Healthcare Access to the Poor in Afghanistan

by French Medical Institute for Mothers and Children
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Healthcare Access to the Poor in Afghanistan
Healthcare Access to the Poor in Afghanistan
Healthcare Access to the Poor in Afghanistan
Healthcare Access to the Poor in Afghanistan
Healthcare Access to the Poor in Afghanistan
Healthcare Access to the Poor in Afghanistan
Healthcare Access to the Poor in Afghanistan
Healthcare Access to the Poor in Afghanistan
Healthcare Access to the Poor in Afghanistan
Healthcare Access to the Poor in Afghanistan
Healthcare Access to the Poor in Afghanistan
Healthcare Access to the Poor in Afghanistan
Healthcare Access to the Poor in Afghanistan
Healthcare Access to the Poor in Afghanistan
Healthcare Access to the Poor in Afghanistan
Healthcare Access to the Poor in Afghanistan
Healthcare Access to the Poor in Afghanistan
Healthcare Access to the Poor in Afghanistan
Healthcare Access to the Poor in Afghanistan
Healthcare Access to the Poor in Afghanistan
Healthcare Access to the Poor in Afghanistan
Healthcare Access to the Poor in Afghanistan
Healthcare Access to the Poor in Afghanistan
Healthcare Access to the Poor in Afghanistan
Healthcare Access to the Poor in Afghanistan

Provision of Quality Healthcare Services to the Poor

 

According to the World Bank estimates, over 2/3rd of the Afghanistan population live under poverty line. There is no social health insurance and more than 76% of the healthcare expenses are paid by families’ out-of-pocket. An estimated 6 million people have no access, or insufficient access to healthcare due to unavailability of the public health services or unaffordability of costly private health services.

 

For the past 15 years, FMIC has been serving Afghans regardless of their abilities to pay while focusing on quality services, innovation, and excellence. FMIC's Patient Welfare Program covers a part or the full cost of the treatment of the patients whose family income is less than US$ 200 a month. This program enables people with no or less financial resources to avail high quality in-patient and out-patient medical and surgical services. In other words, FMIC ensures that no patient leaves the hospital untreated due to lack of money. FMIC’s Patient Welfare Program has been in place since the establishment of the hospital and has helped over 600,000 needy patients with services worth over $41 million.

 

For many patients, even a $10 expense is an obstacle to healthcare. Imagine that just a few dollars you contribute can help save a life. A donation of $10 will pay for an initial visit to a doctor, $15 will pay for one-night stay of a patient in general ward, $65 will pay for one night stay of a patient in the Intensive Care Unit (ICU). 

 

Ileal Conduit Urinary Diversion-Another First -Time -Surgery in Afghanistan

 

Abubakr (3) lives in Kapisa, a province in the central part of Afghanistan. When he was a one-month-old baby, doctors observed a rare disease of bladder exstrophy. In this disease, the bladder is open and exposed on the outside of the abdomen. This disease was an anguish for the whole family since many of the doctors told them that it was not possible to treat him in Afghanistan. Unfortunately, Abubakr’s family was too poor to take him abroad to seek a treatment.

Considering the lack of family’s financial resources, the provincial hospital of Kapisa referred Abubakr tola Chaine de l’Espoir located in Kabul through which Abubakr’s family visited Dr. Homayoon Ghairatmal, the paediatric surgeon at FMIC.

Thankfully, FMIC is a safe haven for patients across Afghanistan. The protective measures were applied accurately and the infection control team was trying their best to save the patients. When little Abubakr visited FMIC paediatric surgeons, he was in a critical condition and his father was losing his hope.

After a complete checkup, it was confirmed that little Abubakr was suffering from a rare disease called “Bladder Exstrophy” in which the lower part of abdomen wall is not formed as a result, the urinary bladder is out of abdomen and it’s not formed normally and if the patient is not treated, the prognosis will be kidney failure or cancer.

The surgery team made their final decision to conduct a surgery for the first time in paediatric surgery of Afghanistan, an “ileal conduit urinary diversion”. Of course a multi-disciplinary team including nurses, anesthetists’ and surgeons was formed to avoid errors.  In this surgery, the ureters (the tubes that carry urine from the kidneys to the bladder) drain freely into part of the ileum (the last segment of the small intestine). The end of the ileum into which the ureters drain was then brought out through an opening in the abdominal wall. Within few days, Abubakr was getting recovery fast and convincing.

