Wednesday, June 18, 2008

The importance of name and place

My surname Willy and hometown of Kokomo, Indiana rarely bestow upon me any kind of social advantage. Countless times I have given my name as “Willy” at a registration desk or government bureau only to have an annoyed functionary ask me to please voice my last name. Usually I explain quickly that Willy is my surname, but once I simply repeated “Willy” to the question and the clerk looked at me, puzzled, and inquired, “So your name is Willy Willy?” I guess that wouldn’t be so odd in Indiana, as I once had a basketball coach named Allen Wayne Allen.

My hometown of Kokomo also creates confusion as most people want to know why the Beach Boys sang about the place as a tropical oasis if the city sits in the fertile plain of north-central Indiana. There is no other place in the United States called Kokomo, and my hometown’s namesake is the legendary Chief Kokomo of the Miami Indians. Unlike the Beach Boys lyrics that equate my hometown with Bermuda and the Bahamas, the actual Kokomo is more similar to Muncie, Indiana and Peoria, Illinois.

I’m happy to report, however, that in Afghanistan the surname Willy has served me well by endearing me to many Afghans. A very common Afghan family name is W’Ali, reportedly derived from the name of the Prophet Mohammad’s cousin Ali. It’s so common, and so many Afghans have told me that I have a local family name, that I have begun introducing myself as Dr. W’Ali. I simply explain that I’m from America but that my father is Afghan; and I just happen to look and speak like my Germanic mother. So far, the Afghans have accepted this without question, and oftentimes welcome me back “home” to Afghanistan with an extra piece of na’an bread.

Unfortunately, Kokomo doesn’t mean much to most Afghans. They are not nearly as impressed with the name of my hometown as were most Kenyans several years ago when I traveled to Africa. Kenya has a number of tribes, and many Kenyans consider themselves primarily a member of their tribe and secondarily a citizen of the country. Typical tribal names are Kikuyu, Kalenjin, Kamba and Pokomo, so when Kenyans asked me about my tribe back home in Indiana and I told them I came from the Kokomo, they were mightily impressed. They also applauded the fact that my tribe was more than 50,000 strong, herded many cows in our fields, and had diversified ourselves economically by producing mass quantities of motor vehicle parts.

Afghan tribes include the Pashtun, Tajik, Hazara, and Uzbek. Regal names all, but none with the repetitive velar plosive articulation of Kokomo. So my tribal credentials haven’t assisted me much in Afghanistan. Also, Afghanistan has a long history of invaders coming from the west, north and east, and I find they are a bit more worldly than the Kenyans. The Afghans know that foreigners usually adhere to customs and beliefs very different from and oftentimes threatening to the local milieu. So I’m happy to simply introduce myself as Dr. W’Ali, and hope nobody asks me from what village my father hails.

Friday, June 13, 2008

On the Road ... in Kabul

Last week I completed the instruction necessary to obtain a driver’s license for Afghanistan. The course took about 45 minutes. Since Afghanistan has no driving rules, no stoplights, no stop signs, no lane markers, no speed limits – there’s really no auto etiquette at all – there isn’t much to learn in the way of motor vehicle regulations. Instead, the class focuses on operating the electronic frequency jammer inside each US military vehicle, an essential piece of equipment as it (usually) blocks the viability of a remote control to detonate an improvised explosive device (IED) that could be planted along a convoy route. The real driving instruction is OJT – on-the-job training. You take to the streets of Kabul in an armored Suburban or Humvee and learn as you proceed.

Amongst the Americans I have met, two distinct schools of driving exist. The first school preaches that Americans “own” the roads here, that the threats to our safety come from insurgent Afghans hidden among the general population, and that all Afghan drivers and pedestrians need to clear the way for our convoys or risk impact with a speeding, armored vehicle that would simply rumble over most local automotives and certainly flatten any body it contacted. I don’t adhere to the tenets of this school and its dogma that aggressive, sometimes outrageous driving is the best way to guarantee that they make their destination without harm to themselves. (I do understand that, like most other military personnel in a war zone, they wish to return home with their limbs and sanity.)

The aforementioned school doesn’t seem to consider that the typical Afghan on the street might not like to see US military vehicles careening through the sovereign state of Afghanistan with reckless disregard for the children and other pedestrians who are forced to stay vigilant for our convoys. (This threatened population would include the innumerable burka-clad women walking the streets with what must be drastically reduced peripheral vision.) I don’t think aggressive driving assists in the “hearts and mind” campaign over here. I know that I would be a bit peeved if I encountered, in front of my home, a foreign Humvee on the sidewalk with its horn blaring as it attempted to navigate around a fruit cart pushed by a sixty year-old man.

