First mission

Finally, all the stars align and I can blog about my Afghanistan adventures. I have been plagued by Internet connection issues, computer problems and just all-around business since arriving two weeks ago. I have so much to write about. I struggle with where to start!

I went on my first mission this week, and it was thrilling! I am happy to say we experienced no adverse events and considered the two days a complete success. We spent much of our time looking at our current engineering projects (several sections of road and some school projects) but my favorite part was playing with the children. The photo is of several children at one of our stops.

They were initially very shy but, once the camera came out, they all rushed to have a photo taken. The girls are all a little hesitant and tend to keep their distance but will creep closer as the boys become more engaged. I found getting them busy doing something with me helps break the ice. Counting was easy. I would try to remember the numbers in Dari, often getting them wrong. The children would laugh and try to teach me. I would also point at various objects and ask the word, then try to teach them the English equivalent.

The countryside is beautiful but barren. It reminds me a lot of southern Arizona, with beautiful blue sky and hidden canyons with flowing streams and trees. The living conditions are simple; often mud walls, few cars and true manual labor. We saw several wheat fields being harvested by hand and one area where the cows were being walked in a circle to separate the wheat.

I had the opportunity to meet with several doctors at the only hospital in our province, and they are very excited to work with our team. We hope to introduce a nutrition supplement for malnourished children at some point in our tenure here. It is a project that is having impressive results in other areas and the people of Kapisa would benefit greatly. There is also a physician training program here at the main base that incorporates didactic lessons with hands-on experience at all three international hospitals (American, Egyptian and Korean) and the providers were anxious to be recommended to the program.

We did have one medical emergency while staying overnight at a French base in the area. My counterpart who I am replacing (a physician assistant from California) and I were going to meet the French doctor for dinner. When we entered his clinic, we found him working on a local young man who had suffered a traumatic amputation of most of his hand. Somehow, he had put his hand into a thresher machine. The French team had stabilized him so, while my counterpart dressed the wound, the doctor and I called for help from the U.S. hospital. The goal is for the local providers to learn to care for their population, but this injury was so significant that we were able to send him to the American facility for surgery. We were thrilled to see this young man get appropriate care. It goes a long way to show the people of his village that we are there to help them.

This continues to be an amazing opportunity, and I look forward to the next nine months. I admit I miss my family terribly, but the time is flying by and, if the next 34 weeks go as fast as the first two did, I will be home before I know it. Nate and the kids are doing great and enjoying their summer travels—a much needed adventure to help their time pass quickly as well.
I promise to write more often, as long as the computer and connection cooperate!

Why Afghanistan?

This is a question I ask myself most days. What is it all about? Why are we going? I have learned a TON in the last several weeks about the region, in general, and the long, tumultuous struggle the people have endured. They have been at war for the last 30 years—first the Soviets, then the Taliban and ensuing civil war, and now “occupation” by international forces. I use “occupation” in quotes as we are not there to fight the people of Afghanistan; we are there to liberate them from the Taliban. But some, here and abroad, see it as something else.

Who remembers that many of those involved in the attacks of 9/11 were from Afghanistan? Did you know Afghanistan has the highest infant mortality rates in the world? That nearly 80 percent of the population is illiterate? That just a few years ago, more than than 80 percent of the population lacked access to any medical care? That is why we are there. The long-term goal is to leave the people better off than the day we arrived (opposite the goal of those who came before us, when you consider the destruction caused by the Soviets and the Taliban).

So, why is a family nurse practitioner going? And what will I be doing to make the above happen? We—the members of my team and 11 other teams training here with us—are part of something called a Provincial Reconstruction Team (PRT). There are 25 PRT teams spread across Afghanistan, 12 manned by U.S. forces, 13 by other international teams. Our goal is to connect the Afghan people with their government and promote growth throughout each individual province.

In general, it is believed that the insurgents have an easier time manipulating people who are isolated from their govenment and countrymen, so our main responsibility is building roads. We don't actually do the manual labor; we have engineers on our team who help the Afghan locals bid and hire the necessary labor required to complete the job. Throughout the project, we return frequently to ensure adequate quality standards are enforced. We also partner with local leaders, physicians and educators to help meet the basic needs of the villages.

Prior teams have built schools, clinics and government offices. As a whole, the work done by American military and coalition members has enabled more than 50 percent of the population to have access to health care. Now, many more children—boys AND girls—have access to basic education.

I didn't really answer what I am doing, did I? I will wear several hats on this LONG trip. When you include training, it will be at least a year away from home! I am the senior medical advisor to the commander. As a senior ranking member, I also have some responsibility to ensure that everything, in general, runs smoothly. I will provide daily opportunities for our team to receive medical care, organize the necessary medical support for any missions off the relative safety of our home base and develop various medical outreaches to the local communities. In addition, I am constantly preparing for the worst-case scenario by training the entire team on how to respond to battle injuries and save their buddy, if injured. We want to leave in a year knowing we helped the Afghan people of Kapisa province, but our primary goal is to come home with everyone we leave here with.

As the coming year develops, I am sure there will be many more “hats” I will wear. Some days, I am the motivator, the one keeping the group moving forward on a five-mile march. Some days, I'll be the listener as lives back home compete for our attention. Some days, it will be my turn to struggle with the daily stress. Our team has a great sense of humor and lots of variety in skill sets, which will definitely come in handy.

So, readers, what else do you want to know about our upcoming job? About my role? Think I am crazy?