Inside Kabul's war-shattered hospital

Inspecting the filthy operating theatre of Kabul Chest Hospital

By the BBC's Emma-Jane Kirby In Kabul

A thick, oppressive dust hangs perpetually over Kabul and a film of dirt has crept into every street and smothered every building.

But when Afghan surgeon Nilab Mobarez suggested we should check out her old hospital, I was naively hoping that the word "clinic", especially "chest clinic" would offer some sort of reprieve from the grime of the city outside.

But of course, the dust had got there long before us. There was no electricity in the hospital, so even at midday, the corridors were suffused in a dingy, dusky light.

Waiting in the hospital

Women in dirty burkhas huddled side by side on the stone floors, groaning lethargically.

Outside the intensive care ward, an old man with an unravelled turban had built a tiny camp fire and was stirring a muddy brown stew with a piece of wood.

"That's the hospital kitchens," said Nilab in a voice heavy with irony. "And the women are crying because they can't afford the prices, which means their families in the wards here won't get fed today."

No oxygen

A filthy curtain separated the intensive care ward from the rest of the hospital. Inside, four rusty iron beds had been crammed into a tiny space.

The air was heavy with the maddening dust and each patient was wheezing erratically, fighting with every breath against its clogging, stifling weight.

I felt as if I was trapped inside someone's asthma attack.

Abdul, a young doctor who had newly qualified under the Taleban was listening to an elderly man's chest. The old man was coughing pathetically and staring at us with dull eyes

Nilab and Abdul with the heart attack patient

"He's had a heart attack," explained Abdul. "He needs oxygen urgently". He shifted uncomfortably. "But we don't have any oxygen, so we're going to try to move his bed nearer the window."

Nilab began to quiz Abdul about his training and about the other patients in the ward. Again he looked embarrassed.

He pointed to a listless child lying on an uncovered mattress. "This boy has rheumatic fever. He also has stomach pains - maybe appendicitis - but I don't know what to do for him."

"Under the Taleban, medical students weren't allowed to take part in dissection classes - so I've only ever taken out an appendix from a plastic doll."

The operating theatre

Until this moment, Nilab seemed to have taken everything in her stride. Now she became visibly angry and demanded to be taken to the operating theatre.

Abdul walked with us, head down, muttering "I'm sorry. Really, I'm so sorry."

The operating theatre looked as if it had taken a direct hit, although in 23 years of war, no bomb had ever touched this hospital.

How has this happened? This isn't an operating theatre - this is just a place to catch infections

Nilab, surgeon

The sheet of dust that covers the whole of Kabul had taken on a different quality in here, clinging to the sticky residues of iodine and cleaning fluid, until it had become a thick black soot.

Everything was broken - wires hung from the walls, the glass from the operating lamp crunched under our feet and tiles lay in pieces on the floor, persuaded off the walls by a persistent damp which made the room smell sour and fusty.

On the filthy pillow of the operating table a few needles were wrapped in a dirty piece of green rag.

Someone had marked the rag with the word "sterile."

It was the first time I'd seen Nilab cry. "How has this happened?" she asked me. "This isn't an operating theatre, this is just a place to catch infections."

She turned over a packet of bandages in her hand marked "Use by June 97" and moved to a long cupboard in front of us.

"Each time I operated, I would take my white coat from in here," she said. She grasped the cupboard handle and the door promptly fell off.

The fairy godmother

A team of nurses and doctors in off-white coats had gathered at the door of the operating theatre, their eyes focusing on Nilab in hope.

In her well-tailored Chanel suit and with her 13 years of experience doctoring in a plush Western hospital, Nilab was for them, the fairy godmother who could turn all of this around.

There is much to be done in the hospital

But I knew that the bootload of medical supplies that were sitting in our car couldn't even scratch the surface of this hospital's problems.

I watched her take a notebook from her handbag and begin a list.

"No 1" she wrote in a determined hand. "Buy trowel and cement and stick tiles back on wall."

I left Nilab writing and wandered downstairs to the hospital pharmacy.

A question from the pharmacist

Three men in anoraks were sitting on broken wooden crates, sharing a mug of tea. One of them got up when he saw me and offered me his box, wiping away the dust with his sleeve.

I asked him if he was the chemist and he bowed proudly and said yes, he was, and yes, this was the Kabul Chest Hospital Pharmacy.

There was of course nothing in it. Rows and rows of empty cupboards gaped hungrily and a few glass bottles with no stoppers, collected dust, for want of anything better to do.

As we don't have so much as an aspirin to offer them, it's probably better for them just to rest at home

Hospital pharmacist

The pharmacist answered my questions politely and informatively and without a single trace of self pity:

"Oh yes Madame, you`re absolutely right, its very hard to turn away the people who come here - but as we don`t have so much as an Aspirin to offer them, it's probably better for them just to rest at home."

I thanked the pharmacist for his interview and turned to go, switching off my tape recorder.

"Please Madam" he said, without breaking his tone. "I wondered whether I might ask you one question."

I was surprised but nodded curiously.

"I wonder," he said quietly, looking at me with expectant eyes. "I wonder if you could tell me - is anyone coming to help us?"