Plastic surgeon Abdul Ghafar Ghayur is practicing his own brand of welfare in Afghanistan, where access to healthcare is limited and many cannot afford private treatment.The money he makes from the hundreds of nose jobs and Botox injections he performs on wealthy Afghans allows him to perform life-changing surgery on low-income patients at a discount or sometimes for free.Ghayur's practice in the capital Kabul offers a microcosm of Afghan medicine, where doctors, driven by a sense of civic duty, try to fill huge gaps in a public health system devastated by decades of war.The surgeon ticked off parliamentarians, business directors and other "rich people" among his clients, who got their ideas online or during trips abroad and were prepared to pay thousands of dollars for cosmetic surgery. The average Afghan monthly wage is around $35.Income from such treatments, a relatively new phenomenon in Afghanistan, allows him to make a good living as well as treat low-income patients who turn up unannounced seeking reconstructive surgery to treat disease, congenital disorders and post-traumatic wounds.Many of these patients arrive with late stage illnesses and require urgent attention."If a patient comes and says 'I can only pay $100', I can do it for $100. Or $20, or $30," Ghayur told Reuters during a recent morning consultation."Because if we decide to wait until the patient has the money, the patient will have no chance of survival."He added: "I have treated lots of skin cancer patients for free, because some of them had small tumors that were 100 percent curable."