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Innovation In a War-Torn Land

Capt. Demere Kasper, a 2010 graduate of the second-degree BSN program, has been serving as a military intelligence officer in the U.S. Army since 2004. This role has taken her to Iraq, Qatar, and currently to Afghanistan, where she is teaching local people the basics of healthcare.

Kasper is stationed 90 miles northeast of Kandahar City, in the Mya Neshin district, as a member of a program called the Cultural Support Team, or CST. CSTs are female helpers for Special Operation forces (SOF), who are often deployed in remote locations assisting with village stability and security. In this role, Kasper provides access to the other half of the population that male SOF members cannot engage with due to Afghan cultural norms. 

Until recently, healthcare in Mya Neshin revolved around a privately owned, Government of the Islamic Republic of Afghanistan (GIRoA) run, clinic in a valley nearby. The clinic was staffed by a doctor from Jalalabad, a nurse from the Uruzgon province, and two pharmacists. Because of multiple complaints from villagers and the lack of time spent at the clinic, the doctor was fired. Throughout her tenure in Mya Neshin, Kasper and her CST partner had been working to build an official GIRoA clinic adjacent to the Mya Neshin District Center to provide healthcare access to more of the district population. On June 1, their perseverance paid off as the Mya Neshin Comprehensive Health Center opened, with provincial officials attending the ceremony.  The comprehensive Health Center now sees approximately 25 patients a day, and continues to grow. 

Since the start of her deployment, Kasper has been endorsing and lobbying for a program called Community Health Workers (CHW) which trains local men and women to act as health educators, first responders, and perform limited checkups within their villages. 

 

Outreach to villagers in Mya Neshin has been done through radio messages created by Kasper and her partner… 15 episodes focus on common maladies and infectious diseases in Afghanistan as well as basic nutrition, hydration, and hygiene.

U.S Army Capt. Demere Kasper, GNu’10, treats patients in AfghanistanU.S Army Capt. Demere Kasper, GNu’10, treats patients in Afghanistan

Since the Taliban movement started in Kandahar province, there is still a strong adherence to the standards exacted under the name of Islam during its rule in many districts, including the Mya Neshin district. Many of the Afghans in the district believe it is wrong for a male doctor to perform any exam on a female patient, other than blood pressure, and believe women cannot fully disclosure the nature of their problems to male doctors, or even to their husbands. 

“Community health workers are important for several reason - they are given emergency birth training, and prenatal and infant training, which increases the local capacity for maternal and infant health as most women give birth in their home with the aid of their mother,” said Capt. Kasper. “They are supposed to provide education and limited checkups within their villages and it’s important that couples volunteer for CHW training, so at least a partially trained woman can provide some sort of healthcare and education to other women.”      

During her time in Mya Neshin, Capt. Kasper has worked in what is known as the “med-shed,” treating Afghans who seek medical care. Supplies are limited, there is virtually no lab work capability, and instruments that are disposable in the united States must be re-used because resupplies don’t happen often. One of her main tasks is educating locals on medication compliance and acceptable treatments. 

“You cannot write down instructions either, as the majority of the population in this district is illiterate. If you find nothing wrong with the patient, they are often very disappointed. For example, Afghans want high blood pressure, because then they receive medication,” said Kasper. “They also believe that IVs cure almost everything. So do injections - we have one recurrent patient who received and injection of Tordol and told us that the medicine is so good that it lasts a whole month, so now he comes monthly for his injection.” 

Outreach to villagers in Mya Neshin has been done through radio messages, since it is the only form of entertainment in the district. Along with her partner, Capt. Kasper has created 15 episodes that focus on common maladies and infectious diseases in Afghanistan as well as basic nutrition, hydration, and hygiene. The radio spots also provide an opportunity to advertise to sign up for the Community Health Workers program. The series has been
requested by teams in other districts, and the Provincial Minister of Public Health has requested copies to air in Kandahar City.