According to the United Nations, Afghanistan has the second highest maternal mortality rate in the world and the third highest rate of child mortality, while only 23 percent of the population has access to safe drinking water.
Abject poverty also makes it impossible for families to seek care for their children. Some 9 million Afghans, or 36 percent, live in absolute poverty, while 37 percent live only slightly above the poverty line, according to the U.N.
With many children malnourished and infected with intestinal roundworm, wounds take longer to heal or heal improperly, said Klimo, who until July was with the 88th Medical Group at Wright-Patterson Air Force Base in Ohio. He wrote about his experiences in the August issue of the Journal of Neurosurgery: Pediatrics.
While stationed at Bagram, Klimo's patients included families who came with their sick children by bus or taxi, who'd had their cars shot at in Taliban-held territory, and who kept their destination a secret to avoid problems, he said.
Over the course of two years, Klimo and the medical team at Bagram performed nearly 300 neurosurgeries, including 57 operations on 43 children. About 54 percent of the surgeries were for battle-related traumas and the rest were for humanitarian reasons, or conditions unrelated to the fighting.
At times, the doctors had to make tough choices, including turning away patients they would have been able to help in the United States, Klimo said. While they had an X-ray and CT scan, they didn't have an MRI or other neurological equipment that neurosurgeons would have in a stateside operating room, Klimo said.
"You're not back home. You don't have all the equipment and all the personnel, especially in neurosurgery where we rely heavily on a lot of special equipment," he said.
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