166 Days: My Journey Through The Darkness by Jennifer Clark Page A
Authors: Jennifer Clark
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mountains. As I sat there, I realized what a beautiful country it was. Sadly, the horrible things that happened here made it hard to appreciate the natural beauty.
After our break, we pressed on for another forty minutes until we reached the compound where we would have the MedCap. I’m not sure what I was expecting it to be, but I was not prepared for what we saw. It was a building made of mud, like all of the other compounds we saw along the way, with no electricity or plumbing. The floors were covered with straw that was saturated with urine and feces, both human and animal. I found the most “private” appearing room I could to set up as my exam room. I made an exam table out of a litter and four MRE (meals ready to eat) boxes to hold the litter up off the ground. I set my box of medicine off to the side and my other supplies on a shelf that was carved out of the wall. We would see the patients with an interpreter because the locals in the region either spoke Pashto (the same language spoken in Pakistan and typically used by members of the Taliban) or Dari, a language used less often by the Taliban.
Four of us would be treating patients; I was the only female. The others were the two medics (Vance and Chad), an Afghan doctor, and Don, my fellow PA. I was there for the women, but I was anticipating a low turnout if any at all based on the briefing before we left.
“Don’t expect many female patients, their husbands rarely allow them to leave the homes,” Don had said. This forecast could not have been more wrong. There were at least two hundred women that came in the morning alone. Up to then, I had not seen any local women and now they were flowing in. It was heartbreaking to examine them; they were all covered in filth, their teeth were falling out, and they had to cover their faces when in public. I think what struck me the most about them was the sadness I saw in their eyes. I could see how tired they were from the poverty stricken lives they had led.
The condition of the men and children wasn’t much better. Most of the children didn’t have shoes and if they did they were falling apart. Hundreds of people showed up and their complaints were all the same: body aches, belly pain, headaches, colds, and fevers. Every once in a while I would see something different, but the majority was all the same. Women often complained of the symptoms of their “monthly sickness” and their babies dying shortly after birth, which was most likely due to malnutrition and dehydration. I had never seen patients before in a situation where we didn’t speak the same language. Relying on the interpreter to translate what the patients were actually complaining of, and then my instructions on how to take the medications I prescribed or specific lifestyle changes they could make to improve their conditions was challenging. I realized very quickly how much I had underestimated the importance of being able to speak directly to patients. With my patients back home, I could pick up on a tone of voice and body language much easier, which was so important in deciphering if what was being said was the whole story or not. I could watch their reactions to what I said and could see whether they understood or whether I needed to explain things more appropriately. In this situation, it was all a guessing game, a frustrating one at that.
Late in the morning I saw the two patients I will never forget. The first was a three-month-old infant girl who was so malnourished she looked like a newborn. She was deathly ill from severe dehydration. The child was lethargic and her skin turgor was unbelievable; I could pinch her skin, and instead of it bouncing back like well hydrated skin, hers stayed tented up for several seconds before returning back to her body. Her tongue was sticking out because she was trying to suckle food and it was as dry as her fragile skin. Her respirations were extremely labored and fast and I knew that this child would die
After our break, we pressed on for another forty minutes until we reached the compound where we would have the MedCap. I’m not sure what I was expecting it to be, but I was not prepared for what we saw. It was a building made of mud, like all of the other compounds we saw along the way, with no electricity or plumbing. The floors were covered with straw that was saturated with urine and feces, both human and animal. I found the most “private” appearing room I could to set up as my exam room. I made an exam table out of a litter and four MRE (meals ready to eat) boxes to hold the litter up off the ground. I set my box of medicine off to the side and my other supplies on a shelf that was carved out of the wall. We would see the patients with an interpreter because the locals in the region either spoke Pashto (the same language spoken in Pakistan and typically used by members of the Taliban) or Dari, a language used less often by the Taliban.
Four of us would be treating patients; I was the only female. The others were the two medics (Vance and Chad), an Afghan doctor, and Don, my fellow PA. I was there for the women, but I was anticipating a low turnout if any at all based on the briefing before we left.
“Don’t expect many female patients, their husbands rarely allow them to leave the homes,” Don had said. This forecast could not have been more wrong. There were at least two hundred women that came in the morning alone. Up to then, I had not seen any local women and now they were flowing in. It was heartbreaking to examine them; they were all covered in filth, their teeth were falling out, and they had to cover their faces when in public. I think what struck me the most about them was the sadness I saw in their eyes. I could see how tired they were from the poverty stricken lives they had led.
The condition of the men and children wasn’t much better. Most of the children didn’t have shoes and if they did they were falling apart. Hundreds of people showed up and their complaints were all the same: body aches, belly pain, headaches, colds, and fevers. Every once in a while I would see something different, but the majority was all the same. Women often complained of the symptoms of their “monthly sickness” and their babies dying shortly after birth, which was most likely due to malnutrition and dehydration. I had never seen patients before in a situation where we didn’t speak the same language. Relying on the interpreter to translate what the patients were actually complaining of, and then my instructions on how to take the medications I prescribed or specific lifestyle changes they could make to improve their conditions was challenging. I realized very quickly how much I had underestimated the importance of being able to speak directly to patients. With my patients back home, I could pick up on a tone of voice and body language much easier, which was so important in deciphering if what was being said was the whole story or not. I could watch their reactions to what I said and could see whether they understood or whether I needed to explain things more appropriately. In this situation, it was all a guessing game, a frustrating one at that.
Late in the morning I saw the two patients I will never forget. The first was a three-month-old infant girl who was so malnourished she looked like a newborn. She was deathly ill from severe dehydration. The child was lethargic and her skin turgor was unbelievable; I could pinch her skin, and instead of it bouncing back like well hydrated skin, hers stayed tented up for several seconds before returning back to her body. Her tongue was sticking out because she was trying to suckle food and it was as dry as her fragile skin. Her respirations were extremely labored and fast and I knew that this child would die
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