MarySmith’sPlace -Afghan adventures #19 #Health #Leprosy

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Malestan clinic – this was taken the previous year

Mubarak’s clinic was a shambles. The premises, rented from a local farmer, consisted of several dreary rooms round a central courtyard. I suspected if just one of the posters Mubarak had stuck on the walls to brighten the place up was removed, not only the plaster, but the whole wall would crumble.

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Mubarak in his consulting room

Peeping through a doorway into the medicine store, my heart sank. Medicines were heaped on narrow shelves in total disarray. The floor was almost entirely covered by cardboard boxes, some of which had been torn open allowing plastic drip bottles and crepe bandages to spill onto the dusty floor.

My face must have registered my feelings because Mubarak spoke apologetically, ‘We have so little space it is a big problem for us to find a place for everything.  When we move to the new clinic it will be much better.’

‘When will the new clinic be ready? Wasn’t it supposed to be finished ages ago?’

‘Well, maybe after a few months. The problem is, the builders are also farmers, and now they have to work on their land. When the harvest is finished they will be able to carry on building. Maybe you should wait until we move before doing the stocktake. I can give you a list of the things we need. Already we need more supplies.’

I shook my head. ‘No, I think it’s better to find out what you have in stock here, so we know what you will need when you move.’ Mubarak gave a nod, which I guessed was non-committal and suggested I go and have tea while he saw the last of the day’s patients.

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Baba and Khala, the couple who worked as watchman and cook/cleaner

Outside the living room my eye was caught by something stacked against the wall. Under a canvas covering was this year’s medicine supplies, not yet unpacked, although Mubarak was crying for more. Inside, I half expected to find last year’s unpacked boxes hidden under a table. Instead I found Khala, waiting to introduce me to two of her friends from the village.

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Taking tea after dinner in the living room at the clinic.

When Mubarak joined us I assumed the women would leave immediately, or at least cover their faces and turn away from him as they would in Jaghoray. They did neither, greeting him warmly. One of the women patted a place near her and he sat down, taking the glass of tea she poured and laughing at some comment made by the other woman. I nearly choked. These women from Malestan were indeed very free.

As a leprosy patient Mubarak had gone to Karachi for treatment, later training as a leprosy technician. He’d worked in Pakistan until asked if he would return to Afghanistan to open a treatment centre in his own area. He admitted he’d been apprehensive about coming home. ‘The Russians were still trying to win control of the country, but more than that, I was afraid the community would not accept me because of the leprosy.’ In fact, people were so desperate for any kind of medical services to be provided they hailed Mubarak as a conquering hero.

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Mubarak and his field assistant

At the end of the day Mubarak drove me to the house he shared with his mother, about half an hour’s drive away. The clinic guest room where I would have slept was currently occupied by Nasiba, a young woman with leprosy who had come from the north of Hazara Jat.

Her nose was depressed and she had huge, suppurating ulcers on the soles of both feet.  Another, on her side, had been caused by an accurately thrown stone. When still a child, she had been thrown out of her village when it was discovered she had leprosy. For the next ten to twelve years she had kept on walking, sleeping rough when she could not find shelter, begging for food. Sometimes people had been kind and given her food, discarded items of clothing, permission to sleep with the cow or goats for a night. Often, though, she was driven off by people terrified she might pass on her disease. Eventually she had been directed to Mubarak’s clinic.

He had started Nasiba on medication and each day he dressed her ulcers, which were slowly healing. Later, he would arrange for her to travel to Pakistan, to the leprosy centre in Karachi, where she would undergo reconstructive surgery on her nose. For now, though, she was content and happier than she could ever remember.

As we drove to Mubarak’s house I noted near the river everything was green and fresh with poplar trees in abundance. Things were later than in Jaghoray. There, the wheat had already been threshed but here it was only now being harvested.

The house was at the top of a steep incline, at the foot of which was the site for the clinic. It was a two storeyed house: the ground floor was used for the storage of animal fodder and wood and sleeping accommodation for a cow and some sheep. Two flights of stairs led to two front doors both of which were painted bright blue. The window sills were full of red geraniums. Mubarak’s mother was waiting for us; an elderly woman whose face was wrinkled like a walnut but who was still sprightly and welcomed me cheerfully. I was grateful she did not throw anything at me.

The three of us ate together. Mubarak laughed when I said I’d been surprised about the women talking to him. ‘Jaghoray women have no freedom. Malestan is different. Women here can talk to men when they meet. In the clinic we can even give women injections in the buttock.’  This was a concept of freedom I hadn’t previously contemplated.

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Who couldn’t fall in love with such a landscape?


25 thoughts on “MarySmith’sPlace -Afghan adventures #19 #Health #Leprosy

    • Thanks, Jim. I’ve been thinking about that and decided I’m perhaps not quite as free as the women of Malestan as I much prefer a woman doctor if I’ve to have a buttock injected! 🙂


  1. When I see the photos, I am always thinking how uncomfortable it must be to have to sit cross-legged on a hard floor all the time. If I did that for even five minutes I would get terrible cramp!
    I was glad to hear that the poor lady Nasiba finally found a better life.
    Best wishes, Pete.

    Liked by 1 person

    • You do get used to it, Pete. I found it difficult at first and was always shifting about to try and get comfy but in time it became quite natural. I’d struggle now, though. The knees are not the same! Nasiba was so happy even staying at that run down clinic with Mubarak caring for her ulcers, proper food and somewhere safe to sleep.


  2. Mary, a superb article! The conditions are beyond horrendous and it’s hard to imagine working in them. In between the bleakest of moments you see light and even fun, your ending sentence of ‘This was a concept of freedom I hadn’t previously contemplated.’ Yes, freedom varies for us all!

    btw. I’ve put a post out today with a review of your latest book.

    Liked by 1 person

    • Thank you, Annika. The conditions seem bleak to us coming from the shiny modernity of the western world but they didn’t seem particularly bleak to the people who lived and worked in them (with the exception of people like poor Nasiba). Mubarak was so laid back he was almost horizontal! Yes, his clinic looked liked it would fall down at any moment but he was having a new one built – eventually – until then, he just got on with his work.
      I have seen the wonderful review of A-Z of Dumfries on your and left a comment and reblogged. Thank you so much.

      Liked by 1 person

  3. Pingback: Afghan adventures #19 ~ Mary Smith #Health #Leprosy | Sue Vincent's Daily Echo

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