MarySmith’sPlace – AfghanistanAdventures#55 – Pesky commanders, dentistry & an inside loo

l to r: Ashraf, Arif’s Field Assistant , Arif, and important people

Afghanistan, December 1989

When I requested a tour of the premises Arif led me up and down staircases and along passages and in and out of so many rooms I lost all sense of direction. From the guest room there were two exits, one leading through the kitchen down a flight of stairs to the storerooms below, one of which was filled with a supply of wood for winter heating. The second exit from the guest room took us along a short passage to the consulting room and the pharmacy. I was astonished to think this had been built as an average family home. Arif rented the premises from the owner who lived in Kabul with his family. He did say the landlord was a wealthy man, so perhaps his home was more splendid than average. I haven’t found any photos so I guess I didn’t take any – have included random pics for you to enjoy.

I particularly liked one of the upstairs rooms, which was empty and unused; a beautiful room with fret worked wooden designs decorating the walls and ceiling, arched alcoves in the walls. Sunlight streamed through two large windows which gave onto a view of the sloping hillside below us. ‘Why don’t you use this room? It is lovely,’ I asked.  

Arif agreed, ‘Yes it is a nice room but there is no heating and it is too cold. If we were going to stay here I would install a bukhari but as you know we are going to build a new clinic in Saydabad.’

The decision to move the clinic had been taken earlier in the summer. Arif was not from Day Mirdad and had faced difficulties in being accepted by the people who were suspicious of strangers. These problems had been made worse by the animosity between Pashtun and Hazara, both of whom came daily to the clinic. Frequent disputes arose as they waited in the compound to consult Arif. The Pashtun people did not trust Arif because he worked with Hazaras, and often went touring in Hazara areas to treat leprosy patients. The Hazaras were equally suspicious of him because he was Pashtun. There were no leprosy patients amongst the Pashtun in the surrounding district and they resented the clinic being closed when Arif went to his monthly tour programme to treat Hazara leprosy patients.

I spotted a staircase leading further upwards. ‘What’s up there? More empty rooms?’  

Arif replied, ‘The bathroom and toilet.’ Eager to see an inside loo and greatly intrigued as to what kind of plumbing system was used, I went upstairs. It was a hole in the floor, but the room had been constructed to jut out from the rest of the house so the waste dropped down a three storey lift shaft to a deep pit below. I’ve seen such arrangements in old Scottish castles.

Next morning Rahimy, bored with having no work to do, offered to help in the clinic. Jon frowned forbiddingly over Arif’s accounts. From time to time, Arif would take a break from his patients to come and see how things were going. As he became more manic, the more silent Jon became. The building estimates for the new clinic were too high, and Arif had already overspent on the work done. The difficulty in finding money from donors was explained and when I suggested he could perhaps manage with fewer rooms; perhaps an office and two guest rooms were not entirely necessary, he seemed agreeable to the suggested cut backs.

I was silently congratulating myself on how easy it had been, when he took the wind out of my sails. ‘Now it is winter the builders will not be able to work until next spring. You can go back to Pakistan and write your reports for the donors – I shall tell you many stories, sister, stories they will like – and get the rest of the money we need for the building to continue in spring.’

I repeated all the arguments and finally, the budget was reduced to an amount more or less acceptable to both parties, though I suspected we’d have the same arguments the following spring.

In the meantime, I was happy to hear Arif’s stories. Each month he travelled to one or other of the treatment points, established to allow patients from further afield to come for medicines. Once, on the way, he was kidnapped by a Party commander and imprisoned in a mountain cave. The commander and his men spent several days joy riding around in Arif’s jeep, almost wrecking it in the process. When Arif did not arrive at the expected time at the treatment point, the people began to worry about him, and when his jeep, mujahideen spilling over the sides, was spotted, they guessed what had happened. The villagers marched, en masse, to see the commander, demanding Arif’s release. The commander tried to persuade them it was in Arif’s interests for his clinic, medicines, equipment and money to come under the control of the commander and his Party – so they could ‘look after it’. The people insisted the clinic, the jeep and everything else belonged, not to the Party but to them. Sweeping aside the commander and his men, they released Arif from his mountain jail and carried him, shoulder high, back to the village.

Despite a tendency to tell stories which dwelt rather lovingly on his superior medical knowledge and his excellent public relations successes Arif was also able to tell stories against himself – such as his first tooth extraction. Not having any dental equipment other than local anaesthetic and dental cartridges, Arif sent his assistant to the carpenter to procure a pair of pliers. In the meantime, he prepared the anaesthetic. His patient, despite the pain his rotten tooth was causing, became slightly anxious.

‘Sister, it was dreadful. I forgot how hard gums are. When I tried to inject my patient the needle bent, just like this.’  He crooked his finger to demonstrate before continuing, ‘Most of the anaesthetic dribbled out of his mouth, so his lips went numb more than his gum. Ashraf brought the pliers and I tried to pull the tooth out. You know, Sister, I am a very small person – and that tooth was deeply rooted. It was a struggle. By this time, my patient wanted to leave, and tried to get out of the chair but I put my knee on his chest and pulled really hard. The tooth came out. There was a lot of blood, though, and the patient was not happy with me.  I did not charge him any fees for this service.’ Having been a lifelong coward in the dentist’s chair I could feel my toes curl as Arif told his story.

A butcher’s shop

Another commander objected to Arif working amongst the Hazaras and was trying to push him out of the area. When Arif was visiting a village on tour, he was asked to go to the home of an old woman who needed medical treatment. The woman had an eye infection which had caused her pain and distress for some time but it was easily treated. It turned out she was the commander’s mother. When Arif returned to check on the progress of her eyes, the woman asked if there was anything she could do for him. He explained the problems he was facing because her son did not want him to work there. She assured Arif he would have no more trouble and indeed, a few days later, the commander himself arrived at the clinic – bringing a gift of a chicken from his mother, and assurances that Arif could come and go and work freely in his area.

Bazaar scene