Wednesday, April 30, 2008

Soporific delivery compensates for lecture's sparse humor

Double-click the photograph to read the witty captions.

This week I gave an ophthalmology lecture at the National Military Hospital in Kabul, during which I silently recalled one definition of a professor: A person who talks during someone else’s sleep. The topic was glaucoma, a diagnosis of interest to very few people outside of ophthalmology. In fact, many ophthalmologists have little interest in the disease, so I was not surprised that a couple of staff physicians and a handful of medical students were dozing during the forty-minute presentation. I’ve written before of the easy and prolonged sleep I’ve enjoyed during my stay in Kabul, and evidently many Afghans are not immune to the sedative vapors that propel me into slumber. I was a little disappointed when I noticed that Dr. Abdulmanan, the only other ophthalmologist in the room, was asleep, but I doubt I had anything new for him. The lecture had begun with two ophthalmologists in attendance: the aforementioned Dr. Abdulmanan and Professor Lalzoi, the latter a seventy-four year physician who claimed he was the oldest faculty member at the hospital. But the Professor departed the lecture, after sitting in the front row looking extremely bored, five to ten minutes after I began. He later told me some sort of emergency compelled his departure, an excuse that is the Afghan medical equivalent of Saturday night hair washing.

I try to add humor to my lectures whenever possible, but what I thought would be laughable injunctions failed to elicit much mirth. Perhaps my idiomatic English didn’t translate well. For sure I thought I would get a chuckle when I showed a photograph of an Afghan hound, a show-breed canine famous for its long hair and distinguished profile; and also one of the more than forty breeds of dog predisposed to glaucoma. Instead of laughing at the veterinary allusion to a dog named for their country, the Afghans simply stared at the photograph, confused as to why the dog was called an Afghan hound as not a single person in the room had ever seen one or heard of the breed.

The audience also seemed confused when I stated that the prevalence of closed-angle glaucoma was unknown in Afghanistan, but since it was more common among Asians that Afghans with Asian blood were likely at increased risk for the disease. My translator himself seemed confused at this, and he turned and said to me, “We are all Asian.” When I informed him that I meant Chinese Asian, as in the bullied and widely despised Hazara Shiite minority of Afghanistan, he simply nodded his head vigorously and told the audience something that provoked them to slightly gasp in unison and then discuss briefly with their neighbors what I could only imagine was their perceived luck at being born Pashtun or Uzbek or Tajik.

I was able to elicit group laughter during the question-and-answer session when a nurse asked what he could do to treat his near-sightedness (an issue, by the way, that has nothing to do with glaucoma). I told him that no good, scientifically proven prevention treatments exist; but that, in America, some people believe that a diet heavy in carrots improves vision, the proof being that you never see a rabbit wearing glasses. Even after translation, that quip had the entire crowd chuckling.

Monday, April 28, 2008

Taliban remain a disruptive force in Kabul

April 27 is the Victory Day holiday when Afghans celebrate their liberation from communist rule. A military parade yesterday at the main stadium in Kabul was supposed to highlight the national celebration, but instead an attack by the Taliban disrupted the event. Three Afghans died in the rifle and explosives barrage, including a ten-year old boy. Several others suffered wounds. It’s unclear if President Hamid Karzai was the target of the attack, as he was forefront on the main reviewing stand when the attack took place, along with many other Afghan leaders and foreign diplomats; but those men were unharmed. If the Taliban were aiming for Karzai or the main stage, then they are very poor shots. If they simply wanted to disrupt the event to illustrate their ability to infiltrate the security of Afghan defense forces, then they accomplished their goal.

I knew several people who attended the event. The day prior, I asked around for an official invitation for myself, but I didn’t inquire very earnestly about attending the celebration as many people suspected the Taliban would try to disrupt the parade; and usually the increased threat that insurgents will target a route or gathering prompts the US military to declare that site off-limits to all of us. First-hand reports I received from attendees confirmed news reports that considerable confusion surrounded the attack initially. Small arms fire errupted across the parade ground in front of the reviewing stand just as a twenty-one gun salute began during a rendition of the Afghan national anthem. A friend in another bleacher section told me he knew something started to go wrong, but he wasn’t sure what, when he heard people yelling to get down and then his section of US military guests, all of whom had been disarmed before they entered the bleachers, cleared the area quickly and hurried back to their vehicles and exited the stadium.

