Memorial Service for John Andrew Fixsen, FRCS, 1934-2014

The recent memorial service for John Fixsen, our urbane and distinguished consultant who carried the flag for SGAA in Afghanistan for many years, was a fitting tribute to a remarkable man. Modest, unassuming, and softly spoken, John bore his great medical knowledge lightly. There was often a mischievous twinkle in his eye, but he was deadly serious about his mission: for John the patient came first and last.

John FixsenJohn Fixsen

John Fixsen tests these baby boys for developmental dysplasia of the hip (DDH).

A pilot project in Samangan Province found 16 babies out of 80 sent for testing to have dislocated hips.


When we began working in Afghanistan in 1986, there were after years of revolution and war many hundreds of thousands of amputees and other disabled patients. Since then, year in year out, we have treated literally thousands of amputees, providing them with artificial limbs [prostheses]; and many more thousands of children suffering from polio, cerebral palsy, club foot and spina bifida - a disease of the spine. Our main activity now is to send out regularly our highly experienced consultants who were led by John. The work they have done, often in difficult conditions, without complaint, has been enormously valuable. We are immensely grateful to John, who would have been 80 this year. His companion on many trips, a leading physiotherapist, Mrs Jeanne Hartley, currently representing SGAA in Afghanistan, sent this moving tribute, read out at the service by her husband, Peter, in the 11th century St Bartholomew the Great church in the City.

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Chairman's Letter 2014


Here is my letter that accompanied our 2014 Calendar.

The calendar contains some eye-catching photographs, for example the June entry of a tribesman with his magnificent Afghan hound and an aerial picture of Mes Aynak, in Logar, one of the world's biggest Buddhist sites, under which lies a huge copper deposit.  I was in Afghanistan twice this year, in March and September, accompanied by Fiona who was our 'rep' there for seven years, brought up her family there and speaks fluent Farsi.

On the surface central Kabul looks much as usual, choked with traffic, up to the minute 4x4s, each bigger and better than the last.  Somebody must have plenty of money, not that that's new!  They must have belonged to warlords, or their henchmen, since they were full of bodyguards.  In the smarter parts of town such as Wazir Akbar Khan, everyone has security, outside and in, with a sentry box on the gate and more security men inside.  Assassination is a threat every VIP has to live with.  Even the tall, good-looking former Governor of Kandahar, and friend of President Karzai, who had just made him head of Afghan Intelligence, was fooled by one visitor who somehow got through the security screen and set off a bomb in his office, not killing him but very seriously injuring him.  Suicide bombing is a typically treacherous al Qaeda trick, which has killed many of Afghanistan's best leaders.

After several days in Kabul we drove with a friend, one of Massoud's top commanders, who lost a foot fighting the Russians, up the Panjsher Valley.  It is still as beautiful as ever, the autumn colours painting the trees along the river gold, the river itself which I first saw when I went to report the Russian invasion in 1982, unchanged.   The big house that Ahmad Shah Massoud, the Lion of the Panjsher, built on the mountain half way up the valley, looks empty and forlorn.  Massoud himself was killed by al Qaeda suicide bombers posing as TV journalists in 2001, two days before 9/11. He was a heroic figure, certainly to his own people and to many others including the British and myself.  It was a pity, in historic terms, that the Americans never, alas, got the point.

Back in Kabul, where all the talk was of the 2014 presidential election, a former Interior Minister told me that things were looking worse now than before the last election in 2009.  Taliban attacks were up, he said, a lot, and Afghan Army casualties, too, to a worrying extent.  Since Pakistan still supports the Taliban, the inference is they are still determined to force the Taliban back into power.  

On the charity front, there still seems to be as much need as ever to support our clinics.  For example, the Afghan Red Crescent, in whose hospital we have been financing a small but very popular physiotherapy clinic for mothers and children for several years, are now saying they want our room for themselves, giving us the choice of either giving up the clinic or paying for alternative accommodation.  And yet our Department for International Development (DFID) say they are giving huge amounts of money to the Afghan Ministry of Public Health.  In fact when I asked for a grant some years ago, they suggested I should ask the Afghans! I nearly replied 'You must be joking!'

Despite this there are some good results, amongst them the two paediatric programmes initiated by us for children with clubfoot and developmental dysplasia of the hip, [DDH].  We identified and treated over 200 cases in 2013.

At the end of next year, 2014, the US, Britain and other NATO forces will depart the battlefield.  But Western backing, especially for the most vulnerable Afghans, will continue to be essential.  We hope, with your support, we will be able to continue to play a small but significant role in the future Afghanistan. It will be the 31st year of our involvement!

With Warmest Good Wishes,

sgaa sig

Sandy Gall, Chairman




According to the 2005 National Disability Survey of Afghanistan, one in every five households in Afghanistan has at least one family member who is disabled. This is a result of 30 years of war, landmines, disease and poverty.

Since 1986 Sandy Gall's Afghanistan Appeal (SGAA) has trained Afghan professionals to provide artificial limbs and other mobility aids for more than 25,000 people with disabilities and provided physiotherapy treatment for over 60,000 patients with temporary and permanent disabilities.

Activities were initially based in Peshawar, Pakistan where there were over 1 million Afghans living in refugee camps in the 1980s and 1990s. SGAA gradually moved its activities inside Afghanistan from 1991 onwards and set up two main centres in Jalalabad in 1993 and Kabul in 1996.

Since 2006 SGAA has signed a partnership agreement with Swedish Committee for Afghanistan and its activities are now merged in a community based disability programme which works in 13 provinces.

This programme both treats people with different types of disability and offers them a range of services including home-based training, physical rehabilitation, education, skills training and business loans.

Physiotherapy Consultant’s Report. April 2013

The Chairman and Mrs Gall visit Kabul and Jalalabad March 2013

MahpekaiSGAA staff from the Component and Orthopaedic WorkshopsSGAA staff from the Component and Orthopaedic Workshops
Malek swimming raceMalek swimming race


Top left: Mahpekai, senior prosthetist-orthotist, and double amputee, showing a drop hand splint she has fabricated.

Top middle, top right: SGAA staff from the Component and Orthopaedic Workshops

Bottom: Malek, who is a double amputee, winning his race in Kabul.


Hashmatullah’s story

The boy in the picture is Hashmatullah. He and his father were walking through Darulaman (a suburb of kabul), Hashmatullah in front, when the father shouted: 'Look out, there's a mine !'


The words were no sooner out of his mouth then there was a terrific explosion right beside Hasmatullah, wounding him in both legs and seriously injuring his father who died two days later. By some miracle, Hasmatullah survived but he lost almost the whole of his leg. It was amputated just below the hip and half of his leg, amputated above the knee in what is known as an AK.

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2015 Calendar

Giles Duley photographs an amputee trying out his new leg at the ICRC hospital, Kabul

Our 2015 calendar featuring images by award winning photographers is now available. Click here to order

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Memorial Service for John Andrew Fixsen, FRCS, 1934-2014

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