News: Medical engagements more than just health care missions in Panjshir province
Story by 1st Lt. Lory Stevens
By 1st Lt. Lory Stevens
Task Force Warrior Public Affairs Office
BAGRAM AIR FIELD, Afghanistan – Government officials and the Provincial Reconstruction Team Panjshir medical team coordinated with local leaders in two separate districts to augment health care services to 563 Afghans, including more than 150 women and 320 children, during medical engagements held in Panjshir province.
A representative from the Directorate of Women's Affairs and two Afghan national police accompanied the PRT medical team to Estayca Village in Rokha District for a medical engagement on Oct. 14, 2008. Inaccessible by road, the isolated Afghan village lacks basic medical services.
Capt. Glenn Little, chief medical officer, coordinated in advance to have local manpower waiting near the Panjshir River to transport medical supplies needed for the event across the footbridge and trail leading to the village.
"Coordination with village elders can be the most difficult aspect of conducting these engagements. But serves as a critical task in ensuring a successful outcome," said Little.
"The role of the PRT is not to meet all the needs of the Afghans, but to support the local elders as they take the lead providing essential services to people in their village," Little said.
Working with the village elders, the team set up temporary treatment facilities. Women were seen on the balcony of a private residence, and men were seen a short distance away outdoors in the centrally located village gathering place.
The team conducted medical screenings and provided routine treatment for 202 patients. There were two referrals for Afghans requesting to be seen at the Egyptian Hospital at Bagram.
"The village elder suffers from suspected carpal tunnel syndrome and another adult male presented with varicose veins," reported Little.
Miriam Panjshiri, the Director of Woman's Affairs, and the PRT medical team assisted a local midwife and nurse at the Obdara medical clinic in Anaba District on Oct. 16, 2008. The original plan was to have separate rooms inside the clinic for treating male and female patients. However, treating males and females in the same area created the problem of having males and females in close proximity as they waited to be seen by providers. The women were then moved a short distance away to a large open room inside a girls' school.
"The big room allowed for the medical engagement to flow smoothly," said Staff Sgt. Janine Duschka, a medic for the PRT with a background in trauma and emergency medicine. "There was space to work and move without being crowded, which is often the case during medical engagements."
Almost all the women complained of headaches and kidney and back pain. Many of the children showed signs of dehydration and malnutrition.
"Motrin, an anti-inflammatory medication; Levafloxacin, prescribed for urinary tract infections; multi-vitamins and Pedialyte were the most common medications given out," said Duschka.
Blood pressure medications, insulin and other dangerous drugs were not offered, said Little.
Also, medications given out to local patients are manufactured in Afghanistan, ensuring continued availability of medicines and avoiding treatment with products manufactured in the United States.
"Medical engagements empower women and children by having someone listen to them," said Maj. Jillian Torango, PRT Panjshir women's affairs liaison, as she explained the benefits of interacting with the local populace.
"Working with the DoWA is very helpful in treating the women," said Torango.
During engagements, women discuss health issues in confidence with the female providers and the DoWA, as well as voice concerns they are having in their village.
"The DoWA can take the lead providing teaching on the importance of good feminine hygiene, handwashing, breastfeeding, and boiling water before drinking," said Torango.
During nine medical engagements over the past six months, the PRT medical team has built a reputation where villagers trust and have confidence to seek out care.
"It is notable in the conservative posture of Panjshir to have two women request my [a male provider] services," said Little, as he reported on one woman who needed a referral for high blood pressure and another who suffered an injury to the foot.
Capt. Jason Aftanas, chief engineer, said Little is responsible for many good works in the local medical community in Panjshir.
"Previously there had been only one clinic, and Doc identified a lot of projects totalling $1.7 million in medical construction," said Aftanas, explaining the role of medical engagements in connection with four clinics built and one in the works.
"Medical engagements provide an opportunity for Doc to assess local clinics, health care providers and needs in the area, and then information is shared with local health officials who organize efforts to improve the local medical infrastructure," said Aftanas.
In addition to the medical screenings and treatment, the PRT medical team also provided school supplies, hygiene kits and stuffed animals to the children. Women were given metal pots and pans, which Torango stressed as a great benefit to this society where utensils are limited.