He recalled that most Afghans around him, while well aware that an attack was taking place, were amazingly calm. People were exiting at a brisk pace, but not running or panicked. An Afghan in front of him smoked a cigarette as he walked out of the stadium. Below is a link to a CNN video of the event that is remarkable for the nonchalance exhibited by the Afghan leaders and dignitaries who shared the stage with President Karzai, most of whom simply sat down once the attack began and appeared content to wait out the action in their chairs. The majority of Afghans seated to the lower right of the primary dias, where gunshots appear to hit at least one man in the front row, didn’t flee either. A few of them actually stood up and pointed to the direction of the gunfire. I don’t know if these guys are warlords and accustomed to small arms fire; or believers that, inshallah, they would survive this nuisance just as they had survived the Taliban before. All I know is that I was mightily impressed with their composure, and now that I’ve learned just a bit about the Afghan temperament and their customs, I would bet that if the skirmish lasted more than a few minutes they would have demanded that tea be served while they observed the gunfire below them.

CNN video of event:

Unaware of the disruption at the parade taking place less than two miles from my secure base, I was in the basement of the Post Exchange shop searching for an electrical adapter for my laptop computer when a store employee started yelling for everyone to clear the building. It was approximately 10 am and, I thought, fairly early for the shop to be closing, even on an Afghan holiday. After I climbed the stairs and proceeded to the door, I heard the base alarm blaring and people scurrying in every direction. I hadn’t heard the alarm before, but I knew it signaled either an actual attack or an attack drill; and either way I needed to get myself to the nearest mortar shelter. I ran by a military policeman ten yards outside the shop door who was yelling “This is NOT a drill! This is NOT a drill!” I picked up my speed after hearing that, and was in a mortar shelter in about three seconds.

The shelters are long, rectangular boxes of thick concrete with benches that seat twenty to thirty people seated back-to-back. Once inside, I heard an announcement over the base intercom reporting that this was indeed a drill, leaving me confused. A contractor with a cell phone called a buddy of his who was attending the parade and we then learned that an attack of some sort had disrupted the event. As more people streamed into the bunker, I heard rumors of a US convoy encountering an IED nearby and that a multi-national base very near ours was taking mortar fire. At this point, I was more curious than nervous, and I sat waiting for either an explosion or the “all clear” call. Thankfully, after fifteen minutes we got the announcement that we were safe to leave the shelters.

Friday, April 25, 2008

Quality shampoo serves as hard currency

Every Friday Afghan merchants gather at a secure section on the perimeter of my base for a bazaar that offers a variety of wares: wool carpets, antique rifles, tailored clothing, marble flatware, Afghan hats, bootleg DVDs of American movies, etc. Amahkbaru sells pistol holsters and protective vests at his stall. I met him the week I arrived in Kabul when I was searching for a holster better suited for my body armor than the Army-issue item I received. During the price negotiation segment of that encounter (“My friend, $30 is special price and only for you!”), Amahkbaru let fly that he has five children and he would trade anything in his stall for a bottle of good American shampoo. (non sequitur you say? Perhaps. But Afghans often employ language and reason a bit differently from what the Western mind accepts.) He claimed that only Chinese-produced hair care products are available to most Afghans, and then he added what I believe where both Dari and Pashtu expletives as a verbal rating of the quality of those Chinese toiletries.

You will notice in the photograph that Amahkbaru has a beautiful head of hair, full of curls and bounce. I could not let him suffer any further ignominy due to dirty limp locks, so I rushed to the base PX, purchased a bottle of Pert shampoo for $3, and then traded it for a $15 holster. I tried to explain to Amahkbaru that Pert is shampoo plus conditioner and perhaps worthy of two holsters per bottle, but I’m not sure he understands the product’s double-action. I got only one holster. Regardless, he was thrilled with the transaction, as was I. I now visit with him weekly at the bazaars and his hair looks terrific. (Also, he reports that his children are doing well.)

Before you draft your email berating me for taking advantage of Amahkbaru with the exchange, I would like to emphasize that these Afghan merchants are crafty fellows and would NEVER make a trade or sale if they suspected they were not coming away with a profitable deal. The items in Amahkbaru’s stall are over-priced and he knows it. He also knows that most Americans will not barter for 30 minutes for a $3 reduction in price. Amahkbaru clearly values American shampoo as several of my friends, on my advice, have swapped bottles for holsters. In fact, two weeks ago I saw that he had at least three bottles of the stuff stashed underneath his stall, and I asked him why he was stockpiling. “Save for the future,” he said,”and my wife now want the shampoo before even the dollar when I am home from business.” No non sequitur there.

A bit more about Chinese-manufactured toiletries

I have heard several Afghans offer unsolicited commentary on the substandard quality of most Chinese products. Many futurists predict that the next 100 years will be the “Asian century” led by China as that country of 1.3 billion people will leverage its population and resources to become an economic superpower. But I have some (unsolicited) marketing advice for the whole of Chinese industry: You might want to implement some quality control. The future doesn’t bode well for you if low-income people in developing countries shun your (markedly inferior) products. I would imagine that many Chinese themselves are avoiding Chinese products. A Malaysian Chinese friend of mine recently told me that he avoids purchasing anything made in China, and that he resents the reactive "smear campaign" against honest, hard-working Chinese people worldwide that these cheap exports promote. People around the world, both rich and poor, are beginning to prove that a low price and availability do not necessarily stoke a desire to purchase. Add to that recent media coverage of potentially harmful Chinese exports such as toys doused with lead-soaked paint, incendiary batteries, tainted pet food and structurally unsound bicycle frames, and you get the impression that the label “Made in China” is becoming the standard for “dangerous and defective.”

