This is the latest in a series of conversations I am having with a friend in Afghanistan about life under Taliban rule.
Dear David:
On top of everything else in Afghanistan, our public health system here is a disaster. Standard health indices, including the infant mortality rate, the childhood mortality rate, and the maternal mortality ratio, are among the worst in the world. The government does not regulate the pharmacies or the hospitals. Many pharmacies sell drugs that have been imported illegally. They also sell drugs that are ineffective. Many of our hospitals do not meet the minimum standards for adequate health care.
Two weeks ago, my brother who lives and studies in Kabul got a rash. When he visited a doctor who said she was a dermatologist, she prescribed him some antibiotics and a balm. He used these but his rash got worse. The “doctor” didn’t actually say anything to my brother and it turned out later that she is not a dermatologist at all and is illiterate.
Through friends I located a competent dermatologist. When my brother visited him, the dermatologist diagnosed my brother’s condition as a very common allergic reaction, and said that when he used the antibiotics prescribed by the first “doctor,” it had only made the condition worse than it should be.
In Afghanistan we have no recourse when something like this happens. There is no authority to report the fake doctor to, and no authority to address the situation.
Last year, when my friend's father got sick, he took him to a nearby hospital. The doctor told him that his father had a common cold and injected him with Ceftriaxone, which is an antibiotic used for the treatment of a number of bacterial infections. It can have many serious side effects. The next day his father fainted so he took him to another doctor. The other doctor explained that his father had had a heart attack. The doctor could not save him. His father died.
Last year, another friend's father died after a dentist pulled three of his teeth without checking his blood pressure.
Such stories are common here. But again, we have no recourse. We cannot sue the doctors for malpractice. They stay in business while we mourn our dead.
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