The Afghan Patient

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Even missed bullets and missiles leave scars. Rage attacks, depression and infertility — photojournalist  Garima Jain captures the plight of Afghan medical tourists seeking solace in India

Waiting for a cure Afghans like Nangialani have more faith in Indian doctors
Waiting for a cure Afghans like Nangialani have more faith in Indian doctors

YALDA MUSAMEM, 18, studies law in Kabul. She’s had a lump in her breast for the past few months. Local doctors prescribed medicines that didn’t help. “I still have the pain,” she says. “The only way I’d get better was if I came to India for treatment. It’s not the cost, it’s that we don’t have confidence in treatment back home.” She’s now being treated at the Moolchand Hospital in New Delhi. She polishes her broken Hindi by watching Shah Rukh Khan movies.

Medical tourists come to India seeking state-of-the-art facilities available at low cost. Cardiac surgery costs Rs. 2.5 lakh in India and Rs. 25 lakh in the US; CT and MRI scans cost Rs. 5,000 here and about Rs. 1.35 lakh in the US. There’s little advanced medical technology, drugs and specialised staff in Afghanistan, even though treatment is cheaper, and India is often the only option for reliable medical treatment.

Ahmed is a lifelong Delhiite with an Afghani mother and Indian father. He exports stainless steel to Afghanistan; four months ago, he started a side business of an Afghani restaurant with an all Afghan staff of chef and waiters. Ahmed stresses how his customers, mostly Afghan medical tourists, often have high stress and suffer from mental problems, which come out in their behaviour. A client recently threatened a waiter, saying, “If this was Afghanistan, I would have slashed your neck.”

Wheels of painNangialani, 38, came to India with his brother for a kidney transplant. His treatment at Apollo Hospital cost Rs. 4 lakh; back home it would have been Rs. 2 lakh. Wringing his hands about the expense that he can’t afford, he explains in despair that he’s here because “I don’t have any faith in my country’s healthcare”. There’s time for loveYalda, 18, with her father Mir Aziz, who is undergoing physiotherapy for knee pain. She has a lump in her left breast that Afghan doctors couldn’t treat. They have found asylum at Rs. 1,200 per day in Delhi’s Lajpat Nagar — favoured by Afghan patients for its proximity to several well-known hospitals.

Adds Ahmed, “Of Afghans visiting India, nearly 60 percent come for treatment, 20 percent are graduate students, 10 percent are leisure tourists and remaining are business visitors.” Unlike other countries, Afghans applying for Indian visas don’t require medical insurance or financial statements; visas usually take about a week to process.

Most Afghan patients complain of headaches and stress. Many are soldiers suffering nerve injuries from bullets and missile shrapnel. Says a Ministry of Public Health statement from last year: “Recent surveys conducted by national and international organisations indicate that 66 percent of all Afghans are suffering from stress disorders and mental problems.” Anup Kohli at Delhi’s Apollo Hospital adds, “In the past year I’ve checked around 1,000 Afghans for mental illnesses. I find three common problems: rage attacks, non-epileptic seizures and manic depression.” Gynaecologist Helai Gupta at Delhi’s Spring Meadows Hospital has been treating Afghan couples for infertility for a decade. Gupta, who was educated in Kabul and speaks Persian, says decades of war and stress have led to hormonal disturbances and fertility problems. In most cases, it’s the men who are infertile (and are astonished to find this).

Many Afghans borrow from relatives or muddle through expenses. Dhiraj, who owns Suraj Chemist in Delhi, observes, “The sales of medicines per day to Afghans are about a Rs. 1 lakh. I offer special discount of 10 percent to them and earn a profit of Rs. 5,000.”

Wait a little longerSisters Nabilah, 28, and Afshan, 26, (names changed) are being treated for infertility. They recently underwent laparoscopy surgery at Moolchand Hospital in New Delhi. Their husbands objected strongly to the sisters being photographed. Reason? Infertility is taboo in Afghan society. The cost of everythingMost chemist stores in Delhi’s Lajpat Nagar Central Market offer special discount to Afghan patients. Dhiraj, a shopowner, explains, “They buy a full year’s supply of medicines at one go and return the next year for more.”

Cultural affinities help. Afghans are huge fans of Indian television and cinema. Musamem wants to stay back in India and continue her law studies here. She’s been to a Delhi palmist asking after her health and love life and is trying to seek admission in Delhi University. “I love the life here,” she says. “I’ve always dreamt of going to McDonalds, but we don’t have them in Afghanistan.”

garimaj@gmail.com

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