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April 27, 2006
A Scientist-Novelist Helps Heal a People

HHMI-NIH research scholar alumna Nassim Assefi, at right, with Zelaikha Anwari, training director of the International Medical Corps in Bamiyan, Afghanistan.

In the ravaged cities and remote countryside of Afghanistan, even basic health care is a luxury. The overwhelming need of that war-torn country so horrified Los Angeles-born Nassim Assefi, 33, a Shiite Muslim whose parents are from Iran, that she left a faculty position at the University of Washington School of Medicine and moved to Kabul to help.

“After nearly a quarter century of war and civil chaos, Afghanistan has one of the worst maternal and infant mortality rates in the world,” Assefi said. “One out of every seven Afghan women dies during pregnancy, and one out of every five children does not reach age five.”


“Moving to Afghanistan was a very personal decision. It has given me an unprecedented opportunity to apply all of my skills and background at once–medical, cultural, and linguistic—toward my life mission of improving the lives of vulnerable women.”
Nassim Assefi

Working through a private, non-profit organization called Management Sciences for Health that has operated in Afghanistan since the 1970s, Assefi established a program to reduce maternal and infant mortality by training rural health care providers in clinics, including physicians, nurses, midwives, laboratory technicians, and pharmacists. She helped develop eight clinical and practical “crash courses” in everything from prenatal, postnatal and newborn care to common childhood diseases, infectious diseases, family planning, and mental health, and implemented them in training centers all over Afghanistan. Her project was funded by the United States Agency for International Development, which is active in relief efforts in Afghanistan.

While she was still in medical school at the University of Washington, Assefi spent the 1995-96 academic year doing immunology research as an HHMI-NIH research scholar at the National Cancer Institute in Bethesda, Maryland. The HHMI-NIH program enables selected medical students to spend an academic year conducting mentored research in NIH labs. The goal is to interest more upcoming medical doctors in becoming physician-scientists.

In 2000, Assefi joined the faculty of the University of Washington School of Medicine, where she did clinical research as a women's health and refugee medicine specialist. Her work with refugees took her to Afghanistan for the first time in 2004. Assefi was horrified by the state of women's health and education there.

“I rearranged my entire life and moved to Kabul,” she said.

In Afghanistan, Assefi lived with danger and without dependable electricity and running water. Her friend and neighbor, Italian aid worker Clementina Cantoni, was kidnapped and held hostage for nearly a month before being released.

“In 2005, eight of my friends were killed, and one was kidnapped,” she said. “These extreme situations led me to deeply appreciate the happy moments, and to realize that happiness is not so complicated as we make it out to be in the West.”

In spite of the danger, Assefi never regretted her decision to go to Afghanistan.

“Moving to Afghanistan was a very personal decision,” she said. “It has given me an unprecedented opportunity to apply all of my skills and background at once—medical, cultural, and linguistic—toward my life mission of improving the lives of vulnerable women.”

Although she has never been particularly religious, Assefi said she has always felt a connection to the Near East that goes beyond the borders of Iran and her extended family, many of whom still live there. To her, the entire Near East is what she affectionately calls “the old country.”

“As an Iranian-American living in Kabul, one who speaks Dari—the Persian language spoken in Afghanistan—and has an entrée into the generally inaccessible world of Afghan women, I was able to do the tight-rope walk between the disparate communities of international aid workers and the Afghans,” she pointed out.

A novelist as well as a doctor, Assefi wants to write about the Islamic world during this tenuous time. “I hope to dispel Western assumptions about the primitive and barbaric texture of life in Afghanistan and take part in the dialogue to humanize the faces behind a reconstructing civil society,” she said.

“Writing fiction is my scalpel,” Assefi explained. “It allows me to get under the skin and understand processes at work in human life that can't be explained by science alone.”

Her first novel, Aria, examines the struggle of a young cancer specialist and single mother to come to grips with her daughter's death and to reconnect with her estranged Iranian parents and heritage. It is slated for publication in the spring of 2007.

Assefi's rural health care training program in Afghanistan is continuing with new volunteers. She has moved back to Seattle and started work on a second novel set in Afghanistan.

“After that,” she said, “the future is open.”

Photo: Management Sciences for Health

   

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