yes" then we should talk about something else for a bit
2. The second step is: After talking a bit return to the request and ask it again. But this time throw in an extra phrase like, "What do you think, can you...?"
3. The third step: Go on to talk about something and return to the request a third time. This time, however, give valid reasons why the friend might not be able to do what you want even if they are willing, so they have a good excuse why they can say no.

In returning to the story, it eventually came out that the patient had been at a wedding the night before and it can be supposed she knew when the surgery was being scheduled she would not make her check in on Tuesday night, however she did not raise this schedule conflict as an issue. It is also likely that given Afghan cultural understandings, she did not foresee her showing up late for her surgery to be a problem.

It's when these two cultures meet head on that a power struggle ensues. American bound by their adherence to schedules and appointments and Afghans subscribing to a fluid, forgiving concept of time, find themselves frustrated and confused about why the other is so inflexible and cannot adapt in order to get things done.

So today has been a pretty great day. This morning when I got off shift, my team leader and I went over to the hospital and we did our first hospital visit. We visited with one servicemember in ICU who had a gunshot wound to his abdomen. We sat with him and held is hand and just tried to let him know he wasn't alone.

Then when we got back to the office we ran into the Lt Colonel who is in charge of the vet clinic for the entire Northern half of the country. He invited me to come back over to the hospital to sit in on a surgery of one of the working dogs but by this point it was after 10am and getting really close to bed time so disappointingly I had to pass.

Then after I sleeping during the day, I got back into the office for my shift at 9pm and the office was packed with troops here for a movie night. We also got to talk to a Sergeant Major whose son had just been selected in the NFL draft!

But the best news of the night was that my food service request for our Memorial Day BBQ was approved so we now have burgers and hot dogs and drinks and fruit salad approved for our event! To top everything off, I may have acquired a microphone for the Wednesday Health Education talks that we have been organizing for the Afghan women at the Korean Hospital. So pleased!!!

Hi there,
Quick update to say that all is well, but I am pretty exhausted everyday from the schedules we are maintaining. We are working particularly long shifts at the moment to make sure we've got all our bases covered at the start of the deployment. The result though is that after an 11 hour night shift, a workout and then lots of running around meeting people and planning events and visiting units and volunteering I am barely functioning!

That being said though, there's lots of wonderful stuff going on. The other day I visited the Warrior Restoration Center which is another equivalent of Combat Stress. I recently found out there IS a combat stress/therapy dog on base known as Maj Eden. She was a bombing sniffing dog who loved food more than the smell of chemicals so she didn't make the cut as a working dog. Unfortunately she's out on mission at the moment, but lots of plans to partner with her and her handler when they return.

I also went over to the CASF the other day, the unit that runs the MedEvac missions. A friend of mine who I worked with at the CASF on my last deployment is actually back in theater! So I got to catch up with her and get an update on how to get back on board with the MedEvacs.

And finally, this morning I was back over at the Korean Hospital. I wanted to follow up on a story I wrote last Wednesday about a girl who had been seperated from her family who was holding her medical paperwork. She DID come back this week and was seen by the OBGYN. Even better news was that her diagnosis came back far more positive than originally thought. More than anything I was just so pleased and relieved to see her.

I am slowly starting to learn Dhari and can now have a very basic conversation. I'm also learning really random words in Dhari from working at a hospital... glucose, diabetes, does this hurt? Yep, I've got really great chat at the moment :-)

Perhaps most exciting of all, plans are really coming together to run a women's empowerment program through the hospital. Are primary challenges at the moment are that is needs to be extremely subtle so as not to affect the reputation of the hospital. Equally as challenging is the resistance expressed by the women themselves. However, we may have found a way to account for these conditions. Most certainly more to follow!