When Dr. David Crawford arrived at a Kabul hospital with two fellow medical professionals, he and his colleagues saw something they have never encountered in their careers: A sign telling them that weapons were banned from the hospital.

“We’re not in Kansas anymore,” said one of the nurses.

Crawford — a local physician and former Napa city councilman — was in the capital of Afghanistan last month, volunteering at CURE International Hospital of Kabul. Specializing in internal medicine, Crawford — who works at Kaiser Permanente Medical Center in Vallejo — said he left on Sept. 29 and returned to Napa on Oct. 19.

Several factors led to Crawford’s decision to visit Kabul, the capital of a country wracked by war, terrorism and poverty for decades.

“We were told (Afghanistan) has the second-worst health statistics in the world,” he said, adding that the country’s residents can only expect to live to about age 44. Crawford also said the convenience of trainings in English and an opportunity to work in a teaching hospital influenced his decision to travel to the Middle East.

Afghanistan’s medical statistics are daunting — more than half of the country’s children are severely malnourished and a quarter of them die before reaching age 5, according to CURE International, a Pennsylvania-based organization that runs teaching hospitals in developing countries. The group has a 25-year contract with Afghanistan’s government to train new doctors.

Crawford, who said he learned about CURE’s mission while attending a medical conference in Louisville, Ky., in 2006, worked alongside pediatricians, obstetricians, surgeons and other internists in Kabul. The hospital boasted a total of 15 resident physicians, a handful of which specialized in internal medicine, said Crawford. On a typical day, he said, the internists saw 20 to 30 patients.

Crawford said his patients primarily suffered from the same diseases and conditions as westerners, including coronary artery disease, heart failure and pneumonia. Still, there were some more unusual diagnoses, such as tuberculosis and meningitis. Crawford also said some of his female patients — many of whom wore burkas for decades — suffered from thinning of the bones due to vitamin D deficiency prompted by inadequate exposure to sunlight. Crawford even treated a few patients with leprosy, a condition he had never witnessed first-hand.

In spite of the fact that he treated illnesses rarely seen in the west, Crawford said Kabul’s medical facility was fairly well-stocked with basic antibiotics, blood pressure medications and other supplies. However, he said, the hospital lacked extensive lab services, so it took about a week to get test results after doctors shipped samples to a nearby facility.

Though he spent most of his time treating and assessing patients, Crawford said he had the opportunity to leave the hospital a handful of times. Most locals were friendly, he said, but it was unsafe to venture outside of the hospital for long because of the risk of hostage-taking or suicide bombings by terrorists. Visiting only open markets and a restaurant, Crawford said most homes in the area featured eight-foot perimeter walls and armed guards.

Crawford said the trip, his first to Afghanistan, will likely not be his last experience in a teaching hospital overseas; his next destination may be Kenya.

Crawford said the most rewarding aspects of volunteering at a teaching hospital include “seeing how grateful the patients were and likewise how grateful the doctors were and how eager to learn they were.”

Crawford said developing countries like Afghanistan benefit most from teaching hospitals. “You know you are doing good that will last, because these doctors will be there for years and will improve medical care in that city.”