LLUAHSC SCOPE Spring 2002 - Loma Linda helps rebuild Afghan medical school

The Loma Linda University Center

Loma Linda helps rebuild Afghan medical school

[SCOPE, Spring 2002]

Loma Linda University chancellor Richard H. Hart, MD, DrPH (left); Joan Coggin, MD, MPH; and G. Gordon Hadley, MD, take a tour of the Kabul University campus.

There are few places in the world more devastated than Kabul, Afghanistan.
The capital city, nestled in the foothills of the Hindu Kush Mountains, was once a lively and cosmopolitan metropolis. But more than 20 years of war have left their mark.

After forcing the Soviet Union to abandon Afghanistan, the Afghans turned their weapons on each other in a series

of factional civil wars that have left their capital city and country devastated.

For nearly all of its 100-year history, Loma Linda University has been involved in international health-care initiatives. Loma Linda’s alumni have been instrumental in developing nearly 500 health-care institutions, including 160 hospitals, around the world.

As a natural outreach of this global interest, Loma Linda University has had an involvement with Afghanistan for 40 years. Primarily anchored by G. Gordon Hadley, MD, dean emeritus of the School of Medicine, this affiliation has included World Health Organization support and has provided faculty and consultation resources to the medical school in Kabul and several other medical institutions in Afghanistan.

At the request of both national and university leaders in Afghanistan, Loma Linda University has focused its activities for the past five years on assisting Kabul Medical Institute. Previously the leading medical school in Afghanistan, the school has suffered greatly for nearly 20 years.

Dr. Hart (left), Khushal Stanisai, MD (third from left), and Dr. Coggin, visit with Suhaila Seddiqui, MD, minister of public health. Dr. Seddiqui was Dr. Hadley’s student in Kabul in the 1960s.

Now Afghan nationals, Loma Linda University, the Euro-Africa Division of Seventh-day Adventists, and the Afghan Medical Association have joined in a unique partnership to assist in rebuilding Kabul Medical Institute.

The devastation caused by factional fighting is slowly changing—with the help of Loma Linda University. “The entire medical school complex was severely damaged during the Soviet invasion and civil struggles, with complete loss of all equipment,” says Richard H. Hart, MD, DrPH, Loma Linda University chancellor, who—with Joan Coggin, MD, MPH, vice president for global outreach for Loma Linda University Adventist Health Sciences

Center; and Jerry E. Daly, MSLS, MA, director of the Del E. Webb Memorial Library—made a site visit to Afghanistan

in early April. “An early decision was made to rehabilitate this facility in stages as funds became available.”

“The Loma Linda project was the first to actually begin repairing portions of the main building,” comments Dr. Coggin, who is coordinating the project.

Opening ceremonies for the new Loma Linda University Center, located in a prime area of Kabul Medical Institute, were held on Wednesday, July 4, 2001.

Dr. Hadley (standing, left) teaches a pathology class at Kabul Medical Institute. He has been involved with various projects in Afghanistan for more than 40 years.

The Loma Linda University Center consists of four rooms. One is reserved for teaching laboratory situations, another is devoted for a tissue laboratory, a third room is reserved for a medical library, and the fourth is designated for computers to be accessed by students and faculty.

“Even though this is a small area of approximately 4,000 square feet, the Loma Linda University Center has provided an example and hope for the rest of the institute,” Dr. Coggin relates. “The next phase of repairs within Kabul Medical Institute has been taken on by the United States Military Reserve which is currently working in the country. Reserve engineers and other professionals have developed plans for rehabilitating six classrooms and support areas. This project is expected to be complete by July, 2002.

“The medical school’s current library consists mostly of books and journals dated prior to 1972,” points out Mr. Daly, who is assisting Dr. Coggin. “Their collection has not grown at all. We are trying to rebuild their medical library with standardized books and journals. We have a standard list of books and a standard list of reference materials we are trying to acquire. The World Health Organization (WHO) of the United Nations has said that it will assist with the shipping costs from the United States to Afghanistan.”

When Kabul Medical Institute authorities decided they needed help in rebuilding their medical curriculum, they knew exactly who to turn to—Dr. Hadley, who most recently served as president of the Sir Run Run Shaw Hospital in the People’s Republic of China.

Dr. Hart (with camera around neck), and Jerry E. Daly, MSLS, MA, visit with Afghans in front of Afghani-operated tanks.

On the Loma Linda University School of Medicine faculty for more than 50 years, Dr. Hadley established the pathology department at Kabul Medical Institute more than 40 years ago. Some of his former students are now on the faculty of the Afghanistan medical school.

“My wife, Alphie, and I went to Afghanistan in 1960 to work in the pathology department,” he recalls. “When we arrived, there was very little equipment, so we essentially began from scratch.”

Dr. and Mrs. Hadley spent several months in Afghanistan over the past couple of years. They returned to the embattled country earlier this year for an extended stay to continue assisting in the redevelopment of the medical school and to teach pathology.

One of the greatest needs now of Afghan medical students is qualified professors, according to Dr. Hadley.

During one of his trips back to Afghanistan, a government health official pleaded with him to come back and teach the new Afghan medical students. “I remember that I told him, ‘I’m 80 years old.’ He told me that was no problem. ‘We just want you to come.’”

