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Last Updated: Monday, 25 October, 2004, 00:01 GMT 01:01 UK
Healing the wounds of Afghan war
By Melissa Jackson
BBC News Online health staff

Alberto Cairo fits a young patient with a prosthetic limb
Alberto Cairo fits a young patient with a prosthetic limb
Afghanistan is a country where the physical scars of war are all too apparent among the thousands of landmine victims who have lost arms and legs or both.

But hope in the face of despair comes in the form of Italian physiotherapist Alberto Cairo and his team, who are helping these people to overcome their disabilities and fears of being "written off" by society.

The Afghanistan orthopaedic project has six centres across the troubled country where it provides artificial limbs and physiotherapy for amputees and fits braces, corsets and orthopaedic shoes for those wounded in wars or by the deadly weapons left behind.

The project was launched by the International Committee of the Red Cross (ICRC) in 1988, and Alberto joined in 1990.

Over the past 16 years it has helped more than 55,000 people.

The centres were set up solely to give new limbs to the war wounded, but by 1994, they had opened their doors to anyone who had a motor disability, whatever the cause, although the victims of war - and the thousands of landmines left behind by conflict - still make up the majority of patients.

If you can improve the life of a person it gives you so much joy
Alberto Cairo, physiotherapist
Alberto and his 450 staff see people with disabilities caused by, for example, polio and congenital deformities and cerebral palsy.

They have also ventured into the world of social welfare.

A job centre has been launched to help people find work instead of begging - a trap that many disabled people fall into because they feel unemployable and can see no other way of making a living.

Running alongside the job centre is a small bank which can offer loans to enterprising individuals, subject to them devising an appropriate business plan.

In Kabul alone, 2,700 small businesses have been started as a result of the job centre.

Disabled workforce

They also encourage disabled children to go to school or have lessons at home if they have a severe disability.

Alberto insists on solely employing people with a disability.

He said: "We employ only disabled people, from the cook to the cleaner to the doctors.

"I know it's discrimination but it is positive."

The Taleban used to come to inspect us... but we were never disturbed by them
Alberto Cairo, physiotherapist
He thinks it forges a good relationship with patients and helps to build up trust and create good role models.

"It's good for patients to be treated by disabled doctors and physios because it helps them to see that their lives are not finished," he said.

Fifty-year-old Alberto loves his job and, although modest about his own role, cannot disguise the sense of satisfaction that comes with helping others.

He said: "To see someone coming in without legs and crawling and after two or three weeks or so, they are able to walk out again, is so rewarding.

About 80% of prostheses are for landmine victims. There are about 900 accidents a year involving landmines, some fatal.

Of those who survive, about 80% of amputees are adult men, over the age of 16; 7% are adult women and the rest are boys and girls.

Patient queues

Between them, the centres - at Kabul, Mazar-i-Sharif, Herat, Jalalabad, Faizabad and Gulbahar - see about two or three new mine victims every day.

There is no appointment system - people just turn up at the door and by 7am there is already a queue outside.

All prosthetic limbs are made to measure. A cast is made and three days later they come for their fitting and if all is well, they are discharged a week later, once they have got accustomed to the new limb.

Alberto Cairo
Alberto Cairo loves his work
People travel long distances from remote villages to reach the clinics and often have to stay nearby in temporary accommodation while the limbs are made and fitted.

Landmine victims are sent directly to the clinics by the hospitals once their affected limb has been amputated.

Their stump needs to be prepared before a limb can be fitted.

Orthopaedic technicians and physios draw up an exercise programme for patients to follow until they are ready to return for a fitting about six weeks after amputation.

Alberto said the clinics are highly regarded by the Afghanistan medical profession.

He said: "They trust us so much and sometimes even come to us to ask our advice."

Rocket fire

Alberto has carried on working through wars and the Taleban regime.

He said: "We always managed to have good relations with the Taleban and our work carried on under their regime.

"The Taleban used to come to inspect us with their religious police to see if women and men were separated and men had a long enough beard, but we were never disturbed by them.

"We had more problems with the Mujahideen than the Taliban and the most difficult time was during the civil war of 1992-95 when the Mujahideen were fighting amongst themselves.

Alberto Cairo working in his clinic
Alberto Cairo sees children and adults
"There were rockets being fired every day and sometimes we had to work in shelters or stop for a couple of hours until the bombing stopped.

"This is the sixth regime I have been through and each one has seen that we have been really useful."

Alberto qualified as a lawyer and claims physiotherapy was "always a hobby".

At 30 he "went back to school" and turned his hobby into a job and has never looked back.

He said: "I think I made the right choice.

"I think I would never have been as happy as I am now if I'd been a lawyer.

"If you can improve the life of a person it gives you so much joy.

"If I had to compare what I give to what I get, I get much more than I give.

"I feel really happy now. Sometimes I wait for the weekend to be over so that I can go back to work."

It is rare to hear someone say that with such genuine conviction.

Afghan aid workers live in fear
10 Jun 04 |  South Asia
Drugs expert goes to Afghanistan
16 Apr 04 |  Merseyside

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