The medical situation...

Is pretty abysmal and awful here.

I had a hard time writing about it last year, mostly because of the glut of information. but also because I was in the company of actual doctors and people working with companies bringing actual telemedicine technology out here (MedWEB). I didnt feel like I had much to add to the conversation, other than a needling sense of injustice. And confusion. And helplessness.

There's the corruption factor: people who are not qualified for jobs are given expensive government grants (your tax dollars hard at work) to accomplish reconstruction that never happens.

There's the "ick" factor: jobs aren't completed properly, and there is no oversight, and so sewage systems arent built properly and babies end up playing in untreated bloody, needle-filled runoff from hospitals

There's the brain drain factor: anyone who obtains enough training to bring up more people behind him/her is almost certainly too smart NOT to bail

There's the technology factor: So many modern machines are donated, without the donors understanding that the limiting factor is f*cking electricity

There's the "reach-back" factor: Even when machines are usable, there is often insufficient training to use them properly - let alone fix them when they break.

Here's a horror story for you: Fary told me about a time she visited the teaching hospital, after the Rotarians/Sister Cities had made some equipment available to the medical students. Including, as it happens, an autoclave. Neither faculty nor students were able to operate the (totally functional, undamaged) autoclave, and so sterilized their surgical tools in boiling water. Next to the unplugged autoclave.

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Medieval.

More horror: Mehrab's son came down with a condition. Kid wasn't feeling too hot. So he takes the boy to a specialist here in Jalalabad. The doctor listens, palpates, strokes his beard. Then he tells Mehrab that his son has a deadly serious lung infection, and will require surgery.

"Whoa. Easy there, distinguished sir." Says Mehrab, and hightails it across the border to obtain a second opinion in Pakistan (several hours journey, on deadly roads, through a border that's tighter than a hymennorrhaphy). The doctor they visit (a lady, Mehrab doesn't hesitate to interject), orders things like an X ray and blood work because this is Pakistan and they can do that here. She is pleased to inform him that his son has Pneumonia only, that it can be cured with antibiotics and rest, and no surgical intervention will be required. "If I could not visit her, my son would be dead." He is certain of this, the way only a father can be.

So... the ultrasound. What I thought was going to be a technological fix (i.e., it's not working, see if we can make it work) is actually a more subtle problem. Fary, who is a nurse, claims she jumped the "is it working" hurdle last time - in part by removing sensors from their original pacakging and firing the thing up for the first time after it had been there for godknows how long. A year? Two years? The thing works. The challenge will be to find someone suitable to train in its use.

Again, there are many programs in place bringing up new young doctors who would be willing to put in the time investment necessary to become proficient in this sort of diagnostic tech. And I have a few ideas up my sleeve.

Tomorrow, we visit a school. And a hospital. Not sure which ones. I'll keep you posted.