Good day everybody. Dr. Sajja Sanyal, professor of department chair. We are going to focus on the neurovascular structures and the relative supply on the gluteal region. This is the prone cadaver So this muscle that we have exposed here This is the gluteus maximus and you can see that it is arising in a very extensive way from the coccyx sacrum and from the outer surface of the alium posterior to the posterior gluteal line and the fibers are then converging here and this is The iliotibial tract that we can see here Where the three fourths of the superficial fibers get inserted and this aponeurotic expansion goes down and gets attached to the natural-atrial tubercle of GRD So what we are going to do now we have already cut the origin of the gluteus maximus and we are going to reflect it and We are going to go straight to the neurovascular structures and their supply When we reflect it we see the neurovascular structures. So let's take them one by one These neurovascular structures that we can see here. This is above the pyriformis. So this is the superior gluteal artery The superior gluteal artery is a branch from the posterior vision of the internal iliac and the superior gluteal artery supplies the structures Deep to the gluteus maximus namely the gluteus medius and gluteus minimus and tensor fissure letter When I reflect the gluteus medius Which I am doing right now We can see the rest of the neurovascular structures here, and I have lifted them up here and we can see that this is These are the other branches of the superior gluteal artery and These are the branches from this superior gluteal nerve the superior gluteal nerve root value is L5S1 and we can see the superior gluteal nerve is supplying the gluteus medius and We can see other branches Are supplying the gluteus minimus, which is here and we can see the gluteus minimus from the other side here and The superior gluteal nerve also supplies the tensor fissure letter, which is located further antrolaterally here So that brings me to the action of these muscles the gluteus medius and the gluteus minimus as you can see the fibers Are descending vertically down and they get inserted on the top of the greater trochanter both the gluteus medius and The gluteus minimus so therefore their main action is abduction of the hip and medial rotation They also have to stabilize the pelvis Especially when we are standing on one leg it prevents the other side pelvis from sagging down by virtue of their unique insert That brings me to a very important clinical correlation here If there's a deep penetrating injury in the gluteal region and the superior gluteal nerve is injured Then the gluteus medius gluteus minimus and the TFL will be paralyzed and that produces a condition known as Trending Berkside what happens in trend and Berkside When the patient is asked to stand on the leg of the paralyzed type The hip on the other side will sag down because the gluteus medius is not able to stabilize the pelvis That is called trend and Berkside and Because of that the person will develop one of three gates One is called the gluteal or the waddling gate or Outswinging gate or a high-stage gate So that is the manifestation of superior gluteal nerve injury from a deep penetrating stab injury Now let's take the next neuro vascular structure This is again the piriformis as I mentioned and we can see the piriformis is coming from the anterior aspect of the sacrum And my fingers is in the greater sciatic notch The piriformis emerges from the greater sciatic notch and by means of this narrow tendon It gets inserted onto the tip of the greater trochanter. So therefore the piriformis divides the greater sciatic foramen Into a suprapiriformis compartment, which I described just now which gives passage to the superior gluteal vessels and the superior gluteal nerve And it divides the Greater sciatic foramen into an infra piriformis compartment and that is this one here The portion below the piriformis is the infra piriformis compartment and what are the structures which are emerging through the infra piriformis compartment We can see this big nerve here I'm going from lateral to medial. This is the sciatic nerve. So this is the first structure The second structure which comes out is this one, which I have lifted up collectively This is the inferior gluteal nerve and the inferior gluteal artery and the vessels The inferior gluteal nerve is S1 S2 the posterior division and this the inferior gluteal artery Which is the branch from the anterior division of internal IAC This inferior gluteal nerve is the one which supplies The gluteus maximus and the artery also and we can see the cut portions of the nerve which were entering into the gluteus maximus This is one cut portion here. This is another cut portion the vessel Another cut portion and there are numerous cut portions. So we have to cut them here to reflect the gluteus maximus What happens when there is an injury of the inferior gluteal nerve? Inferior gluteal nerve injury will produce parallel to the gluteus maximus and action of the gluteus maximus is Extension and lateral rotation of the head. So therefore the patient will not be able to extend and lateral rotate the head Additionally more important action function of the gluteus maximus is To make the person sit from a standing position and stand from a sitting position or climb or walk uphill Just imagine when a person is standing and he is about to sit down on the chair His gluteus maximus is undergoing isotonic eccentric contraction, which is also referred to as controlled relaxation and Likewise from a sitting position when he's standing his gluteus maximus is undergoing Concentric isotonic contraction to enable him to stand So all these functions will be lost when inferior gluteal nerve is injured in this connection I can mention there is a condition called epicona syndrome Where there's a legion of the spinal cord just above the conus That means just above S3 and an epicona syndrome which can be due to a tumor The patient has very similar findings as gluteus maximus paralysis namely He has severe inability to extend and laterally rotate the hip So that is with respect to injury to the inferior gluteal nerve Next you can see here as I mentioned is the shiitake nerve So let's take a quick look at the formation of the shiitake nerve The shiitake nerve is formed inside the pelvis By a combination of the lumbar plexus and the sacral plexus the component from the lumbar plexus is L4 5 Which comes through the lumbosacral trunk and the sacral plexus S123. So that is the root value of the shiitake nerve In the pelvis it has got two components a pre-axial division and a post-axial division and here it is also met by What is known as the posterior femoral cutaneous nerve, which we cannot see very clearly here, but it unites with the shiitake nerve and as the shiitake nerve emerges from the infrabidiformis compartment The posterior femoral cutaneous nerve separates off and it supplies the skin of the back of the thigh and also the inferior gluteal region The rest of the shiitake nerve then descends down on this bed This bed is composed of the following four muscles. One muscle we can see here This is the superior gemalus The next muscle we can see here. This is the operator internus The next muscle that we see here is the inferior gemalus and the last muscle is the Quadratus femoris So this forms a bed for the shiitake nerve to pass through and it passes roughly midway between The greater trochanter and the ischial tuberosity and this is an important landmark if you want to keep shiitake nerve blocked We follow the portion midway between these two bony prominences Likewise when a person who is jogging for many years Friction of the shiitake nerve against the ischial tuberosity can produce shiitica This shiitica nerve can be compressed under the piriformis In about 12% of cases the one of the divisions of the shiitake nerve can go through the piriformis and in 0.5% of cases one of the divisions the common fibular division can come even above the piriformis These are the conditions when the piriformis is especially prone to compression or entrapment And this is referred to as the