Early Days

Shortly after I arrived in Bamiyan, I was walking along a dusty village road when a US Army jeep passed by. I wanted to shout, to run after them, but MSF had been clear: no fraternizing with the soldiers, the “invaders” they called them. They very likely would have said the same if the soldiers were French. Neutrality is at the very heart of their work, and I, after all, was Irish. So, instead of shouting after them, I remained quiet, went on my way, and hoped they’d find me.

I’d already quickly settled into a routine. Whether in mobile clinics or hospital and OPD, I rose early and heated water for my cup of instant Nescafé coffee. I washed up and dressed, and by 7:00 A.M., I was on the road, either by foot through the irrigation fields to get to the hospital, or in an MSF jeep going to the mobile clinics. For that, I had an interpreter and a driver, both Afghans, with me.

The start of each day in clinic, whether mobile or hospital-based, meant accepting copious greetings and handshakes from the staff and any men who wanted to greet me. “Salam-aleikum, chetore asti, khoob asti, jonna jurast?” The greetings were endless. When men were clearly uncomfortable with my outstretched hand, I would put my right hand over my heart and nod my head, a way of showing respect without touching.

The women were friendlier, and one morning, as I scanned the waiting group for anyone who might be seriously ill, I felt a tap on my shoulder. I turned to see a burqa-clad woman holding up a lipstick tube. I smiled. “Lipstick in Afghanistan,” I whispered, as though I’d just sighted a unicorn. The woman bobbed her head and passed me the tube. I shook my own head. “Nay,” I said. “It’s yours.” She lifted her burqa, revealing her face and a swipe of tangerine-colored lipstick across her smiling lips. “For you,” she insisted, and it was then I remembered Asma, the woman in Thal with the chickpeas, and the unspoken rule that you must accept an offered gift. “Tashakore,” I said, tucking the tube into my pocket. She readjusted her burqa and sat to wait while I went to work seeing patients and supervising staff and wondering if, under every burqa, there were brightly colored lips, not so different from my own.

Though busy, I wondered about the soldiers—where they lived, where they went every morning, and would they ever come to the clinic—but I was too busy to linger over my musings or my new tube of lipstick. My memories of the Persian language had emerged shakily from the dust and recesses of my mind, and though I spoke enough Dari to get by, I usually had an interpreter at my side. Aasif was nineteen, and until recently, he’d lived with his family in Kabul. Life in Bamiyan was an adjustment for this city boy who was used to at least some electricity and amenities, neither of which was readily available in Bamiyan. He was always dressed impeccably, his clothes clean and his hair neatly combed. He missed his family tremendously, his mother, father, three brothers and two sisters, but he hoped that this job with MSF would lead to more opportunities, perhaps in Europe or the United States. Aasif was wise and mature beyond his years, probably due to the ever-present war and chaos in his country. He was shy and sweet and more comfortable with me than other Afghans his own age. His family had some money, and he had been encouraged to go to school; most Afghans don’t have that luxury. When they are able to walk, they are able to help the family and work at something, whether gathering wood or cow dung from the fields, or tending sheep or assisting farmers. Children had no time for growing up—only for growing old, one backbreaking chore at a time.

But for Aasif, it had been different, and that difference set him apart from the other national staff. At first, he sat alone at meals, lived in a rooming house in the village center, and studied every chance he had, hoping to be admitted to college one day. His English was perfect. He spoke Dari and Pashto and was trying to learn French. “It will help me with MSF. Do you agree?” He wore a permanent smile, and he was never happier than when he was working alongside one of us. He arrived at the MSF compound each morning to accompany me to whichever clinic I was assigned that day. “Good morning,” he said without fail, a smile always on his face.

I divided my time between the hospital and clinic in Bamiyan village and the outlying and mobile clinics. I worked, as the others did, independently and only rarely worked with another expat. My primary responsibilities were to supervise and train the national staff as needed. I spent the first few days at the hospital and clinic getting comfortable with the staff and protocols there. The hospital was small, with only eighteen beds. Admitting a patient meant admitting a part of the family; it was disruptive to their lives, to their struggles, and meant an interruption in field work and family life. Not even being hospitalized provided rest for the weary patients and families, because they were responsible for their own meals and basic care.

The International Committee of the Red Cross (ICRC) provided surgical services in a smaller building across the compound. The surgeon, Franz, was a retired Swiss physician, always available and never too busy; he had time for all of us—no questions, no consults off limits.

The MSF clinic on the hospital grounds was always busy. The staff saw and treated about 150 patients a day. When I arrived, the clinic area was chaotic; there were hundreds clamoring to be seen, and many were turned away. The loudest and those who were able to elbow others out of the way seemed always to be seen first. There was no triage system, no way of deciding who needed care or who should be seen first. Those who were turned away were understandably angry with MSF’s way of doing things. MSF asked us for suggestions, and I proposed a nurse clinic, similar to others I’d worked in all over the world, where expat nurses saw patients, diagnosed and treated disease based on well-established protocols. MSF had their own handbook of well-used and respected clinical guidelines, perfect for a nurse clinic. The coordinator agreed to give it a try at both the hospital base and outlying clinics, and once we started, we were able to see most of the people who presented at our clinics. It was good for MSF and good for the Afghans.

