NOORIA MEHRABY worked as a doctor in Afghan refugee camps from 1987 to 1993. A refugee herself, her own experiences were intertwined with those of her patients. Last year she returned to the camps and found that life is not getting any easier for Afghan refugees.

In 1987 Afghanistan was experiencing many problems as a result of the Russian occupation. Internal security was virtually non-existent and the country’s infrastructure was deteriorating rapidly because of the widespread fighting. There were an increasing number of rocket attacks on Kabul, the capital, and food was becoming scarce. People had difficulty finding fuel for heating during winter and most parts of Kabul were without electricity.

As doctors, my husband and I were at risk of being targeted by the Communist regime. Many people from educated backgrounds were living in fear because the government wanted an ignorant population that it could easily control. Thousands of middle class, educated people were persecuted and imprisoned. My husband and I felt that the safest thing to do was to escape from Afghanistan as our lives would be endangered if we remained in the country.

I left with my mother and two young children. We took a bus from Kabul and set off for Peshawar in Pakistan, where we had organised to meet my husband. He had already escaped by himself the week before because if we had left together, as a family unit, our intention to escape would have been too obvious. My children were anxious about where he was and wondered why he wasn’t travelling with us.

During our escape, I wore a chaderi, which is a long piece of cloth that covers the entire body and face. My mother and children also had to wear traditional clothing. It was usual for us to wear Western-style clothing but on this occasion we wanted to be inconspicuous and blend in with the local people from the area we were travelling to.

Leaving was made all the more painful because I couldn’t say goodbye to any of my close friends and relatives. Doing so might have jeopardised our attempt at escape. In a climate of such fear and treachery, it was foolhardy to trust anyone.

We had given a lot of money to a smuggler who had promised to help us to escape to Peshawar. He arranged for us to travel by bus to Logar province and spend the first night there with his family.

The next day we walked for two hours and caught a lorry. It was over 40 degrees Celsius. The road was very rough and my head was constantly bumping on the roof. My four-year-old son kept asking why other people travelled by plane but we had to travel in a lorry. We travelled for a whole day and in the evening reached a place called Tera Mangle. We had run out of food and only had bread to eat and tea that we got from the local people. We slept in the parked lorry because there was nowhere else for women to stay.

In the morning we discovered that the smuggler had disappeared. He had told us he would send all our belongings in a separate lorry, so as not to arouse the suspicion of the authorities, but it never arrived. My jewelry and other precious things were in the lorry along with my documents, a book of poetry I had written and an address book. The loss of my poetry and address book was the hardest thing to cope with. Now, I had no means of contacting the friends and relatives I had been close with in Afghanistan.

We continued on to Peshawar in Pakistan where my brother was living. Peshawar is close to the border of Afghanistan and a large number of Afghan refugees live there, both in refugee camps and in residential areas in the city itself. Overall, there are about three million Afghan refugees who live in Pakistan.

At my brother’s place I was reunited with my husband. We stayed with my brother for three months and felt lucky to have him there because, by the time we had arrived, all of our belongings and most of our money was gone. However, the living conditions there were extremely difficult. My brother was already sharing his four-bedroom house with 26 relatives who had also escaped from Afghanistan.

After three months in Peshawar I found a job as a medical doctor in Shamshatow refugee camp. The refugee camp was two hours from Peshawar so I spent four hours travelling every day in the heat, wearing a hijab.

There was a huge demand for doctors at the refugee camp. I worked in an under-resourced health clinic with rudimentary supplies and medicine and saw about 60 patients a day. All my patients were women or children. A lot of women had lost their husbands, or male supporters, who were killed while fighting against the Russians. They felt a lot of anger over their losses and suffered many physical and psychological problems due to their poverty, dislocation and war-trauma. Their needs were so great that it was not possible to assist all of them at the clinic with our limited resources. It was a terrible, frustrating position to be in. It was hard to address their psychological problems because people were so overwhelmed with the basic tasks of survival.

I worked for two years in this situation. During the time I was working at Shamshatow refugee camp I had my third child. Forty days after her birth I had to return to work because of the huge demand.

After two years I got a job in another refugee camp which was only one hour from Peshawar. I kept on seeing patients and I also started teaching medical students at the women’s university in Peshawar. I was working six days a week with very long hours each day. I continued working in different refugee camps for the next four years and kept on working at the university as well.

In 1993 I arrived in Australia with my husband and three children. We had only a small support network of four people. Our experience was similar to that of most refugees. I was facing multiple losses: loss of extended family, identity, job, society and friends.

