Disaster Services

Jan 2, 2011   //   by LouBu   //   Uncategorized  //  5 Comments

Yes­ter­day Megan and I taught CPR to a group of Uni­ver­sity Stu­dents who have taken it upon them­selves to form a Dis­as­ter Response team and are try­ing to amass skills and knowl­edge that will be of use to them and their com­mu­ni­ties. One of the boys, Hameed, is part of our infor­mal “geek squad” at the Taj and wrote the pre­vi­ous post on this blog. Of the four he was the only one who spoke fully flu­ent Eng­lish. Two could get by in Eng­lish and the fourth spoke none, although he was flu­ent in Pashto, Dari, Urdu and Russ­ian. Many Afghans in this area can speak and read (if they are lit­er­ate)  Pashto, Dari and Urdu. If they are in their for­ties or fifties, they can get by in Russ­ian. The younger gen­er­a­tion tends to know dab­bling of Eng­lish. Pashto is the main spo­ken lan­guage but Dari seeps in from the West, Urdu from the East, and West­ern Lan­guages trickle in through the occu­py­ing armies sta­tioned here.

The class was punc­tu­ated by Hameed’s rapid fire trans­la­tion, side con­ver­sa­tions in Pashto, and the boys wrestling matches as they were a lit­tle over­en­thu­si­as­tic when prac­tic­ing the Heim­lich maneu­ver on one another. The best part of the class was the myr­iad of ques­tions the boys had, indi­cat­ing both a sin­cere desire to learn skills applic­a­ble to dis­as­ters they had wit­nessed first hand, as well as expos­ing deep seated cul­tural dif­fi­cul­ties that never arose in my numer­ous First Aid re-certification classes.

Noorah­mad probed about how to clear water from a person’s lungs, the mem­o­ries of last year’s flood­ing and earth­quake still penetrating.

They asked about the spread of infec­tion and how they were sup­posed to avoid get­ting dis­eases when sweep­ing a victim’s mouth clean or pro­vid­ing res­cue breath­ing. (The next step of prepa­ra­tion involves each of them assem­bling a med­kit, com­plete with lots of latex gloves).

Through Hameed’s trans­la­tion, Najib explained to me that he was from a very rural area where there were no trained med­ical per­sonal in any kind of prox­im­ity. He wanted advice for preg­nant women that he could bring back to the vil­lage and dis­perse. Accord­ing to the UN, Afghanistan has the sec­ond high­est infant mor­tal­ity rate in the world, topped only by Seirra Leone. It is the only non-African coun­try in the top twenty-five. Access to infor­ma­tion on preg­nancy and birthing, let alone trained med­ical work­ers, is slim at best. Even where there are med­ical facil­i­ties, mis­in­for­ma­tion abounds. I was shocked to find out last night that the direc­tor of the Neona­tal ward at the Pub­lic Hos­pi­tal in Jalal­abad has never seen a live birth.

Rah­mat raised his hand and said “In our cul­ture we are not sup­posed to touch women. What should we do if it is a woman who is not breathing?”Although sur­pris­ing to my west­ern sen­si­bil­i­ties, the ques­tion is of utmost impor­tance. Most women in Jalal­abad still wear their burqas in pub­lic. Although Afghan soci­ety is extremely phys­i­cal, it is so in a fully seg­re­gated way. Men and boys are always play wrestling, hug­ging, and walk­ing with their arms around each other, but the two sexes never touch in pub­lic.  Mean­while, in the pri­vacy of the university’s two-month-old women’s dorm, I chat­ted with half a dozen teenage col­lege girls play wrestling in their own way– hug­ging, pok­ing and slap­ping. Still, one girl there was mar­ried and five months preg­nant yet her hus­band lived across cam­pus in a men’s dorm. There was no place they could live together within the orbit of the school.

Even in a life or death sit­u­a­tion, where a women would die if she were not given a few breaths of oxy­gen, there is a hes­i­ta­tion if it is the right thing to do. The ques­tion was not uncar­ing, quite the oppo­site, but it reflected the extreme chasm between men and women which will take more than an effec­tive counter-insurgency force and an army of preda­tor drones to solve. In the end, if these boys ever have to per­form life sav­ing aid they will have to make those deci­sions for themselves.

  • h.mes


  • Tak

    Just get­ting to read­ing your blog for the first time today… amaz­ing sto­ries. FYI re: the ques­tion of avoid­ing con­t­a­m­i­na­tion dur­ing res­cue breath­ing, this past year has seen sur­pris­ing data regard­ing improved out­comes when res­cue breath­ing is avoided in favor of chest com­pres­sions only. The sug­gested expla­na­tion is that at the rec­om­mended rate of chest com­pres­sions, that there is enough lung compression/expansion to pro­vide gas exchange. Tak

    • Ed Myers

      This is true and the red cross has revamped the CPR course so chest com­pres­sions are most ompor­tant after mak­ing sure the patients air­way is clear

  • Agil

    So I grew up in what some may call a war-torn coun­try as well (at least late 80s and early 90s). High­schools had a manda­tory pre-conscription classes. Unfor­tu­nately due to sex­ual seg­re­ga­tion girls got to learn what are now use­ful skills of first aid/nursing while guys learned what is not as use­ful skill of walk­ing in a row and throw­ing stuff over­head method. imple­men­ta­tion of a for­mer in schools both for boys and girls would IMHO ben­e­fit the soci­ety and increase the like­li­hood of hav­ing a same-sex first respon­dents around when one needed, espe­cially if they are lack­ing ambu­lances. I am also will­ing to bet that the soci­ety will ben­e­fit from pro­mot­ing “healer, not killer” men­tal­ity among males.

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