In those first days, I saw and admitted several people with anaphylaxis (a severe and sometimes fatal allergic reaction) caused by a toxic weed that they were eating. Most who ate it wouldn’t develop the terrible and potentially dangerous facial swelling that could halt their breathing, nor would they develop the necrotic sloughing off of skin or swollen extremities. And, because of that, many people in the countryside took the chance and ate those weeds, which grew in abundance, the only thing that mattered when people are starving. We saw only those who developed the allergic reaction and made it to the hospital. Those villagers, we could treat. For those who developed anaphylaxis and lived too far away to get help in time, the price for eating the weeds would surely be death. We would never learn the actual numbers of those so affected. When someone died in a distant village, they were buried there without the benefit of epidemiological studies. We tried to pass the word to avoid that particular weed, and we did start to see fewer and fewer of those patients. But for people who were starving, the temptation to feast on weeds, regardless of the risks, was irresistible.

One morning, as I arrived at the hospital clinic, the Afghan staff summoned me and announced that there were five Taliban prisoners waiting to be seen. At the time, there was a Taliban prison a short distance from the hospital, which housed about one hundred prisoners who had been captured several months earlier. I was told that these men were particularly vicious murderers, and because I was the only expat in clinic that day, it would be my decision if they were seen or not.

I walked up and stood toe to toe with them. I wore sunglasses and a splash of color on my lips. The prisoners wore sullen expressions that peeked through unkempt beards on gaunt faces. Their raggedy shalwar kameez, the traditional pants and shirt, hung on skeletal frames so embedded with grime that it might have been a second layer of clothes. Some men wore the traditional turbans, others had long, unkempt hair. I felt not an ounce of sympathy for any of them. Neither did they make me fearful. They were a ragged sorry lot, a far fall from the evil bastards they’d once been.

I moved closer, and they seemed to cower as I asked each of them, in Dari, what was wrong. “Mariz? Che taklif dori?” (‘Sick? What’s your problem?’) Each had a minor complaint, a cold, scabies, not a really sick one among them. As an American, I hesitated before answering the question of whether or not we would see them in the clinic. My stomach clenched and I chewed on the corner of my lip. MSF is unwavering in its position on neutrality in all circumstances. I knew there’d be hell to pay from the coordinator if I sent them away, and he would surely wonder why this Irish nurse was so intent on punishing them further. So, I took a deep breath and spoke. “Balay,” I said in a whisper, and then louder when it was clear they hadn’t heard me. They nodded and smiled happily and were effusive in their thanks. “Tashakore,” ‘Thank you,’ they said as they folded their hands and nodded their heads as if in earnest prayer.

Once I turned my back and walked away, I could hear their low murmurs—insults, I was sure, that a brazen woman would dare to look them in the eye. They would return frequently over the next months until the prison finally closed and they were all released back to their own far-off villages. I had long since tired of their whiny complaints and darting eyes, and I was glad to hear they finally were gone from Bamiyan.

In mid-June, just when the novelty of my Irishness was wearing off, at least for me, an American soldier appeared at the hospital-based clinic looking for health posters. He was wearing a New York Fire Department (NYFD) baseball cap. The sight of the soldier in that cap filled me with a quiet sense of pride. Though I’d often seen the soldiers on the road or in the bazaar after that first sighting of them, I hadn’t had a chance to speak with them, and I was almost desperate to tell someone that I was an American.

The soldier, tall, tanned, and smiling, stuck out his hand. “Matt,” he said, introducing himself.

I took his hand, gripping it tightly. “Roberta,” I said, smiling. “I’m an American, too,” I whispered. It felt so good just to say it, like releasing a long-pent-up secret.

His eyes opened wide and he looked at me. “We didn’t think there were any Americans here. You must know the risks. How have you managed it?”

I explained that I had an Irish passport for safety’s sake, and I spoke in a brogue around my own team. He looked at me and smiled. “Wow,” he said. “I was watching you speak to an old man in Dari, too.” He shook his head. “I never would have guessed you’re an American. I’m proud that you’re here helping, but I have to report this. We need to keep you safe. I’ll be back,” he said, striding off with a wink and a wave, and without the posters he’d come for.

