Few places in the world are more devastated than Kabul, Afghanistan. Kabul, the capital city, is nestled nearly a mile high in the foothills of the Hindu Kush Mountains. Once a lively and cosmopolitan metropolis, 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. Today, relative peace has returned to Kabul, and the city is resuming normalcy.

In their return to normalcy, the Afghan government is taking steps to improve the health care of the people. During a recent visit to Loma Linda University, Afghan deputy minister of health Abdullah Sherzai, M.D., asked Richard H. Hart, M.D., DrPH, chancellor of Loma Linda University, if Loma Linda would consider running the Wazir Akbar Khan Hospital and upgrading the facility to the equivalent of an American community hospital.

Responding to this request, a team of five health-care professionals, headed by Hart, traveled to Afghanistan during the week of March 15 to visit the hospital and evaluate this request. Accompanying Hart on the trip to Afghanistan were Jerry E. Daly, MSLS, Loma Linda director for the Afghanistan project and director of the Del E. Webb Memorial Library; Larry A. Feenstra, director of clinical engineering, Loma Linda University Medical Center; Roy V. Jutzy, M.D., professor of medicine, Loma Linda University School of Medicine; and Jan Zumwalt, MS, MBA, RN, executive director for case management, Loma Linda University Medical Center.

Each member of the team evaluated specific aspects of the hospital facilities and staff. The Wazir Akbar Kahn Hospital, operated by the Afghanistan ministry of health, was built approximately 35 years ago. Today the hospital is located among a cluster of medical facilities including the Indira Gandhi Children’s Hospital, a physical therapy clinic operated by the International Committee of the Red Cross, and an allied health educational complex. Located on an adjacent piece of property is a military hospital operated by the Afghan ministry of defense.

Currently, the hospital is undergoing a complete renovation, according to Hart. All patients have been referred to other medical facilities in Kabul. “The Norwegian Red Cross, operating under the auspices of the International Committee of the Red Cross, is completely rehabilitating the hospital,” Hart says. “When completed later this year, what was a 248-bed hospital will be downsized to approximately 200 beds.”

“If Loma Linda University is able and willing to take on this task, this collaborative effort could play a significant role in changing the way the Islamic world sees the United States,” Sherzai says. “What better way to change the world view and the world direction than to give life to a country that has nothing but its will?”

Prior to the closing of the hospital for renovation, Wazir Akbar Khan Hospital could only accept the most needy patients. “Only those in immediate need could be helped,” says Mahammed Njib Haleem, M.D., vice president of the hospital and an internist. Saleem Tawana, M.D., chief of surgery, noted that they could only schedule elective surgeries one or two days a week because of a lack of medicines.

Hospitals in Afghanistan have limited resources, according to Sherzai. Many of the hospitals in regions outside Kabul do not have electricity or running water in the facility. Although Wazir Akbar Khan Hospital has those amenities, the facility lacks basic medical equipment such as stethoscopes, modern medications and blood pressure cuffs.

“We estimate that it will take approximately $2 million worth of equipment and supplies to raise the level of the hospital,” Hart states. “We will need an additional $3 million or $4 million for staffing, construction of an outpatient clinic, and housing for expatriate medical staff.”

The University administration is currently exploring ways for external funding of this project. A positive answer is expected in a few months. “This will be an opportune time for Loma Linda University to collaborate with the ministry of health in operating the hospital,” says Jutzy, who with Zumwalt, evaluated the current medical staff needs for the hospital.

Wazir Akbar Khan Hospital is situated in an ideal location, according to Hart. The facility is located in the center of extensive grounds that can be transformed into a park-like setting for patients and visitors. In addition, there is enough vacant land surrounding the hospital to build housing for the expatriate staff.

“We are very interested in helping Afghanistan with this facility,” Hart says. “We have been working with Kabul Medical Institute, Afghanistan’s primary medical education facility, on upgrading medical education and recognize the additional value of establishing a solid teaching hospital.”

Loma Linda began its involvement with Afghanistan in 1962. Primarily anchored by G. Gordon Hadley, M.D., dean emeritus of the School of Medicine, his involvement has included World Health Organization support and has provided faculty and consultation resources to Kabul Medical Institute and similar facilities in Afghanistan. Loma Linda’s involvement in Afghanistan ceased during the time that the Soviet Union invaded Afghanistan in the late 1970s and early 1980s. After the Afghan people defeated the Soviet Union, Afghanistan was taken over by the Taliban.

“Approximately six years ago, we were contacted by the Taliban government to see if we would once again come to Kabul to help strengthen the medical school. We responded to this request,” Hart says.

After Sept. 11, 2001, and the fall of the Taliban government, the new government of Afghanistan once again asked Loma Linda University to return and assist the redevelopment of medical education in Afghanistan. As part of Loma Linda’s renewed interest in Afghanistan, a new Loma Linda University Center was constructed at Kabul Medical Institute. The center consists of teaching laboratories, a medical library and a computer facility for students and faculty. Recently, 45 computers from Loma Linda have been installed in the computer laboratory that is networked by a system donated by Cisco Company Systems, Inc., of San Jose.

Currently, two Afghan teaching faculty are studying current teaching methods at Loma Linda, according to Hart. Three additional Afghan faculty members will arrive in Loma Linda in the next few months after the two current teachers return to Kabul.

“Tremendous challenges lie ahead,” Hart says. “We are pleased that Loma Linda can be a part of this effort to rebuild the health-care and medical education systems of Afghanistan.”