MELISSA BLOCK, host:
In Afghanistan, U.S. troops spend a lot of time trying to help Afghans. They build schools, they build roads, they host medical clinics for people living in remote areas who otherwise wouldn't get care. But the Americans' good intentions can go awry, sometimes with potentially fatal results - such as this case of a six-year-old Afghan girl.
NPR's Soraya Sarhaddi Nelson spent time with the girl and her family in Kabul.
(Soundbite of child crying)
SORAYA SARHADDI NELSON: Beeping monitors and strangers in this Intensive Care Unit frightened Adila. A few wails are all she can muster. He dark eyes close. She falls asleep, exhausted from her outburst. Adila struggles to breathe even with an oxygen mask. Her Pashtun name is a variation of the Arabic word for just. Yet what is happening to Adila seems anything but just. On this night, doctors are trying to stabilize her after she showed up for a heart test. Her lips were blue from a lack of oxygen.
Adila suffers from a birth defect called Tetralogy of Fallot. Parts of her heart are malformed and can't get enough oxygen to her tiny body.
(Soundbite of medical equipment)
SARHADDI NELSON: She's six years old but looks more like three. Doctor Amena Shaheer, who heads the ICU here at the French Medical Institute for Children, says the girl is in bad shape but there is little they can do for her here.
(Soundbite of child crying)
SARHADDI NELSON: What does she need to survive?
Doctor AMENA SHAHEER (ICU Head, French Medical Institute for Children): She needs surgery, immediate emergency surgery.
NELSON: An American army doctor who reviewed Adila's case made a similar diagnosis. He wasn't available for an interview. Relatives and Afghan officials say she was taken by her family to Camp Blessing, an American outpost in wartorn Kunar province in northeastern Afghanistan. There, the army doctor hatched the plan to have Adila evaluated in neighboring Pakistan. If doctors there deemed her a suitable candidate, he would ask a charity called Save a Child's Heart to send Adila to Israel for corrective surgery.
The military told Adila's family that all they needed to do was to get her a passport and make the trip to Kabul. That's no easy task for an impoverished family without documents - and who rarely leave their remote village. But with Afghan official's help, Adila got her passport in one day. American soldiers nearby at the Kunar PRT or Provincial Reconstruction Team, dug into their pockets for the $70 cab fare.
Last Tuesday, Adila and her guardians set off by taxi for Kabul. And that's when the American plan fell apart.
Mr. TALIB (Adila's Uncle): (Speaking in foreign language)
NELSON: Adila's guardian, an uncle named Talib, says by the time they got to Kabul, the girl was dehydrated and blue from lack of oxygen. But no hospital was aware of Adila's arrival, let alone her case. The army doctor who made the plans had left the country. The people he asked to follow up her case in his absence failed to do so.
So in a mad scramble, the Kunar PRT told Adila and her uncle to go to the CURE hospital in Kabul, run by a Pennsylvania-based charity group. Eric Sinclair, chief operating officer of the hospital, agreed to admit Adila and stabilize her. He is bothered by how the military handled her case.
Dr. ERIC SINCLAIR (CEO, CURE International Hospital): I applaud the work that they are doing here in behalf of the community, but in this case, they've dropped the red-hot potato, so to speak.
NELSON: Major Nick Sternberg, an American military spokesman, called it a miscommunication.
Major NICK STERNBERG ( Brigade Public Affairs Officer, Task Force Bayonet): Based on the fact that we've helped so many people in the past, locals often expect that once a problem has been given to us, it'll be taken care of immediately and completely.
NELSON: With the help of CURE hospital, Adila was sent across town to the French Medical Institute for Children where she could get the tests she needs. The half-hour trip sent the girl crashing again. She wound up in the ICU at the French hospital. Her condition improved and she was moved to a regular room, where she remains. But doctors say Adila is running out of time.
Officials at the CURE and French hospital say they've repeatedly asked the Americans what they plan to do. Both charity hospitals say they are in no position to pay for Adila's treatment, let alone the surgery. They say she needs to be flown to Karachi in Pakistan where the surgery can be done quickly.
Major Sternberg says soldiers again reached into their pockets to pay for her care at the French hospital to date. Sinclair says, he waived his hospital's costs. But the main obstacle is still money for the surgery. The medical officials in Kabul say it should come from the military which sent Adila here in the first place. Major Sternberg says they can't, under their rules, spend military funds on her surgery. But he says the army has located an anonymous donor, willing to pay for it. How Adila will get to Karachi, though, is still unclear.
Soraya Sarhaddi Nelson, NPR News, Kabul.
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