piriformis syndrome This typically occurs in skiers when they fall on their buttock and there is swelling and inflammation Which compresses the shiitake nerve and that can produce symptoms very similar to shiitica in terms of shooting pain on the back of the leg The shiitake nerve can also be enjoyed in posterior dislocation of the hip And after it has crossed these muscles the shiitake nerve then enters it to the thigh and We shall see the course of the shiitake nerve when we come to the thigh And we can see the shiitake nerve running on the back of the thigh till it reaches and shiitake nerve is the one which supplies everything on the back of the thigh, back of the knee, back of the foot, leg, right under the sole of the foot This is a photomicrograph of a distal stump of a ninja shiitake nerve showing axon regeneration That brings me to yet another neurovascular structure which I'm going to just show but I'm not going to mention the details And that is this here. I've lifted up a composite neurovascular structure here This is the pudendal nerve and the internal pudendal artery This complex it comes out from the greatest shiitake for a minute below the piriformis It winds around this pony prominence, which I can feel here and you can see a little bit here This is the ischial spine and then it goes back through this space This is the lesser shiitake for a minute and it enters into the ischial enulfosa And it runs in the canal called the pudendal canal or the alcox canal and supplies the structures in the perineum So therefore to summarize going from lateral to medial we have S, shiitake nerve, G, gluteal, inferior gluteal nerve and artery and P, pudendal, internal pudendal artery and pudendal nerve And just to complete the story, let me mention quickly the nerve supply of these deep muscles The piriformis is supplied by the nerve to piriformis, which is from the anterior ramai of S1, S2 The rest of the muscles, the superior gemalus and the operating ternus is supplied by the nerve to operating ternus, which is L5, S1 and the inferior gemalus and cortidus femoris is supplied by the nerve to cortidus femoris, which is also from L5, S1 the action of all these deep muscles is Lateral rotation of the hip. So if any of these nerves are injured, which is not very common Then there will be weakness of lateral rotation and that brings to the final point When do we use medial rotation and lateral rotation of the hip? On a day-to-day basis, when we are just walking with each step that we take our hip Rotates medially and the opposite hip rotates laterally and vice versa So therefore lateral and medial rotation of the hip is an unconscious thing Which we do not do consciously, but it automatically happens each time we walk So these are all the points which I want to mention about the neurovascular structures and the supply in the gluteal region Thank you very much for watching. Dr. Sanjay Sanyal signing out David O is the camera person. If you have any questions or comments, please put them in the comment section below. Have a nice day


Alrighty, so I was going through YouTube and I accidentally discovered a new type of coaster that's already been posted on YouTube that there hasn't been much conversation around. But it looks like we have a Sky Roller as a roller coaster now, which is actually really intriguing to me and kind of why I'm making a video to get it out there quicker because when I went to this company's website and YouTube channel, they posted this concept yesterday and it only has 400 views. So definitely want to get the message out there. I'm going to post the link to the YouTube channel that this came from down below. I'm simply just reacting to this new concept. It looks amazing. And I actually already know one person that would love a ride like this at their home park Canada's Wonderland. But think about it's a very simple design. In reality, it really is a very simple design, but it's a very high thrilling attraction if you know how to flip. So one of these at any park around North America or the world would be phenomenal. I mean, I know how to flip on a Sky Roller myself. And I can tell you those things are very high thrill. I can flip about 12 to 14 times before I get really like start to feel ill and I have to hold my wings out flat to stop myself from flipping anymore. I know other people who can flip literally up to a hundred and something times and they handle it really well. So it all depends on the person. And that's what I like about these attractions is you're in control. Now as a they were suggesting this is a launch coaster. So obviously you see it launching out of the station. It would blow my mind to see what they could do with this kind of a design. I'm thinking they have to keep it pretty some like simple in terms of like the design and not making it too high thrill. But it still looks phenomenal seeing like the Sky Roller design on like a on a train is like a coaster train is just so weird to me. Like I'm literally sitting here again. This is literally the second time I've watched the video because I saw it. And I saw it only at 400 views and I was like, what this needs to get out there. So I'm going to try doing my part, get this out there. All of you get this out there as well because this looks phenomenal. And parks need to know about this thing because this looks absolutely amazing. I want to hear from you guys down below. What do you think of this thing? Do you think your home park could use something like this? Would you ride this and give the video like subscribe? You haven't and obviously share this for others to see. Thanks so much, guys. Have a good one. Bye.


Well, good morning everyone and welcome to CSIS in today's discussion at Insider's Perspective on Afghanistan. We're very, very honored to have two very distinguished individuals to discuss this issue. My name is Rick Ozzie Nielsen and I'm the Director of the Counterterrorism and Homeland Security Program here at CSIS and a modest role of moderating these two distinguished individuals. Just to give you a quick overview of how this is going to work today, I'm going to interview Dr. I'm sorry, introduce Dr. Atash first.  Before we get started though, I'd like to ask all of you to check make sure your cell phones and pagers and water are off or at least in vibrate mode and then when we ask questions we're going to have individuals with microphones here. Please limit your questions to questions and not statements. I'll be a very hard moderator so it's be the question and answer period as opposed to the statement and answer period. And we'll have microphones please say who you are and what your affiliation is that helps us understand you know the dialogue of the context of the questions. So without further ado I'll get right into this our first speaker today and both these individuals have published books is Dr. Nadir Atash. Dr. Atash was born in Kabul. He attended the American University in Beirut and then returned to Kabul where he served in the Ministry of Education Science Center where he was the head of the Chemistry and Research Department so he was a scientist by trade. He then went to the United States and received a Master's in Science at Claremont and a PhD from Florida State and then stayed in the United States and worked as an educator and a statistician both for the state of South Carolina and with a country with a company called Westat. From there this is what I found one of the most intriguing parts about his bio. He launched a chain of automotive lube shops. I'm trying to figure out if it's into the whole thing but and he also started his own consulting firm, Parsa. Dr. Atash has been a well-known activist among the Afghan diaspora supporting numerous organizations in the areas of sports and culture education. In 1999 he founded the Noristan Foundation, a non-profit organization dedicated to rebuilding rural areas in Afghanistan. After the 7th, 11th attacks he returned to Afghanistan to help with the reconstruction efforts and to serve as a bridge between the United States and his birth country of Afghanistan. We're there. He established the Afghan-American Chamber of Commerce and established the