The bloody results of IEDs
6th Nov
Last night (5th Nov) I watched as US surgeons and medical staff from the FST (Forward Surgical Team) operated on a local kid to save his life. He was brought in with a hernia, which had somehow gotten caught up in his testicle, and if it wasn’t treated it was going to kill him. The head surgeon, a Lt Colonel, explained that while they are not required to carry out this type of surgery on locals, they will always endeavour to help when time and resources allow. This was classic “Hearts and Minds” stuff, and the Colonel was well aware of that, but it appeared to me to be a genuine attempt to help as opposed to a contrived effort to win over the local population.
When the surgery was over the soldiers invited me over to their fire pit for after-dinner coffee. They have a huge brick fireplace and chimney built outside their rooms, and it was very pleasant to sit and bask in the warmth and glow of the fire. It was also a very conducive atmosphere for story telling. Many of the stories were of horrific wounds treated, or sad tales of death, but some were brighter and lifted the hearts both of those telling them and those listening. One such story was of a baby that they delivered just a few weeks before. The pregnant mother had been shot through the womb in an ambush, and the baby had to be delivered there and then. It had a small graze on its back, but was otherwise unhurt. Both mother and child recovered. Or the story of a young 10th Mountain soldier that arrived on a Medevac with an RPG sticking out of his body. Despite the fact that the patient had live ordnance in him which could have killed all those working on him, a doctor and several assistants volunteered to operate, and eventually removed the rocket and saved his life.
Of course, the soldiers said, you will never hear these stories on CNN or read them in the New York Times, as they are too positive. The old anger against the “liberal media” was high here, and they made no attempt to hide it from me. While polite and professional, as I have come to expect all US soldiers to be, they spoke of their anger that every story about the wars seem to be negative, and in no way reflect their experience downrange. They told me that it is almost impossible to find a story that shows any of the good work they do in Afghanistan, or the fact that the local people constantly voice their appreciation for their efforts to improve the lives of ordinary Afghans.
Today I saw those efforts again, firsthand. After a morning of excitement, due to the arrival of a container of mail, including letters, gifts, and Amazon parcels, there was an alert that two Afghan patients were on their way by Medevac. They had been travelling in a vehicle that struck an IED. Three others had died at the scene, and now the fight was on to save the remaining two.
I asked if I could stay and photograph and fim, and was told as long as I stayed out of the way they didn’t care. They had more important things on their minds than one inquisitive journalist.
The helicopter landed in the dark, the roaring noise and swirling dust adding to the intensity of the moment. Four soldiers rushed out of the darkness, their head-torches reminiscent of the flashing lights on an emergency vehicle, carrying the first stretcher. The patient was wrapped from head to toe in a green foil, to preserve his body heat and avoid the onset of hyperthermia. I followed them into the Aid Station, and straight into a scene of organised chaos. People were shouting orders, calling for x-rays, charts, blood tests, while the Chief from the Medevac crew gave a quick brief to the surgeons. The second patient was rushed through the doors, and laid out beside the first. As the foil was peeled back a man and a woman were revealed. Their wounds were horrible, and if anyone is squeamish, I recommend skipping ahead to my next entry.
The IED had exploded under their vehicle, and so the most extensive injuries were to their legs. Their were severe cuts and bleeding further up their bodies, but it was the damage to their legs that would threaten or change their lives. I was totally unprepared for what I was witnessing, and anyone who tells you that a journalist behind the lens of a camera is removed from the event, or is somehow distanced from the suffering that he is recording, is an idiot. I nearly passed out when I saw the woman’s leg being lifted, and then bending at the mid calf. In fact one of the medics got me a seat and told me if I thought I was going to faint I should sit down, as they had no time to deal with a head wound. Another medic told me there was no shame in passing out, that they had all done it at one time or another. He then went on to photograph me, telling me he had never seen someone go so white!
It was decided that the woman’s life was in more danger, and so she would be operated on first. Both legs were broken, and her left foot had a huge gash in it, as though someone had tried to chop it in half with an axe. It was gross. She was moved to the operating room, and prepped for surgery. I donned the requisite hat and mask, and steeled myself to document the doctors efforts to save the woman’s life, however sick it made me feel. However, when she was moved onto the operating table, and the true extent of the damage to her left foot and leg were revealed, I wondered if I would make it through the surgery.
The explosion had gone up through her foot, and it was destroyed. I can’t describe it any better than that. It was a bloody and broken pulp of bone and flesh. I just couldn’t believe it could be repaired, and unfortunately the surgeons voiced my thoughts. The woman would certainly lose her leg. But now came the worst news. Because this is an Aid Station and not a hospital, there is no follow up care facility. If a soldier is hurt in this area he will receive life saving treatment here, and then be flown to the ICU in Bagram to recover, before flying on to Landstuhl Regional Medical Centre in Germany. Because the woman would need massive aftercare following an amputation, the doctors couldn’t perform the required surgery. All they could do was open up the wounds, clean them out to try and avoid any infection, and then wrap them up again until a civilian hospital could be found to take her. The surgeons were angry and impotent. There was simply no way they could do what they knew had to be done, and so they did as much as they could.
The second patient also had broken legs, and one was so badly shattered that they had to drill screws into his leg and then attach metal bars on the outside to fix the bones in place. His other leg would heal itself, but would result in the bones fusing together around the ankle, and leave the man with massively impared movement.
The doctors were pretty despondent after their work was done. They said it was extremely frustrating to be put in a position where they couldn’t give the care that they wanted to. Even though they had done a huge amount to save the lives of the patients and certainly given them far superior care than the Afghans could have expected at any local clinic, the doctors said that was the most unsatisfactory night they had experienced in a long time.