Thursday, June 2, 2011

In Afghanistan, millions are disabled by war but receive little assistance

From The New Republic:

Mazar-e-Sharif, AFGHANISTAN — The petitioners arrive at dawn and climb the dirt path in silence. Men with arms missing. Veiled women with artificial limbs. Children with faces drawn and prematurely old solemnly leading blind relatives by the hand. Their grim procession staggers toward the provincial office of the Ministry of the Disabled and Martyrs to solicit an annual disability stipend of $120.

Among them is Lojward, emaciated in a black-and-white shawl and on crutches. She labors her way up the slope and, out of breath quickly, lowers herself onto a tall step outside the squat concrete building, her prosthetic leg outstretched in the packed dust at an awkward angle. Men and women file past, mute and mutilated. No one offers to help her. No one offers water in the heat. Compassion is a luxury no one here can spare.

In Afghanistan’s wartime kleptocracy, which chronically neglects its most able-bodied citizens, people with disabilities occupy a special rung of the forsaken. Most survive on the sometime charity of their impoverished neighbors and relatives, on trifling alms tossed into the dust at mosque gates and bazaar stalls. To them, the government stipend—a pittance even in this country, where a kilogram of rice costs around 70 cents—is a lifeline, access to which winds through a bureaucratic labyrinth that seems designed to discourage beneficiaries rather than assist them.

Handicap International, which monitors the rights of the disabled worldwide, reports that more than half of all Afghans—or more than 15 million people—live with some level of physical or sensory impairment, and that more than 800,000 suffer from severe disabilities. Most of these impairments are the poisonous repercussions of war, which has been lashing Afghanistan ceaselessly since the 1970s: battle wounds and injuries from land mines and ordnance that detonate in villages and cities long after the fighting has ceased, and handicaps that could have been averted had incessant conflict not decimated the land’s infrastructure and stunted its health care system, condemning millions of people to lifelong suffering from preventable diseases and accidents.

The ranks of the disabled swell with each bombing, each firefight of the U.S.-led counterinsurgency, officials in Kabul say. Last year, more than 3,270 people were injured in this most recent war. But only 124,661 disabled receive government support: a fraction, government officials admit.

A macabre panoply of war mementos unfurls around the step where Lojward sits in the stifling morning shade. To the west rises a defunct military base feuding local warlords shelled into rubble two decades ago. To the north, Mazar-e-Sharif’s fabled white pigeons cartwheel through the carcass of an oil factory warehouse that Soviet planes had bombed some years prior. Lojward’s prosthesis is a ghastly fit in this disfigured landscape: It replaced the leg she lost in 1998, when Taliban soldiers slaughtered her husband and two sons in front of her, then shot her through the right tibia. “Whee,” she laments. “Tragedies, my whole life is full of tragedies.”

To prove that she is eligible for the stipend from the Ministry of the Disabled and Martyrs, Lojward must collect an assortment of stamps and signatures, in this order: from the ministry’s provincial office; the city hall; the elder of her village; the mullah of her mosque; the district court; a specially appointed medical committee; the district court again. Then, she must return the resulting paperwork to the ministry’s office at Mazar-e-Sharif’s southwestern edge, where the droughty Northern Plains slope up into the dramatic massif of the Hindu Kush. Even by the cheapest zaranj moto-rickshaw, shuttling between these officials will cost $5 and take at least ten days.

Lojward closes her eyes and tries to figure out how she will pull it off. She is distracted: by the heat, by despondency, by hunger. The only meal she has had in the last 36 hours was a small plate of fried eggplant a neighbor had shared with her the night before. “Whee,” she whimpers again, sucking the corner of her shawl. “A lot of countries are sending aid to Afghanistan, but it is not helping the poorest. I have never received anything.”

A man stops by her perch to show off his bullet scars: in his left shoulder, through both of his cheeks, in the middle finger or his right hand. He was wounded six years ago in the ancient Bactrian capital, Balkh, when Taliban gunmen ambushed his police unit; he has come to the office to pick up his annual allowance. He says he is 50 years old. He looks 80. “The worry of this world ages us,” he explains, “and our own worry does too.”

Inside the office, bedraggled petitioners stand hushed before the desk of Ghulam Mohammad, a stern gatekeeper to the coveted stipend whom they call, respectfully, the Engineer. He sits in a swivel chair in his tinted glasses and military-cut khaki shirt. He studies each plea thoroughly before dispensing his verdicts in a baritone that echoes starkly off bare concrete walls.

To a man on a cane: “Disability has to be thirty-five percent for you to receive the stipend, and yours is only twenty. Get documents from the doctor showing that your disability is more severe, then come back.” He flings the man’s papers at him. “Next!”

To an aunt of a girl orphaned by the Taliban: “The girl must have a birth certificate in order to receive disability for her father.” The girl has no identification papers; few first-time visitors to the office ever do. Since paperwork in Afghanistan must be obtained in person, getting the birth certificate means a 400-mile, $200 roundtrip by bus to Ghazni, the province where the girl was born. It is an expense her aunt cannot afford. “Come back when you’ve got the birth certificate. Next!”

The petitioners hobble out of the office in respectful and downbeat silence. Only once they are outside do they complain sotto voce about the Byzantine application process, the meager pay. “All these offices are so far from each other,” says Nasim Atta Mohammad, blinded by shrapnel during a Soviet air raid on his village. “I have spent half my savings just to come here,” says Nur Ahmad, a wheat farmer whose feet are swollen grotesquely from a mysterious illness that began five years ago when a village nurse gave him a shot to ease his backache.

“They make us run so much to get all this paperwork done,” Lojward says, trying to get up from the step, flailing, wheezing. “And I can barely move.”

One by one, the visitors make their way slowly down the dirt path to the road, where they will haggle with zaranj drivers over precious pennies. To the south, the lavender crags of the Hindu Kush knuckle the sky, indifferent witnesses to the perpetual scarring of the land and its people.