Office of Kabul. And then in 2005 after serving as a senior advisor to the Ministry of Finance in Afghanistan he was asked by the Minister of Transportation to serve as an advisor in that capacity as well. And then as with most overachievers no good deed goes unpunished. He was then asked with the great honor of serving as the President of Ariana Airlines and did that for a small but very influential period of time. In fact he was responsible for attracting one of the largest private investments into Afghanistan in his history. And he returned to the United States since 2006 and then from there the last three years obviously he's a well-known expert on Afghanistan and an educator, entrepreneur and an activist and has appeared in you know TV and media in numerous conferences. And he's here today to talk about his new book Turbulence, the tumultuous journey of one man's quest for change in Afghanistan. So I'll go ahead and turn it over to you Dr. Ntosh. Because I may read yours. Good morning. It's great to be here with you this morning and especially I'd like to thank the CIS people and folks to hosting this conference and this event and I like to be short on target. Usually I am not on time in terms of timing so if I go overboard you can stop me. I'm here to discuss basically the book but I just don't want to talk about the book because the book is one tool in my chest of tools to talk about Afghanistan and what we should do. So although the focus is my the book Turbulence but I'm going to be a little bit more broader in my presentation here with you but but certainly I will come you to read the book and then we can have a conversation about the book. Let me start you know by saying that the Turbulence is a true story about Afghanistan told from two perspectives. A boy is basically myself and an airline and it's interesting how the paths of these two entities crisscross and and of course at that time I didn't know this but and then eventually the paths overlap and it gives rise to some interesting and intriguing stories. In the book I tried to portray what Afghanistan was in those days when I grew up and so sort of three distinct periods in Afghanistan are basically portrayed in the book. The first period which is the golden age for Afghanistan and is from the 50s onwards till 78 is what I call the period of progress in Afghanistan and in this period there are many episodes in the book depicting how Afghanistan was achieving its goals. Not only in terms of the country but in terms of individuals and I gave my example of my life story in those days and for institutions and infrastructure and as a whole the country was was moving in the right direction. Given the fact that those achievements and progress were made with meager and scarce resources it's very I think critical to understand that how achievement can be made possible if you have the right leadership and the people are on the same line in the same tune with the government working together to achieve the goals of the nation and given the brevity of time I'm not going to elaborate too much on this so move forward to the second period which is a period of by the way we have some pictures from the book from each period this is basically a picture you know of my childhood in the center when I was I think about five years old with my mother in the background and the family portrait in 1965 I just returned from the US as an exchange student I think I'm right in the back and this is basically when I graduated from high school with my friend who is a medical doctor here in this country doctor I had the one on the on your left and this picture is what my father has when I was leaving for my AUB scholarship basically in 1972 I got a scholarship to go to Claremont this is my wife in those days you know that was but the fashion and that's a in the conference at the Singapore I'm the first one there on the on the right on science and technology in the area and this is in 1982 when I was receiving my actually diploma I had graduated in 80 but I didn't fill up the forms I got my my PhD diploma in 82 and also for the airline you can see differences between 95 and and 1960s you know you can see the people with beers you know shabby kind of things that changed in that area anyway and then we go to the this era of really the great era of devastation for Afghanistan starting with the Soviet invasion actually the communists take over in 1978 till 2001 where all the devastation in Afghanistan occurred starting with the Soviet invasion where the jihad that ensued to to purge you know get Soviets out of Afghanistan more than of course the estimates are estimates about 1.5 million Afghans died in that struggle more than 5 million Afghans had to leave the country and we have close to 1 million Afghans who are disabled maimed and so forth as a result of that so that it was huge devastation in that era and not I don't think that any Afghan has escaped that the negative effects of that era for example in my case and I put this tell my story I was in the US just a few months before the coup to work on my PhD at Florida State so I should have escaped that devastating effects that wasn't the case and how much of an effect it had on me personally because my family all my male members of my family were in prison four of my brothers my father it was executed and with a lot of other friends and I every day were here we heard of these devastations and in the whole country was going through a process that was very very much negative and and of course it didn't stop after the Soviets withdrew it continued even worst in some cases the civil wars of the 1990s and then the Taliban take over and all the atrocities that were committed by the jihadis in the Taliban on the Afghan people for example this picture which is in this in the book is my daughter my third daughter Samira standing in front of our house family house which was a beautiful compound in those days when we were living at least for us but at all church and all the things but you can see that so this is an example of that devastation and this is and a document that basically we found through you know back channels that show how the communists you know when they were executing my father when some of my relatives and that there's a document in this in the book so now I just want to move fast so that we are we don't run short of time then we in the book I discuss this area of the era of turbulence for Afghanistan which is after the fall of Taliban and and of course in that period Afghanistan started with high hopes after Taliban's were defeated by the Afghan forces in the US and in NATO hopes were set very high for reconstruction democratization and prosperity for Afghanistan and great progress was made initially from 2001 to 2005 I think we were on the right tracks and we made a lot of progress but somewhere you know things changed and that's why the turbulence you know that we move up and you know it's not a one way movement it's up and down movement in this era and we have been on this deterioration course since 2005 and and I think still we are in that process I have not seen positive effects even though the US military has recently announced that we have seen some positive achievements and I don't believe in that unless I see really on the on the criteria that are important for us not just getting Marja you know it's very easy to capture the Soviets did this every day they captured the places but to sustain that to hold that and and make sure that the population is not turning against us that those are the real criteria for success but the question is why did we move from our initial success to to basically this course that this we are following now the iteration this picture is something that I want to show because in my one of the reasons I think is that we don't listen to Afghans although I heard some good things from my friend mr. Guttman who was in Afghanistan he said that now the US military has changed its ways recently and are listening to Afghans but I I have to see the results in my mind that's that thing is still in formation but we need to listen to Afghans if you are there to help Afghanistan that's the