Mideast edition, Saturday, June 30, 2007

KUZ KHADOKHEL, Afghanistan — From the dusty center of this tiny mud-walled village, a round-trip journey to the nearest medical clinic takes roughly four hours.

Yet it’s not just the distance that prevents many village mothers from seeking medical care for themselves or their ailing children. Intimidation from Taliban insurgents and deeply held cultural attitudes detract from good health as much as bad hygiene, poor drinking water and germs.

Such was the case recently when Afghan doctors and U.S. medical officers with the Ghazni Provisional Reconstruction Team visited this agricultural village some 100 miles southwest of Kabul and set up a one-day health clinic.

More than 175 villagers flocked to the mobile clinic and crowded beneath blue tarps to collect hygiene kits, attend health lectures and consult doctors and medics. However, very few of those who attended the event were adult women. To PRT officers, this phenomenon spoke volumes about the overall health of Afghan women and the state of the insurgency here.

“You can see how much influence the Taliban has on a village when very few adult women show up,” said Maj. Diana Hay, an Army nurse and a civil affairs officer. “You can see that they’re scared.”

Malnutrition, water-borne diseases, intestinal parasites and poor hygiene are among the main threats to women and children’s health here. Each year, roughly 1,000 children die of diarrhea nationwide, and Afghanistan still maintains one of the highest infant mortality rates in the world.

In a village like Kuz Khadokhel, which has roughly 300 inhabitants, about 75 percent of women give birth to children without ever seeing a medical professional and an even greater percentage of women suffer from anemia.

“We’re seeing that there’s not enough protein and not enough food in general,” Hay said. “Also, everybody’s a little dry. They could use some more water.”

While a report several months ago by the Center for Strategic and International Studies found that women’s health care was among those few aspects of Afghan life that had improved noticeably over the last year, women and children in Afghanistan’s rural southern and eastern provinces were still hard-pressed to find proper medical care.

Not surprisingly, those are the same areas now struggling with a resurgent Taliban insurgency. Among other efforts at undermining Afghanistan’s struggling government, insurgents here have targeted women for interacting with NATO forces, or for just leaving their homes.

In the last month, troops with Task Force 2 Fury and the Afghan National Army and police have conducted operations aimed at clearing Ghazni province’s most troubled area, the Andar District. Monday’s Medical Civil Affairs Patrol, or MEDCAP, was intended to reinforce tactical gains by showing residents good will and filling a gap in the region’s medical care.

“It’s frustrating because there’s only a limited amount we can do,” said Hay, of Knoxville, Tenn. “But it’s still a whole lot better than nothing. The care people see here may actually be better than what they see at the hospital level.”

During the PRT’s recent visit to Kuz Khadokhel, Hay and Navy Lt. Keith Hoekman separated villagers into groups of males and females and lectured them on good hygiene practices, and then provided them with vitamins, deworming medications and toiletries.

Hoekman said that poor nutrition and intestinal parasites were responsible for much of the illnesses found in this and similar villages. Improving nutrition through the use of vitamins, better diet or the elimination of intestinal worms would, at least for children, promote higher IQs, as well as better health in general.

The availability of drinking water was an issue as well, he said, particularly in a nation as poor as Afghanistan.

“Water from deep wells is fairly good for drinking, but most wells aren’t dug deep enough,” said Hoekman, of Murdo, S.D. “People will also use standing water and streams, but they often don’t have the means to purify the water. There’s not a lot of wood available to build a fire, and it can be very expensive to actually boil the water.”

Among those people who participated in the medical clinic was a representative from Afghanistan’s health ministry. Villagers here have requested a permanent health clinic closer to their village and the ministry official was researching this possibility, officers said.

Hay said also that Ghazni Hospital had recently opened a nutrition program, but the facility was still far from Kuz Khadokhel.

“I’d like to see us do more to help moms and babies,” Hay said.