I am a British nurse who has been working for Emergency since 2010, I arrived in Kabul in May 2012. Before working for Emergency I was based in the intensive care unit at the Royal London Hospital in the east end of London.
The Surgical Centre in Kabul is one of three hospitals in Afghanistan that is run by Emergency. In Kabul the admission criteria for the hospital is victims of war; casualties injured by mines, fragments, knives or bullets. Emergency also run a maternity center and 27 first aid posts in the country.
The job I do here is very different to my job at home. I am part of a small international team, running the hospital, treating the patients and teaching national staff.
Before I arrived in Afghanistan I thought I had an idea of what to expect. I prepared myself as best as I could for the mission, but witnessing first hand casualties of war is difficult to prepare yourself for.
Treating children who have picked up something shiny while playing and then it has exploded in their hands, causing traumatic amputations or loss of their sight, is not uncommon. Children like Mehdia and Sediqullah, who Giles photographed, have experienced such adversity. Mehdia, who was brought to the hospital after finding an unexploded ordnance, lost several fingers and had to have a skin graft. The only time I witnessed her crying was when she was undergoing her first dressing of the skin graft.
The people of Afghanistan are resilient and survive horrendous injuries. Many patients arrive at the hospital after travelling for hours or even days, like Said Karim and his brother both injured when they detonated a land mine while working collecting stones. They were the main wage earners supporting a large family.
The war in Afghanistan does not only cause physical injures to people but means that people like Said Karim who lost both his legs are no longer able to provide for an entire family.
Not long after I arrived in Afghanistan I realised that I would not be able to survive working in this environment if I spent time thinking about the circumstances which had brought the patients to the hospital and the journey they had suffered to get medical treatment. It is important to concentrate on the fact they have reached us.
When the injured arrive at the hospital gate we don’t ask questions. Every patient is treated equally. They have reached a safe environment and now they will receive the best health care available without the worry of having to pay for it.
Durning the summer months the paced picked up more than ever. In August we admitted 278 patients, 273 of which were war wounded. This is the highest number of war injured in one month since the hospital opened in 2001. An extra ward was opened and all the wards had additional beds. At one point we had 107 patients in the hospital.
The winter has been quieter: we are still receiving patients with the same injuries but at the moment we have empty beds. This allows me to spend more time with the national staff, teaching. Witnessing the nurses improvement is very rewarding, it is the aspect of the job that I enjoy the most.
Now I have been here for nine months I have seen a lot of patients coming back for follow ups. A few weeks ago a patient returned after spending four months in the hospital last year, he is in his early twenties. In June 2012 he was injured by a mine, losing his right hand, most of the fingers on the left hand, one eye, one ear, and breaking one leg. He was one of the first patients that I admitted after arriving in Kabul. The nurses and I spent hours with him and his father, doing dressings, physiotherapy and teaching his father how to care for him. When I saw him walking in through the hospital gates, looking so well and smiling it was very inspirational.
It is great to be part of something that is actually making a difference in this country. One of the things that I find empowering about this job is having the opportunity to see patients who arrived with life threatening injuries recovering and being able to help them. Furthermore, supporting and encouraging the national nurses is incredibly satisfying.
Emergency’s work in Afghanistan is unique and I am very proud to be part of the team.