purpose it makes sense to listen to Afghanistan and then set goals aspirations and based on an Afghan view not something that we go in and just based on our preconceived notions and say okay this is what we want to do in Afghanistan and a lot of this the reason that we are losing the people from 95 percent now to 68 percent based on the December last December's poll is because that we have not listened to their aspirations to their grievances legitimate grievances so this is an example when I was in Afghanistan the first thing I did I went to the most remote areas like new ristan and we where there are no roads you have to walk no you know you cannot take a no showers and no toilets nothing but those are the kind of conditions that we have to face in order to listen to the people you just cannot be in the hotel you know Serena continental and say okay now I'm I'm the embassy and you can see that this is what I did a lot even though I was not an government official I was not sponsored by anybody but just for my own sake to make sure that whatever we I do is based on something that the people want and to establish the rapport that is necessary to be with the people of Afghanistan and and you can see a different era that we have these discussions these talks and and I spent a lot of my time listening to the people and talking with the people and I learned from that I learned a great deal from what needs to be done and what and this is a model that we should use now I think even now we don't have a national vision for Afghanistan and I challenge anybody who says that we have to produce it like this president Obama's strategy we have yet to see it we know it's there but only the military aspect we have seen but the overall strategy I don't think that anybody has seen first we have to have a national vision for Afghanistan we and in order to do that we have to include the Afghans in the process and these are the some of the challenges I'm going to skip this I think we are running so I think I go to what needs to be done as the national vision has to be developed through a consensus development process it has to come from Afghans it cannot be imposed on Afghans because whatever is going to impose it's going to not be sustainable in a few years we have to change and the people are going to abandon with that aspiration or whatever it is we need to you know sever our relationship with these unsavory characters if you are there to help the Afghan people we need to forge good relationship meaningful relationship with the Afghan people yes we use these unsavory characters to to get rid of Taliban and evil power but if if this means that the Afghan people are hostile to these unsavory characters for the rest of their lives I don't think that we are going to succeed so because these people only commit atrocities only commit bad things to the people just for their own benefit and believe me they don't even know what their benefit is because if they knew in reality they wouldn't do these things because they have a very narrow perspective they are brought up during the war era all they knew is killing in those atrocities and we need to require effective governance in Afghanistan without a credible partner I don't think that we can succeed and a lot of journalists a lot of analysts are in agreement on that but unfortunately we are unable to deliver on this and we are still unable to do this you know from Afghan perspective when the US says that we cannot achieve this then they say what if you are so helpless that you cannot you know form a government that is your puppet then how can you come and tell me what to do the Afghans so they would they would lose our credibility to for Afghanistan because the Afghans think differently so we have to show that we have the courage the wisdom and the guts to to make sure that we take effective action on these and with this kind of a government I don't think that any action that we do is going to be successful because what we are trying to do now is we have assumed that this government is there that now we are trying to compensate for it and it's not going to work because look what happened to Marja we we brought an administrator now that we know that he was he stabbed his son and when he was in Germany he was in prison for four years can you imagine that we cannot find one good individual without with a clean record to be and this is a showcase believe me you just made this to the showcase and with a showcase we have a we select an individual like that he may be a good person I don't know because some Afghans because of their conflict in terms of their adjustment to the Western ways of living I think they made some things that thinking that they were still in Afghanistan but I think it's totally inappropriate to bring somebody like this after we have made it known to the world that now we got we bring the cleanest government in the best people and then the administrator of Marja is somebody and and now we are we are trying to defend that so I think that's a bad government we need to really pay attention to the Afghan National Army National Police I think given given the fact that we did not listen to the Afghan to Afghans and we didn't know the context of Afghanistan we came up with a military system that is totally inappropriate for Afghanistan from one perspective from social justice perspective the people who are in the military are the poorest of the poor in Afghanistan we asked them to stake their lives for a few people who are getting rich so if my son you know isn't a military because of you know 80 dollars or 100 dollars or 120 because they are making a living because I have no other options otherwise I will not be in the military and I go and kill you know to be killed to keep these few people who are getting rich that's not going to work in Afghanistan every Afghan is obligated to defend for the homeland in this this is the mentality this is the context the historical context in Afghanistan I don't know who changed this all of a sudden that we have this kind of army so with this so if you have if you listen to Afghans I think we can come up with the systems that are going to be workable and I think we need to work in terms of the needs of reconstruction and we have to do it effectively we cannot do it with the system where 80 90 percent of our dollars are wasted by estimate which I have done some people the US effectiveness in terms of his aid is between 10 to 15 percent and with that kind of effectiveness most of our dollars are wasted meaning that the taxpayers we have to pay for it and it goes to not to the purposes that were intended for and so there is a lot of waste frauds we need to bring a monitoring system that is effective and then and we know what total quality or quality improvement there's now so that over we have to make refinements to the system as we get the feedback and then those systems are available in this country we know the technology we know that we know how it's there but we need to apply it in a meaningful way in Afghanistan I just want to how much time do you have okay the story that I kind of tell in this in the book it was based on my own experiences when I was running the national airlines for Afghanistan and I saw how crap the system was I knew there was corruption but when I got into the system and I saw how much of corruption there was at the high levels believe me that things that were achievements were considered to be acts of treason acts of crime from those people because they didn't want to see that they didn't want the national airline to succeed because of their self-interest because and if you read the Washington Post article I think you can some of that now is clear you know why they didn't want the national airline to succeed but well of course I had made a decision to to work in that manner but I didn't know that the repercussions would be such huge I thought they would say okay step aside we don't want this kind of but so in the book I tried to give realistic pictures of what happened in my own case we as an example and with that kind of a system I don't think that we can succeed and in the major motive major motivation for the