Merry Christmas from Kabul…

I want to wish everyone a Merry Christmas from Kabul. Here I am, on another Christmas away from family and friends. Christmas 2005 was in Al Taqqaddam, Iraq and Christmas 2009 is in Kabul, Afghanistan. As I write this, it is Christmas morning here. Santa is making his way from East to West across the United States.

I only have a few days left here in Kabul, so I will recap the past few days and reflect on my time here.

Since I last posted, there haven’t been any significant events here. I have completed my turnover with Brian and Marvin. On Monday, I was the Convoy Commander for our trip to NDS hospital. It has been awhile since I wasn’t driving the lead truck. While at NDS, I introduced Brian & Marvin to the staff and we toured the OT. We changed into scrubs and I took them into the rooms so they could observe the staff during surgery. We still have many improvements to make…

The rest of the week was spent at NMH in the OT. We have done some observations in the rooms and completed turnover. Just like NDS, there is still much to be done at NMH. I did mail my last tote home. It is so much easier mailing things home rather than having to carry them in a seabag. I mailed a 63-pound tote home for $40.

Early in the week, we were hearing rumors of a VIP visit to NMH. On Wednesday, we found out it was President Karzai coming to visit. When we got ready to leave and walk up to NMH, we found out we weren’t allowed to go up. Security was extremely tight and none of us were allowed to leave the base. I did not expect to personally meet President Karzai, but I was hoping we would be able to see him. I was not happy that I wasn’t allowed to be at the hospital because the President was there. How do we win the hearts and minds if we aren’t allowed to leave the base and do our mentoring mission? Are we (the Americans) too much of a security risk? They have no problem asking us to treat and consult on high-ranking Afghans when they are sick. Makes you wonder…

Last night, I finished reading Three Cups of Tea by Greg Mortenson. I recommend that everyone read this book. I should have read it 6 months ago. The book is his personal account of his building of schools in both Pakistan and Afghanistan. We can make huge changes in both countries with schools and education. The book has really made me think and reflect on what I have been doing for the past 6 months. The nurses and doctors I have been working with, have various levels of experience. Some have been in the medical field for less than several years, and others have been practicing for many, many years. When I first got here, I did not know what my job or mission was going to be. Yes, I knew that I was going to be a Perioperative Nurse Mentor, but what exactly does that mean? All of our time in Fort Riley was spent on Army training: combat and COIN (Counter Insurgency) not what a medical mentoring mission is.

I spent the first two months here building relationships with the nurses and trying to define what my mission was. I define my mission as “what is best for the patient”. Everything I have done is to influence the nurses and doctors into doing what is best for the patient. We educate, train and mentor so the patients can get better, safer care. It is all about the patient, not personal feelings and egos. I have to work hard to teach the Afghans that the reason we try to maintain sterility and develop a surgical conscience is for the benefit of the patient: The patient is the focus of our care, why we do what we do. It is a hard concept to teach to adults who are set in their ways and have only experienced war and suffering. Many of the nurses and doctors didn’t want to do what they are doing, working in the medical field. At the time, it was all that was available to them. They were told that they would be doing the job given to them and nothing else was available.

It isn’t all bad though. Many of the younger residents, nursing students and combat medics want to learn and make a difference in patient’s lives. They want to provide safe, effective care and want to raise the standards of care in their country. We can make a huge difference in Afghanistan teaching those who want to learn, but it is going to take years. If we really do pull out of here in 2011, very little will be accomplished. It is a double-edged sword though. If the security improves over the next 18 months, then the NGO’s can come back to Afghanistan and improve the medical care. Nation building isn’t really the mission of the US Armed Forces. We can make a country safe, but the military doesn’t elect a government. It is the various NGO’s who come in and help that really builds a nation.

It took me 6 months to really figure out my job and build the rapport with my mentees. I think I could get a lot more accomplished with them, but I really need a break to recharge. My opinion on how to make this mentoring mission succeed is to do repeated 6-month rotations. By that, I mean 6 months in Afghanistan, then 6 months in the US, and then come back for another 6 months. I would work in tandem with my replacement. We would keep in touch and work together to raise the standards here. It would be a 2-year total commitment. I personally think it would work better than a single 6-month deployment or a year deployment. 1 year in Afghanistan without a break is a very long time. I think 6 months here, and then a 6-month break, followed by another 6-month deployment would benefit all. I have really enjoyed working with the Afghans, but it is tough being away. This has been the hardest deployment I have done. Some days are so frustrating, and others are awesome when I see the light bulb go on and they understand what I have been teaching and have incorporated that into their own individual practice. It is time for a personal break, to go home and be with family, but I would gladly come back here.

Once again, Merry Christmas to all…