The hospital that gives courage and hope

He is watching you as you walk in, and you don't know which way to look as the thought crosses your mind – this man has no legs. Lying face down on a gurney that he wheels himself, the young man follows you through the labrynthine twists and turns in Kabul's Orthopaedic Hospital. Difficult to ignore, he furiously powers his way through the throng, watching your every move as you examine the prosthetics made here, and talk to the patients.

There are maimed children struggling with calipers for the first time, helpless adults having their wasted limbs massaged, a 13-year-old with cerebral palsy whose high-pitched screams echo through the halls, refusing to heed his parents' plea to use his crutches....but through it all, it is the young man on the gurney who holds your attention.

He waits until we have completed a tour of the haphazard collection of buildings, set up some 16 years ago to deal with war victims, until he makes his move.

The shy smile as he reaches out and introduces himself melts the initial awkwardness. Mirwais Rahim, 20, may be paralysed from the waist down but his story like that of so many others in this beehive of activity is how they have transformed utter despair into courage and hope. His story is repeated many times over in this corner of Kabul where the staff, of whom ninety per cent are disabled in some way or the other, have found not just a home but also meaningful careers and, more importantly, self-respect.

He was playing on the street when the rockets came raining down. He was nine. "I was kicking a football around near a mechanics shop in Kabul with my friends when the rocket attack started. I have no idea what happened immediately afterwards except through the haze of pain, I could smell singed flesh and when I tried to get up I felt myself crumble, I couldn't stand up."

He has no recollection of the events thereafter but the people on the street rushed him to the ICRC hospital. He has never left. The hospital could do little. The rocket had destroyed his hip and the vertebrae in his lower back. Here, among the hundreds of others who come to seek care and solace, Mirwais like so many others now wants to give something back.

"This is my home," he says, "I go home, of course, I wheel my gurney through the streets until a taxi driver takes pity on me and decides he will take me home. It's not easy, they have to help me off and into the cab and then fold my gurney into the back."

Mirwais has a special place at the ICRC hospital which runs a special school for bomb victims like him. Studying in the 11th grade, his subject, Elective English, Mirwais now teaches the smaller children who come for treatment and stay at the hospital's hostel.

"I get $1 an hour and I teach here every day from Saturday to Wednesday. It helps me with my English, and I am good with languages. Isn't my Urdu good," he asks, adding "I watch all the Hindi movies, my favourite actresses are Kareena Kapoor and Aishwarya Rai."

Not alone

Alberto Cairo, the Italian who heads the hospital, says that the most difficult moment for any victim is the day he steps into the hospital. "But then they see a man with one hand answering the telephone, another with a prosthesis holding the door open, or a woman in a wheelchair counselling you, and they realise they are not alone."

Six ICRC officials train and assist some 450 local workers of whom 50 are female, and about 85 per cent are disabled.

Confidence

Mohammad Naim Nahik was walking in west Kabul when a bullet smashed through his knee. An agricultural scientist from Pune University in India he is now an ortho specialist. "When people see me conducting myself, they gain a lot of confidence, they know they too can have a future."

Afghanistan is the most mined country in the world after Cambodia. The number of mine victims had risen during the years of Taliban rule when they mined areas that the Soviets and the mujahideen had previously mined, making most places outside Kabul extremely dangerous.

But Cairo says in the last three years, the number of mine victims, especially among children, has dropped dramatically as a result of the concerted de-mining effort by ICRC and Halo Trust.

"Only one in every five or six is a mine victim, the bigger problem is trauma victims, that is children who fall from roofs and those who suffer from other disabilities."

This is where Afghanistan needs urgent help in setting up a comprehensive home health care system where young mothers are taught about nutrition, hygiene and basic health care. Apart from pulmonary tuberculosis, says Cairo, more and more women and children, packed 10 to a room in remote villages are contracting a tuberculosis that destroys their bones.

"For women it is terrible, they become social outcasts. With disabled children we have to work hard to ensure they get home schooling, so that when they are a little older and more confident they can be encouraged to study further and interact with the outside world."

Their biggest problems lie with adult males who find that they can no longer feed their families. "We have started a small home assistance programme where we visit the disabled's home, offer him micro-credit so that he can start a small business, even if it's selling cigarettes outside his home."

Originally intended for war disabled, the ICRC from 1995 onwards extended assistance to any kind of motor disabled. They now treat those who contract polio, have spine injuries, congenital deformities and cerebral palsy.

The ICRC, which moves this week to new premises, now has a multi approach programme, says Cairo, that provides not just medical and follow up care, but also gives social support, and tries to economically and socially reintegrate the victim, while ensuring the family support remains intact.

"It's not easy, which is why unlike Sophia Loren, I look my age," laughs Cairo.