book was that so that I could tell this story but then of course I didn't want to be completely negative then because there are a lot of misconceptions about Afghanistan and that's something that I want to allude to for example a lot of policymakers they said there was no state ever as an Afghanistan completely contradicting history Afghanistan a rich history of 5,000 years where there is always a state of course the name has changed over the years and they say that for example that the government never ruled Afghanistan this is totally wrong and and there are some episodes in the book that shows that this was wrong for example my father was a governor of Pactia province and and and he was a military person but there was complete rule in Pactia where now we have problems like host which is one fraction of Pactia province and in those days nobody was outside the realm of law in Afghanistan and they said there is was a culture of corruption this is totally wrong Afghanistan there was no culture of corruption of course in every government there is some degree of corruption but Afghanistan was relatively clean government and that's why those achievements were possible with me good resources and so I hope that by reading the books some of these misconception misconceptions and myths about Afghanistan are also resolved and and since we are running short of time I'm going to stop my presentation and we'll welcome any questions and comments that you have thank you well thank you very much Dr. Tasha's are really appreciate those remarks you know personally I always found find that the personal stories you know the most compelling and so intriguing and interesting but along the same lines it's also important that we have you know journalists and individuals that capture the story when people can't actually speak for themselves and our next author and speaker doctor I'm sorry Roy Goodman has a history of doing that he's currently the foreign affairs journalist he's been a foreign affairs journalist in Washington for over four decades currently he's a foreign affairs editors from a clatchy and he's a former senior fellow at the US Institute for Peace his reports on ethnic cleansing and Bosnia Herzegovina won the Pulitzer Prize in international reporting in 1993 it was also the recipient for that work for the George Polk Award and the Selden Ring Award for investigative reporting in 2002 he was co-winner of the Edgar Allen Poe Award for White House Correspondence Association and in 2003 the National Headliners first prize for magazines formally with Reuters Newsday Reuters Newsday and Newsweek he's the author of numerous books including banana diplomacy witness to genocide and co-editor of crimes of war what the public should know today he's here to speak with us about his latest book his latest work how we missed the story Osama bin Laden the Taliban and the hijacking of Afghanistan so Roy it's an honor to be here today and to help celebrate not here's a new book and I appreciate CSIS for organizing this turbulence it's a terrific title and it sums up so much about Afghanistan of the last 30 years and I do agree that the that memoirs of this kind which really tell a story and expose it and put it right before you and give you the experience are just invaluable for getting insights into what's what's going wrong and and maybe how to put it right I must say Ariana Airlines needs you back so please reconsider in fact the whole airline industry in in Afghanistan really needs you I wanted to deal with one aspect of the turbulence that is the topic of Nader's book and that is the rule of law issue and I wanted to deal with the issue at the very highest level of the violation of the rule of law and just to say a couple of obvious things but sometimes they're not always so obvious Afghanistan is a country by the way in my own career which has fascinated me from going back certainly to the Soviet invasion period but it's a country that's been at war for 30 years it's a place which has a lot and a lot of history occurred during those 30 years and much of it was not recorded by us in the Western media and even historians have I think given relatively short shrift to significant periods in Afghanistan's recent history which is why I did the book about the 1990s which I thought was the biggest vacuum in the history of Afghanistan from the Western perspective and tried to reconstruct a series of those wars but there have been in wars that a series of wars actually five wars by my count there's a lot of history that many people would like to forget for the and it's it's it's principally the crimes that occurred in those wars for the victims of those crimes for the survivors though forgetting it is not easy what was done to people in by definition of having fallen into a group be it to Hazara be it to Pashtuns be it to Tajiks or to anybody a collective punishment rankles the sore festers and as we know from the former Yugoslavia it carries on from generation to generation as oral history the original crime is often magnified many times from its from its actual size and especially if there's been no exhaustive investigation no judicial process for resolving it no agreement on what happened who is responsible who were the victims who were the perpetrators my contention is from my study of the 1990s in particular and really going up to this day is that impunity on these massive these atrocities of war is one of the bigger problems of Afghanistan today and it's all the bigger because no one in power will acknowledge it and there seems to be nobody outside including the United States who wants to force this into the realm of public discussion and and actually resolve and resolve it as I say there are five wars they the first one is familiar to everybody who's seen Charlie Wilson's war the war against the Russian occupation from 1979 to 1889 the second was the war from 89 to 92 to unseat the proxy government left behind by the Russians 1992 to 96 the civil war between the Mujahideen who actually were installed this is Amit Shah Massoud and Burhanuddin Rabani who were installed with support from the State Department I should tell you between them and the Pakistani backed Mujahideen groups including Hekmat Yar who were supported by Pakistan's ISI intelligence network agency and by extension by the CIA so you had the State Department on the one side and the CIA basically backing the other the war between 1996 and 2001 was between the Taliban who tried to conquer the entire country but were never able actually to vanquish the remnants of the Mujahideen government of Massoud and then finally you have the war from 2001 to this day between the Karzai government or the government of the United States helped install and the remnants of the Taliban regime five wars it's really quite a record in modern history the American attitude in the issue on the issue of the crimes that have occurred in these wars is really to me surprising throughout these wars and in some cases the CIA was the major agency of the US government involves turning 79 to 89 period and at times it's been the State Department that's carried the lead but the policy has been on the whole pretty empty that throughout this this period the US attitude has been very consistent we've shown no interest whatsoever in the crimes and atrocities some of which bordered on genocide certainly in the Taliban period nothing little was written or said about what Soviets did to Afghans in the in the 1980s and almost nothing was written about what Afghans did to captured Soviet soldiers my book begins when the Russians pulled out 1989 and when I think the modern era really began and I tried to record every allegation of violations of the laws of armed conflict and and to find out what had happened about what the international community did about them if anything the the very first of the major atrocities was in 1997 and this is when the Taliban tried to conquer the north of Afghanistan it went to Mazari Sharif they set up they created a kind of a new government they imposed Sharia law they acted like conquerors but they stepped into a trap of their own making and they fell into it thousands of