“We will be teaching in English. A few of the students ‘fight’ learning English, but they must realize that English is now the language of science and medicine, and if they are going to be physicians, they must know that language.”

A majority of the medical students are able to read and understand English, but have difficulty speaking it. To help alleviate this situation, Loma Linda is planning to send two English-language instructors to Kabul to assist in the language program.

“The government is behind us in our desire to teach the students in English,”

Dr. Hadley states, “and they are behind us in setting high academic standards—which we will do.

“I feel very warm toward the Afghans because I have worked with them,” Dr. Hadley continues. “They are desperate. They are tired of war, and they are suffering. For this reason, I wanted to come back to help the people. The Afghan people need our help now.”

A convoy of trucks from the World Food Program bring supplies to Kabul, the capital of Afghanistan.

After the July 4, 2001, opening ceremonies, Loma Linda personnel returned to the United States. Dr. and Mrs. Hadley had made plans to return to Kabul no later than early autumm. September 11, 2001, changed their plans. Because of the uncertainty of the world situation, the Hadleys postponed their travel to Afghanistan.

The political situation did not deter Dr. Hadley or Dr. Coggin. Even though the future was uncertain, planning at Loma Linda University continued. After the Taliban government ceased to exist, communication was once again established with Kabul Medical Institute. It was learned that Loma Linda University Center and its meager resources were untouched, and the staff were waiting for Loma Linda to return.

Currently, anyone admitted to Kabul University can choose to go to medical school. The medical branch of the university is by far one of the most popular areas of learning because every graduate of the school is guaranteed a job with the Afghan government at $40 per month. As one Afghan national physician puts it, “We have no qualified doctors. We have too many so-called doctors.” One reason for this dearth of physicians is that many Afghan physicians leave the country for training abroad. Once abroad, it is sometimes more enticing to stay in the new country rather than return home.

Prior to the beginning of the project, Dr. Coggin; Dr. Hadley; Michael Ryan, PhD, director of Global Mission for the General Conference of Seventh-day Adventists; Gary Krause, also from Global Mission; Denzil McNeilus, president of Adventist-laymen’s Services and Industries (ASI); and two representatives from the Afghan Medical Association based in the United States—Khushal Stanisai, MD, and Yousuf Sadiq, MD—traveled to Afghanistan on a preliminary site visit to assess the medical school curriculum and see what needed to be done in the way of construction. Also making the trip to the opening of the Loma Linda University Center was Peter R. Kuntz, treasurer, Euro-Africa Division of Seventh-day Adventists.

“We enlisted the help of Maranatha Volunteers International, headed by their president, Don Noble,” Dr. Coggin noted. Maranatha Volunteers International has an excellent track record in construction projects around the world.

Mr. Noble asked Karl Schwinn, president of KS Construction, Phoenix, Arizona, a long-time project manager for Maranatha, to head up the construction project. In addition to the teaching center, Mr. Schwinn and his Afghan team also built a four-bedroom house and three apartments. This complex is located about 15 minutes from the medical school campus.

According to an agreement reached by Dr. Coggin and Afghan officials, the house and apartments belong to Loma Linda as long as Loma Linda is involved in the teaching process at Kabul Medical Institute. First to occupy the new housing facilities are Dieter and Christa Hang of Switzerland, who are the on-site representatives for the Loma Linda University Center.

“Much of the infrastructure of Kabul University was destroyed during the years of fighting,” Dr. Coggin details. “Windows were shattered by artillery shells; wiring was literally pulled out from the walls and sold in neighboring countries.”

One of the major difficulties faced by Americans teaching in Afghanistan is the lack of adequate communication.

Since the first of the new year, communication has been restored in parts of Afghanistan. Dr. Hadley is in contact with Loma Linda personnel almost on a daily basis. Unfortunately e-mail is still not yet possible, and the use of the Internet has not reached the Afghan medical school. This will hopefully change in the near future.

In a visit to Loma Linda in March, the Afghan ambassador to the United States, Ishaq Shahryar, met with Loma Linda University administrators to explore the possibility of partnering in more areas than just the medical school.

“We are definitely looking to the future,” Dr. Hart assures. “We are developing plans for a variety of primary health-care programs to be funded by external grants.

”Fast facts about Afghanistan

Size: Slightly smaller than the state of Texas

Population: 25,838,797 (July, 2000, estimate)

Life expectancy at birth: 45.88 years; male: 46.62 years; female: 45.1 years

Literacy: 31.5 percent of population age 15 and older can read and write

Climate: Arid to semiarid; cold winters and hot summers

Land use: Arable land, 12 percent; permanent crops, 0 percent; permanent pastures, 46 percent; forest and woodland, 3 percent; other, 39 percent

Labor force: 8 million—agriculture, 68 percent; industry, 16 percent; services, 16 percent

Average income per capita: $800 per year

Airport runways: 14 paved; 32 unpaved

Radio broadcast stations: One active, six inactive

Television broadcast stations: One government-run central television station

Highways: 12,600 miles—1,676 paved; 10,924 unpaved

[SCOPE, Spring 2002]