Mir Wais Hospital is a hospital in name only, a concentration of misery rather than an oasis of relief. There is nothing remotely resembling sanitation. Flies collect on old men's sores and the eyes and mouths of listless, malnourished children.

Yet overcrowded and understaffed as it is, Mir Wais remains the only advanced-care medical facility for perhaps 1 million people living in Kandahar, Afghanistan's third-largest city, and in four surrounding provinces.

On Saturday, something like hope arrived when two trucks — with four to follow — delivered the first installment of about $50,000 worth of medical supplies, courtesy of the 10th Mountain Division's 2nd Battalion, 22nd Infantry Regiment.

But even as laborers unloaded the nuts and bolts of medicine — such as intravenous solutions and catheters — Army officials warned not to expect any miracles.

"A Band-Aid over an arterial bleed," is how the officer who shepherded the donation described it. Capt. Brad Frey, a physician's assistant with the 3rd Battalion, 6th Field Artillery Regiment toured the hospital and rated it "less than nothing."

Rebuilding Afghanistan is "fragmented," said Lt. Col. Monti Zimmerman of the 321st Civil Affairs Company, based in San Antonio, Texas. "There are places where [the effort] is really starting to come together, and places where it's very much not."

In a second-floor nutritional center at Mir Wais, a mother swats at flies, trying to keep them off her son. The 18-month-old boy came in weighing 5 pounds, said Dr. Abdul Kareem. Now he's up to about 13 pounds.

But the boy is lifeless, his head misshapen and his body stunted by vitamin deficiencies.

However, the hospital supply a few yards away turns out to be surprisingly well stocked, with containers of vitamins and cases of antibiotics, such as Amoxicillin.

Doctors at Mir Wais say there are 350 beds for 800 patients. A new wing is under construction, funded by aid agencies. But entire floors of existing buildings are empty, and most of the equipment useless.

While Afghanistan grows more stable, there is still a health crisis. There is also a little-publicized humanitarian effort. Army brigade commanders and Provincial Reconstruction Teams have $100,000 a month to spend pretty much as they like. The cash comes from $40 million in Commanders' Emergency Response Program funds for 2004.

"The lists of can'ts is very small," said Lt. Col. Bob Duffy, deputy commander of Civil Affairs operations, Task Force Warrior at Kandahar airfield. "The list of things we can do is very, very broad."

Things such as medicine, medical equipment and glass in the hospital windows, for example, can be done. On Saturday, Duffy's crew fixed an X-ray machine and Duffy left with proposals to fix others, including a blood serum centrifuge, and to buy additional equipment.

The challenge is to make the Afghans self-sufficient, not dependent on the United States and international aid organizations, Zimmerman said.

It's easy to drop off truckloads of supplies. It's much more difficult to address the causes of the symptoms, Duffy added. The Army can throw money at the problem, or can go to the root of most illnesses, which is the lack of a water system, Duffy said.

U.S. donations are part of the newly emphasized effort to eliminate the Taliban threat by expanding the influence of the central government. The U.S. military's presence makes it possible to establish a humanitarian aid effort — and the pre-eminence of the central government.

"It's not one or the other," Zimmerman said. "It's working toward a synergy in efforts."

At Mir Wais, the International Committee of the Red Cross "keeps that place together," Frey said, with the World Food Programme also participating.

Believe it or not, Mir Wais is "better than most" hospitals said Dr. Nazar Mohammed, a Kabul-based physician assisting the team. Patients often show up at other provincial hospitals to find there is no medicine there, Mohammed said.

During the chaos of Taliban rule, most doctors left for Iran or Pakistan. Those remaining have few skills and less equipment, he said. Mohammed himself only graduated two years ago from Kabul Medical Institute.

On Saturday, it seemed like all of Afghanistan was going to Mir Wais.

As Staff Sgt. Clint Wunderlich, with the 10th Military Police Company, pulled security for the delivery, a man approached, saying his wife's blood pressure is out of control. Doctors told the man there's nothing they could do here and he should take her to the American hospital at Kandahar airfield. Even though he's a military policeman, Wunderlich dutifully went from official to official trying to help.

Americans must resist the urge to transfer patients to the airfield, Frey said, and concentrate on Mir Wais. "Every time someone goes to the [airfield] hospital, or even when we do a village [medical clinic], we're undermining that hospital."

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