Due to misleading information, it was six months until I found out that there were free AMES English classes that I could attend. Gradually I found out about and attended other courses as well. After 16 months I got my first job, as a health educator, and have been working in Australia ever since.

In March 1998 I returned to Pakistan to visit my extended family in Peshawar. It was the first time I had seen them in five years. I stayed for a month and the time passed quickly. We stayed up late most nights talking about the things that had happened in the years we had spent apart. It was good to see them again

After two weeks my brother and cousin took me to see Naser Bagah refugee camp for newly arrived refugees from Afghanistan. Many educated, middle class families from Kabul were living there. In the past, when I worked at the refugee camps, most of the residents were from poorer rural areas.

There were about 75000 people living at Naser Bagah. They were given a small amount of money to build their own houses from clay. Those who had not yet built their houses lived in tents distributed by the United Nations.

The houses were very small with two to three rooms and small windows with plastic coverings rather than glass. A house this size would be shared by three families. Doors were considered a luxury so most people hung hessian sacks at the entrance to their homes. They had dirt floors and no furniture, just some cushions on the ground. Most people got their water from a communal well. The water was unclean and was a cause of much illness

The camp residents were forced to take up menial jobs to survive. Men frequently did construction and labouring work, cleaned shoes, or established stalls from where they sold fruit and other food products. Women made handicrafts which they sold in the city. People had no choice but to do this work as the cost of living in Pakistan is constantly increasing.

There was one school for the 15000 children living in Naser Bagah camp and it went to primary school level only. Girls were not allowed to attend. There were no chairs or tables so students had to sit on the ground.

There was one public health clinic. The other clinics were private and people could only go if they had money to pay the fees. The main health problems were infectious diseases such as diarrhoeal diseases and dehydration, respiratory infections, typhoid, and tuberculosis. Also common were malaria, kwashiorkor and anemia. Gastroenteritis and malnutrition were widespread and often caused death in children. Most deaths among children at the camp could have been prevented by immunization. Pregnancy-related deaths were common as babies were usually delivered at home by relatives.

The people looked lifeless. There was an 80-year-old woman  who was dying from stomach cancer and could not afford any medication. She was in constant pain. She had been living in a mud house with her daughters for two years. Her daughters previously worked as school teachers in Afghanistan.

The day-to-day life of residents at Naser Bagah was taken up with the basic tasks of survival. They cooked over an open fire and did whatever they could with the basic facilities available. Bread was baked in a tanoor (clay oven) which the residents had made themselves. Most of them couldn’t afford meat or any other proteins.

I was in tears after seeing children living in this situation. Many children played in the cemetery because they had nothing else to do. I saw other children dying of starvation. It broke my heart to see highly educated men and women unable to utilise their skills. I admired their strength and ability to survive.

My visit to Naser Bagah camp disturbed me more than my experiences in the various refugee camps five years ago. I couldn’t help but compare the situation and note how much worse it had got. The refugees of Naser Bagah have been on my mind ever since.

I talked to a repatriation officer from the UNHCR who was working with Afghan refugees in Pakistan. The UNHCR tried to repatriate some refugees but it was a difficult process. Most returned due to the continuing war in Afghanistan which endangered their lives. The people in Naser Bagah camp are living in limbo, waiting for the day when the situation stabilises in Afghanistan and they can return home.

In Afghanistan today, it is as if the 20^th century does not exist. The human rights situation is worse than it ever was, particularly for women. The prices of goods and services are grossly inflated and the people are cut off from the outside world with no television, radios, newspapers or music.

International support for Afghan refugees has been reduced dramatically in comparison to the first years of Russian occupation. A lot of hospitals and schools for Afghan refugees in Peshawar were closed because they lost their funding from various aid agencies. The remaining hospitals and schools began charging fees, which the refugees cannot afford.

When the Cold War came to an end the international focus moved elsewhere and Afghan refugees were no longer considered "refugees" but "displaced persons". This has made it difficult for them to be granted residency in other countries. Despite the worsening internal situation in Afghanistan, and the refugee camps in Pakistan, the international intake for Afghan refugees has been reduced. The widespread corruption in Pakistan only exacerbates matters for the refugees.

When the time came to return to Australia I had to go through the separation process all over again, just as I did five years before. I cried during the plane trip because I was so sad. At the same time I was overjoyed that I would soon be with my children and husband again after a long absence.

This is typical of the life of a refugee. With family scattered all over the world things will never be the same as before. The loss of extended family is one of the greatest losses of all.