In the follow-up visits, in early 2021, Abubakr was a normal kid playing with his parents without any suffering. According to Abubakr’s father, “it was impossible for me to travel abroad and there wasn’t any chance of healing to my son, but FMIC was here to help me”.

His treatment was done free of cost at FMIC, the family of the boy was happy and satisfied they were amazed by having such a hospital in this country.

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Angela Photo
Angela Photo

FMIC ensures that cost should not build hurdle for families who needs medical care. Thus makes healthcare accessible for the needy people in Afghanistan.  FMIC patient welfare program helps the poor patients for their healthcare when they are unable to pay for their treatment. With the current growing demand each year, the hospital is in dire needs and support to continue this life-saving endeavor.

The French Medical Institute for Mothers and Children is the product of a unique four-way partnership that includes the Governments of Afghanistan and France, the Aga Khan University (an agency of the Aga Khan Development Network), and the French humanitarian organization La Chaîne de l’Espoir.

FMIC has so far served over 1.6 million patients from all over Afghanistan through its in-patient and out-patient services. In diagnostics, 4.6 million Laboratory tests and 0.8 Million Radiology procedures have been performed thus far. FMIC’s Patient Welfare Programme underwrites the cost of care for people who cannot afford to pay for all or part of their treatment.  Since FMIC’s inception in 2006 to date FMIC’s Patient Welfare Program has spent over $40 million so far in providing the medical and surgical care to those in critical need.


We are highly grateful to the generosity of our donors for their support to the patient welfare which ultimately helps us serve the most deserving and deprived segments of the society.

On a daily basis, FMIC ensures that no patient leaves the hospital untreated because of lack of money. For many patients, even a $10 expense is an obstacle to healthcare. Envision a child or mother suffering from life-threatening diseases in an impoverished and war-affected zone. Imagine that just a few dollars contributed by you can help save lives and improve quality of life for many. For example, $10 will pay for an initial visit to a doctor, $15 will pay for one-night stay of a patient in general ward, $65 will pay for one night stay of a patient in the Intensive Care Unit.  We do appreciate your continued support and cooperation!  

 

Angela can play with her toys now– Nerve transfer performed for the first time in Afghanistan

Angela can play with her toys now– Nerve transfer performed for the first time in Afghanistan.

 Angela’s parents were delighted as they were expecting a baby in early 2019. They had bundles of hope and plans for the new addition to their family. Likewise, Angela’s grandfather was super excited and dreamt of her granddaughter becoming a doctor. All those dreams and hopes were badly shattered upon the birth of the baby when the family discovered that Angela had nerve disorder in her upper limb. She was suffering from weakness and motion disorder in her right upper limb. Her parents took this 3-month baby to a local hospital in their native province – Baghlan. The hospital referred her to La Chaine de l’Espoir (One of FMIC’s partners) in Kabul for the financial assistant to her treatment in Kabul.

The LaChaine office referred Angela to FMIC for treatment. Based on the diagnosis, Angela was found suffering from brachial plexus birth palsy in which paralysis or weakness of the upper limb was present.

Angela was unable to elevate her right shoulder and flex her right elbow. Initially, she went through a process of physiotherapy but the result was not convincing and the doctors at FMIC opted for a surgical approach. In this operation, a nerve transfer was performed for the first time in Afghanistan. After the operation done by, orthopedic surgeon at FMIC, the casting was applied for 6 months. In the first follow-up of Angela, she was able to move her hand and arm.

The next stage of the treatment includes physiotherapy for almost three years. It is really heartening that Angela is improving fast. Her smiles bring a spark of hope and her family gets excited each time she holds her toys.

 

https://www.fmic.org.af/Pages/Home.aspx
Link to FMIC website - Patient Welfare Programme
FMIC Website - Home Page
FMIC Annual Reports
FMIC Patient Welfare Program- A ray of hope!