Unfortunately, aggressive Americans are not the only drivers terrorizing the local population. Many Afghans are quite proficient in maneuvers that would have you arrested in Boston for attempted vehicular manslaughter should you attempt them. A local told me, when I suggested that my driving skills might enable me to work as a Kabul cabbie after completing my military obligation, that the essential attributes of an Afghan taxi driver are fearlessness, recklessness, and a total disregard for the well-being of others. When I asked him if he thought that most Afghans thought similarly of American drivers, he simply shrugged his shoulders and said, “You have strong vehicles, so you will be safe.”

I belong to the driving school that teaches crazed driving, moreso than an insurgent in a suicide vest or a roadside IED, is the factor most likely to dictate harm to ourselves and others while traveling in Kabul. Thankfully, the commanding general of my base agrees with that philosophy as well, as recently he instructed us to remember that Kabul is an urban environment; and that safe driving means we must move tactically and cautiously in our vehicles without endangering the local Afghans. Recently an Afghan child died after a NATO vehicle struck him on a busy Kabul street, and a small but vociferous group of Afghans picketed an American base near the incident to protest the death and the aggressive, dangerous driving that they claimed was responsible for the boy’s death.

This second school doesn’t preach passivity on the roads. Kabul drivers seem to believe that passivity equals weakness that deserves dishonor and ridicule. If you don’t continually push your vehicle forward on the streets of Kabul, you will find yourself enveloped by bicyclists, buses, bread carts and small herds of sheep.

Although many of the streets I travel feature sidewalks, a significant percentage of Afghans prefer to ambulate on the asphalt amongst the vehicular frenzy. None of the streets have traffic lines or marked turning lanes. Occasionally, a one-way route suddenly will produce oncoming vehicles due to a crumbled road or obstruction ahead. Busy intersections and traffic circles often feature a frantic policeman waving his arms and blowing a whistle, but drivers usually ignore him which renders the cop as just another obstruction to navigate around. The Kabul streets are filled with challenges to the primary tenet of tactical driving: Keep moving. A stationary vehicle is an easy target for someone looking to cause harm and induce mayhem.

Even the most courteous drivers must constantly nudge into packs of other vehicles blocking a route, or authoritatively enter a roundabout with a bit of speed and sound of horn. You cannot drive more than a few blocks without encountering families trying to cross a busy street, sometimes with their livestock; and thankfully both humans and animals here are adept at dodging traffic. Driving in Kabul is an elaborate, frenetic dance that involves dozens of sudden partners, and every day I learn a few more moves.

Tuesday, June 10, 2008

The European Way of War

Not far from my base in Kabul sits the NATO compound that holds the International Security Assistance Forces, or ISAF. Although the commanding general of ISAF is American, most of the military personnel at the Kabul ISAF command headquarters are European. I visit the ISAF base at least once most weeks and I see Germans, French, Portugese, Poles, Croats, Czechs, Romanians, Italians, Turks … There seems to be an inordinate number of Macedonians. I’m not sure of the size of Macedonia’s army, but my guess is that about half of that small country’s armed forces are deployed to Kabul.

The reputation of ISAF among many American combat troops is not overly endearing, as evidenced by the different explanations for the acronym ISAF:

1. I sit, Americans fight.
2. I saw Americans fighting.
3. I sunbathe at FOBs. (FOB=forward operating base)
4. I suck at fighting.

The European idea of the mission in Afghanistan does seem to differ from ours. Weekly I meet with the my ISAF medical counterparts, and rarely have I heard them speak of any developmental initiatives they’ve undertaken in Afghanistan. They serve here for only four months, which barely gives them enough time to become familiar with the challenges of Afghanistan; and certainly not enough time to make any impact on healthcare. I heard a British colleague once scold my boss for venturing out to reach the Afghan population. “See these walls,” he said, pointing to the faux-fieldstone walls of the outdoor cafĂ© that looked as if they were lifted from a grade school set for Hansel and Gretel. “Stay within these walls where you are safe and secure.”

I told my boss at that moment that I agreed, and I recommended we forego the return trip to our base in order to stay at the ISAF compound, drink beer and chase some of the cute Czech nurses we met earlier. “We’re getting out of here,” he replied. “The temptation’s too great at this place.”

