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Dachverband des
Afghanischen
Medizinischen Fachpersonals
und deren Kollegen im deutschsprachigen
Raum
D.A.M.F.
e.V.
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- The first
seminar of the umbrella organization of Afghani Medical Personnel and
their colleagues in German speaking
countries, the D.A.M.F., held in Freiburg, Germany from November 20,
2004 to
November 21, 2004: Health care in Afghanistan. Problems in the
implementation
of developing projects and finding solutions
- Taking place at the same time
as the annual meeting of
members of the umbrella organization, around 80 Afghani and German
doctors from
Germany, Switzerland , Austria, Franc and Holland took part in the
conference
at Novotel (a hotel) in Freiburg, Germany. In twenty sessions
presenters
provided information on the current political and medical situation in
Afghanistan as well as reporting on projects already implemented.
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A
report on the political situation (“Elections and the security
situation in
Afghanistan”) was given by Gernot Erler, a member of the German
Parliament, Mr.
Sohak, Secretary of the Afghani Embassy in Germany, and the journalist,
Dr. R.
Rahim. They gave a thorough description of the military situation and
the
enormous amounts of money that are being spent on the military.
- The No. 9 Special Report
of the umbrella
organization “Medicina Afghanica” from December 2003 provided a report
on the
situation of medical care in Afghanistan. Additional and current
information to
this was added by Dr. Quaderi, who reported on the wholly insufficient
medical
care in the area of dentistry, by Mr. Poppe and Dr. Mehran, who
reported on the
catastrophic condition of X-ray machines as well as on the equipment
used to
protect against X-rays in Kabul, and by Dr. Rahim, who reported on the
lack of
treatment possibilities in the field of neurological surgery.
- A lecture by Dr. Roostai
on the dangers
of ionising rays in Afghanistan and one by Dr. Müller-Noshabery on
the
possibility of using natural remedies in Afghanistan rounded out the
reports on
the current situation there.
- The second group of presentations
concerned themselves with projects already implemented or being
implemented.
There are two types of projects: those, which are focused on
co-operating with
Afghani medical faculties and hospitals and those focused on
independently
implemented training.
- The majority of these
projects are
co-operations. Among these is a training program for surgeons in Zurich
organized by the Association of Afghani Doctors in Switzerland. Dr.
Asefi gave
a report on this. Additionally Dr. Ahmadjahr described the 16
operations (done
by visiting surgeons) performed by the Afghani Solidarity Fund since
1993. Another
co-operative project is Dr. Darmangar’s training (program) at the
University of
Freiburg. The most extensive report on co-operative projects came from
Dr.
Timour, who is organizing co-operative efforts between the University
of Lyon
and Kabul on behalf of the French Foreign Ministry. His experiences
doing this
could provide a model for future co-operation efforts. Working closely
together
with the University of Lyon is the current plan and in the summer of
2005 a
conference is to take place there. Plans of the ADAV-Weimar to arrange
an
exchange of students with scholarships between hospitals in Kabul and
the Bad
Berka Clinic in Weimar is another example of these co-operative
projects as is
the setting up of computer rooms for a computer center at the
Polytechnical
Institute in Kabul, about which Mr. Noor, a civil engineer, reported.
It may be
noted that this last project might just as well be listed in the group
of
independently implemented projects.
- In the second group of
projects we could
include the cardiology courses reported upon by Dr. Zulfacar, and the
testing
of a vulnerary drug, Na Clorosum, by Dr. Stahl and a related
dissertation by an
Afghani student. Besides these two there is also the maternity and
children’s
clinik of the ADAV in Jalalabad with its courses in ultrasound, which
could not
be mentioned due to time considerations.
- Dr. Domen and Dr. Siegel
summed up the
standards for training courses in their lectures: examination of the
use and
possible misuse of training prior to its implementation, surveying the
technical possibilities in the difficult circumstances in Afghanistan,
careful
selection and examination of the prerequisite training of participants,
the
maintenance of a quota for women, the participation of Afghani
instructors,
combining practical and theoretical instruction, distributing written
instructional materials, using English as the language of instruction,
multi-tiered training processes, well-defined regulations for exams and
certification. Training courses of the umbrella organization will hold
to these
standards.
- The lectures by Dr.
Kohler of the
Medical Missionary Institute of Würzburg, by Mr. Büchler of
the Maltese
International and Dr. Würkner of Caritas International made it
clear in what
kind of environment large and internationally active NGOs are working
without
even mentioning other Norwegian, Swedish and Dutch organizations, which
are
also active in the area of medical care in Afghanistan.
- In the plenum discussion
these problems
were talked about as were other difficulties such as dealing with the
authorities, the lack of an integrated approach to medical care, and
the
difficulty of finding doctors who have enough time to work in
Afghanistan for
one to three months. Seeing as there is a ratio of doctors to
assistants of
only 1 to 0.5 (in Pakistan, for example, it is 1 to 4.1), there was
general
agreement on the necessity of training medical assistants as well as
the
necessity of better pay for doctors and medical assistants in
Afghanistan.
Whether or not to ask patients to pay for their treatment was, in
contrast, a
rather controversial topic.
- At the end of the
conference other areas
of activity for the umbrella organization were considered. One
suggestion was
that the umbrella organization and the individual associations should
increasingly concentrate their efforts on specific tasks such as
ultrasound and
X-rays. Similarly co-operative projects should not be spread out in
many
directions, but rather restricted to certain thematic areas. In the
long-term
the umbrella organization and the individual associations should
concentrate
their efforts on specific regions, working closely together with other
aide
organizations already present there. The standards for training courses
mentioned above should be implanted as well. Again looking at the
long-term, a
central information office for application procedures is to be created,
which
will provide aide for making applications as well as information about
available public funds. A professional fundraiser might also be hired –
someone
who would be responsible for bringing in a certain amount each year.
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Afghanisch Deutscher Ärzteverein
e.V.
Kaiser-Joseph-Str.205 79098 Freiburg
E-mail:doctor@adav.de Tel.:+49 (0)761-2924064 Fax:+49 (0)761-2927831
Bankverb.: Sparkasse Freiburg BLZ 68050101 Konto-Nr.2308638
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