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The French Medical Institute for Mothers and Children is the product of a unique four-party international partnership that includes the Governments of Afghanistan and France, the Aga Khan University (an agency of the Aga Khan Development Network), and the French humanitarian organization La Chaîne de l’Espoir.


FMIC has so far served over 1.5 million patients from all parts of Afghanistan through its in-patient and out-patient services. In diagnostics, 4.3 million Laboratory Tests and 0.8 Million Radiology Procedures have been performed thus far. FMIC’s Patient Welfare Programme underwrites the cost of care for people who cannot afford to pay for all or part of their treatment.  Since FMIC’s inception in 2006 to date FMIC’s Patient Welfare Program has spent over $39 million so far in providing the medical and surgical care to those in critical need.
We are highly grateful to the generosity of our donors for their support to the patient welfare which ultimately helps us serve the most deserving and deprived segments of the society. 

There are numerous stories of our patients who have benefited from the world class services of FMIC at their doorstep. One of such stories is that of Natasha (Pseudonym). Natasha was 14 when she began to experience stomach pain and fainting spells. Her parents took her to several hospitals, but to no avail. They were on the verge of taking her abroad for treatment when friends advised them to visit FMIC. There, doctors diagnosed Natasha with a large cystic mass in her abdomen. A day after FMIC’s paediatric surgeons removed the 5 kg (11 lb) mass from Natasha’s stomach, she was discharged from the hospital and returned home. She is now in good health and excited to attend school again. Natasha is just one of the many Afghans whom FMIC has saved from the trouble, stress and expense of seeking treatment abroad.

On a daily basis, FMIC ensures that no patient leaves the hospital untreated because of lack of money. For many patients, even a $10 expense is an obstacle to healthcare. Envision a child or mother suffering from life-threatening diseases in an impoverished and war-affected zone. Imagine that just a few dollars contributed by you can help save lives and improve quality of life for many. For example, $10 will pay for an initial visit to a doctor, $15 will pay for one-night stay of a patient in general ward, $65 will pay for one night stay of a patient in the Intensive Care Unit.  We do appreciate your continued support and cooperation!  

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FMIC remains safe haven for patients during Covid
FMIC remains safe haven for patients during Covid

Greetings from FMIC- Kabul, Afghanistan,

While working in fragmented and fragile situation, challenges are always enormous. Further exacerbated by Covid-19 pandemic; the circumstances in Afghanistan are more peculiar and unprecedented. Healthcare system in Afghanistan is already fragile and its capacity to deal with a pandemic of this scale is very limited. At this point in time, people are faced with more challenges when it comes to tertiary healthcare. As ever before, FMIC stands as a ray of hope and safe haven for patients coming from different provinces of Afghanistan. Due to the lockdown situation, a number of patients have found it hard to access the hospital, however in a desperate situation FMIC remains a hospital of choice owing to its state of art technology, highly qualified doctors and dedicated healthcare professionals.

In May 2020, a gut-wrenching terrorist attack left huge scars on the heart of anyone who believes in humanity. A women’s’ ward in a Kabul hospital was brutally attacked. Mothers and newly born babies either died or were left stranded. An 11-hours old baby-girl was rushed to FMIC immediately after the attack when her mother was shot dead in the same heinous attack.

The baby was brought to FMIC emergency room. She was taken under immediate management by ER medical and nursing staff. The baby was in a state of complete shock, suffering from pain and very agitated status. Within no time orthopedic and cardiovascular teams were immediately called for the multidisciplinary approach, and management.

On clinical exam she was found with an ischemic leg with motor lesions of bones and muscles as well as three huge open gunshot lesions with huge loss of muscular and skin tissues. She was immediately admitted in NICU for further investigation and exams. The X ray showed multiple, complex and open fractures of right femur, tibia and fibulae. The arteries and veins were verified and exposed: small lesions seen, homeostasis done and the conservative treatment started to keep her leg safe.

In the morning after a wide discussion with radiology, orthopaedic, anaesthesia, neonate ICU, nursing and cardiovascular team, she was taken to OT for a detailed and deep investigation under general anaesthesia. The vascular pockets were investigated from the femoral arteries up to end popliteal zone, together with venous system, and open homeostasis done, lavage and cleaning, with primary debridement performed.

