Aliabad-Kabul, Afghanistan
Tel: +93 79 96 69 751
Dr. Fatima Mohbatali, Director – FMIC
An urgent need in Afghanistan
The Country
Independent from the Great Britain since 1919, Afghanistan covers 251,672 square miles making it slightly smaller than the state of Texas. It shares borders with Iran on the west, Pakistan on the south and east, Turkmenistan, Uzbekistan and Tajikistan on the north. The population is 31 million. Kabul the capital is home to 3 million. 43% of the population is under 15 years. The income per capita is $1,310. Life expectancy is 43 years. The infant mortality rate is fearful, 16.5%. Even more tragic is that one child out of four dies before reaching the age of 5. The maternal mortality rate is 100 times higher than in the USA or Europe: one mother dies every half hour when giving birth. These mortality rates are the highest in the world.
Healthcare situation
For more than two decades (1973-1997) Afghanistan has been going through constant upheavals, fighting, and the destruction of its infrastructure, economy, and environment. The health care system is one of the worst affected social sectors, with the majority of the population depending on external assistance. Almost all the infrastructure, including hospitals, clinics, and basic health centers has been totally or partially destroyed. Currently, there is only one doctor for 50,000 inhabitants (one for 140 in the USA) and 20 of the 31 provinces do not have basic obstetric facilities.
Within the strategy of reconstruction of the Afghan Health Sector, a large investment has been made on primary health care with the help of main donors including the rehabilitation and construction of new primary health care units all over the country. Still it is only a drop in the bucket.
The area of Kabul concentrates the highest density of population and still medical program there remains. The construction of the French Medical Institute for Children has been a huge step forward.
A Training hospital integrated in the Public Health Program
The September 11, 2001 terrorist attack on New York’s World Trade Center elicited worldwide sympathy for its victims and for America. Even the children of faraway Afghanistan were learning at first end what bombs were and what they did, for the war against the Taliban was in progress. Just weeks after 9/11, Prof. Alain Deloche (founder and president of La Chaine de l’Espoir and Surgeons of Hope) and Dr. Nilab Mobarez, president of Afghan Foundation Bactriane, proposed to President Amid Karzai the building of a mother and child hospital in Kabul.
Master agreements were signed with the Afghan government, integrating the Project into the public health program, and granting the new hospital with independent management, tax exempt status and free land. An international media fundraising campaign helped La Chaine de l’Espoir promote its Enfants Afghans Program and raise the $10M necessary to implement and monitor the first phase of the hospital (85 beds).
In November, 2005, the hospital’s first surgeries on Afghan children were performed.
On April 8, 2006, the French Medical Institute for Children was inaugurated by President Karzai.
The Facility
Hospital Program
The initial 85-beds phase currently built consists of a two-floor technical building and one three-stage hospital wing. The total surface is 5,000 sq. m. (53,820 sq. ft.).
The Technical Building (Ground Floor)
- 1 radiology unit including CT scanning, general radiology
- 1 medical analysis laboratory
- 1 pharmaceutical laboratory
- 3 Supply delivery rooms
- 1 mortuary
Second Floor
- 4 operating rooms
- 1 endoscopy room
- 15 ICU beds
- Hospital Wing
- 70 beds in three levels
The Departments
The primary treatment programs that FMIC is ensuring are concentrated on two departments: Pediatric surgery and Gynecological obstetrics.
Pediatric surgery is currently opened for:
- General pediatric surgery of congenital malformations and after effects of malformation.
- Orthopedic surgery of congenital malformations and after effects of trauma tissues.
- Reconstructive surgery of extremities malformation, particularly face and hands.
- Cardiovascular surgery
Gynecological obstetrics: The Institute will make possible in a second phase the delivery of medical care to male and female adults and children, including maternal care, obstetrics and neonatology.
The Staff (January, 2008) - 210 persons
- Medical Staff (surgeons and physicians) — 20 persons: Pediatricians, anesthesiologists, visceral, orthopedic surgeries
- Nurses Staff — 80 persons: Anesthesia, Intensive Care Unit, Out-Patient
- Paramedical Staff — 25 persons: Chemists, radiologists, attendants (stretcher bearers)
- Non-Medical, Technical and Administrative Staff — 25 persons: Directors, administrative agents, receptionists, security guards, maintenance technicians
The Organizational Structure
Legal Framework
The realization of FMIC is integrated in the Afghan strategy of reconstruction of the health sector. A memorandum of understanding has been signed with the Ministers of Public Health and Higher Education to agree on the creation of the new structure and guarantee its sustainability.
Administration
FMIC is managed by a non- profit Foundation established under the Afghan law with Aga Khan Health Service which is ensuring the management and control of the expenses of the daily operation of the hospital. The Foundation finances the treatment of indigent children.
The Training Program
The Foundation is ensuring the continued training of the Afghan medical, paramedical, and administrative corps to guarantee the proper functioning of the Hospital.
Accomplishments 2005-2006 (October)
- First operation — general surgery was performed in November, 2005. The first cardiac surgery ever in Afghanistan was performed in April, 2006 by Dr. Alain Deloche, founder and Board of Surgeons of Hope Foundation and president of La Chaine de l’Espoir, with a European team.
- August, 2007, the first cardiac surgery performed by an American surgeon in Afghanistan – Dr. Bernard Vasseur, The Reading Hospital Heart Center.
- By January, 2008, 130,000 child patients have received medical care, 3,000 surgeries (350 cardiac) have been performed, and 300 local staff have been trained.
SoH has programmed for May 2007 the first US Cardiac Surgery at FMIC. A team of seven led by Professor Francois Lacour-Gayet, Professor of Surgery, University of Colorado and Head, Cardiac Surgery Department, Denver Children’s Hospital, will perform 15 pediatric open-heart surgeries to indigent Afghan children.
The mission will be composed of:
- 1 Surgeon
- 1 Cardio Pediatrician
- 1 Anesthesiologist
- 1 Perfusionist
- 1 OR nurse
- 2 ICU nurses