Casualties at Camp Bastion:
British Army Field Hospital Saves Lives in Afghanistan
The most advanced hospital in southern Afghanistan is housed in a tent in the middle of the desert and provides life-saving treatment to the injured personnel of NATO's International Security Assistance Force, Afghan government troops, Taliban fighters and the innocent civilians caught in the middle of the conflict.
The British Army Field Hospital at Camp Bastion in Helmand province is run by the United Kingdom Joint Forces Medical Group. It boasts a five-bed accident and emergency department equipped with two portable digital x-ray machines, a CT scanner and an operating theatre. Ward space is provided for 25 casualties including up to eight patients in intensive-therapy beds.
The moment I arrived at the hospital in early May I had to deal – photographically and emotionally – with the scene of six British casualties brought in by helicopter from the front lines. The young Brits had been seriously wounded by a rocket-propelled grenade attack carried out by the Taliban.
At first, I photographed from a corner in order to stay out of the way and out of respect for the usually sensitive reaction of the military to photographing casualties. But as I spent more time with the UK Med Group, they became accustomed to my presence and my documenting their work. They would even call when casualties were expected.
I had seen casualties in other war zones. But this was the first time I daily witnessed blood gushing from the open wounds of Western soldiers in a Western military hospital. It was the first time I could understand the shouted orders and comforting whispers of the medical personnel and the frightened pleas and cries of pain from the soldiers.
Outside the temperature was about 45 degrees C (113 degrees F) and although the tent is air-conditioned, it was hot and very humid inside. The scent of blood mixes with the body odor of the soldiers, many of whom have not washed for days because of the lack of water at the Forward Operating Bases where they are stationed.
Against the dusty dun of the desert, the scene is graphic: the red of the blood and of the vests worn by members of the trauma team, the green of surgeons' vests, the tent's white fabric walls and the soldiers' khaki uniforms stained with blood.
One soldier, his face an expression of pure horror, was covered with blood. The Army Medical Emergency Response team that picked him up in the field had written his blood pressure and pulse readings on his forehead with a marking pen.
The trauma team stabilized him and moved him to the operating theatre where he underwent surgery to extract shrapnel from all over his body. He was flown back to a military hospital in the UK a few hours later as is standard for all the soldiers passing through the field hospital.
British Army Major Andy Bruce, wearing a Union Jack on his surgical cap, performed the operation as well as roughly 130 other surgeries in the seven weeks he had been at Camp Bastion. The orthopedic surgeon said that in the UK a surgeon usually does no more than two or three surgeries a week.
The field hospital also had a general surgeon and a neurosurgeon on staff but Major Bruce was the busiest since most of the casualties had injuries to their limbs. The soldiers' bulletproof jackets protect their upper bodies but leaves their arms and legs vulnerable to razor-sharp shrapnel flying from roadside bombs, improvised ordinance devices, land mines and rocket-propelled grenades.
One day I joined the ambulance troops at the helicopter landing zone. But instead of medics carrying a stretcher I saw four British soldiers come out with a body bag. The soldiers were from a unit I had been embedded with just a few days earlier.
Led by Sergeant Major Wayne Scully from the 1st Battalion Grenadier Guards Regiment, the soldiers were carrying the body of Guardsman Neil Anthony Downes, killed in action on June 9, 2007 when a roadside bomb exploded.
One of the soldiers shouted: "It's Tony!"
We had been out on the front lines together. We had slept in sleeping bags on the road exactly where he was killed. One moment I was photographing the life of a soldier and a few days later I was taking pictures of his death.
The soldiers have volunteered to do a dangerous job, but in the eyes of the injured Afghan civilians, especially the children, there is complete confusion.
The first time I entered Ward 1 of the hospital I saw an Afghan girl wearing a red shirt recovering in her hospital bed. Her face had been completely burned.
Felishima, 8, was injured when the roof of her house collapsed following a mistaken U.S. bombing of her village during the fighting between ISAF and the Taliban.
I was captivated by the smile of another patient, Malalia, a 5-year-old Afghan girl whose right arm was crushed when she was hit by an Afghan National Army vehicle.
She was taken directly to the operating theatre in the military field hospital. The doctors thought an amputation was necessary but in rural Afghan society it would have resulted in her being ostracized so Major Bruce promised to do everything possible to save her arm.
Her arm was repaired with makeshift external scaffolds of wires, plastic tubing, aluminum bars and plastic ties, since the hospital did not have specialized pediatric equipment. Five weeks later, after more surgeries and skin grafting, the arm had healed and Malalia was able to move all her fingers.
The British military medical personnel from the UK Med Group are committed to saving their patients, no matter who they are; they put in 24-hour and even 48-hour shifts without giving in. They are beacons of humanity in a horrible war.
© Marco Di Lauro
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