She got normal blood stream in arterial and venous systems with good saturation in the right toes after surgery. She tolerated the surgery very well without any complications. The fractures have been fixed with splint and will be treated as the inflammation of the revascularization would be subsidized. The vital signs are normal and she was fed with one big baby-bottle milk now. She is now getting better day by day. This is a unique management of its kind from surgical standpoint, but most importantly it has a humane and emotional dimension to it, which is so heartening. Her mother was killed nearby her with multiple gun shots on the chest and face, unfortunately. She survived and will become the strongest lady- FMIC team believes! She was rescued and named in FMIC. Her name is Bibi Amina and she is our shining star. Here is the link to her story and how the global community overwhelmingly reacted in favour of this brave girl while praising the great work of FMIC. While she is in safe hands for her treatment, the FMIC Patient Welfare Department takes care of her treatment cost with the help of generous and philanthropist donors. Here is the link to Amena’ Story

Another heartening story is that of Modasir (7 years) an energetic and happy child who lives in Kabul with his parents and siblings. He is an enthusiastic football player and a big dreamer. Modasir loves to socialise with his friends. But during this COVID-19 pandemic, he was not allowed to go outside. So his only option was to play on the roof of the building where he resides. Accidents happen and one day, losing his balance, he fell off the rooftop. He survived the fall – his family found him alive but unconscious, with severe head injuries. The hospital nearby refused to treat him as his condition was so serious. As a last resort, Modasir’s family decided to visit FMIC hoping for a miracle. Dr Homayoon Atiq Ghairatmal, a highly specialised paediatric surgeon at FMIC examined Modasir and immediately recommended an MRI. The report showed an intracranial hematoma, a collection of blood within the skull, that was putting pressure on the brain. The decision was to operate and perform a life-saving procedure, decompressive hemi-craniectomy, used for traumatic brain injuries.

Scrubbed and ready, Dr Homayoon, assisted by Dr Yalda, Dr Haseeb and Dr Rashad, removed part of his skull to relieve the pressure on the brain. But even after cleaning out the hematoma and washing the right side of the brain, Modasir was still in a coma. The blood clots continued to be visible with severe swelling on the left side of the brain. So the same procedure was repeated on the left side of the skull. It took Dr Homayoon and his team three sessions to complete the delicate operation. Nursed carefully, 15 days later Modasir opened his eyes to the pleasant surprise and jubilation of his family as well as his doctors. This complicated procedure is rare in Afghanistan but FMIC continues to keep to its tradition of going beyond the call of duty to save precious lives in highly volatile and unpredictable situations. Modasir’s delighted father, an employee of the Wulesi Jirga, Parliament, shared the news of his son’s recovery at work – leading the Parliament to present Dr Homayoon with a certificate of appreciation for this extraordinary performance. Modasir can now walk and talk normally and regularly visits FMIC for follow-up appointments. Details of Modasir’s story can be found here.

Despite many challenges, FMIC has achieved remarkable success over the past 14 years. In 2009, it became the first hospital in Afghanistan to be ISO certified whereas the first open heart surgery was performed by indigenous doctors at FMIC in 2010. Since 2011 it has annually sponsored an international scientific conference as well as a quality and patient safety convention, both of which showcase Afghan health professionals’ high capacity for critical thinking. The Post Graduate Medical Education Program (PGME) is a flagship program of FMIC established in 2012, with the support of the Aga Khan University (AKU) and Ministry of Public Health (MoPH). The programme has so far graduated 45 physician specialists whereas 39 are currently enrolled in three to five-year programmes in eight disciplines. Five of those programmes – such as anaesthesiology, cardiac surgery, cardiology, pathology and radiology – are not offered anywhere else in Afghanistan. Moreover, healthcare access to patients in remotest areas for tele-consultation and training of human resources has been ensured through eHealth program since 2007.

FMIC has so far served over 1.39 million patients from all parts of Afghanistan through its in-patient and out-patient services. In diagnostics, 4.1 million Laboratory Tests and 0.73 Million Radiology Procedures have been performed thus far. FMIC’s Patient Welfare Programme underwrites the cost of care for people who cannot afford to pay for all or part of their treatment. During the year 2019 alone, 42,598 patients were supported through patient welfare program with a financial contribution of US$ 2.3M by FMIC. Since FMIC’s inception in 2006 to date FMIC’s Patient Welfare Program has spent over $39 million so far in providing the medical and surgical care to those in critical need.

