Salaam Afghanistan

Health and Ethnic Conflict.

My first visit to the Heart of Asia -- Reflections and Photos.

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Name:
Location: Mbarara, Uganda

Internist and Pediatrician with a passion for international health.

Tuesday, July 20, 2004

FGD Semi-Urban Site: Shakardara


The first day of our semi-urban site did not go as planned. It all started off wrong. Everything.

Our cars were an hour late. Our female moderator threatened not to come.

(background on that: Challenge #One: Trained moderators are extremely difficult to come by here. There is, not surprisingly after so many years of war and oppression, a very real lack of trained Afghan staff who are qualified to do the kind of work the NGOs are looking for. Because there are so many NGOs, those few who are capable are already very busy and hard to come by. I spent several days and several meetings trying to identify moderators for our FGDs. Finally, the Research Coordinator at PSI made a recommendation for a male-female couple who, we were told, had experience moderating FGDs. Challenge #Two: On the day of the training, which I had designed entirely in English, we discovered that our moderators did not, in fact, speak English. On the day of the field tests, we discovered that, Challenge #Three, there was no way these people had real experience with FGDs before. The male moderator was both especially committed (he spent time at home working on rewriting the questions!) and especially lacking in skill. Because the male groups were the most important groups for our study, we had to find a new moderator at the last moment. The day before our first study site, a man from one of our grantee organizations, Dr. Ihsan, agreed to act as the moderator, despite an extremely busy schedule. We informed the original moderator that we would not be able to use his services. The day of the study, however, he showed up. When we told him again that, Thank you, but we have a different moderator, the female moderator (who has a harsh personality) said that if he did not go, she would not go. I'm not sure how we convinced her, perhaps it was an empty threat and when she realized we were going ahead, she thought better of it. Regardless, she came.)

We arrived to the clinic there to discover that no one was expecting us. This despite a confirmation the previous day that all was set and we would arrive to a staff who had been briefed, prepared to help us conduct our study without a hitch.

"I'm sorry, who are you?" It was going to be impossible to assemble complete groups this day. We did our best with the women's groups, and were able to recruit small groups of women who had delivered at the clinic. The men's groups were another story. We were extremely fortunate to have our new male moderator, Dr. Ihsan -- he was well-connected in that community and, working his connections and the respect he and his organization have earned there, he was able to set up the discussions for the next day. We would not be able to recruit from the waiting rooms as hoped, but were guaranteed to have full groups and spacious rooms at a home out in the community for the following day.

As he busied himself tending to the arrangements for us, we were invited in to share lunch with the folks from Sanayee Development Foundation, one of the civil organizations that works out in the community. We politely declined, not wanting to take advantage, but accepted some dogh -- a drink made of sour yoghurt, cucumber, and pepper. As a muslim country, Afghans don't drink alcohol -- this drink serves a similar purpose, it seems. People joke about how relaxed and sleepy you get after having too much dogh. If you joke about feeling tired after drinking a glass, you are guaranteed to get a laugh and win some points for really knowing the culture. Drunk on our dogh, we ended up accepting a bit of lunch.

On the way back to the city that afternoon, I spent a little more time talking with our moderator, who was very polite, very kind, and very informative. It was he who first told me that all of the land we pass on our way out of Kabul was once lush and green with fields and fields of grapes and fruit trees. Looking out at the dry, dusty earth and the demarcated plots of mines I felt a clutch in my chest imagining what it must be like for him, who knew the beauty and fertility this land used to be. The Taliban burned these fields, burned the villages, killed many of the remaining few villagers that had not fled north prior to the invasion of that evil regime. The air must have been thick with the smell of smoldering grapes, gunpowder, and violence. After this devastation, even the rain was afraid to return to the region, and now, after eight years of drought, little remains to remind us of what it must have looked like then.

As he looked out of the windows toward the past with me, he was reminded of his boyhood in fields like these. He smiled the smile that I have only seen Afghans give as he recollected the days he passed chasing small birds through the vineyards, the grass, with the sound of bullets zipping past his ears. He remembers that he didn't even consider it extraordinary, that he didn't then recognize the dissonance of such childish playful innocence and such adult violence and evil. There is no clever or poignant adjective or allegory to really characterize that smile, the one that accompanies such tragic memories, tragic histories, tragic todays; or if there is, I am just not clever enough to think of it.

We dropped him off with effusive thanks and I wished it were not inappropriate to give hugs. He would not be able to accompany us the next day, but he would be sure to send a well-respected and qualified colleague.

The following day, Day 2 at Shakardara was just lovely. Mr. Shirzai from SDF performed wonderfully at the male FGDs, and I had a wonderful time with the women. Instead of conducting the discussions at the clinic, the efforts of SDF the previous day paid off tenfold -- all of the men and women had been recruited ahead of time, and were waiting for us in small but comfortable rooms at Malalay House out in the village. Little girls gave me beautiful flowers -- fresh picked lavender and a bunch of other sweet smelling blooms that I didn't recognize. The women smiled at me continuously and sent their children over to me to sit with me and be touched by me. I was told that they thought I was cute and that I seemed very kind. It never ceases to amaze me how far a wide, ignorant smile carries me in foreign countries. That and my jilted, toddler-level language skills: "Thank you, thank you so much, thank you. Flowers, no? Flowers? Flowers are beautiful. Beautiful? Yes? Girl is beautiful." I'm sure this is a large part of what endears me to them.


After we finished, the men were still in their groups, so we were escorted by the senior women in the village to a garden owned by one of the community leaders. "Very safe and beautiful" we were told. And indeed it was. It was an enclosed garden with rows and rows of fruit trees -- apples, especially -- and flowers and plants and the famous fat-tailed sheep.




A blanket was laid for us beneath a large mulberry tree, and we wandered in and out of the trees, picking fruit, picking flowers, and breathing the fresh air. The women I was with wanted to share some mulberries with me, so two of them took up a large sheet and held it underneath while another shook the branches above with a force that surprised me. Large berries, white and purples, rained down into the sheet for our enjoyment. We sat in the shade of green trees, eating their luscious, decadent fruits, laughing and talking until our male colleagues came to fetch us.

I thought, this is what it was like before the wars began. This is the joy of being Afghan, the joy of living in this land, the joy that has sustained these people through so much and that encourages them to continue, to work, rebuild, and move forward with a gratitude that I am embarrassed to admit I too often fail to feel myself.

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