ISAF docs struggle to save scores of children in Afghanistan

CAMP BASTION, AFGHANISTAN

07.17.2010

Story by Gunnery Sgt. Steven Williams 

Marine Corps Air Station Miramar

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CAMP BASTION, Afghanistan – A call comes in to the Camp Bastion Hospital – medical evacuation helicopters are inbound. The staff scrambles to ensure they have enough medical personnel available. They also have to prepare special kits for this batch of patients they are about to receive – the pediatric kits.

Six children ages 6 to 11 years old are brought into the emergency room with burns over 20 to 70 percent of their bodies. Two are sent to Kandahar Air Field for specific care. Two are hustled off to the intensive care unit. Two are placed in “expectant” care – the nurses are just trying desperately to keep them comfortable and out of pain as they pass away.

It’s not a rare occasion. The hospital cares for scores of children every week, suffering from all kinds of severe trauma like head injuries, burns and gunshot wounds. As interviews for this story were being conducted, nurses said approximately 50 percent of the patients in the intensive care unit were children.

“I think our staff is quite well-versed in that now,” said Royal Air Force Squadron Leader Sarah Charters, the officer in charge of the emergency room at the hospital. “Before we came out here, some members of staff had some anxieties about looking after children. But we’ve got two pediatrics specialist nurses who are based in the hospital and they’ve done a lot of training and mentoring with our staff. I mean, most of our staff are used to looking after sick children, but not with the same frequency and intensity as we’ve seen out here.”

Out here, the enemy follows no laws of war. Their tactics take a toll on even the most innocent victims.

“It’s frustrating sometimes because you feel as if they’re carrying a burden,” said Lt. Cmdr. Tymesia Cortez, a critical care ICU staff nurse. “They’re innocent.”

The coalition doctors say they only hope the children truly understand what they’re trying to do for them.

“We don’t know what a lot of Afghans feel about us,” said Lt. Cmdr. Cheryl Cottrell, another critical care ICU staff nurse. “And when they come through our door, I think it’s part of our culture to be a good host in this hospital and show them we are very decent people and we give them as much care as we would give to a U.S. soldier or a U.K. soldier. It’s my hope that they feel that we are attentive to their needs and that we are caring for them in them in the best way we know how.”

It seems to be something many Afghan adults understand. Like the case with the six children in this story, adult Afghans often rush children or other injured adults to the nearest coalition troops asking for emergency medical attention.

“They know if they get to the closest point where there are coalition troops that a corpsman will look at them,” said Navy Hospital Corpsman 1st Class Jose Belen, a corpsman with 3rd Marine Aircraft Wing (Forward) who is one of the medical personnel who plays an integral role in coordinating medical evacuations in southern Afghanistan. “The corpsman will then make a decision as to whether or not the injuries are serious enough for the casualty to be evacuated.”

And the care doesn’t stop at Bastion. There is a unique team at the hospital responsible for getting patients, child or adult, on to follow-on care at other hospitals. The Critical Care Air Support Team is a five-person Royal Air Force team capable of any level of care on any aircraft.

“We have an excellent standard of care with the most modern intensive care technology,” said RAF Squadron Leader Lucy Ryder, CCAST flight nurse medical officer. “We can activate and be in the air in an hour.”

The CCAST team treats local nationals, Afghan National Army, Afghan National Police, U.K. and U.S. service members along with pediatric patients. The Afghan patients are taken to places like the Afghan National Army’s Herat Regional Hospital or Kandahar Regional Military Medical Center, or the civilian-run Bost Hospital in Lashkar Gah.

The Bastion Hospital staff doesn’t hear much after the patients leave the doors for follow on care. Many wonder if they made a difference.

“I always wonder about that feedback,” said Cortez. “Has their perception of us changed? Did they see how much we give of ourselves to care for them? I hope that they think we’re better than what they may have heard.”

The 9-year-old boy with 32 percent burns over his body thought so.

“We called the interpreter,” explained Cottrell, “just to let the child know they were going to put him on the litter and he was going to fly to this other hospital, and he did not want to go. He was a little upset. He wanted to stay here.”

But the staff hooked the boy up with the typical going away gifts – some extra clothes, stuffed animals and other little things donated to the hospital to share with the children.

The nurses say it’s difficult to see the number of children flowing through the ICU with the severity of the wounds they suffer. Many, like Cortez and Cottrell, are parents and are empathetic for a child in pain. However, their passion for helping the children and all ailing Afghan people thrives because of patients like the 9-year-old boy who did not want to leave.

“He feels comfortable here,” said Cottrell. “He feels safe here.”