On the road again...

Now that we are past the elections, we are able to travel throughout Kabul and revisit many of the places we have been to before. During the past week, I had the opportunity to drive to ISAF for a little NATO medical get together similar to the one I went to several weeks ago, but no BBQ this time. I was the driver for the lead vehicle and it was sobering to survey the damage from the SVBIED.

I also drove when we went to NDS Hospital one day this past week. We continue to establish a small mentoring role with NDS but I am 0 for 3 on observing any surgery in the OT there. Each time that I have been there, no surgeries were scheduled. Hopefully, the next time we go in the very near future, I will be able to observe a surgery there. Once I do, I will be able to form a comparison between NMH & NDS, then try and renew the working agreement between the two OT's with regards to training each other.

I also had the opportunity to drive to Camp Eggers for a meeting about possibly building a new OR/ER/ICU and Central Sterile Processing for NMH. Some money was allocated for a new building, but not enough for a completely new hospital. We are only in the very, very, very preliminary meeting stages so the sky is the limit for the new building. Eventually, we will get reigned back in by the dollars or lack there of, but it will be awesome to help design.

In other news, I was sent a website about the Afghan Army. It has a little background on the ANA. I ask you to skim the info, but look closely at what the pay scales are near the end of the article. Most of the staff at NMH are paid very little. Those who can, also work in private practice to supplement their ANA pay. Many of the surgeons at NMH want to be done their surgeries by lunch or shortly there after so they can work in private practice the rest of the day. It is one of many problems in the medical system. The article is

http://www.understandingwar.org/themenode/afghanistan-national-army-ana

So, the big question is what did last week's elections accomplish here in Afghanistan? Did it make the situation better or worse? Most of you have seen the various articles on the net and on tv with all the individual reporter's opinions of what is happening. For now, I am only going to say that the reporters are biased and opinionated about what they want to report. From what I hear at NMH, no one is talking about the elections on a daily basis. If I ask one of the nurses what they think about the elections, they will tell me, but as a whole, they don't talk about it. They know there is corruption in the government now and they see it at the hospital. Maybe corruption isn't the best word. It is all in who you know here. There is little personal accountability. Let me explain this further. For example, a nurse is scheduled for overnight duty on one of the wards. What do you think would happen to a nurse in the states who was scheduled for duty, but didn't show up, didn't call, or didn't do anything? Here, your answer would be wrong. Even if someone threatened to fire that nurse, all the nurse has to do is go to someone they know who has some positional authority and get a letter saying they can't be fired. It is that simple.

Another example, is the soldiers get paid every month in cash. How do they get that cash to their family? Well, it depends on where the soldier is stationed and where his family lives. He might decide he needs a week off to travel to his home to give his family the money. As long as he returns with his weapon, nothing is said and it is like it never happened. The problems go on and on...

So, is it corruption? Not really by the definition of the word. Will last week's elections change anything? Only time will tell and it also depends on what alleged election irregularities and fraud can be proven. Even if proven, what will happen and what will change? A very complex question with no easy answers....