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 café 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.