Training Afghan Medics: The Language of Healing Pt3

Lisa’s Diary 2014

Captain Lisa Irwin

Captain Lisa Irwin is a REME Reserve Officer currently on a three-year Full Time Reserve Service commitment with the Defence Cultural Specialist Unit.  She has spent 15 months learning Pashto and Dhari before deploying to Camp Bastion to be the 2 IC of a team of medical personnel set up to mentor Afghan medical personnel. This is her third tour of Afghanistan and her second blog, as she blogged during her last tour in 2010/2011, when she was deployed as a Female Engagement Team Commander.

24 Feb

We have had a testing few days as a team, after some Afghan patients presented at Shorabak with rare conditions including  acute leukaemia, a brain tumour and some kind of systemic infection that caused hydrocephalus (fluid on the brain). Two patients died despite our best efforts, which was very sad, but there was some benefit as we were able to explain to the Afghan health workers in Shorabak how important it is to carry out regular patient observations and to act on any irregularities.

We had a couple of good cases for reactive mentoring this week. One of the casualties had surgery following an IED strike but was otherwise stable so I helped to co-ordinate his transfer to Shorabak and set up the team to go over with him. Whilst surgery was being carried out in the Shorabak operating theatre I acted as an interpreter on the ward and in the laboratory, as we only had one local interpreter with us and he was needed in theatre. I was really pleased that I was able to interpret most things and I used my nursing experience to encourage the Afghan medics to ensure they had all they needed, and were ready, to receive the casualty on the ward once he came out of theatre.

While I was there I helped another patient who had become quite distressed. He is an ANA soldier with a good record for finding IEDs who had been caught in a blast, suffering facial injuries. He was concerned about his sight and the fear of long-term damage was making him anxious for his future. I held his hand and tried to explain that the healing process would take time. He calmed down but it was an upsetting conversation.

On a lighter note my relationship with the Afghan medics and the local interpreters goes from strength to strength. One of our interpreters recently came back from leave and told me he had brought some gifts back for the members of the team that were dear to him, and I was one of them! He then presented me with a lovely watch which was so thoughtful and a lovely surprise. One of the medics was trying out his best English to try and tell me how much he liked me, so at the end of our conversation (which had been in Pashto) he said to me ‘Goodbye, I love you’! It was very sweet but I’m not sure that was what he really meant to say! Still, whilst there are difficulties associated with my role, I am still really enjoying it and loving the challenges it brings.

1 Mar 14

This week has passed very quickly. I have been across to Shorabak with the team every day except Friday (we don’t routinely go across on Fridays due to it being their religious day) and in the last week the Shorabak hospital has been quite calm.  There has been a small, but steady, number of patients and the Afghans have been coping with them.  Occasionally when we visit our doctors may advise their doctors on the most appropriate management of some of the cases but generally they have been able to cope on their own. However, there haven’t been many major trauma cases recently so our input hasn’t been required as much when it comes to patient management. 

It has been a useful week for the team though as we have been able to use the time to encourage the Afghan medics to ensure their departments are well stocked and organised and to carry out some teaching. I meanwhile, either assist with interpreting when teaching is going on, or go on to the ward and talk to the patients.  Generally I am incredibly well received as the patients really appreciate a woman being able to speak to them in their own language and like to tell me about what happened to them (most patients suffer injuries due to IEDs or gun shots) and talk about their life and their family.  They are always very curious as to how I learned to speak Pashto and constantly tell me what a difficult language it is. I agree with them on that!

While it is generally quiet at the moment ISAF still stand the chance of suffering casualties, which has happened on occasion in the past month. Any death from the coalition hits everyone hard.  On previous tours I have been to repatriation ceremonies and I have always found them to be deeply moving, whether the soldier concerned was known to me or not. It is a difficult aspect of the job.

I have been particularly fortunate this week to have been asked to help with one of the Afghan children on the ward here.  The boy, who is aged around 14 (many Afghans are unsure of their actual age as birth certificates generally do not exist), suffered major leg injuries in an IED explosion while playing with his brother. He is naturally grumpy given what he is going through, so I was approached to perhaps do some reading and writing with him to try to occupy him.  I had helped with his nursing care before so he knew me and he and his uncle, who is his guardian, were pleased to see me.  My initial session was about establishing his level of literacy. He was illiterate, which is not uncommon in rural parts of Afghanistan, so I just spent the first session teaching him to read and write the first 5 letters of the Pashto alphabet (which has 42 letters) and to read and write his name.

He seemed interested and happy but I wasn’t entirely sure as he was also in some discomfort and so concentrating was difficult. However, the following day lots of the hospital staff kept congratulating me on the change in him and how good my intervention had been. After I had left he spent ages painstakingly writing and rewriting his name and showing the staff his achievement. I am so pleased that I was able, with something so simple, to put a smile back on to his face.  I have since been back and taught him the whole alphabet, some basic maths and made him laminated alphabet and picture flash cards and he has been thrilled.  He excitedly tells everyone ‘She is my teacher!’, though in Pashto so only I know what he is saying, and shows everyone his work. He is due to be discharged to an Afghan hospital soon but is keen to continue so I have made some more work books for him to take with him. It has been so gratifying to be able to help him in this way and I am glad I was given the opportunity.

Pt1: Lisa’s Diary Week 1-2 2014

Pt2: Lisa’s Diary Week 3-4 2014

Read Lisa’s previous blogs from 2010/2011:

Lisa’s Diary 1: October-December 2010

Lisa’s Diary 2: January-March 2011