It’s a different war at ISAF, many of us Americans like to exclaim as we schedule superfluous meetings with the Euros in order to return to their base which features real butter in the dining hall, Toblerone chocolate and Cuban cigars. Recently an American Navy physician joined the ISAF medical staff, and when I first met him he asked if he could assist on any of my projects as he was doing very little with the Euros. I remember his words as “You can’t get anything done here with all the coffee and tea breaks destroying the momentum of the day.”

The ISAF base has bars, restaurants, and a courtyard full of small groups of soldiers chatting, smoking and drinking. A volleyball court there seems always in use, as does a small soccer field. The Euro Cup began this week, and I would bet that most work comes to a stand-still during the soccer match broadcasts. Today a Czech colleague told me that he will watch a match late into the night, and tomorrow little will get done at the office what with fatigue and the need to endlessly dissect the highlights. I asked him how long people can talk about a game with a final score of 1-0, but I don’t think he understood my sarcasm.

I do enjoy the company of the Euros. One of their senior physicians, a Croat who appears to spend most of his time eating and smoking, tells delightful stories about his travels to America including a six-month stay in San Antonio when he was accosted at restaurants for not tipping the wait staff (he had no idea of the custom) and scolded by women for his boorish behavior. This Croat, after dinner, usually enjoys a cigarette or two or three with a few of the German physicians. I once jokingly asked him if he recommended smoking to his patients. “Of course,” he replied. “Smoking is protective. 30% of people in Europe die from smoking, which means you have a 70% chance of dying of something else. Your odds are better if you smoke.”

Not satisfied with that justification of his habit, he added that in Africa, a child’s chance of dying is greater than that of an adult European smoker. “The science is clear,” he said and offered my a Gauloise. I assured him that he could always find work with an American tobacco company serving as a medical authority and corporate apologist.

Friday, June 6, 2008

Case Study in Frustation: The Helipad Project

This incompletely demolished building supposedly holds in a wall the unexploded grenade which gave the Afghan deconstruction workers a long weekend and the helipad project another delay.

A former girlfriend of mine described the beginning of our relationship as a series of “fits and starts:” My behavior would give her fits every time she attempted to start something meaningful. Development projects in Afghanistan usually follow a similar course, and I am the person frustrated. I offer the case of construction of the National Military Hospital (NMH) helipad in Kabul as an example.

The NMH is the tertiary care center for the Afghan Army’s hospital system, and a helipad to accommodate casualty evacuations from smaller regional Army hospitals and battle areas is a reasonable expectation. Utilization of the helipad necessitates helicopters, however, and the fledgling Afghan Air Corps has only a dozen or so of those, none of which are outfitted specifically for carrying casualties. Moreover, the Army has few if any medics who could actually accompany and support casualties on a flight; and even if trained medics were available they would not have the life-support equipment necessary for the job. The fact that Kabul sits at an elevation of 6000 feet also presents a big problem for casualty transport as a helicopter would have to climb even higher than Kabul itself to clear mountains around the city, and the altitude necessary would not behoove the state of a critically ill patient aloft in non-pressurized aircraft. So I don’t expect to see activity resembling the M*A*S*H intro anytime soon.

In fact, I might not see a helipad at all in the near future as controversy (as well as supposed unexploded ordnance discovered at the site) has stalled its construction. Several buildings stand on the site where the helipad will rest. A local firm procured the contract to level the buildings, but when crews arrived to begin the deconstruction project an Afghan general stopped them, claiming that the bricks, wood and metal from the buildings were property of the Army; and that he would supervise razing the structures with his own personnel. A few weeks before this confrontation, I attended a meeting where Afghan medical authorities requested a crane in order to assist with the helipad project. I thought that was strange, as I assumed the contractor would bring his own equipment to the job site. Only in retrospect did I realize that the general was planning then his own deconstruction project, an activity well outside the contract for the helipad as the language clearly gave the private firm possession of all scrap material from the buildings’ destruction. I’m not sure where the general instructed his men to transport the building material, but I would guess that, were he successful, the yard at his home would have resembled a second-hand lumber outlet.

In the past few days, the engineers and contracting officers seem to have quelled the contentious debate over ownership of the scrap material (by ruling in favor of the contractor). That does not mean, however, that the deconstruction/construction project is once again moving along, as work crews reported two days ago that they found an unexploded grenade in the walls of a building they were wrecking. Now work at the site is suspended until someone (who exactly I don’t know) comes to remove the ordnance. I’m suspicious that what they found was not an explosive at all, as the workers claimed they tore the top off the ordnance before recognizing it as a grenade. I don’t know very much about combat arms, but I think that ripping “the top” off a grenade either would leave it inert (as you removed the firing tab) or cause it to explode after a few seconds. Yesterday I toured the now-barricaded helipad site with one of my supervisors who wisely suggested that we explode the thing ourselves as that would not only destroy more of a building that’s coming down anyway, but also get the Afghans back to work on the project.

