Treating traumatic wounds: two stories

Warning! This is a bit bloody, so if you have a weak constitution skip this post...

One day one of our Mountain friends came to me and said that a man who was staying with them had cut his hand, would I look at it? I asked if he had been seen at a hospital, and he said yes, but he needed surgery and the hospital wouldn’t do it because he didn’t have enough money. I agreed to see him because it sounded a bit serious. I was so unprepared for what I saw.

Apparently he had been in a fight in Iran, and had been cut in the fight. That was about 6 days before I saw him. He came to our office and I rather nonchalantly removed the bandage from his wrist/hand (I am used to Afghans exaggerating their wounds for either money or attention)... then I nearly fainted.

These mountain people are EXTREMELY thick. They aren’t fat at all. They can't be, there isn’t enough food for them to be fat, and walking up and down mountains makes you fit. But they have huge hands and feet and their wrists and legs are thick. I would estimate his writs was about three times bigger than mine. The cut into his wrist was at least half way through. If it had been my wrist, it would have completely severed my hand from my arm. Thankfully, as I mentioned he was thick.

I cleansed the wound, covered in triple antibiotic cream, re-bandaged it, and gave him $60 from the blessing fund to go to Cure hospital and have surgery to reattach it. He got sewn back together, and thankfully no infection set in, and as far as I know he is living his life back up in the mountains...

A few weeks later, my language teacher brought her daughter to our lesson to have me look at her hand. She is an active three year old, and had climbed up onto the roof and fallen off. (This is such a common occurrence here, so many children die of falling off roofs.) Thankfully she didn’t hit her head. What she did do though, is grab a skewer to slow her fall, and ripped her hand to pieces.

I saw her three days later, and again, my first question was did you go to the doctor? I want them to learn how to navigate the medical system, because I don’t know how long I will be here and if they are dependent on me, what will they do when I am gone? I would love to stay in Afghanistan forever, but I was evacuated before for medical reasons, and security is not so good right now, who knows what will happen from day to day?

They said that they had taken her, but that the doctor didn’t do anything except bandage it. I agreed to look at it, and was appalled! her hand was completely shredded! She had needed a really good cleaning, debridement, and stitches. Sadly, none of that had been done. He had just bandaged it.

What I did next was what you would expect. I took her into the house, took some soap and a scrub brush to clean the back of her hand and all around that was not injured, then cleansed the wound with soap and water. I took her back outside and poured betadine all over the wound, put triple antibiotic all over it and bandaged it with a clean dressing.

Normal stuff...

What wasn’t normal was her reaction... Did I mention she was three? When I took her inside, she whimpered a bit, but not from what I was about to do, but because she was going into the house. I scrubbed her, cleaned her poured alcohol and betadine on her, and bandaged her up, all without a single tear... These children are tough beyond their years.

Oh, I found out later that they had NOT taken her to a doctor. They had taken her to a pharmacist. By the time I saw her, I couldn't put in stitches, because she was at such a high risk for infection.

I saw her several weeks later though, and her hand was healing well, and I think it may not even scar! Oh the healing power for children. We truly are fearfully and wonderfully made!

Nan recipes

This blog is for those of you who live in countries that have nan, or naan. (that would be the name for bread in about half of the world's languages) If you can go down to your local baker, and get some of the dough before it is baked, you can make practically anything! So wonderful.

I love to cook and bake, but time is very limited and I can't wait all day for different breads to rise, so I use nan dough for nearly everything.

I thought I'd share a few of the things that I have made.

We'll start with savory breads...

My favorite is soft pretzels. You take a chunk of nan dough, roll it into a long stick, then twist it into a knot. Then dip it into melted butter, and sprinkle really whatever you want onto it. I usually sprinkle garlic salt and sesame seeds onto it. then bake until brown. YUM! (If you don't twist it, they are called breadsticks, which are also yummy!)

You can also make cinnamon pretzels using the same method... or just a bit of sugar, and when done dip them in Nutella... Yes, we can get Nutella in Afghanistan. It is one of the advantages of living in a war zone. You can get lots of yummy food from the different countries involved. Reeses from the States, Nutella from Germany, Tim Tams from Australia... you can even get kimchee...

One of the easier recipes is pizza. Simply roll out the dough to the desired thickness (actually it is very difficult to roll it out very thin), bake it a few minutes, and then add whatever toppings you want and bake.

You can also make calzones. Just take the dough, roll it out as thin as you can without breaking it, and fill up half of it, and fold the other half over the first half, pinch together with a bit of water and bake...

My absolute favorite thing to make with nan dough is bagels; unbelievably easy, yet impressively tasty!

Simply boil water with salt, roll nan-dough into balls, then poke a hole in the middle. Make the hole as big as possible, because it tends to bounce back into just a little depression. Then drop the bagel into the boiling water. When it floats to the top, flip it over, then take it out. Drop IMMEDIATELY into whatever topping that you choose... whether savory or sweet, while it is still wet, so that it sticks. Then put it on a pan and bake until hard and brown on the outside, but soft and done on the inside.

Toppings for bagel:

My favorite is sesame seeds. They make it really taste like a bagel. But you can use fried onions, poppy seeds, garlic, butter (you can NEVER go wrong with butter), cinnamon and sugar... really your imagination is the only limitation.

I have noticed that if I buy a ready made nan, I eat a lot more than if I buy dough and make a little at a time. One of my favorite things to do is grab a little chunk of dough, flatten it out and fry it in a bit of butter and salt (also sometimes adding sesame seeds... notice a pattern here?) It makes a wonderful addition to any meal...

If I am having people over for a meal, I take nan dough and divide it into 3 balls and put all three into a loaf pan. I then take a knife and put a cross into each ball and pour melted butter with garlic all over them and bake. Best garlic bread you will ever have!

If it is summer, let the dough sit out on your counter for a couple of days. It will ferment and when you bake it, it will taste like sourdough!

Another easy, fun thing is pigs in a blanket (though we call it cows in a blanket, as we are not allowed to eat pork...)

Sweet stuff:

Sometimes, I take nan dough, roll it out into a cookie sheet, bake it for a while, then spread cream cheese mixed with whatever flavor jam I happen to have in the house, and bake... voila instant cheese cake!

You can also roll into tiny balls, dip in butter and cinnamon sugar, and put three at once into a cupcake or muffin tin. HOT CROSS BUNS!!! :)

hmm... I am out of ideas for the moment. Sitting in a living room in Austria, it is easy to forget what you do when you have a limited repertoire. But never fear, when I come up with new things, I will be sure to add them! If you think of any ideas, please share in the comments. I love to try new things!