Afghanistan's First Open-Heart Patient Thriving

"I’m so happy that sometimes I’m afraid my heart might be affected by the happiness I have," said 13-year-old Elaha. Her concern about her heart is no figure of speech – Elaha is the first person to have undergone open cardiac surgery in Afghanistan.



A month after the operation, she sits alive and well at home in the capital Kabul, surrounded by her relatives.



Given just a few years to live, Elaha lost hope after her father, Ali Akbar, was told by doctors in Kabul that he should take her abroad for an operation to correct a heart defect. She knew he would never be able to afford it.



But then a miracle happened - doctors at the French Medical Institute for Children in Kabul were able to do the open-heart surgery, the first ever carried out in the country, and Elaha recovered successfully.



"It’s incredible that I was operated on in Kabul and can start living my life," she said with tears of happiness rolling down her face.



Elaha's father, Ali Akbar, is full of praise for the doctors, and is also grateful for the low fee they charged. A retired military officer, he has no income apart from a farm which earns a modest amount.



"Hospital administrators charged me only 400 [US] dollars for my daughter's operation and their services. They give a lot of discounts to needy patients. In my view, my daughter has been operated on for free," he said.



The French Institute, also known as the Mother and Child Hospital, was opened in April 2005 by France’s first lady Bernadette Chirac and Afghan president Hamed Karzai in the Kart-e-Sakhi area of west Kabul.



Doctor Fatima Muhabbat Ali, head of medical services at the hospital, said the institute was a joint project involving the Aga Khan Development Network, which she represents, the French charities La Chaine de l’Espoir and Enfants Afghans, and the Afghan government.



Hospital manager Abdul Rauf Baha said the hospital has about 100 beds and four operating theatres. The 230 staff include 20 doctors, two of them French.



Baha said 26 cardiac operations have been carried out at the hospital since it started working, 12 of them involving open-heart surgery.



The cardiac operations are performed by French doctor Alain Deloche, with Afghan physicians assisting.



"The closed heart operations may have been conducted in other hospitals but this one is the first to have done open-heart surgery," said Baha. "This is… a big help for the Afghan people, because they had to take patients abroad for treatment before this hospital was established.”



Younus Delyab, who heads the hospital’s charitable arm which assesses patients’ ability to pay, explained how discounts are awarded, "Many patients aren’t able to pay a lot of money. Fees vary from 25,000 to 30,000 afghanis [500-600 dollars] per operation. But most patients pay 16 per cent of the fees."



The hospital has carried out around 500 operations of various kinds, but Delyab said only two patients had been charged the full rate.



“I wasn’t able to pay a lot of money for my daughter's operation, but when they found out we were poor and we could not pay a lot, they just charged us 20 dollars," said a mother waiting for her seven-year-old daughter to come round from a kidney operation.



Muhabbat Ali said the hospital cost eight million dollars a year, with funding coming from French donors including the two charities.



"The hospital is also a training facility,” she added. “As it has just started up, it cannot train university students yet. However, a number of the medical staff have been sent to France to receive training and the rest will go later."



At the Ibn Sina Hospital, an Afghan-run institution in Kabul, doctors welcome the French institute’s milestone surgery and only wish they had the same levels of equipment.



Hospital head Mohammad Sharif Sarwar recalled that the closest the country ever got to performing open-heard surgery before this was during under communist rule in the Eighties, when some of the right equipment was imported, only to disappear in the turmoil and looting that followed the collapse of the regime in 1992.



These days, said Doctor Sarwar, "We have very skilled doctors in this field, but the government has not been able to provide them with the equipment they need."



Salima Ghafari is an IWPR contributor in Kabul.