Pakistanis & Afghans: Brothers in the Dysfunctional Family of Muslim Countries

09/08/2010 11:47 am ET | Updated May 25, 2011

As politically incorrect as it sounds, every nation has its Mexicans. The more borders, the more Mexicans. They are treated like all immigrant worker populations are, as though they are pariahs on civilized society. They are the unwanted, the untouchables. Often fleeing nightmares in disintegrating countries, they are blamed for government issues beyond their control and limited to menial jobs. They remain a marginalized sector of society, but also a vital one, paramount to the survival of the nation. This is a sad truth that no one likes to admit, but that everyone is cognizant of. This immigrant saga not isolated to Mexicans in the United States. It is well-known to Palestinians in Lebanon, to Russians and Ethiopians in Israel, to Turks in Germany, to North Africans in France, and to South Asians in... well, take your pick: England, Saudi Arabia or the Emirates. It certainly resonates with Afghans refugees in Iran and in Pakistan as well.

According to the UNHCR, Pakistan has one of the world's largest refugee populations, which consists of 1.7 million Afghan refugees. But who are the Afghans? I'm beginning to suspect that there are very few pure "Afghans." There are Tajiks, Uzbeks, Nuristanis, Kyrgyz, Hazaras, Turkmen and infinite types of Pashtuns. There are Shia and Sunni Muslims, and people speak Pashto, Dari, and even Urdu, which they learned during their time spent in Pakistan whilst fleeing Afghanistan's conflicts.

I came to Afghanistan with the expectation that I would be able to play the "Muslim card" and build alliances easily. Not exactly so. The sense of Muslim brotherhood has helped me tremendously, particularly since I have come during the holy month of Ramadan, but still, tribalism trumps all. Every single colleague has asked me about my ethnic origins. Every single one. Grocery shopping at the markets entails a detailed description of my family tree in order to purchase eggs. This is not unusual in my travels, as people have a hard time placing my name and face. Here, though, there is an intention, not just a curiosity, behind the question, which is essentially, "Whose side are you on? Are you one of us? Ally or enemy?"

Oddly, my Urdu language skills have helped me build solid relationships with Afghans. My background -- American, but mixed, with a predominance of Pakistani roots -- was initially a hindrance. The sense of distrust it provoked was rather astonishing, even to me, and I anticipated a great deal of this. I can see people here trying to categorize me: Muslim? Check. Urdu-speaking? Check. American passport and accent? Check, and check. Now what?

The deep-seated misgivings and suspicions about Pakistan stem from a sense of betrayal in Afghanistan. After Pakistan allied itself with the U.S., and especially now, since reports of Pakistan aiding the Afghan insurgency have surfaced, it is easy to see where the skepticism originates. Add to this a sense of camaraderie with Pakistan based on a shared faith and culture, and the superior treatment of Afghan refugees in Pakistan compared to Iran, and it makes for a labyrinthine relationship.

When we have a patient at CURE International Hospital that necessitates a higher level of care and we need to transfer the patient outside the country, the first place we consider is Pakistan. As opposed to Iran, Pakistan often accepts the difficult pediatric cases with no visa fees and sometimes the transportation is even free.

What confuses the entangled issues even more is the genuine generosity of the Afghan people. Hospitality is engrained into the psyche of the people here. I have been invited to more iftars (Muslim ceremony to break the fast during Ramadan) than I can fit into my schedule. Each one is a delectable five course meal set out on a toshak, where we all feast on family-style Afghan delicacies. It then concludes with the sundown prayers together followed by feasting through the evening. At one iftar, I spoke before thinking. I likened the spectacular food to my mother's Pakistani home cooking, then, realizing my faux pas, awaited my host's reaction. While my palms were sweating and palpitations ensued, she got up and left the room. She came back holding a jar of "National" achar, a famous brand of Pakistani of pickled chutney, which Pakistanis pride themselves on and which apparently, many Afghans love.

It was not just our common faith which brought us together here, but a common tongue, a mutually loved food, that universal trait of mothers: force-feeding guests until you are about to burst, and yes, spicy food.

Where I fall into place here as an American, a Pakistani, a Muslim and a female physician, is unclear. I am wading, and sometimes drowning, in a soup of identity ambiguity. What is clear is this: In this country, it's not about the grandiose plans I have for the future of the children of Afghanistan. It's about where I came from. It's not even about Islam or Shariah; some of the practices of various tribes are in absolute contradiction to Shariah. It doesn't matter how hard I work to save the Afghan children from poverty or disease. It doesn't matter how hard I try to pull their little legs back to our side of St. Peter's gate while they are mid-cardiac arrest. It only matters where I came from, otherwise all those ideas I have hold no credibility. The sooner we are cognizant of this framework, entrenched in tribalism, and incorporate these unspoken laws into our policies, the more productive our efforts will be. The sooner we realize that our presence in Afghanistan is contingent upon building strong relationships with various sects, not the fictitious everyman or the mythical pure Afghan, the more genuine strides we will make.

Pakistanis and Afghans are brothers in the dysfunctional family of Muslim countries. Sibling rivalry flourishes, complete with back-stabbing and false alliances with bullies. But in our hearts, like all good family, we are there for each other through all the painful family get togethers and religious holidays full of forced merriment, and more importantly, in times of desperation, of which Afghanistan has had more than its share.