I’m calling this project a helipad, as that is the eventual purpose of what will in reality be a large concrete slab; but some of the contracting agents insist on calling it by its official name: overflow parking lot. The US military command funding the construction had not allocated money for a helipad in the budget for fiscal year 2008. Therefore, you cannot officially build a helipad in the year 2008. But a budget somewhere must have committed money to parking lots, because under that financial rubric the project received money; and now the helos, if they ever arrive to land, will technically alight on Parking Lot LZ, which will be distinctive for the large H painted in the middle of it. Hopefully, the few Afghans who own cars will not decide to park there, and no grass will grow at the edges of Parking Lot LZ, as I can imagine a helicopter approaching with a wounded soldier only to find a couple of 1985 Toyota Corollas blocking the middle of the slab and grazing sheep occupying the periphery.

The wisdom of the US federal budgeting process dictates that the fiscal year 2009 budget will include money for helipad construction, and my engineering colleagues informed me that next year the site will receive upgrades such as lighting and increased size. With nightly illumination, the helipad will be one of the few sections of the hospital actually designed and funded to operate 24 hours per day (if someone remembers to turn on the lights in the evening).

I am not trained in anything aerospace related, so I was intrigued last week when I met with officials from the local airport and Europeans from a neighboring NATO base and they showed me a satellite photograph of Kabul with a few circles drawn on it, circles that designated restricted Kabul airspace and which bisected the NMH campus and the site of the helipad. I got a bit nervous when they explained that the restricted space was to prevent aircraft from flying over, among other structures, the Afghan Presidential Palace. They assured me that the restricted space could be redrawn, especially in light of the military medical helipad construction, but that they would appreciate a copy of the site survey, surely conducted before selection of the landing site, which would outline approach patterns and possible flight obstacles and other things you apparently are supposed to study before selecting a site for a helipad. I assured them that I had absolutely no idea if a site survey had been done, but that I had seen the site and my layman’s evaluation was that the helicopters would be able to come in just fine as long as we kept the Corollas and livestock off what, technically, will be a parking lot.

Wednesday, June 4, 2008

Same place, different lives

At least once a week I drive with a team through several villages on the outskirts of Kabul on our way to a clinic. In most of the villages, children will run alongside our Humvees waving their hands. At first I thought they merely were being friendly and were excited to see a convoy of armored vehicles pass by their homes. There was certainly an element of that in their behavior, I was told, but the children also know that sometimes we will throw bottled water or candy through the windows to them. Lately we have not been tossing anything as we want to discourage the children from coming too close to the vehicles. I’ve seen a few kids so close to the Humvees that, if they slipped, they would fall under a tire.

I often think how very different my life is from that of these Afghans even though I am physically close to them as drive through their villages. For security reason, we cannot stop and leave our Humvees to meet them. So the armor of the vehicles serves as quite a metaphor for the barrier between us.

The villages are mostly dusty settlements of mud-brick homes. My photographs of them are poor as I have to shoot through the dirty windows of our Humvees. I wrote the following poem recently after returning from a drive through the villages.


Our Humvee crawls over the cratered road
Of the village like an enormous beetle
Navigating a boulder-strewn field,
Laboring under its heavy, plated shell,
Its antennae prodding the air
For sound of distant trouble.
Dusty children skip alongside us
Each with one thumb pointed to the sky and
The other to the mouth,
Their smiles pleasant reflex sewn
In weeks past when we tossed bottles of fresh water
Out the windows to them until
They came too close,
When they ran and pounded our armored doors
So feebly I could barely hear impact
On the steel that kept us separate
As the Humvee, a tottering insect,
Rolled past them.
After that came the orders:
Nothing more to the children
To keep them back from us,
Safe in the cloud of dust
That follows our crawl past their homes,
That dirties them more and increases their thirst.

