In response to Afghan government concerns, Gen. Stanley McChrystal, the commander of US troops in Afghanistan, issued a directive last July making the protection of civilian life a top priority during combat operations. The US effort to contain civilian casualties appears to be meeting with success, even though McChrystal issued an apology in late February for an air strike in Uruzgan Province that killed 21 civilians. Despite the US success in reducing collateral damage, Afghan doctors, including Sayed Omi Shayan, the head of orthopedics at a medical facility in the western city of Herat, still say the number of war-wounded civilians is rising.
Mirwais Hospital in Kandahar treats a large number of civilian casualties due to its location near Taliban strongholds. Concurring with Shayan's observations in Herat, doctors in Kandahar say they are seeing an alarming upsurge of wounded civilians coming through the hospitals doors, victims of air strikes, gunfire, and, increasingly, roadside bombs.
The International Committee of the Red Cross ICRC has been operating in Afghanistan since 1979, assisting the war-wounded rebuild their lives. Overall, the ICRC is now operating six facilities around Afghanistan, relying on a mostly Afghan staff totaling about 1,600.
In December of 2009 the ICRC registered 525 new patients, 93 of those being amputees. In addition to those with combat-related injuries, in particular land mine wounds, the ICRC is treating Afghans with special needs, including those suffering from club foot, cerebral palsy, spinal cord injuries and disabilities connected to polio and scoliosis.
For civilians who have lost limbs to war-related violence, the rehabilitation process is not merely a grueling physical experience. It involves an uphill mental battle too. Limbless Afghans are often viewed as unable to contribute to society, and many remain jobless and despondent.
The ICRC has developed a two-part system covering physical and social rehab. The program includes formal education, vocational training, micro-credit loans to assist the disabled in entrepreneurship, and a job center where rehabilitating individuals can explore employment opportunities in prosthetic friendly situations. The centers also hold classes for victims and families on how to cope with physical disabilities. The ICRC center in Herat center has even started up a wheelchair basketball league for men and women.