Health

Tajik doctors provide valuable medical care to Afghans near border

By Nadin Bahrom

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Tajik gynecologist Gulazor Otambekova (right) in September performs surgery at a clinic in Shighnan District, Badakhshan Province, Afghanistan. [Courtesy of Gulazor Otambekova]

KHOROG, Tajikistan -- Tajik doctors are providing medical assistance to Afghan residents on both sides of the border as part of a charitable agreement between the two countries.

The agreement, signed in 2010 between the two countries' health ministries, allows Afghans in Badakhshan Province receive free medical assistance in Tajikistan's Gorno-Badakhshan Autonomous Region and Khatlon Province.

The project is supported by the Aga Khan Development Network (AKDN), a network of private, non-denominational development agencies with a focus on Asia and Africa.

For Afghans who live in border villages along the roughly 1,300-km-long border with Tajikistan, it is easier to cross the border for medical treatment than to travel inside Afghanistan, according to doctors.

Urgent care, diagnoses, surgeries

Patients who need urgent surgical intervention -- for example, childbirth complications, accidents with heavy blood loss or other medical emergencies -- may cross the Tajik border without a visa to receive medical assistance at hospitals in Gorno-Badakhshan Autonomous Region, a source at the AKDN told Caravanserai.

According to the source, who asked to remain anonymous to protect the integrity of the project, 99% of the residents in Badakhshan Province lack passports or other forms of identification, because of their province's remoteness.

A bilateral agreement between the countries circumvents the need for such documents, allowing Afghans to receive urgent medical care in Tajikistan with ease.

In 2016, 148 Afghan patients received medical care in Gorno-Badakhshan Autonomous Province (GBAO) and in Khatlon Province, the source said. During the same period, Tajik doctors performed 323 on-site surgeries and treated 3,326 patients in Afghanistan.

"Doctors specialising in therapy, ophthalmology, gynecology, surgery and other fields visit Afghanistan for one to three weeks to provide diagnostic services for patients," the source said. "If the conditions allow it, after the examination, they also conduct the surgeries right there, or prescribe treatments."

In addition, Tajikistan's Health Ministry and the ADKN in 2012 opened a modern diagnostics centre on the premises of the Khorog Provincial Hospital in GBAO.

The centre provides both Tajik citizens and Afghans from Badakhshan Province (which lies across the border from the Tajik GBAO) with access to diagnostic services, the source said.

Tajik doctors in Afghanistan

Gulazor Otambekova, a gynecologist from the the GBAO, works as a supervisor at AKDN health clinics in Afghanistan. She is responsible for ensuring the quality of service provided in clinics in Darwaz and Shighnan districts of Badakhshan Province.

"I visit clinics in Darwaz and Shighnan ... several times a month, as needed," she told Caravanserai. "We are involved in training and re-training local medical personnel."

Her work includes monitoring hospital quality, including how well doctors are prepared to cope with emergencies, how they communicate with patients and how they perform child deliveries, among other duties.

Paymora Silmonova, an obstetrician-gynecologist, has been working for more than 10 years at an AKDN clinic in Badakhshan Province. She is responsible for taking care of women who are giving birth by caesarean section.

"Our main goal is to help a nation that has been in a state of war for decades," she told Caravanserai.

The clinic is equipped with the latest technology, she said. If complications arise in patient care, doctors can remotely consult with other doctors in Khorog, Tajikistan.

That option allows on-site treatment and avoids the potential deterioration of the patient's condition during transport, she said.

A duty to help Afghans

This medical assistance especially proved its merits after the Taliban seized several districts in Badakhshan Province in April-May this year.

Eleven Afghan troops who were severely wounded in fighting during that period were admitted to the hospital, said Parviz Borokov, chief physician of the Ishkashim District Hospital in Tajikistan, said.

"Swift surgical intervention was necessary since the officers, who were supposed to defend their homeland, were in critical condition and in their home country they were not able to receive medical assistance," he told Caravanserai. "One of the officers died in the hospital, while the other 10 [fully recovered and] went back to their loved ones."

Tajik doctors and nurses feel a responsibility to provide the best possible care to Afghan patients, he said.

"When your neighbour's home is burning, you should ring the alarm, [because the fire] can spread into your house," Borokov said. "We should, and will, help patients from Afghanistan while we have the chance to do so."

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