US medicines for Afghan soldiers disappear

[December 23, 2010]  KABUL, Afghanistan (AP) -- U.S.-donated medicines and pharmaceutical supplies meant to keep the new Afghan army and police healthy have been disappearing before reaching Afghan military hospitals and clinics, and the government said it is removing the army's top medical officer from his post as part of an investigation into alleged corruption.

Afghan Defense Minister Gen. Abdul Rahim Wardak told The Associated Press that Surgeon General Ahmad Zia Yaftali was being removed from his post as part of the inquiry. Three officials from the country's top medical facility, Dawood National Military Hospital in Kabul, have been fired, he said.

It's unclear just how much has gone missing of the $42 million worth of medical goods the U.S. has donated this year, and whether any Afghan soldiers have died as a result. U.S. officials say they do not account for the supplies after delivering them to the Afghans.

The Americans have repeatedly urged Afghan President Hamid Karzai to root out government corruption to show that his administration can be a true partner in re-establishing control over the country. However, many anti-corruption campaigns have stalled. And last summer, Karzai blocked an investigation into high-level aides supposedly accepting bribes.

Embezzlement of army funds, if proven, would be particularly worrying because the rapidly expanding military is seen as key to the NATO exit strategy. The U.S. is focused on training Afghans so they can take over authority for securing the country in 2014.

A U.S. military official said that American-supplied medicines, along with additional donated funds, should have been enough for the entire Afghan army. The official spoke on condition of anonymity because he said any announcement should come from the Afghan government.

However, Afghan army units around the country complain of shortages of medicines, including morphine and antibiotics. Officials say patients at Dawood Hospital often go without adequate medicine, don't get their dressings changed and are left unattended by doctors who skip rounds to work at private clinics.

Expensive equipment also has disappeared, an Afghan army official familiar with the investigation said. In at least one case, diagnostic machines meant for the army have ended up in private clinics in Kabul, said the official, who spoke anonymously because he was not authorized to talk to reporters.

Nasar Ahmad Rahimi, the director of an army clinic in Kabul, said the Afghan army health department delivers far fewer types of medicine and in far smaller quantities than he requests for his clinic, which sees some 200 patients a day.

"We request about 120 different kinds of medicines, but at the end we get something like 30," he said. His clinic hasn't had metronidazole -- a key antibiotic for treating gastrointestinal infections -- for two months despite repeated requests.

So he rations. A patient who normally should get a course of four drugs gets three instead, or the period of treatment is shortened, Rahimi said. He has set aside a stock of lifesaving drugs for emergencies that he said he sometimes replenishes out of his own pocket.

"Shortages of medicine are not only a problem in this clinic, but throughout the entire army," he said. In other parts of the country, commanders say soldiers often buy medicine in the local market.

Rahimi showed off an X-ray machine that cannot be used because its battery is broken and a lab full of modern equipment where his staff cannot do blood tests because of missing chemicals.

"If a patient comes here with a high fever we just guess what medicine we should give him," he said.

American provisions of medicines for the Afghan army have kept pace with the growth from 70,000 soldiers in 2008 to 147,000 today, said Col. Schuyler Geller, commander of a U.S. medical training advisory group for Afghan forces. But, he said, poor tracking once the supplies are given to the Afghan army makes it hard to know where it has all gone.

Geller said it is "very likely" that the drugs are being sold on the side.

The U.S. donated $42 million worth of medicines and pharmaceutical supplies in 2010, according to Maj. Richard Zavadil, who oversees medical contracting logistics for U.S. forces training the Afghan army. The medicines are accounted for up to the point they are turned over to Afghan regional supply depots, he said. Zavadil and Geller would not comment on the investigations into Yaftali, the top medical officer in the Afghan military.

Wardak told The Associated Press that Yaftali has been removed from his job because of accusations that he neglected his duties to protect Dawood Hospital. He said Yaftali also was under a ministry investigation on a broader accusation of embezzling funds or medicines meant for soldiers, and that this was also part of the reason he was being dismissed.

The U.S. military official who spoke on anonymity about the quantity of U.S. donations said that he had been told that Karzai had approved an order removing Yaftali from his post.

But despite those statements, Yaftali's status was unclear. On Tuesday during an AP interview, he said he was still in his post and working from his office. He said he had been informed he would be moving to a new position but that he considered it a promotion and had been told his rank would be raised from a two-star general to a three-star.

Wardak, the defense minister, expressed surprise Yaftali was still in his office. He did say Yaftali, who has held the surgeon general post for seven years, would likely be reassigned to a new position, but said it was too soon for any talk of a promotion.

It is not clear whether Yaftali was involved in misappropriating medicines or "if it is more on the negligence side," Wardak said. "Once the investigation is finalized, we will know."

Speaking to the AP, Yaftali denied the accusations of corruption, saying medicines disappeared before making it to his department and have shown up in pharmacies. He suggested contractors providing the supplies could be to blame, along with U.S. advisers who he said help make the contracts.

"I found this medication in the market myself," Yaftali said, showing a shrink-wrapped package of three vials of morphine, with a bar code and a Hospira-brand label. "This is U.S. medication. This is right now in the open market in Kabul." He said he gave the samples to U.S. advisers several weeks ago and they haven't come back with any information on where it came from.

Yaftali said he had investigated in his department and had not found significant diversions.

"If we had this kind of leakage from our side, we would know," he said.

Taking issue with Geller, Yaftali insisted that U.S. medical donations had stayed the same or even decreased as the size of the Afghan military grew.

Wardak said the defense ministry has gotten serious about tracking and punishing misconduct.

"There was a problem that we have identified," he said. "Now the ministry is responsible for delivering."

But Rahimi, the army clinic director, insisted Yaftali is not to blame, saying he is "doing his best to provide with all these shortages."

"Today's health department is modern and we have access to everything. This was because of the efforts of Gen. Yaftali. He is a star," said Rahimi, adding that Yaftali helped arrange for him to get his master's degree in Turkey.

[Associated Press; By HEIDI VOGT]

Associated Press writers Rahim Faiez and Amir Shah contributed to this report from Kabul.

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