The hospitals here are somewhat loose about utilization. Many patients are admitted for reasons we would not admit in the US. Many stay far longer than needed. Some patients just come and go. One soldier decided to leave against medical advice one day. The next day, we saw he was back; he was in his fatigues; he was lying on top of the sheets but shrouded in a blanket. Reason? He was tired of being in the hospital and left, but his barracks was too cold so he came back in the middle of the night and crawled onto an available bed!
A visiting Navy pharmacist related his first visit to the national military hospital in Kabul. The doors to the operating rooms were propped open and he could see a surgeon stitching up a hernia repair with a cigarette dangling from his lip.
Most of our admissions here are injuries so I dutifully asked about tetanus vaccine. One doc chuckled and talked about how tough Afghans are and immune to tetanus naturally. Apparently, the standard treatment for scrapes and cuts in children is rubbing a handful of the dry dirt into the wound to stop the bleeding. That's where the tetanus spores are so that's how they become immune. The old saying is literally true: "If it doesn't kill you, it makes you stronger".
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