Womb with a view!

Fary is an action hero. In the time I've been here, I think she's visited 12 schools. I am still shaking off jet lag, puttering around the guest house, and she is shaking hands and kissing babies, literally.

It's nice to meet native students, and Jenn has championed right alongside her for every outing. but I'm reserving my energy for an actual class I might teach, or that Jenn and I might teach together. There is great interest here in learning how to find scholarships, how to apply to study abroad, and how to improve one's study skills generally. I don't feel qualified to teach about these matters in the way I feel qualified to teach, say, algebra. But if there's sufficient interest and I can be of some help in elucidating matters I'll do my best.

I also learned that UCSD offers a credential program in exactly the course I had planned to teach a workshop in - english for medicine and science. And many of the students and teachers I have met so far have already received their certificate! So, bonus points for accurately identifying a need in the community. Demerits for coming late to the party.

In the meantime, I have been troubleshooting the portable ultrasound device here in the comm room, left by MedWeb. This has been a fun project - I finally feel like my BME education is paying off. I wish I'd discovered earlier in life how much I like computers. At any rate, I was able to diagnose and patch a software issue in Windows XP, and now I'm up and running with the field sonogram... except the resolution is not so good. Meeting planned with the MedWeb honchos for sometime tomorrow, hopefully we'll get this sorted, maybe even in time to loan it out to the Ob/Gyn dept at the National Hospital.

We visited the day before yesterday. One of the ironies round these parts is that healthcare is paradoxically more available in Afghanistan than in the USA. Anyone in Afghanistan can walk into the National Hospital and expect to be treated. No insurance necessary. That is why I actually received my first prenatal exam from the distinguished faculty here.

We started with a quick tour of the sonography department in the main hospital. Two broken machines (old, dusty) which I photographed, kicked the tires, so forth. The main hospital also has one newer machine, a Honda, that works. And a full schedule. I did not wish to embarrass the doctor by asking pressing questions about diagnostics, but Fary has mentioned that her goal is to train a suitable technician.

I wish I could have taken more pictures of the hospital. People gathered outside to wait on the grass in the courtyard, sometimes hanging IV bags from trees. The interior of the buildings are not air conditioned, and reek of bodies and disease. At home, I find hospitals a little unsettling in their sterility - the bracing, chemical aroma of disinfectants, the threat of the superbugs left after the 99.99% kill rate advertised on their bottles. The opposite is true here. Nothing about this hospital seems even remotely sterile. It is not scary in the abstract - it is concretely the stuff of nightmares. Yes, it's free to visit, but if you end up here the feeling is that it may be your last visit anywhere. I actually wish I had worn the burqa, it might have been possible to stealth some more photos. In my alien western garb, it would have been poor form to just start snapping pics randomly.

Making our way into the Ob/Gyn building was a relief. It didnt smell so bad. Women and children only.

We spoke first with two lady doctors who gave us a sense of their load - 1400 patients per month. They took us to see the dedicated Ob/Gyn ultrasound - broken. Recently. Power here is unreliable, and surges. It's possible this machine was fried.

They took us to meet the department head, a sweet middle aged lady whom her students proudly proclaim to be the best doctor in all of Nangarhar. And the rest of the entire department! About ten doctors, all young women, all married save a single widow. Everyone crowded into one room, tried some english on us, told us about their studies. I sprawled on the exam table as the department head gave me an abdominal exam - the first time a doctor has laid hands on me during this entire process.

"Congratulations," she says. "16 weeks." She prodded me further, checked my eyeballs, and wrote me a presecription for iron and folic acid. And told me to eat. Thank god, she also told me I was completely normal.

This is an enormous relief. I have been haunted by stories of women who show up to their 16 week checkup, only to find a dead 12 week old floater in there. But everything is the right size and all I have to do is make sure I don't become anemic. Excellent! After 4 months it's such a relief to have a doctor look at me and say, "you and your baby are fine"


Fary asked the department head some questions about working during Taliban rule. They were in charge for 12 years, and in that time, she said, it was possible for women to work in medicine, but not to train.

They asked us if we would be able to fix the sonogram - I think it more likely to be replaced than repaired. But no promises. Inshallah.

It was truly an honor to have met and interacted with these women - for sure the smartest in Nangarhar and doubtless among the hardest working. They deserve technology that works. I would like very much to help in any way.

We then visited the school of midwifery, which is where I had assumed I would receive my checkup. This is an amazing progam - young women in rural villages are selected by tribal elders to come to the city and participate in a 4 year midwifery program, promising to return home when their training is complete. This is a very beautiful building, and it even has a kindergarten attached for the girls who have babies of their own.

I am touched and inspired by the professionals I'm meeting here, their dedication and their bravery, men and women alike. The feeling of helplessness is still there.

And I'm anxious to get this portable ultrasound working. How fun, to have one here in my bedroom... a womb with a view!