Many Afghans believe that Chinese companies and plants are able to manufacture quality items, but that international business executives simply choose to dump inferior products in Afghanistan as they consider the Afghans either too unsophisticated to recognize the low quality or too desperate to clamor for anything better. Also, the typical Afghan has very limited spending power and considers a simple bar of soap a luxury item, no matter what the quality and price. Chinese know-how and reputation also withstood a public beating here recently when a building that a Chinese firm was refurbishing suddenly collapsed, killing more than a dozen Afghan workers. The firm and/or the Chinese government are compensating for the tragedy by building a brand new hospital in Kabul, a generous and thoughtful contribution; but I wonder how many Afghans will be comfortable heading there for medical care once the facility is finished?

Where’s my stuff made?

The Afghans and their complaints about Chinese toiletries prompted me to investigate the origin of my own personal hygiene products. Currently I have no gripe with the performance of my Edge Pro Gel Vitamin Enriched Sensitive Skin shaving cream or Axe Stimulating Guava and Volcanic Stone Extract shower gel, but I encountered significant difficulty when I tried to determine the locations of the production plants. Not one of my toiletries stated on the label the product’s place of origin. Several included the product’s US distributor’s name, which I found very suspicious as the implication is that Desenex foot powder and Colgate toothpaste are imported into the US from some undisclosed location. Two products listed websites for reference, so I reviewed company information on Listerine and the aforementioned Axe body gel to find that those sites, too, failed to identify manufacturing sites. (I also read nothing on the benefit of cleaning your body with fruit extract and rocks belched from the Earth in a volcanic explosion.) I was ready to contact the Food and Drug Administration to inquire about regulations for disclosure on US products until I found, in a self-directed internet search, that almost all Listerine is produced in Pennsylvania.

I’m not sure why Pfizer, the manufacturer of Listerine, doesn’t highlight the fact that its mouthwash is made in the USA. I haven’t heard anything negative about Pennsylvania exports recently; and if the Democratic primary candidates can be believed, the people of the Keystone State are some of the most-hard working and honest folks around. Real solid citizens. Listerine is pretty much synonymous with clean fresh breath. Why wouldn’t Pfizer want the public speaking of Pennsylvania mouthwash just as they refer to German engineering and French cuisine?

Perhaps a few of my bathroom products are made in China. If so, I give a segment of Chinese manufacturing high marks for quality and consistent performance. My grade would be even higher if I could find Kung Pao-flavored toothpaste and Sweet and Sour dental floss. The Chinese certainly produce quality food. Even the neutered Chinese entrees typically found in American restaurants taste pretty good, if only faintly similar to the original. If China can lift its other, newer exports to the same standard, it just might end the 21st Century with another dynasty.

Wednesday, April 23, 2008

A surprisingly simple way to lose weight

Let me be frank: I can stand to lose 25 lbs. That would drop my Body Mass Index below the obese range and lower my blood pressure a few points. I’m happy to report that I have lost some weight. (I’m five to seven pounds lighter, the operative variable being the number of chicken wings consumed the dinner prior to stepping on the scales.) Unfortunately, I doubt the weight loss is linked to healthy alterations in my lifestyle. I wrote last week about the sedative properties of my environment that have me sleeping 8+ hours nightly and prevent me most days from rising early for exercise before work. Late morning hunger and afternoon fatigue then rule out a gym visit later in the day. In addition, the dining facility here features every meal several entrees plus a buffet line of hamburgers, chicken tenders, french fries, onion rings and hot wings; and I’ve discovered that increased sleep unleashes a powerful appetite once consciousness takes over.

The only way I can explain my weight loss is this: I no longer stop at Carl’s Jr. on my way to work for a breakfast hamburger, hash brown nuggets and a Coke. The Breakfast Burger is a charbroiled all-beef patty, fried egg, crisp bacon, American cheese, hash brown nuggets and ketchup on a sesame seed bun. Living in San Diego County and frequenting the drive-thru at Carl’s Jr. most days of the week, I was always confused why the Breakfast Burger featured the hash brown nuggets smashed within the bun of the sandwich as the Value Meal comes with a side order of those crispy golden nickels. The burger certainly didn’t need the deep-fried potatoes for extra nutritional value: the sandwich provides 830 calories and 47 grams of fat.

