Day 6: This is not a fairytale

"This is not a fairy tale. Not everything ends happily here."

They banned motorcycles here. That is why it is relatively calm, they say. At night nobody woke me up too frequently. They banned them because targeted assassinations were carried out on them. One drives and the other shoots at a target – usually very accurately. The cops commandeered all the motorbikes in Kunduz.

The guy with the torn liver is fine. The drain from above the liver carries about 250 ml per day and the secretion is decreasing. It is filled with a sort of liver juice. Another drain is almost dry and it would definitely be soaked if he were in a sitting position. Beneath the liver, around the gallbladder, there is nothing. Overall the abdomen is calm, with no sign of irritation. The guy is stable, no more bleeding. We are moving into phase two and there could be complications. They have not started yet but I’m not sure what the outcome will be.

The boy who had heart surgery is just fine. This fourteen year old boy, who was shot by his brother, is sitting on his bed and having a lively discussion with his relatives. Tomorrow we will move him from the ICU into the normal department. Eva carried out a control ultrasound today. A crescent of fluid has remained in the pericardium and the apex shows signs of a possible injury, but otherwise he is ok.

But this is not a fairy tale. Not everything ends happily here. An elder who I was treating died today. He died because he was sixty, which they say is a very old age to reach in Afghanistan. By the way, Afghanistan is number three in the world in terms of infant mortality prior to reaching the age of one. An average family has from five to ten children, sometimes more than ten, but never less than five.

The elder had chronic kidney failure. He came to the hospital in this condition, as our lab tests showed. After surgery, his potassium-level gradually increased and despite the dedicated and constructive interventions of Eva it would not decrease – nor, at the same time, did his other parameters. They decided to relocate him somewhere where they could offer him dialysis. I took a look at his abdomen. It seemed healthy and I could see nothing life threatening there, but then he died.

Dust is flying everywhere. Since the wind picks it up from the desert there is tons of it in the air. The whole town lies below the level of the surrounding sand dunes. It’s an oasis on each side of the Kunduz River. The vicinity is completely deserted. Some doctors go to Germany to study, so that they can come back here again. Hats off to them…