A clinic in Afghanistan

Lab technician Nasratullah Ahmadzai takes a blood sample at the International Medical Corps health center at Lower Sheikh Mesri camp for returning refugees near Jalalabad, Afghanistan. The corps, a Los Angeles-based nonprofit, trains health workers in remote and dangerous areas. (Alexandra Zavis / Los Angeles Times)

Peering through a gap in her black veil, Bibi Totia watched anxiously as the doctor examined her fussing grandson in a crowded refugee camp near the Pakistan border.

The doctor diagnosed flu and handed her a prescription for an antibiotic from the free pharmacy.

"God bless you," she said, clutching the precious piece of paper to her chest.

For nearly a quarter of a century, Totia has relied on the doctors of the International Medical Corps to care for her family, first as a refugee in Pakistan and now as a refugee in her own country, Afghanistan.

Although less well known than the Nobel-winning Doctors Without Borders, the Los Angeles-based nonprofit shares a reputation with its gutsy counterpart for working in places where no one else will go.

Corps staff members say they are able to work in places like Afghanistan and Iraq because they refuse to take sides, they build strong community ties and they stay under the radar. In parts of Afghanistan where government forces have little control, staffers say, they are protected by traditional village councils, known as shuras. Although Taliban militants occasionally detain the group's trucks and personnel, they are usually released within a few days.

"The Taliban are local people, and they respect our facilities because their families are coming there," said Dr. Abdul Wakil Ziar, the corps' Afghan medical coordinator. "The important thing is our staff treat all patients. There is no discrimination between Taliban and other people."

From the beginning, the corps emphasized the need to train local health workers who would keep providing care long after foreign aid groups have packed up. In the process, they helped pioneer a new approach to providing help in countries struck by war and natural disaster.

"In emergency work, what people tend to do is they swoop in, they fix things and then they leave," said Andrew S. Natsios, a former administrator of the U.S. Agency for International Development, now at the Walsh School of Foreign Service at Georgetown University. Corp members "were early leaders in the whole business of building healthcare systems."

The corps built and supplies the health center at Totia's camp, in a government-dominated area near the eastern city of Jalalabad. But the doctors, midwives, pharmacist and lab technician are all Afghans. Eventually, the group hopes to turn the facility over to the Ministry of Public Health.

"Capacity building" is now a widely accepted principle in all fields of humanitarian work. But that was not the case 25 years ago, when Dr. Robert Simon founded the International Medical Corps to help the victims of an earlier war in Afghanistan, which pitted local Muslim fighters known as the Mujahedin against an invading Soviet army.

Like most Americans, Simon had paid little attention to the conflict. Then a report by exiled Afghan doctors landed on his desk at UCLA, where he was an assistant professor of emergency medicine.

The report said Soviet forces were systematically arresting, killing or exiling Afghan health professionals, Simon recalled. In a country that had as many as 1,800 physicians before the war started in 1979, only some 200 were left. International relief groups had been ordered out of the country, so villagers had to walk for days to seek treatment at refugee camps in Pakistan and Iran, which were home to an estimated 5 million Afghans. Many did not survive the trip.

In the spring of 1984, Simon, determined to act, made his way to Peshawar, a Pakistani border town teeming with Afghan refugees, resistance fighters and U.S. and Russian spies. There he made contact with the Mujahedin, who sneaked him across the border.

Under cover of darkness, they hiked through rugged mountain passes, dodging helicopter gunships to take medical care to villagers.

Many of them were dying of measles, malaria and whooping cough. Others had lost limbs when they stepped on land mines or picked up bombs that looked like toys.

Among the sick and injured was a 5- or 6-year-old boy who was nearly comatose from an infected shrapnel wound. His father had carried the child for miles when he heard that an American doctor had pitched a tent in the Kunar Valley.

"He had lost his entire family," Simon said. "The only one left was that child."

Simon worked on the boy for 36 hours but could not save him. When he broke the news to the father, the man reached into his bag and, in appreciation for Simon's efforts, offered him the only thing he had to give: an egg.