Simple math illustrates my contention that I’m losing weight by simply eliminating the Carl’s Jr. Breakfast Burger from my diet. If I ate 300 of the burgers last year (a conservative estimate), then the sandwich accounted for 24,900 calories ingested. A pound of fat stores approximately 3500 calories. Therefore, eliminating the (delicious and addictive) Breakfast Burger from my diet equates to (24,900 ÷ 3500) dropping 71 pounds! And that doesn’t even include the calories I miss from forfeiting 300 side orders of hash brown nuggets. Realize I have to eat something first thing in the morning, but imagine that I consume a decent breakfast of 500 calories daily. Again, simple arithmetic shows that such a (surely boring and unappetizing) meal equates, over 300 days, to 43 pounds, or 28 fewer pounds than the (delightful) Breakfast Burger breakfast. I might meet my weight loss goal simply by avoiding Carl’s Jr., which thankfully has no franchising plans for Kabul.

Sunday, April 20, 2008

Kabul Medical University students clamoring for ophthalmology lectures!

Beware owners of this breed, the Afghan hound: Your animal is predisposed to glaucoma and should have a complete eye exam from a veterinarian (not an ophthalmologist).

The efforts of the Navy medical mentoring team at the National Military Hospital are inspiring the medical students from Kabul Medical University who rotate through the medical center for clinical instruction. After a recent trauma care course presented by the Navy team, the several dozen medical students presented the course director with a list of topics they would like addressed in a lecture series. I was shocked to see that the twenty-three proposed lectures included two involving the eye: glaucoma and blindness. I’m accustomed to seeing lists of “essential” medical topics include well-worn issues such as sepsis, cardiac artery disease and gastroenterological dysfunction, but not eye problems.

My experience is that most medical students know very little and care even less about the eye, and that medical schools reinforce the negligence by giving scant instruction in ophthalmology during core courses. You would think that the phrase “life, limb and eyesight” would prompt a little more attention to vision. I cannot remember thinking much about the eye while I was in medical school, except for the day in the anatomy lab when we cut open cow eyes to peek inside. I can’t even recall a lecture on eye diseases and ophthalmic treatments. During our physical examination course I did learn the basic eye exam, although I didn’t really understand everything I was doing; and I remember an emergency medicine resident emphasizing to me that a patient’s visual acuity is measured separately for each eye at the Snellen chart (you know, the sheet of paper on the wall with the big black E).

I doubt most people could define optician vs. optometrist vs. ophthalmologist. Many patients of mine have commented that is must be wonderful to be able to do my work with only a bachelor’s degree. I’ve encountered nurse practitioners and even physicians who have no idea that ophthalmologists handle severe medical problems with the eye and perform surgery. What people presume about ophthalmologists these days is that we all spend our days performing LASIK surgery and making $1 million annually.

Even though the practice of ophthalmology in the US might suffer from the disinterest and confusion of the greater medical establishment, its status in no way compares to the lack of attention to eye maladies in Afghanistan. I attempted an internet search for information on glaucoma in Afghanistan, and found only two articles. I wasn’t investigating a rare disease such as kuru or Sanfilippo mucopolysaccaridosis. Glaucoma is the second leading cause of blindness worldwide. The two articles were simple surveys, valuable but limited in scope. In contrast, I was able to find dozens of internet resources for glaucoma in the Afghan hound, a beautiful long-haired animal that apparently is one of the more than forty canine breeds predisposed to developing glaucoma. I may write the American Kennel Club and try to shame it into a donation for ophthalmic research in the homeland of that distinctive champion dog.

Monday, April 14, 2008

You are in Afghanistan. You are feeling very, very sleepy...

A deployment to Afghanistan might be a treatment for anyone who suffers from insomnia. I usually sleep pretty well myself, no matter what my location or state of mind, but my slumber in Kabul challenges that of a medicated ICU patient. I could have napped for an hour that afternoon or quaffed a Coca Cola immediately before turning down the sheets, but I will still sleep through the night. Yesterday is exemplary: I had a headache and so went under the covers at 8 pm, thinking if I woke up very early the next morning I would simply role out of bed and meander to my office to watch the major league baseball games that the Armed Forces Network was televising live. The early morning line-up was the Padres-Dodgers game followed by the Yankees-Red Sox. But instead of watching baseball, I struggled to make breakfast after logging eleven hours unconscious.

Afghanistan is a major producer of opium, and I theorized soon after arriving here (and discovering that I could easily spend half of this deployment face down on a pillow) that perhaps a narcotic dust lingers in the Kabul air, providing me a gentle, constant sedation. The opium is grown in the southern part of the country, however, the area from which the Taliban emerged and currently the region with the most fighting between the Taliban and NATO forces. So instead of producing a population of listless Lotus eaters, the opium region here has bred just the opposite. The likelihood is that something other than a ubiquitous narcotic cloud explains my fatigue.