We are highly grateful to the generosity of our donors for their support to the patient welfare which ultimately helps us serve the most deserving and deprived segments of the society. FMIC has recently initiated cytogenetic tests in Afghanistan for the first time. This is yet another ray of hope for the people of Afghanistan as many patients lose their lives due to lack of diagnosis for cancer patients.

Envision a child or mother suffering from life-threatening diseases in an impoverished and war-affected zone. Imagine that just a few dollars contributed by you can help save lives and improve quality of life for many. For example, $10 will pay for an initial visit to a doctor, $15 will pay for one-night stay of a patient in general ward, $65 will pay for one night stay of a patient in the Intensive Care Unit.  We do appreciate your continued support and cooperation!  

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Greetings from Kabul, Afghanistan

FMIC started its operations in a volatile situation when security condition was deteriorating while accessing a modest tertiary healthcare facility was a tall order for the Afghans. There was serious lack of human resources in various specialties hence the Afghans highly depended upon medical tourism abroad. In such circumstances the presence of FMIC was no less than a miracle. For the last 14 years, FMIC has been catering to the healthcare needs of Afghanistan with a vibrant vision, “to be a leading institute of excellence and innovation in healthcare, research and education, providing exemplary, safe, comprehensive, accessible and sustainable services to Afghanistan and surrounding regions, while positively impacting the lives of patients and all others Whom it serves.”

Despite many challenges, FMIC has achieved remarkable success over the past 14 years. In 2009, it became the first hospital in Afghanistan to be ISO certified whereas the first open heart surgery was performed by indigenous doctors at FMIC in 2010. Since 2011 it has annually sponsored an international scientific conference as well as a quality and patient safety convention, both of which showcase Afghan health professionals’ high capacity for critical thinking. The Post Graduate Medical Education Program (PGME) is a flagship program of FMIC established in 2012, with the support of the Aga Khan University (AKU) and Ministry of Public Health (MoPH). The programme has so far graduated 45 physician specialists whereas 39 are currently enrolled in three to five-year programmes in eight disciplines. Five of those programmes – such as anaesthesiology, cardiac surgery, cardiology, pathology and radiology – are not offered anywhere else in Afghanistan. Moreover, healtcare access to patients in remotest areas for tele-consultation and training of human resources has been ensured through eHealth program since 2007.

FMIC has so far served over 1.39 million patients from all parts of Afghanistan through its in-patient and out-patient services. In diagnostics, 4.1 million Laboratory Tests and 0.73 Million Radiology Procedures have been performed thus far.

FMIC’s Patient Welfare Programme underwrites the cost of care for people who cannot afford to pay for all or part of their treatment. During the year 2019 alone, 42,598 patients were supported through patient welfare program with a financial contribution of US$ 2.3M by FMIC. 

Since FMIC’s inception in 2006 to 2019; a total of 547,116 patients, from all 34 provinces of Afghanistan have been supported  with patient welfare funds of which 493,961 were outpatient (clinics, radiology and laboratory) whereas, 53,155 were inpatient. As a whole, FMIC’s Patient Welfare Program has spent $38.9 million so far in providing the medical and surgical care to those in critical need.

We are highly grateful to the genrosity of our donors for their support to the patient welfare which ultimately helps us serve the most deserving and deprived segements of the society. 

Envision a child or mother suffering from life-threatening diseases in an impoverished and war-affected zone. Imagine that just a few dollars contributed by you can help save lives and improve quality of life for many. For example, $10 will pay for an initial visit to a doctor, $15 will pay for one-night stay of a patient in general ward, $65 will pay for one night stay of a patient in the Intensive Care Unit.  We do appreciate your continued support and cooperation!  

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Organization Information

French Medical Institute for Mothers and Children

Location: Kabul - Afghanistan
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Twitter: @FMICKabul
Project Leader:
Sultan Ahmed
Kabul, Afghanistan
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