The Children

I didn’t have much time to think of my dinner with the soldiers or my encounters with the Taliban. I had plenty to keep me busy at the clinics and even at home. My most frequent companions in Bamiyan were the children who lived in the nearby compounds. I spoke with them each morning on my way to work and spent time with them each evening. Some days we played with the magic bubbles I had brought from home. They loved the bubbles, the way the sunlight caught them and made them glisten, the way they were carried aloft by a whisper of a breeze until finally they burst. They taught me to use an oo-lak, a hand-fashioned slingshot made of carved wood and the rubber of old tires. To my delight, I got pretty good at it, and I taught the children to give me a high five when I made a particularly good shot. Then we’d all shriek in delight.

On those rare days when they did not have to work at collecting dung or scouring for scraps of wood for fuel, they would come to the hospital clinic to see me. They marched in, usually about six of them ranging in age from two to ten, and would ask for their friend Roberta, although they pronounced it Rabbitta. I would usher them into the triage tent and let them sit there for a bit, their chests puffing out with the privilege. They included Zara, a little girl of about four with sparkling gray eyes; brothers and constant companions—Hussein, about six, and Nasir, maybe nine or ten. The boys spent much of their time working in the fields or collecting dung, where they likely picked up their quick and mischievous natures. Noorem, a small girl who seemed always to be encased in an endless cloud of dust. Even at her young age, she always wore a veil. Zara rarely wore one.

Another child was Nasreen, a spirited seven-year-old girl with sad, deep eyes. The first time I saw her, she was busy beating an older boy. In any other place in the world, my instinct would be to intervene and give a lecture about violence, but here, in this repressed world, seeing a tiny girl take such control and be so sure of her own prowess filled me with hope for her and the women of Afghanistan. I know it sounds wrong, but in this land, I’d never thought that any girl would dare to do what Nasreen was doing and doing so well.

Finally, I did step in and separate them, but when I brushed the dust from Nasreen, I leaned in and whispered, “Well done.” Later, I did tell her to learn other ways to assert herself, but it never quite sunk in. I saw her many times go after the boys who bothered her. And secretly, I always smiled to myself.

All of the children were dirty; to wash meant to go to the canal for water or to wash there in the icy water, not an easy or pleasant task for little kids. Their poor hands were cracked with the buildup of dirt. One evening, I snuck them all into the MSF compound; I peeked in first to make sure the coast was clear, and then we all scurried in. I brought them to our bathroom, heated some water, and scrubbed their hands and faces, slathering them with a rich cream to soften their skin. They all glistened and beamed and were quite taken with my scented soaps and creams. They smelled and rubbed their hands and faces for days until the clean, sweet-smelling softness was buried under new layers of dirt. The clothes they wore were most often their only clothes, so their mothers only washed them rarely, and I didn’t see them as their outfits dried in the sun.

One day as I returned particularly tired and dirty from a long and arduous mobile clinic, the children raced to greet me and invited me to a potato party. I promised them that after I washed, I would meet them in the fields and join them. They looked skeptical, sure I wouldn’t make it, but half an hour later, I heard their delighted squeals as they spotted me jumping over the canal to join them in the fields. The year’s potato crop had been good and had just been harvested. Tiny potatoes had been left in the fields, those too small to take to market, so the children gathered them and celebrated their good fortune.

For a potato party, the children dug small holes in the ground and buried several potatoes there. Then they created mud tents over the holes into which they put kindling and set it ablaze.

One tiny boy just couldn’t make his fire take off. “Che taklif?” (‘What’s the problem?’) he screeched in frustration as he kicked in his mud tent. Minutes later, he was on the ground, rescuing his buried potatoes and trying again and again.

When the fires were really blazing, the children collapsed the mud tents and the potatoes baked while in the ground. After about ten minutes, they dug up the potatoes, peeled, and ate them. That was a potato party. It was very difficult to peel hot potatoes with bare hands and short fingernails. We squatted around the fires as the sun set, sharing hot potatoes and laughter. It was a night I will remember forever; tiny children baking potatoes that they had gathered. Even coated with mud, nothing will ever taste better.

Most of our patients were not as healthy or energetic as my little neighbors, and here, just as in Africa and Pakistan, malnutrition was a big problem. But MSF had a solution, just as IRC did in Africa—supplemental and therapeutic feeding programs for babies and small children. The sickest babies would be admitted to our hospital, while the others—those not in critical condition—could be treated on an outpatient basis, arriving weekly to collect their nutritional supplements, vitamins, antibiotics, and, often, re-hydration therapy.