Boredom, I think, is the etiologic factor that best explains my impressive slumber. Although my base is one of the most developed American facilities in Afghanistan, there isn’t much to do here. The compound is a walled, heavily fortified and guarded three-square-block area in the Wazir Ahkbar Khan neighborhood of Kabul (famous as the setting for the novel The Kite Runner), but I am restricted from leaving the base unless I am on official business and part of an armored vehicle convoy. I do have several sites that I must visit regularly for projects, including the National Military Hospital and the Ministry of Public Health, but both of those buildings are a very short drive and the trips don’t allow me to see much of the city. Most of the day I spend on the base, which does offer a gym, a small coffee house, a pizza restaurant and a few shops. I have internet access in my room (although I pay myself for the service). Meals are provided for me, as is a laundry service. The “library” is an overheated basement room with shelves of Louis L’Amour and detective novels. (I spent an entire afternoon searching for a history of Afghanistan, which is how I discovered the library. I’ve yet to find the history tome.) So I have pretty much everything I need, but I don’t have much to truly enjoy. And when I don't have much to enjoy, I feel bored. And when I feel bored, I get tired. And when I get tired...

A few blocks away sits the International Security Assistance Force (ISAF) base, the headquarters for NATO troops in the country. Many different European countries have forces stationed there, and they play by different rules when they go to war. First, many Americans think that the Europeans avoid combat roles. I’m not sure if that is really true, but more than a few people have told me that the acronym ISAF is short for “I Sit, Americans Fight.” Also, the Euros are somehow are able to afford a superior food service. The only complaint I have with the American food contractor, Kellogg, Brown and Root (KBR), is that the food KBR provided in Kuwait was better than what’s served here. For example, KBR Afghanistan forgot to import the endless dessert bar featured in Kuwait. But the NATO force food comes from a company called Supreme, and supreme it is with a cheese bar, hearty bread selection, butter and espresso machine at every meal. I can eat at either base, and at least one day a week my colleagues and I make business for ourselves at the ISAF base somewhere near lunchtime so that we can enjoy the European fare.

The Euros also allow their soldiers alcohol (it’s a dry deployment for us Americans), and their base has a bar and beer garden that has faux field stone walls and a wooden fence that simulates Bavaria, I assume. Shops on the ISAF base sell Cuban cigars (which are contraband in the US) and nice European chocolates and candies. The PX on my base has Kit Kat bars and stale Pop Tarts.

Again, compared to the quarters of many if not most Americans currently stationed in Afghanistan, I am living in luxury. Recently I visited a small base just outside of Kabul and literally threw a stone the length of the compound. At the regional hospitals in some of the smaller Afghan cities, my colleagues live on the medical complex grounds and wander virtually nowhere else the entire 6-12 months they work there. Kabul itself is relatively quiet and no mortar or artillery fire disturbs the night. So I will continue to sleep long and peaceful hours, inshallah.

Wednesday, April 9, 2008

The Great Massoud: The Lion of Panjshir, Hero of Afghanistan

Photographs: The National Miltary Hospital in Kabul, yet another marvel of Soviet architecture. Clothing hangs out to dry on the Massoud Monument. Another view of Massoud Circle in Kabul. Massoud in the hat he made even more famous.

The National Military Hospital (NMH) of Afghanistan is a paragon of Eastern Block architecture built by the Soviet Union for Afghanistan in the mid-60s. The former USSR’s policies in that decade were more benevolent than in the seventies, when the then second super power decided to create its own Vietnam by invading Afghanistan in 1979 to support (i.e. control) the ruling Afghan communist party. Rumor in Kabul holds that the Soviets then used the basement of the NMH to torture select members of the local populace. A few years ago when US engineers inspected the facility, they reportedly found skeletons in the tunnels that run between NMH and other buildings on the hospital grounds. No one is sure if the remains are simply from a forgotten morgue, or the detritus of man’s indignity to man. I’m still waiting for a tour of these supposed catacombs, but every person I’ve asked to take me down there replies “It’s scary” and abruptly changes the topic.

The same engineers who assessed the building's functionality and soundness recommended that it be razed. The US has constructed new hospitals for the Afghan Army in four major cities around the country, and the NMH was judged to be so wanting for repairs and improvements that a replacement structure would be more economical than renovation. It’s the same argument that professional sports team owners use to coax (i.e. browbeat) municipalities to fund new stadiums, although in the case of NMH the paucity of luxury boxes was never an issue and it’s no stretch to claim that a new hospital might actually benefit the community that surrounds it. The Afghans, however, would have no part of NMH’s destruction, as it once was the operating base of the late Ahmed Shah Massoud, a National Hero of Afghanistan.

Massoud was an ethnic Tajik and one of the mujahedeen military commanders most responsible for the ouster of the Soviets from Afghanistan in 1989. He then joined with other commanders to form the Northern Alliance to fight the Taliban, who were vying for control of the country after 1994. His nickname was The Lion of Panjshir, as he hailed from the Panjshir Valley northeast of Kabul. (Panj is Dari for the number five, and shir means valley, so the moniker translates, literally, as the Lion of the Five Lions.)