their troops were captured by a local warlord this was not general Dostom who's pretty famous for as a warlord who's committed all sorts of crimes this was actually the guy who overthrew Dostom at the time many Malik Paklavan and the UN saw this as one of these things you will be when you have when it happens you've got to do something right away you put the spotlight on it you investigate it you send out people and you try to get everybody to agree to what's happened and then you try to identify the culprits and and what happens next we're just discovering and even in the case of Yugoslavia not not that much happens but at least the facts are known and in this case the UN tried to do that very thing the UN's investigator was the first person on the scene he said that he could see that thousands of Taliban prisoners were lined up and mowed down with heavy caliber machine guns but there was no investigation no formal investigation the US government refused to put any money into a UN probe because we were not we didn't want to do anything to help the Taliban and maybe that was a motive at the time 1998 the Taliban again went back to Missouri Sharif this time they were carried they were determined to carry out a slaughter of the people who they blamed for the massacre the previous year but actually who were not directly to blame that's the Hazara and so they they basically went out ordered from the very top the rounding up of Hazara the ex execution in the streets leaving the bodies for the dogs to get at the whole thing was organized by the Taliban and it was an atrocity was a massacre at least 2,000 people were killed maybe the number was even higher the Clinton administration remained completely silent there was never an investigation and I'd say to the to my regret as a journalist that journalists didn't do their job adequately with a few exceptions didn't cover it didn't follow up didn't really bring out the facts in late 2000 and so that was in the period where the Taliban were the dominant force in Afghanistan after 9 11 the United States sent in forces and with the help of a resurgent force of General Dostum and the remnants of Ahmad Shah Masood's forces basically forced the Taliban out of power and the Taliban rushed out of power in Afghanistan governments don't usually wait around to be defeated they escape to live in and to fight another day and that's what the Taliban did and that's what they're doing right now as you know and when the US and Dostums people captured thousands of Taliban around Kunduz and then transported they transported them to a way station and and then General Dostum reloaded them into container trucks he sent them in these container trucks to a place called Dashdi Laili by coincidence it's the same place where Dostums former deputy had had put Taliban corpses in 1997 and he they loaded these container trucks took them to Dashdi Laili people suffocated by the hundreds maybe by the thousands we've really never gotten the numbers and and then dump them into mass graves I was working on the story when I was in news at Newsweek and we went to the US government again and again and again both here and in Afghanistan there was no comment there was no investigation sometime in the year 2008 it might be a little bit earlier might be later we don't know precisely General Dostum ordered the removal of the graves I was for an editor at McClatchy job I now have and we sent a reporter to Dashdi Laili and he went around to the site of the graves which had been photographed from satellites and and found that they were empty holes now scraps of clothing human remains still scattered about he went around to Dostum Dostum was out of the country at that point and he went around to Dostums former deputies all of whom said General Dostum ordered the exhumation of these graves the US military had no comment as we did the story the US embassy refused to talk to our reporter the Afghan government the Afghan military also had no comment now what is the relevance of these crimes to today I'm not just trying to give you you know this the sordid side of Afghan history but because it I'm convinced that it is very relevant while I was in Kabul this past January I went around and asked that question of people who either knew the Taliban perspective or had a sense of the Western perspective or just knew something about Afghan history so here's one view of a heed Mojde some of you may know him he's a former Taliban official he's friendly to the Afghan government he supports the Afghan constitution but he has good lines out to the Taliban leadership and this is what he said that massacre and he's referring to the 2001 massacre at dash D Lely was the basis was the foundation for all the fighting that is now going on and he said General Dostum did this work I went then to the US military just to because I thought this is a fairly interesting summing up of relevance and I asked what do you think of the of this statement by mr. Mojde and to my amazement American officials at the very heights of the military basically said they agreed and I'm give you a quote I talked to this general but it was on background so I can't give you his name the massacre he said has absolutely increased Taliban motivation those kinds of things just thicken the hatred and cause more people to join the Taliban as for general Dostum he said when leaders like that leaders quote unquote like that do stupid things like that they only serve to hurt what we are trying to do out here so a footnote general Dostum a far from he had been in exile for a while because he had been beating up people and getting out of control general Dostum has now been appointed chief of the Afghan army by Karzai and sometime in January without any public debate and at a point that parliament was not in session president Karzai is reported to have issued yet another amnesty for Dostum and all the others against whom war crimes charges could be placed I say is reported to have because nobody really knows for sure whether this amnesty has been issued and taken and taken effect anyway my conclusion is that the problem remains hidden but it is a lethal one and it's at the center of bringing stability to Afghanistan and preparing the way for an American exit if the Afghans want to address it and I think for various political reasons the Karzai government's not going to the United States should if the United States won't well then perhaps the International Criminal Court should someone should take this up I'm not saying that this is going to end the turbulence of 30 years but it could certainly help thank you well thank you both those very you know intriguing and compelling remarks we'll go ahead and get right into questions again we have microphones throughout the room I'll go ahead and ask the the first question though and it'll be to both the speakers here you both touched on an issue at least a theme that I picked up of credibility and how important that is to success in Afghanistan so I would like to know there's issues regarding the credibility of the Karzai government what needs to be done what can be done about that and who needs to be involved in that process so dr. Tosh will start with you sir I think that we should have been proactive on that issue to make making sure that the president presidential elections were fair open and and just for all people we didn't do that so we know that there was massive fraud and as a result of that fraud present cause I got elected so the issue is what should we do now to enhance the credibility of already of a sort of a tainted president I don't think that we can restore it completely but at least we can enhance it to the extent that we have adequate credibility and in legitimacy from the eyes of the Afghans the first thing that we should do is demand from President Karzai and persuade him in a very friendly way that he should appoint a credible competent and dedicated people the problem in Afghanistan now is that in I've been challenged by some Afghans to show me one individual that is not in the payroll of a foreign government that is in the cabinet so that's the kind of whether this is true truth or not that's the