The United States has spent more than $100 million on a huge hospital in Kabul, Afghanistan, for treatment of Afghans wounded in the current war. On Tuesday, a congressional subcommittee held a hearing about what one member called the "horrendous neglect and abuse of patients" at the facility.
Another congressman blamed one of America's top generals, William Caldwell, for the problem.
The Dawood National Military Hospital is run by Afghans but virtually all the funding comes from the United States and the United States and other allies staff the hospital with doctors, nurses and other medical experts who "mentor" the Afghans providing the treatment.
Air Force Col. Schuyler Geller is a doctor who was the senior U.S. commander for the mentors at the hospital in 2010. Now retired, he said last week that almost from the time he arrived at Dawood, he saw problems.
"Things as simple as dressing changes are not done, patients become infected and then die," Geller said. "There are patients that are starving to death because they can't buy the food, they have to bribe for food, they have to bribe for medicine ... patients were beaten when they complained about no pain medicine."
Within months, Geller said, he began pointing out the problems to his chain of command, including Lt. Gen. William Caldwell, the commander of the NATO Training Mission-Afghanistan.
At Tuesday's hearing of the House Armed Services subcommittee on oversight and investigation, Caldwell was criticized for allowing the problems to continue on his watch.
"In my view, he (Caldwell) displayed a fundamental lack of leadership," said Rep. Mike Coffman, R-Colorado. "The problem really rose to the top and it's stunning that he's still serving today in the United States Army after all that has occurred here."
Geller has said when he first pushed for an outside inspection of the hospital, Caldwell was angry and his deputy said it should be delayed to avoid embarrassing the White House just before the 2010 midterm elections.
Caldwell did eventually ask for a Department of Defense Inspector General investigation of the hospital. But that investigation began after the election.
There is no indication the White House was aware of the alleged delay of the investigation.
The Pentagon does not dispute that there were serious problems at the hospital. But it blames underfunding and Maj. Gen. Ahmad Yaftali, Afghanistan's top medical officer at Dawood. David Sedney, the assistant defense secretary for central Asia, said "Gen. Yaftali was removed from the leadership of the hospital. To our knowledge he does not have another position inside the FDN forces."
Since Yaftali was replaced, the Pentagon says, the hospital has improved. Kenneth Moorefield, a Defense Department Inspector General, testified that a team of inspectors visited the hospital two weeks ago and found there "were no complaints or evidence of patient maltreatment; new processes and procedures to improve personnel accountability and patient care."
But Geller said last week that corrupt Afghans warn the hospital when inspectors are coming so they can clean up and hide mistreated patients. At one point, after the Defense Department Inspector General's first inspection and after Yaftali was replaced, Geller said one of his colleagues made a surprise visit and found "the same horrific conditions."
Rep. Jackie Speier, D-California, said Geller should have been called to testify Tuesday. "I'd like to express disappointment; however, that Col. Geller is not before the committee to discuss his concerns about the significant level of corruption in the Afghan military medical organization. If his allegations are true, we can only conclude that the Army was complicit in wasting millions of dollars and the horrendous neglect and abuse of patients that had a reasonable expectation of quality care."
Geller is expected to testify in the near future when a separate congressional committee holds hearings on the hospital.