So Massoud fought the Soviets, and he fought the Taliban; but history shows that a righteous military commander in Afghanistan always has at least one more warlord or lunatic group to subdue before total victory is his, and in 1993 Massoud found himself in a battle for Kabul with Gulbuddin Hekmatyar, a very nasty figure infamous for fickle allegiance and a well-deserved spot on the USA’s list of international terrorists after he tried to overthrow the current government of Afghanistan in 2003. Hekmatyar was also known for wantonly targeting citizens in his frequent bombardments of Kabul, and during the 1993 battle for the city Massoud led his troops and called for fire against Hekmatyar from the roof of the NMH.

Two days before America’s 9/11, on September 9, 2001, Massoud died when a pair of alleged al Quaeda operatives posing as Belgian journalists detonated a bomb during an interview with the commander. Most citizens of Kabul revere Massoud, and the current military reportedly rebuffed any suggestion that the NMH, Massoud’s former base, should be destroyed. Afghanistan has no registry of historic places, but if it did the NMH might be one of the earliest buildings with a bronze plaque. Or maybe something was lost in translation between the Americans and Afghans as they negotiated the fate of the NMH building, as at least two doctors there have told me that they favored a spanking new facility as long as a proper memorial were built in honor of Massoud. After all, they claimed, the Soviets built the NMH and they aren’t remembered fondly by the Afghans.

Massoud made even more famous the rolled wool hat that has long been an international symbol of Afghanistan and in the past has been called a pakol, or a Chitrali hat or Nuristani hat for the regions where the style evolved. Most Kabul citizens now call it a Massoud hat.

The traffic circle nearest the hospital boasts the name of and a monument to Massoud. The first time I saw it, a man was hanging wet laundry to dry on the wires circling the upper deck of the monument. The scene reminded me of the first time I visited the main temple of Angkor Wat and saw Cambodian cattle tied to the stone pillars and grazing on the grass surrounding the country’s most prized historic landmark. But Massoud was a man of the people, famous for retreating from Kabul to save its citizens from further torment of war, so I’m sure he wouldn’t begrudge that Afghan man a few pieces of dry laundry at his monument’s expense.

Sunday, April 6, 2008

Trouble with weapons

Clear your weapon here: Although this sand-filled clearing barrel can stop an errant bullet, your weapon should be free of ammunition before you put the muzzle in and pull the trigger.

A principle of proper gunmanship is that, even with an unloaded weapon, you must at all times maintain “muzzle awareness.” A basic tenet of muzzle awareness holds that should you never point the barrel of your weapon at another person. It would seem easy to avoid such a scenario, but at times it requires quite a bit of attention and concentration to keep a muzzle directed safely away from everyone else, as when you have a rifle slung across your back and you are trying to move through a crowded dining room. Getting in and out of vehicles with weapons can also present a challenge, and I’ve been poked a few times in the leg and ribs by the business end of a colleague’s rifle as he struggled to get into a Humvee or armored truck while wearing fifty pounds of body armor.

Those incidents didn’t bother me much, as I know the improprieties were a consequence of the burdensome physical load the person was carrying. But what does annoy me is the “flashing” to which I’m subjected daily. If you are devoid of muzzle awareness and allow the barrel of your weapon to point directly at another person, you flashed him. During weapons training in the US and Kuwait, some people were notorious for flashing the rest of the platoon with both loaded and unloaded weapons. At one firing range exercise, another officer turned from the targets with her weapon still raised to ask the instructor behind her a question. Two dozen people behind her immediately fell to the ground as she flashed her loaded weapon at a line of people waiting to walk onto the range. The instructor flinched as well. On the base in Kabul, many people carry a pistol sheathed in a shoulder holster that should hold the gun under your armpit with the barrel facing groundward. Think Jimmy Smits as Detective Bobbie Simone on NYPD Blue. Yet every day I see several people walking with holsters that, because of comfort or misfit, maintain the pistol barrels parallel to the ground, thereby flashing everyone behind them.

When on base, we keep the ammunition magazine out of a weapon and the weapon’s status is termed “green.” If we leave the base, however, we are supposed to lock a magazine of bullets into our weapon, and with ammunition inserted the status of the weapon changes to “amber.” A weapon is considered “red” when a magazine is locked and a round of ammunition is loaded into the firing chamber, hence the phrase “locked and loaded.”

