3rd Time, New Country: I have the keys….

Here it is already a week later and I am updating the blog. I will try to add a few pictures if the connection isn’t too slow…

I would like to start by asking, “what is it exactly that I am doing here? Why is the Navy mentoring at NMH?”

Here are some interesting facts that I received from the Senior Nursing Consultant for MPRI (a NGO here in Afghanistan). Rick has been here for 3 years. First, an analogy that fits perfect:

“We are the Jetsons working in the land of the Flinstones”

· Life expectancy is 46-47

· Infant mortality is #3 in the world. Only 2 countries are worse

· Per capita income is $800 per year

· Approximate population is 32 million

· 60% of kids attend school

· 75 – 80% of all schools have been destroyed in the past 30 years. (1200 schools were built this year for a total of 9400 in the country, of which 40% are actual buildings

· Literacy – 51% male, 21% female. An entire generation grew up without school. Taliban forbade it for girls.

Here are some facts about nursing as a whole:

“The education and training of nurses is a huge issue. Wars, drought and poverty have resulted in a survival mentality meaning that education has not been emphasized or funded. The educational background of most nurses in the ANA varies. Most of the nurses have attended a 3-year program either through the Ministry of Public Health or the ANA, though there were periods during the wars when nurses were trained in as little as 3 to 6 weeks. There is only one 4-year BSN program and it is in its fourth year, getting ready to graduate its first class.”

“None of the nurses have any background in the science of nursing. The mathematics and basic science classes were/are woefully lacking and inadequate. Nurse’s training focuses on the technical aspects only, and even then the fundamentals are not well practiced. Well-educated nursing faculty are essentially non-existent. They are well meaning but incapable of developing or teaching modern curricula.”

“The NMH and Regional Hospitals have begun a rigorous program of training and validating 36 Basic Nursing Competencies. Professional Development and career pathways for the nurses are currently being formulated.”

Needless to say, we have a lot of work in front of us. My group is the fourth group of mentors here in Kabal. There will be many after us, or I should say, there needs to be many after us.

Let me recap the week:

Most of the week was filled with completing turnover with the old group. They left today (Sunday).

On Tuesday, I had my first Afghan lunch at the NMH pharmacy. It was a lunch for some of the outgoing team and some of the new. It was a delicious meal. I wish I had written down the names of the dishes but it consisted of rice with shredded carrots and raisins, lamb kebobs, a meat filled dumpling, and naan (bread).

Wednesday was more turnover and my first day in the OR by myself. (Not really by myself as I have a dedicated interpreter, Walid). The Department Head of the OT (operating Theatre) is Dr. Ayobi, who speaks excellent English. He worked for 1 year at Brooke Army Medical Center in the US. He will be an excellent asset for me in helping to mentor the Afghan OR Nurses and for implementing new OT policies and procedures. (More on that as I get further into the deployment)

Thursday was a trip to Camp Eggers via Rhino. We attended an 2 hour lecture/powerpoint on driving in Afghanistan. Then it was back to NKC and actual driving of our humvees. Each person has to drive twice and be signed off by the outgoing team so we can drive.

Friday was jumaa or the Afghan day of rest. We don’t go to NMH. Instead, I got to drive for a little trip to ISAF (International Security Forces Afghanistan) and Camp Eggers. I can’t go into driving techniques on the blog but lets just say it is very different. Afghanistan doesn’t have a formal drivers license. If you can reach the pedals, you can drive. When we are driving in full battle rattle, we are constantly looking at everything around us. This includes the passengers in the humvee. Donkey driven carts, bicycles, pedestrians and every type of motor vehicle you can think of share the road. The roads are designed for 1 lane of traffic each way, but there can be 2 to 3 lanes of traffic going each way. It is not dull driving in Kabul…

Saturday was another short day in the OT. I had a nurses meeting with Rick where he discussed the current state of nursing in Afghanistan. Then, the 4 of us went to the OTSG building and had a meeting with Brigadier General Rhazia, who is in charge of all the nurses in the ANA. We had some chai and a short talk. We hope to meet with her monthly.

BG Rhazi, Holly, me, Dennis

Today was goodbye to our counterparts, hence the title, “I have the keys” both literally and figuratively. I now have half a dozen keys…It was another quick day in the OT as I went to a meeting with Dr. Ayobi. Tomorrow I am receiving some new gear for the OT ($72,000) and I needed to make arrangements to have it delivered. If I have time tomorrow, I will post on how that went. My team spent the afternoon cleaning up our office spaces and making them ours. So, just like that, a week has past. I will try to update the blog more often…