New French hospital a beacon in Afghanistan's ailing health system  08.04.2006 KABUL - In destitute Afghanistan, where hospitals sometimes have the air of a medieval hospice, the French Medical Institute for the Child in Kabul looks like something from another world with its latest medical equipment and sparkling cleanliness. This week a team of French doctors there performed an open heart operation on a young Afghan girl aged 13, a procedure beyond the capacity of any other hospital in the country ruined by more than 25 years of war. The hospital -- to be formally opened Saturday by Bernadette Chirac, wife of the French president -- is the creation of a French non-government group Enfants Afghans (Afghan Children) formed in the aftermath of the Taliban regime. The hardline Taliban were forced from power in late 2001, leaving behind a collapsed health system that is still battling to recover amid dire conditions that result, for example, in a quarter of children dying before age five. Enfants Afghans has been building up the French Medical Institute for the Child since November: about 100 children have already been operated on in the facility, which has about 100 beds, four operating theatres, a laboratory, a pharmacy and a radiology unit. About 150 Afghan staff, including 13 doctors, support French medical teams that rotate through the hospital and others permanently with the NGO. In March they treated 1,200 patients, some coming from the other end of the country. Considering the need of the nation, the number of patients is expected to rise quickly. For some, the state-of-the-art facility begs the question: in a country with so many pressing demands, would international funds not be better spent on more basic and less sophisticated facilities? The query is rejected outright by Kate Rowlands, executive manager of the hospital. "If we are able to provide this service, then who is to say it is not appropriate? Please, go and ask those heart children if it is appropriate or not go and ask the parents of these children," she says. The response of Alain Deloche, the chief surgeon, is that, "I am still in the simple act of saving." It does "not take away one euro dedicated to public health," he adds. Deloche, head of the France-based Chaine de l'Espoir (Chain of Hope) group on which Enfants Afghan depends, has also opened hospitals in Cambodia, Vietnam and Africa. Besides health care, these hospitals serve to improve the skills of local doctors, he says. The beautiful institute was in danger of becoming an empty shell because, after eight million euros (9.8 million dollars) was spent on its construction and equipment, there was not enough money for the monthly overheads of about 120,000 dollars. After long negotiations and a detailed feasibility study, the Aga Khan foundation headed by the wealthy spiritual head of the Ismaeli community came to the rescue. Now all medical aspects of the institute remain under French responsibility, but the management is handled by the Aga Khan. With this comes the Aga Khan philosophy: every patient must contribute to the cost of their treatment, in part to ensure the long-term viability of the project. "The concept is we provide the care with dignity -- we don't want to make them think we are getting it as a charity," says financial director Karim Kassimali, an Aga Khan employee. An elaborate system, that includes an interview, has been put in place to determine how much each patient can afford. The institute is also going to launch a fund, to which Aga Khan will contribute, to help cover the costs of the most poor, with most Afghans living on less than two dollars a day. << | >> |
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