Even in amber status with the safety mechanism applied, a pistol can be dangerous when you are riding on the rough pocked roads of Afghanistan. A bullet can be chambered inadvertently, the safety switch can be jostled to fire, and suddenly you’ve got a weapon asking for an unintended victim. Which is why I became very nervous very quickly last week when a medical officer riding shotgun (but thankfully without one) in my vehicle had an amber weapon in his shoulder holster pointing not toward the floor but between the front two seats and directly at the head of another officer sitting next to me. We quickly pointed out his breach of muzzle etiquette, but his lackadaisical response was “Oh, that’s just the way my holster holds the pistol.” He made no attempt to adjust the pistol’s position. I politely proposed that the two of us in the back seat aim our pistols directly at his skull so that he could enjoy the same level of comfort we currently were feeling on the trip. He begrudgingly unholstered his gun and held it in a safe position for the remainder of the trip.

From what I’ve seen so far amongst the staff officers with whom I serve, I’m much more likely to take a bullet from someone I know in an inadvertent weapon discharge than to be shot by an insurgent. Personnel from my command carry rifles and pistols for self-defense, and I think we need them when we travel into some areas of Afghanistan; but the primary danger for anyone traveling in Kabul and environs, and maybe the whole of Afghanistan, is an encounter with an improvised explosive devise on the roadside or a suicide bomber on foot or in a vehicle. A personal firearm will do little to nothing to prevent or mitigate that type of attack. We routinely discuss the possibility of taking small arms fire during vehicle convoys, and the plan is always to drive through the attack if it happens. I certainly don’t plan to exit an armored, moving vehicle to search for a sniper if a few unwelcome bullets come my way.

My fellow staff officers and I are not combat arms specialists and we are not nearly as familiar with our weapons, and perhaps we are much more uncomfortable handling them, than is an infantryman or even an enlisted sailor. When we return to our base from a mission, base regulations require us to clear our weapons of any ammunition. The process is fairly straighforward: you first release the magazine of ammunition from your weapon; then you pull the slide or charging handle back to expose the firing barrel and to visually ensure that no bullet sits in the firing chamber; and finally you take your weapon off safe, point the muzzle into a large red clearing barrel and pull the trigger. You should only hear a click when you pull the trigger, as you have already emptied the weapon of ammunition and visually cleared the weapon’s firing chamber. Several times in the past year, however, officers here heard more than a click as they put a slug into the sand packed-barrel designed to smother such errant bullets. That’s called a negligent discharge, and it earns you a visit with the commanding general on base.

Recently only officers have been guilty of negligent weapon discharges on this base, a fact that delights most of the enlisted personnel. Thankfully, the clearing barrels have absorbed only a few bullets. The officers who thought that assaulting the barrels was appropriate may have felt rushed to clear their weapons or they may have been temporarily distracted, but they breached weapon protocol nonetheless.

Some of these officers might also have suffered the illusion that the clearing barrels serve as final barriers to any harm that might come from their inattentiveness. A colleague commented to me “What’s the big deal if you fire a round into the barrel? That’s what it’s designed for.” But that’s dangerous thinking: The barrels are there to ensure that a weapon is empty of ammunition even if the handler fails to clear it properly. Personally, I don’t want to be near a clearing barrel when it is occupied by someone looking for a close-quarters firing exercise; and I’ve seen inattentive people clear a weapon with the thing pointed somewhere toward the barrel but certainly not safely inside of it. In fact, when I heard of the negligent discharge at this base, I was momentarily impressed to learn that the bullets at least made it into the barrels instead of finding nearby metal and wood and flesh.

Saturday, April 5, 2008

Afghan Star and the Afghan Paula Abdul

Photograph: I pose with Monisa, the Afghan Paula Abdul.

Hollywood studios might be the agencies best able to capture the hearts and minds of Afghans. Witness the recent success of the third season of Afghan Star, a television program modeled on American Idol. Afghanistan has a population of approximately thirty million people, most of whom live in impoverished rural areas with few luxuries; but an estimated ten million people watched the final episode of Afghan Star last month. I was impressed that one-third of the country’s population had access to a television. Small towns and villages across the country aired public broadcasts of the show that is the most popular television program in Afghanistan.

Saad Mohseni , founder of the television station that produces Afghan Star, thinks that his television show will bring about social change in the country. You might scoff at the idea that popular entertainment might foster anything but brain death, but consider Mohseni’s quotes: “… people voted, … they lined up in an orderly manner (outside the show) … the losers are gracious. No one is threatening violence. That’s a huge change.”

