'I think people know that we work for everybody'

Alberto Cairo grew up in northern Italy, abandoning law to retrain as a physiotherapist. For more than two decades, he has led the International Committee of the Red Cross’ (ICRC) orthopaedic rehabilitation clinics in Afghanistan, helping those afflicted by war, polio and congenital disorders. Here, he takes Philanthropy Age through his day

When I first arrived in August 1990, I panicked. I’d never been in a hospital for war victims before, and it was shocking to see these young people. And the environment: Afghanistan was strange, and completely different to anywhere I’d been before. But there was some kind of chemistry between the Afghans and me, and I was impressed by the kindness and respect they showed me. What also struck me was the huge need; this was a place where I could really be useful.

I’m up at 4am, and around 5.15am, I start working. The staff and patients come from 7.30am onwards, and it is a battle up to 4pm when everyone leaves. It is a very simple life.

"The budget for all seven of our centres is $20m a year"We have seven orthopaedic centres across Afghanistan, each divided into three sections: physiotherapy, a workshop for making artificial limbs, and social reintegration, which offers vocational training, education, microfinance and employment.

At the beginning, the programme was only for war and landmine victims, but now we are open to anyone with a disability, no matter what the cause. Each year we see around 9,000 new patients, and about 1,000 to 1,500 are war victims. The rest are children affected by polio, congenital deformities or clubfoot, or people affected by work or car accidents.

Treatment is completely free, and quite often we pay the transport cost if the patient lives far away and is poor. It is difficult if you live in a remote area, particularly for women, who can’t travel alone without a male relative accompanying then. The budget for all seven centres is $20m a year. Sometimes it’s difficult to get funding, but so far ICRC has found the money and we manage to reach the end of the year without cutting anything.

We have around 800 staff in our orthopaedic centres, and all of them are former patients. We call it positive discrimination, and it’s an incredible example that any disabled person – man or woman – can do anything, if given the proper chance and opportunity. Afghanistan needs the example of that because, while society does not reject the disabled, it tends not to give them the opportunities to rebuild a life.

Patients say: “I realised the from the very first moment, the person who opened the door was someone without an arm. The person at reception was in a wheelchair. The physiotherapist had one leg.” They feel if these people have succeeded, then they can succeed too.

In the evenings, I usually play sports, train, or work as a referee for wheelchair basketball matches. I did not understand before that sports could be so important. Some of the players were ashamed of their bodies just a few years ago, but now are proud of what they can achieve. This morning we had maybe 400 people here for the women’s basketball finals; there was such roaring noise from cheering and shouting. For many of them, sport was something they’d watch on television and today they play themselves. The enthusiasm is incredible.

"I've seen five regime changes. Of course, we’ve faced difficult moments, but we have never been attacked"I’ve seen five regime changes in Afghanistan. In a way for us, nothing has changed because the patients are absolutely the same. Sometimes they come dressed in one way, sometimes in another. At times with beards or without. Uniforms, or in Western clothes. The patients are the patients.

Of course, we’ve faced difficult moments, but we have never been attacked. I think people know that we work for everybody. Sometimes we have former soldiers belonging to the government sitting beside Taliban.

We expats, we come thinking that we know everything and we mean well. But often we come with our experience and don’t spend enough time to try to understand what the people who we’re supposed to be helping, really want. I remember a child called Jawad who was badly affected by polio. It was difficult to help him walk, but he and his mother were very determined and he learned. His mother would come every day to ask for my help. She asked me to send him to school – this was in ’97 or so – and I discovered she’d asked many schools in Kabul, but the child hadn’t been accepted. She came every day, even though I explained that we couldn’t help, apart from offering physical rehabilitation.

"This lady, illiterate, understood things that I myself, a lawyer was not able to see"She pushed so much, that in the end we had to find a solution: homeschooling, for a three-month trial period. Of course, Jawad was so good that in three months he progressed through two classes, and we had to find another teacher. This lady, illiterate, understood things that I myself, a lawyer was not able to see: education. You cannot focus on just physical rehabilitation; you have to go further. Your job doesn’t finish by giving artificial limbs to a patient; it has only just started. I am so grateful to these people that changed my way of working.

My dream is to open 10 more orthopaedic centres in remote areas of Afghanistan. I hope to keep working for many more years, even after my work with ICRC is finished. There is so much for me to do here still. I cannot imagine my life elsewhere.