Days later, as Aasif and I were cutting through the village bazaar on our daily trek to the hospital compound, an army jeep pulled up and screeched to a halt. Matt and another soldier jumped out and walked back to me. Luckily, Aasif had just made a detour to visit a small shop, and I was waiting outside for him. I was aware that the soldiers and I had attracted the notice of some passersby. “We can’t talk in the open,” I whispered. “MSF has a strict rule about that.” I looked around nervously, praying that no one on my small team was around. I was more worried about MSF finding out that I’d been seen with the soldiers than the possibility that any terrorists might be lurking about.

“We’ll make this quick, then,” Matt said. “We want you to come to the safe house tonight for dinner. We’ll cook up something special for you.”

The lure of good food and good company was strong, but I’d never be able to make it. “We aren’t allowed out at night, and never alone,” I sadly replied.

“Really? Can’t you try?” the other soldier asked.

I wanted to go. “I guess I can try to sneak out,” I said, not at all sure I could manage it. We set a time and place for a rendezvous, and I hiked back to the compound all the while thinking of how I would do this. The rendezvous (a bombed-out, decaying old shell that someone had once called home) was just around the corner from the MSF house. Just before four o’clock, I simply walked through the gate.

I’d been lucky. The team was smaller than usual—the coordinator and his wife had left for home, the physician was at meetings in Kabul, the midwife was sick, and the interim coordinator was up to his elbows in paperwork. No one would even notice that I was gone. I walked the short distance to our meeting place, slipped into a corner of the deserted building, and waited. Before long, I heard the unmistakable hum of a car engine, and when I peered out, I saw a US Army jeep approaching, Matt at the wheel.

He maneuvered close enough to the building that I could climb into the jeep without being noticed. I slumped down in my seat and was whisked off to the safe house, a short ride away. We pulled off the main road into a series of narrow alleys, then over a rickety bridge before pulling up to the house, a stone fortress ringed by barbed wire, booby traps, and gun and rocket turrets.

From the outside, the house appeared to be in total darkness, but when I stepped inside, the first thing I saw was an American flag hanging in the middle of the main room. There were lights, a television with the news on, someone cooking, and the sounds of American voices wafting through the air. Matt introduced me, and we sat to dinner—spaghetti, meatballs, warm bread, and Diet Coke. After a daily diet of beans, rice, bread, and, occasionally, goat, I couldn’t get the food into my mouth fast enough. I never really had to do more than eat. The soldiers did the talking, and the first to speak was the Chief, a tall, thin man who used as few words as possible to say whatever it was he had to say, and today was no different.

“So,” he said, his jaw tight, his eyes on me, “how have you been here for over a month without my intel picking you up?” His eyes swept the room, and I could almost feel the men sink a little in their seats.

“Well,” I said through a warm crust of bread, “I’m here on an Irish passport, I speak in a brogue, and no one knows that I’m an American. I don’t think it’s a failure of your intel, I think it means I’m pretty good at this. Don’t you?”

Easy laughter erupted. The tension faded, and the Chief nodded. “Now that we know you’re here, I wanted everyone to get a good visual—a good look at you. If we ever have to extract you, we need to know who it is we’re looking for.”

All eyes turned toward me. A flush ran along my cheeks to my ears. I took a long sip of Diet Coke to wash down the last of the bread in my mouth. “Extract?” I asked.

“Rescue you,” the Chief answered. Everyone nodded in unison. “You don’t carry a weapon, do you?”

I shook my head.

“And you wander around this village and the countryside alone?”

“I’m not alone. I’m with clinic staff or an interpreter. Sometimes I walk alone here in Bamiyan, but I feel safe.” And I did feel safe. Of that much, I was certain. The Taliban were under control (or so it seemed), the villagers were kind, and as a bonus, the soldiers were here. How could I not feel safe?

The Chief clearly saw things differently. He raised a skeptical brow and cleared his throat. “If you ever need us, leave a message with Basir at the music store in the center. Do you know the place?”

I did know the place, so I nodded agreement and finished my dinner. Once the dishes were cleared, the soldiers gave me a tour of their house. My jaw dropped as they showed me around. They had rigged up a real bathroom, built bunk beds into the rooms off the main hallway, and somehow hooked up a washer and dryer to an intermittent water supply. Damn, how I envied them.

When I glanced at my watch, my heart stopped. I’d been gone for three hours. I was more worried that someone might have noticed my absence at the house than I was about being targeted by terrorists. “I have to go,” I announced. “I have to get back.”

Matt and another soldier spirited me back to the vicinity of the MSF compound. I slipped soundlessly from the jeep, the soft hum of its engine the only sound as I made my way along the alleys and back inside the MSF compound. My stomach was full and my eyes were still blinking from the bright lights. I felt a little like Cinderella after the ball when I reached my room. I heated water and took a bucket bath and then read by flashlight. From the corner of my eye, I spied a scorpion stealthily making his way toward me. I froze, remembering the injuries they’d inflicted in Africa. And as the menacing insect neared, I brought my flashlight down hard on his shell. I scooped him up in a tissue and went outside to dispose of him.

Cinderella, no more.