Afghanistan is a country without a history of democratic elections and where sectarian leaders have traditionally compensated for a political or military defeat by lobbing mortars at innocent civilians. I applaud any effort that models good sportsmanship. And any initiative that convinces a crowd of Afghans to organize themselve into an orderly formation should be carefully analyzed and studied for implementation in different social spheres. I’m thinking that Mohseni is correct, and perhaps the United States might want to modify our engagement strategy with the Afghans by providing every household a television set and wiring the country for digital cable access. We might also want to work a little harder to get urban areas like Kabul reliable electrical power to facilitate prime time viewing. And we shouldn’t forget that most Afghans still lack clean drinking water, proper schooling, medical care …

But back to Afghan Star. Like American Idol, Afghan Star employs a panel of judges to select the winner. The Paula Abdul equivalent is Monisa , a native Afghan woman who has lived for awhile in Germany studying music as an acedemic. She recently returned to Afghanistan and now is completing a clerkship in medicine at the National Military Hospital in Kabul, where I met her today. Like Beyonce or Madonna, she is popular enough to need only one name, and she’s the only woman I’ve seen in Afghanistan who does not cover her hair with a scarf in public. Thankfully, she has also avoided Abdulian displays of public disorientation and suspected intoxication. My Afghan interpreter identified her as the Afghan Star judge, after which I approached her and said “I saw you on tv and would like to take my picture with you.” Like every other Afghan I’ve met, Monisa was thrilled to pose for a photograph.

Wednesday, April 2, 2008

Baking na'an

Na’an is an unleavened flat bread and a staple of the Afghan diet. The Kabul Military Training Center has its own bakery on the premises as the demand for na’an is so great, and I visited the facility this week. The bakery building itself is rather nondescript and surrounded by discarded shipping containers, scrap metal and disorganized collections of firewood. If a single-wide mobile home sat there, you would swear you had stumbled upon a cyclone-ravaged disaster area. One my colleagues thought we had walked to the dump.

I’m not sure why the metal collection outside the building, but the firewood was waiting to feed the wood-burning ovens in the bakery. Firewood is a valuable commodity in Kabul as few trees grow in the dry terrain surrounding the city, and this wood reportedly came from the southern regions of the country. Oddly, none of it was stacked near the doors to the bakery. In fact, none of it was stacked at all but strewn as far as thirty yards from the sole entrance to the building. Already I have learned that the Afghan idea of organization often differs significantly from mine, and since the heat emanating from the bakery indicated that wood was indeed making its way indoors somehow, I gave no more thought to the disorder outside and ventured into the building.

The bakery had three rooms, each with a stone oven that resembled a hive with a large hole in the front. Underneath each oven was a raging fire. As it is now spring in Kabul, the heat was not crippling; but I wondered how high the temperature of those rooms will rise during >100 degree summer days. In each room one man worked at the oven, taking the fresh disks of flat dough and pressing them onto the stone ceiling. I was happy to see that for protection from the stone's heat all of these gentlemen wore gloves -- the only concession to occupational safety that I could identify in the entire place. After the disks had baked a few minutes in the oven, the bakers picked them off the stone with a long iron thongs and tossed them into a collection bin.

The other workers in the room were busy mixing by hand fifty pound bags of flour with water, then rolling the dough into balls before pressing it into disks. These other men also spent considerable time and energy imploring me to take photographs of them. Almost every Afghan I’ve met has been thrilled to pose for a photograph. If we really want to stop the Taliban, my recommendation is that we arm front-line soldiers with digital cameras and color printers, because if the Afghan insurgents are like their fellow countrymen they will interrupt any activity to pose for a snapshot; and they will wait to resume previous activity if you promise that a copy of the photograph is coming soon.

As a visitor and because I was taking photographs, the workers showered superfluous hospitality on me by baking a special sugar bread. It was simply a regular na’an loaf with sugar sprinkled on top, but I felt lucky as it was the Afghan equivalent to being in Krispy Kreme when the hot light is on and you get a fresh original glazed directly from the oven. The sugar loaf was delicious, as the exterior of the na’an had a crispy sweetness and covered a thin inner layer of warm dough. The flour tastes like a hybrid of white and wheat. If Afghanistan has an event similar to the Indiana State Fair, the sugar na’an likely holds the same status as an Elephant Ear or Funnel Cake.

Earlier I referred to the workers as men, but most looked to be teenagers – a few very young teenagers. A translator told me the daily wage there was less than $1, but you got all the na’an you could eat. One of the rooms also offered free Bollywood movies on a portable television with a small screen but surprisingly powerful speakers as that section of the bakery sounded like an Indian discotheque. I spotted a worker wearing a Cleveland Indians t-shirt complete with a large depiction of the arguably racist Chief Wahoo, mascot of the team. Dr. John Kim, a colleague of mine and a native of the metropolis formerly known as The Mistake by the Lake, rushed to get his photograph taken with this Afghan who was completely befuddled by our interest in his clothing. Western garments, especially those discarded, outdated, unwanted and mistakenly produced, make their way to developing countries and to people who see them simply as valuable wardrobe additions, usually with little knowledge of any graphic that might adorn the clothing. In Eldoret, Kenya I once saw an elderly native man walking through town with a shirt that had “F - - k You!” written across it. John and I are on the lookout for t-shirts proclaiming “New England Patriots, 2008 Super Bowl Champions. “