perception in Afghanistan and with that perception do you think that the Afghans would follow that kind of a government and it's the second thing is that we need to deliver on the services for the people very quickly and and I think the issue that Mr. Guttman raised is a very important issue somehow we have to hold these people that have committed crimes and I'm not only talking about war crimes about economic crimes about massive things that have been done in this in these few years I think we need to hold them accountable and I think those things what at least restore some of this lost accountability and I think at least to the extent that we have a workable government the I was very fascinated while I was there I was very fascinated while I was there to see the Parliament actually acting up and acting like a Parliament and rejecting many of the nominations of President Karzai for his new government as a kind of a protest against his legitimacy I think they made some some errors they they knocked out some good people and but they also knocked out some people who never should have been on the list anyway and they did it twice and I went to one or two parliamentary debates and I was really quite impressed by the openness of their of their discussion and their open criticism I mean for a Parliament that had been really in the pocket of President Karzai all along that these guys were really angry they were and and I thought the basis of their anger was that that the President himself his own legitimacy was in question and the one thing that the one ray of hope maybe that you could have in a system of such that has has not really worked there is that the Parliament could become it could could actually do its job as a as an equal branch of government now the problem is they're about to have elections the Karzai wanted to do it actually as early as May and he was going to stack that the deck once again and try to see that his people got elected everywhere and the Parliament resisted that as did the international community and that election now is slated I think for the end of this year and once again President Karzai is is trying his very best to to load the decks in his favor this is something where the international community has a voice it's also something where the Afghans have a voice where and where the Parliament has a voice this is a this is a play in progress I think the one thing you could hope for in this period while Karzai is president is for a Parliament that actually does its job and and starts to expose corruption and so on one of the fascinating things to me is that representatives even if they didn't get elected completely in the most honest way and this goes out actually I've been in Iraq as well another nascent democratic system is that they they still have to represent their constituents or their constituents expect them to represent them and that when something goes very wrong as it did in the in the national elections constituents come to the members of Parliament and and complain and then them and and if the complaints rise enough you know there is there is that thing and so with all the flaws of the system that are there and there are many that were created in this in the bond conference that may be the one the one little glimmer of hope great great thank you both so much okay we'll go to the audience for for questions right right here in the middle microphone again please state your name in your affiliation and question thank you my name is dr. Warner Anderson I'm with the office of the assistant secretary for defense for health affairs the international health division my question primarily is to dr. Atash this this is going to this is going to be a tough question but you wanted the military to ask Afghans the questions so here goes we I think we all believe that all development all projects in Afghanistan need to be sustainable how do you achieve sustainability in a nation that has virtually no tax base and whose major product seems to be illegal in all countries including Afghanistan I think here again your question is premised on misconceptions and myths about Afghanistan just go back to 30 years ago in Afghanistan prior to them we had quite a many projects that were sustainable and a lot of projects done only with afghan resource think of for example the Kabul Jalalabad road this new road the Mahipa the engineers were afghans the workers were afghans and this was completely an afghan project no foreign assistance whatsoever committed to that so the fact that those projects were sustainable and even the projects that were done with the assistance from other countries the major player major condo and were afghans and the projects were designed by afghans and with the support and help us ussr Germany and other countries and those projects are still some of them are working look at Surubi hydroelectric this was you know one of the oldest projects in the hydroelectric in Afghanistan it's still working the Nagloo which is in the Maipar which is a German my Nagloo was a was a Russian all of these projects were sustainable plus many more projects I think they're the way that we can make projects that statement first those projects have to be relevant and needs to be fit with the national goals and I have experienced with small projects that's why we went to those people and I have projects in Neuerson for example through Neuerson Foundation now that's still running for example small hydroelectric projects the way we did the projects was we sat with the people I said okay what do you really need in this community and then they would identify their needs and then we say okay now what is your contribution to that because it's going to benefit you know improve your life and what do you really actually do not have that we can provide you and through this cooperative ventures with the people I think the projects were much more sustainable some of the projects unfortunately were done very quickly and in those days and through especially through the national solidarity program that was a good program but I think some of the those things were done because just to accomplish things in remote areas and provinces and I think we can do it provided that we have a credible level in government and there is no corruption and that that fits the national vision and national plan. We'll go over here to the front in the red picture. Stanley Kober with the Kato Institute for Dr. Atash you said we should demand a president Karzai that's such and so let's say we demand it and he tells us to go jump in a lake so what's the threat what do we have that is so intimidating that he would submit to our demand. From let me answer that from an Afghan perspective the Afghans say who brought prison Karzai into power and who is keeping him in power the fact that we cannot do anything about it whether that's real or imaginary from an Afghan perspective that's something that's kind of baloney. You're saying we should have a clue. Well let me tell you there are mechanisms in the law for this and and I have advocated those publicly and I got into trouble on that for example what do you do when when the president breaches the constitution. By my count and I'm not an attorney 26 items of the constitution were breached by this president. Some of them act of omission some act of commission so there is ample ample justification to proceed on impeachment if you want to do that and it's not cool actually it will be but I think if we if you're serious enough prison Karzai will listen and he will be the last person to resist that temptation. I think we should have a good exit strategy for him and that is a very good exit strategy if he doesn't deliver and deliver on time. The problem is I think that some of the US people are really cozy with him and I don't know which I'm not an expert on the US I think whether it's CIA or DIA or whatever it is but some of those people are really working very close with him and I'm telling him that yes go stay on this course nobody's gonna do anything with you. So first we have to get our act together and come up with a with a strategy that we really mean that mean business and I think if you cannot