Sunday, June 1, 2008

Many Afghans believe the US supports the Taliban

It is a commonly held belief among ordinary Afghans the U.S. forces do not want peace and security in Afghanistan – and that in fact, American forces are supplying and supporting Taliban insurgents.
Kabul Times editorial, May 21, 2008

When I read the statement above, I didn’t know if I should be shocked and angry or simply bemused. I’m not sure of the reputation of the Kabul Times, a periodical that appears regularly on my base. One of my Afghan colleagues, for reasons I don’t understand, dismissed it as a publication of the mujahedeen; but I was very curious if in fact the common Afghan really believes that the US supports the Taliban. So I asked several Afghan friends with whom I work, and their polite yet earnest responses were that many of their countrypeople are suspicious that the US doesn’t want a lasting peace in Afghanistan, and they gave the following arguments as typical for supposed US support of the Taliban:

Why does the US let the Taliban hang around?

In 2001, US forces routed the Taliban from Kabul and most other regions of Afghanistan in less than two months. With that context, the Afghan mind posits: Why does the US now have trouble destroying small cells of insurgents positioned throughout the country? The answer: Because the US isn’t trying. The US is a victim of its own previous success, with the general Afghan public blithely unaware of the complexities and difficulties inherent in expunging organic groups of rebels who merely need to cross the border into Pakistan for sanctuary and training. Afghan disbelief of the true US intent – to rid Afghanistan completely of insurgents – is analogous to a patient’s dismissal of modern medicine with the argument that physicians are not interested in preventing the common cold even though they relish curing some cancers and transplanting organs.

Corrupt government: Perfected by Afghans, funded by Americans

A colleague of mine who is a respected physician in the Afghan Army was quite emphatic when he told me that the #1 enemy of the Afghan people is not the Taliban, but corruption; and especially corruption at the highest levels of government. Many Afghans resent their current leaders and ministers, many of whom fled Afghanistan when the Taliban took control of the country. These elites returned to Afghanistan and power due to American support – and money. The typical Afghan, who has seen little benefit from the billions of dollars of international aid sent to Afghanistan in the last seven years, apparently is easily convinced that the power elite of the country, seemingly beloved of the Westerners, has no incentive to alter the current state of affairs in Afghanistan as their graft of foreign aid is quite a lucrative undertaking; and the Western aid dollars might stop passing into Afghanistan and their own pockets should Afghanistan ever stabilize into a peaceful, secure state.

Western governments, exemplified by America as the US both politically and militarily has the most visible foreign profile in Afghanistan – indeed, many Afghans assume any Caucasian to be American – must know the corruption exists, reasons the typical Afghan, and yet they still support thieving Afghan officials who have no interest in truly reforming Afghanistan for the good of the common citizen; therefore, the Westerners (i.e. the Americans) must support an unstable Afghanistan, which means they support the newly resurgent Taliban.

The Afghan argument here proves itself a syllogistic fallacy at several junctures, but a philosophic analysis and repudiation of what many Afghans believe likely will not change their minds. History shows that emotion and belief are usually cruel victors over reason. What might change the Afghan mind, say my colleagues, is evidence that foreign aid is earmarked for the country’s development instead of the ministers’ bank accounts. “No one here wants to fight,” an Afghan physician told me. “Build a road for people, and they will be thankful and peaceful.” This from a man raised in Helmand, a province infamous for producing Taliban fighters.

The guys you want are just across the border in Pakistan. Why don’t you go get them?

The Afghan people know, as do the Pakistani people and the American government, that most Taliban and other willing insurgents ready to fight in Afghanistan are trained across the border in Pakistan. Pakistan historically has been the prime supporter of the Taliban. If the US truly wanted to rid Afghanistan of the Taliban and other insurgents, thinks the typical Afghan, it would destroy the bases it knows exist in the northwest territories of Pakistan. The US doesn’t do that, but instead maintains a (notably uneasy) alliance with Pakistan. And so the (illogical) deduction holds that the US supports the Taliban as does its ally Pakistan.

I’ve learned over my four months in Afghanistan that most people here harbor little-to-no fondness for Pakistan, as the Afghans believe (with some justification) that their neighbor’s goal is to keep Afghanistan poor and destabilized. So I got nowhere arguing to my colleagues that the US-Pakistan alliance had everything to do, initially, with removing the Taliban from Afghanistan. Nor did they cotton to my proposition that the US is overly taxed now fighting wars in two countries, and a third front just might send the military into an irreversible downward spiral.

I was relieved to hear from my colleagues that although many Afghans might believe the US condones the activities of the Taliban, they don’t think the US directly funds and supplies those insurgents. Instead, many Afghans site evidence that the British are the foreign force bolstering the Taliban with weapons, food and material. I’ll write more on that topic at a later date.