Raziq was just two years old when his mother carried him into our clinic. He weighed just under ten pounds and suffered from severe malnutrition and diarrhea. He was all loose skin and brittle bones, with hair so sparse, he seemed more old man than little boy. His mother, a robust woman with a ready smile, stayed in the ward with him, sleeping on the floor, sometimes sharing his little cot. She’d left her house, her husband, and her other children in order to help her baby get well. Over the next weeks, we tried everything—antibiotics, IV hydration, tube feedings, oral supplements, and though he had a voracious appetite, he just couldn’t gain weight. He cried and fussed constantly; nothing soothed him. His mother, anxious and frustrated at our inability to help her baby, began to pack him up one morning.

I approached her with Aasif at my side. “Don’t go,” I said. “Give us more time.”

She shook her head. “I’ve been gone too long already. I have to get home.” She piled a few of the nutritional supplements we’d given her onto her blanket and began to roll it up.

“One more day,” I pleaded, not sure what I thought we could do in one day that we hadn’t been able to get done in the last weeks, but something in my voice stopped her. She turned, a fresh line of perspiration tracking along her face. She swiped it away with the end of her hijab, blinking the last bits from her eyes. “Balay,” ‘Yes,’ she said softly, plopping back down onto the baby’s cot.

Our newest team member had just arrived. The South African physician was heading home and an Australian was taking his place. She’d be here shortly, I knew, to have a look at our facilities, and I hoped that a fresh pair of eyes might see something that we hadn’t seen. It wasn’t long before Lisa nervously swept into the hospital, her eyes darting from one room to the next. This would be her first humanitarian aid position, and though it had been years now for me, I remembered well the feeling of helplessness I’d felt in the face of such misery. I suspected she was feeling that now, and as her gaze rested on me and Raziq, who’d fallen asleep in my arms, I offered a smile. “Come and meet our mystery baby,” I said.

“Who do we have here?” she asked as she moved close. I told her about Raziq’s failure to thrive despite our efforts. She nodded and seemed to be mulling it over. “And you’ve treated him for TB?” she finally asked.

It was as if a light had suddenly gone off. Though TB was as common here as a cold was in the United States, we hadn’t tried TB medicine. At her suggestion, we arranged for the medicines to be dispensed through UNICEF, and we sent him home days later with nutritional supplements and enough medicine to last three weeks. His mother had promised to bring him back so we could see how he was doing.

As the days, and then weeks, wore on, I convinced myself he’d likely be sicker if he returned at all. But three weeks later, Raziq appeared in our clinic, carried in by his smiling father. Although he had a way to go, he had gained weight, his face was filling out, the once slack skin on his hands was a little fuller, and, perhaps best of all, the gray of his skin was gone, replaced by a rosy glow. His mother was there, too, standing just behind her husband and hidden in the folds of her burqa. Still, she stuck her hand out and gripped mine tightly. “Tashakore,” she said, her voice echoing from somewhere under the creases and pleats of the fabric that covered her so well.

Raziq came monthly after that visit, and each month, as we tracked his progress and watched him grow stronger and healthier, we marveled at the miracle of that one last opinion and the change it had wrought for this baby. He was laughing the last time I saw him as his father bounced him up and down. His mother’s grateful keenings rang through the halls that last day as she wrapped him up and took him home.

Raziq was only one of hundreds of severely malnourished children that we cared for during my six months in Afghanistan. Many did well, but just as many died despite our best efforts. Often, the sickest among them, those most severely malnourished babies, were brought to us too late and then never returned for treatment. It was an added burden for families to have to come back frequently, and many never did. We tried to follow up on those babies, but in this land of nameless alleys, nameless streets, and long-forgotten villages, that was a near-impossible task. Occasionally we were able to find a family, but they were often just too busy trying to survive, regardless of the consequences for their children, to come back. They surely loved their children, but they had to worry about so much—food, shelter, just surviving—they simply couldn’t spare the time or effort to get back to us. There are days, even now, when I can hear the sad and inconsolable cries of dying children, the saddest sound in the world.

But, children here, as in war zones around the world, were the first affected and the last to complain. They learn quickly to adjust and adapt, and they do it quietly and without protest. Their resilient spirits and infinite courage have always impressed me and touched me in ways I could never have imagined.

These tiny, bedraggled children were an amazing lot, and Hamid may have been the most memorable of all.