"If she had not been here ... this kid would have died"
May 10, 2013
BAGRAM AIR FIELD, Afghanistan - When his 16-year-old son Anbia started getting tired all the time, Ghulum Sayed became concerned and took his son to see a doctor. There was a growth, under the skin, on the side of his neck that a person could feel.
"He went to other doctors and other hospitals," said Dr. Mohmammad Mohsen, general practionioner, Korean Hospital. "They couldn't diagnose exactly what the problem [was]."
Ghulum went to six different doctors and hospitals before going to the Korean Hospital.
"He [Anbia] was treated by other doctors," said Mohsen. "Finally, he was diagnosed [with cancer]."
Anbia's cancer, Classical Hodgkin's Lymphoma, had progressed to Stage IIB. It is curable with chemotherapy; without chemotherapy, it is fatal. In the United States, this is treated as an outpatient procedure.
"Usually the treatment of patients with cancer is not easy, especially in Afghanistan," said Mohsen. "Most of the patients go outside Afghanistan to Pakistan or India."
There is a hospital in Kabul with a doctor who will treat patients with cancer, if you are able to get there. Ghulum, who lives in Parwan Province, does not have a car so he and Anbia have to walk to the nearest town and then find a ride to the Korean Hospital, which is over a half hour away. One other prohibitive factor is the cost; the hospital in Kabul is expensive. Ghulum is a farmer with a wife and seven children.
Ghulum met with Dr. Junj Ik Kim, surgeon and medical director, Korean Hospital, to review the options available to Anbia.
"Dr. Kim told us that the treatment for this problem is very expensive and I told him that I have a house which cost 4,000 U.S. dollars," said Ghulum, "I can sell it and take him to somewhere ... so, tell me, where I can take him for the treatment? He told me that 4,000 U.S. dollars will not be enough for his treatment."
Kim agreed to have Anbia treated at the Korean Hospital, which provides free medical care to Afghans. Then came the harder problem: how to treat the cancer, especially since chemotherapy drugs are hard to come by.
Earlier in March, U.S. Army medical personnel with Task Force Gladiator, Headquarters and Headquarters Battalion, Combined Joint Task Force-101, 101st Airborne Division (Air Assault), began working with the Afghan and Korean doctors at the hospital.
Usually the doctors discuss medical techniques and different approaches with the goal of providing the Afghan doctors with various treatment options.
One of the doctors is Maj. Tamie Kerns who joined the 101st ABN. Div. from Tripler Army Medical Center in Hawaii, where she is an oncologist or cancer doctor.
Kim approached Kerns with Anbia's case.
"This is what I do every day," said Kerns. "I personally do not feel that this child should lack the same opportunities that we have, just because they don't have the money."
In Afghanistan, those who can afford to go abroad for medical treatment usually do. For those who can't ...
"They [patients] have a bad fate. We feel very sorry for our people, especially for those patients who have this kind of problem, cancer. They are too poor to go outside [Afghanistan] and little chance to come to this hospital," said Mohsen, "we feel very sorry for those patients."
Anbia's chances improved when he was admitted to the Korean Hospital with it's trained Korean and Afghan staff to care for him. But the hospital does not have an oncologist, there was only Kerns.
"It doesn't seem that there's a lot of hope a lot of times with some of these more chronic medical conditions especially in the world of oncology, where things are very expensive," said Kerns, a native of Mayfield,Ky. " It doesn't happen very much where we get hope and I think that this is what it is for them .... us doing this, us doing the treatment ... they now have hope that he is going to get better."
With Kerns onboard, the only thing left was to find the chemotherapy drugs.
"It was a battle to find the medication," said 1st Lt. Dustin Stuart, physicians assistant, TF Gladiator, CJTF-101and a native of Glen Elder, Kan. "That took several man hours."
If a U.S. service member is diagnosed with cancer they are medevaced out of Afghanistan for treatment, so chemotherapy drugs are not something you would find at a military treatment facility.
"[I] made some phone calls, talked to some folks at the hospital ... trying to figure out what we can do, how we can get the medicine and what would be the best route to go about it," said Kerns. "I also started searching the internet for any nongovernmental organizations that would be willing to help. I got a lot of really great responses from a lot of folks in the U.S., Saint Judes [Childrens Hospital] was very responsive. The Leukemia and Lyomphoma Society was very responsive."
Those options would have meant leaving Afghanistan and if Ghulum accompanied his son to the U.S., who would take care of his farm and provide for the rest of the family? So Kerns continued looking for other options.
"I [found] an NGO that was actually here in Afghanistan called the Afghan Child Project," said Kerns. "They had some contacts outside of Bagram that could help get the medication."
Eleven days after Anbia was diagnoised with cancer, the medications arrived.
"That day was one of the proudest days I've ever had," said Kerns. "I looked like a kid in a candy store when I was going through the medicines. [I was] just so excited that I'd gotten them."
The medications did not come "ready to use", they had to be properly prepared in as sterile of an environment as possible; so Kerns looked for a pharmacist.
"You need to do the appropriate dose," said Maj. Lyle Kolnik, pharmacy consultant, CJTF-101 and a native of Buffalo, Wyo. "There are inherent ... dangers for mixing chemotherapy drugs, there are certain things you have to do thing's a little differently. Its just a [few] simple techniques you need to know how to do to prevent spillage. If we can [teach] the Afghan or Korean pharmacists to do this ... all the better."
With everthing in place, Anbia received his first course of chemotherapy on May 2.
Kerns examined him two days later. The cancer had already begun to shrink. Anbia's chance of living for the next five years has gone from 0 to 90 percent.
"It was great to see him and how happy he was ... how good he felt and how happy and how proud his father was." said an overjoyed Kerns. "When I left, his father put his hand over his heart ... and just bowed his head to me."
Kerns down plays her role in this. Instead, she emphasizes the role of everyone else in helping Anbia; Stuart disagrees.
"It's hard to imagine if she [Kerns] had not been here, been at the right place at the right time," said Stuart, "This kid would have died."
Anbia was released from the Hospital and is back at school now. Ghulum is back on the farm. There will be many more visits to the Korean Hospital as Anbia continues his chemotherapy treatments.
"I feel like he is born from his mother," said a visibly grateful Ghulum, "and starting a new life again."