deliver on that strategy then on that point that we shouldn't send more troops we shouldn't increase the resources because when you always sit and and we are we gonna my you know my kind of worst scenario cases that the US is gonna kill 1 million Afghans in the next year and a half if this situation is not changed and what is going to happen is we are going to spend billions of dollars probably 200 billion dollars in the process in a couple of years and and and achieve nothing I think the best thing would be then if that's the case we should pull out that's a much better strategy than than continuing on this course where we are gonna kill innocent Afghans and achieve nothing. Well he is our guy we created him we put him in there and the whole process of doing these things usually comes a cropper I mean not Afghanistan is not it's only the latest example of that you do want the Afghan people to have their voice and obviously what happened at the Bonn conference was a you know quick fix that was that just left to country in some years down the road in a very messy political situation I have to disagree with Dr. Atash on the on the remedy I think Afghanistan is more than Karzai I think the stability of Afghanistan is a fundamentally important thing for American security and for the security of South Asia and the security of the Middle East I think if if the government creaky though it is is defeated if the Taliban come back into power you are going to have a situation where Afghanistan becomes a magnet as it was during the 19 later 1990s for jihadis from all around the Islamic world but in fact you're gonna but it's going to be even more intense because this will be to a Taliban government that can claim to have defeated the United States the West everybody so I think we have to bear that in mind as we deal with as the United States deals with Karzai it's very interesting I'm not quite sure myself which American institution or body or agency is dealing with Karzai very positively I couldn't find one while I was there certainly at the State Department they're all in disagreement with them the US ambassador is often at sorts points with him the general McChrystal is by default almost the person who sees him the most and who seems to get along the most decently with him but doesn't have an easy time at all you have to find workarounds I think you have to keep an eye on the big picture here and and and and withdrawal in any short-term way and leaving the country to collapse I think would be an utter disaster let me just I don't think that I meant that we should withdraw whether my point is we I agree that this is a critical place and we need to succeed and for order to succeed we need a credible African government and my thesis is that without that we are not going to succeed so well we have to make sure that we get it right on that issue and I don't see any problem why we cannot achieve that because I see it as a very simple process and I don't see it as a very complicated given the persuasions that we have and I give one example I think we can achieve that then and so yes we should achieve we persistent we persuasive and make sure that we achieve that okay let's go with one more question we'd like to end on time the gentleman right here on the right-hand side of the room in the gray suit thank you Frank Kenevich I'm with Beacon Technology a member of the Afghan advocacy group for quite some time I was previously with the state the USA ID the State Department and the World Bank for 40 years my connection to Afghanistan goes back to the early 70s when we worked on the Helman Valley program the Khajii Dam engineering unit school of Kabul University etc. I had a supporting minor supporting role in the cross-border program Charlie Wilson's war and was called out of retirement early 2003 to lead the US government programs flagship the reconstruction of the Kabul-Kandahar Highway we de-mined reconstructed fought with the Taliban and laid down 250 miles of asphalt in 250 days of world record and much of that was because of Afghans helping us thank you on the issues sustainability and I think Dr. Gutmann's point about five wars in Afghanistan I believe there's a sixth war and some of us have sort of touched on that in this room I am a known critic of my own government here because I've seen it not as Dr. Attash says with the courage and wisdom to do what's right and the guts to pursue that I've seen in fighting in the US government go on now for seven years there was a very good start up through late 2005 but the infighting in the US government I can guarantee I worked in poppies in Thailand, Laos, Turkey, Coca in Latin America I have a background in the things that people I'm sorry sir we're running short on time can you can I get to ask a question please but my point is this until the US public pressures its own government to get the plan right General McChrystal and all my former good military colleagues and others are not going to be able to win that isn't the war when the Russians came in in 79 there were two million landless Afghans out of 14 million 80% of the infrastructure and economy was destroyed when we returned there were 10 million landless Afghans and that's what they're looking for and it ain't government thank you. Sir was there a question to that? The question is okay I think I see some positive developments especially with the election of President Obama that he opened up this issue in terms of why we are there and how we can achieve and in terms of I know there was a great deal of work to strategize for Afghanistan but I think that's not enough because I believe that this in the formulation and implementation and assessment of the strategy Afghans need to be integral part of that that's why we need credible afghan government and all Afghans to be part of that strategy I think in terms of the formulation and implementation there is inadequate afghan presence from that in that process secondly we need to do more in terms of winning the hearts and minds of Afghans and I don't think that it would be the PRTs would be adequate for that PRTs serve their purposes when we had emergency kind of situation Afghanistan there was no government and they so and there was corruption basically so we need to come up with mechanisms for delivering services and economic development so that Afghans see improvement in their lives and I think there are ways that we can do this how do we move that with the US government and of course this is a democracy and what we are having here it's it's a it's an example of that I think this is going to influence our thinking first and we are we can develop consensus amongst ourselves different circles that's why I devote a lot of my time to meetings like this and I believe that eventually it will have its effects and I I'm one that I really advocate and you're part of the Afghanistan advocacy group we work together on the involvement of the US in Afghanistan but I wanted to be it's you know constructive and meaningful and fruitful for all of us and I think we can achieve that if you work together Mr. Grubin I'll give you the last word if you have anything to add to that well I think that the US for the longest time is treated Afghanistan as an object and as seen it is not as a real country but as a platform for attacking somebody else or defending something and I think that the beginning of wisdom would be well we have to absolutely have to listen to Afghans and this memoir is is an example of an Afghan we should be listening to but we have to treat the country as a real place it's it's true they have no oil it's true that they're but they have a lot of other resources and their human resources are really incredible Afghans the character of Afghans is really as you know yourself really something to behold and they can be some of the great people and they can do great things we have to look at it as a real place and a place where we're going to be committed to help them until they get it straightened out well great we thank you both for your remarks I think we have copies of the books available for sale in the back but we'd like to thank both of these speakers for those remarks