.The Scots surgeon saving lives as Taliban rockets rain down
THE "ambulances" arrive back with bullet holes in their fuselages. The injuries sustained by the young people in his care are horrific: missing limbs, gaping gunshot wounds, ghastly burns.
To save lives, staff are urged to volunteer blood that can be pumped straight from their veins into a sterile bag and then instantly into a waiting patient.
It is far worse than a Saturday night in the A&E of the Southern General Hospital, Glasgow, and Peter Davis should know.
In his civilian life, he is a consultant at the Southern, often dealing with the aftermath of drunken fights, road crashes and a steady stream of stabbings and slashings.
But as Lieutenant-Colonel Davis, of the Royal Army Medical Corps, he is currently based in Afghanistan's lawless Helmand province, and his job is a constant struggle to save the lives of soldiers and civilians caught up in daily battles with Taliban fighters.
In a moving and exclusive dispatch from the troubled province, Davis describes both the horror and the absurdity of being a medic at war. He stresses he is just part of a dedicated team of doctors and medical support staff battling to keep alive a steady flow of casualties from fighting described as the toughest endured by British forces since the Korean war in the 1950s.
His role is both to treat casualties as they arrive as well as lead helicopter emergency medical response teams that fly out to battlefield incidents. "The helicopters are armed and the situations are dangerous," he writes.
Davis, a 43-year-old married father of three, has been in Afghanistan for a few months but has already seen more major injuries in that time than he would working for three or four years in the NHS. Some of the injuries are rarely, if ever, seen in UK hospitals: limbs ripped off by explosions, high-velocity bullet wounds to the head or neck, and blast injuries.
Although the tented hospital they work in has the best of equipment and staff, their labours have to take place in all-enveloping dust.
"We might as well be on the moon," he says. "The camp has been deliberately constructed in the middle of nowhere for security reasons. The sand has the consistency of talcum powder and the dust gets everywhere."
Even in an Afghanistan war-zone, however, it appears there is no escape from petty bureaucracy. "A recent environmental cleanliness survey of the wards within this hospital reported that the floors were 'dusty.' No kidding!" he declares. "Even the deployed military is not immune to the bureaucratic audit that beleaguers the NHS."
In recent weeks more than 28 British servicemen - including 14 aboard an RAF Nimrod reconnaissance aircraft from Kinloss - have been killed in the fight against the Taliban.
Camp Bastion is on a remote and barren desert plateau that can only be reached by helicopter or Hercules transport aircraft.
Temperatures reach 45C in the afternoon and occasional sandstorms whip up the dust and make movement in and around the camp unpleasant, says Davis, from Fintry, Stirlingshire, who is a regular soldier but works at the Southern when not deployed with the military or training.
Reasonable working temperatures within the hospital can only be maintained by a series of industrial air-conditioning systems.
"Although the hospital is housed in a tent, the hardware of the emergency room, operating theatres and intensive care unit is the same as you find in an NHS hospital."
In an apparent dig at NHS management, he adds: "In many cases, it is superior equipment, and maintained to a higher standard than in many British hospitals."
Davis reveals that the helicopter medical response teams can be deployed to any part of the battlefield, up to 45 minutes flight time away.
"Patients can receive advanced life support at the scene or in the back of the large troop carrying helicopters on their way back to the hospital," he says.
"Every medevac mission is a calculated risk for the operations staff. On occasions helicopters have returned with bullet holes in the fuselage and even damage to the rotor blades caused by ground-to-air fire from the Taliban.
"However, the lives of several British and Afghan soldiers have been saved by my colleagues through this service. For others, their injuries have been made more bearable through the administration of powerful pain relieving drugs and other procedures.
"For the soldiers there is the powerful boost to their morale - the so-called 'moral component' of warfare - in seeing a senior doctor arrive at the front in order to commence their treatment."
Back at the hospital a different kind of help is often needed. Despite the maintenance of a huge blood bank for the number of expected patients, supplies are sometimes still short or of the wrong type.
In some cases, patients had received massive blood transfusions - in excess of 10 pints - but were still in danger of bleeding to death.
Davis writes: "On four occasions now we have had to activate what is termed the 'volunteer blood donor panel' to save some of our patients.
"Volunteers from amongst the men and women at Camp Bastion have been pre-screened (to ensure that their blood is free from disease and dangerous antibodies) and they allow themselves to be called upon to give fresh blood in an emergency. Crucially, their fresh blood contains the precious clotting factors that will enable their critically ill comrades to survive their surgery and intensive care.
"Not surprisingly, there is no shortage of volunteers. Their blood is literally taken from their veins by a drip into a special sterile bag, and then given fresh into the veins of the injured soldier. On each occasion, a life has been saved."
Davis says the hospital is not authorised or equipped to serve the general medical needs of the local population but anyone caught up in the fighting is treated, including the enemy.
"Occasionally, however, 'pure humanitarian assistance' is sanctioned. "One recent example is that of a young Afghan boy whose lower leg was severely injured through detonating an anti-personal landmine left from the Soviet occupation of Afghanistan. He underwent a series of operations to ensure that he could continue to walk on his injured leg."
Davis concludes: "There is a great professional satisfaction and reward in the successes that have been achieved at this field hospital. As I write this, I can say that each UK serviceman that has reached British Military Hospital Helmand alive has left here alive.
"One soldier who was transferred out of Afghanistan to another specialist centre died a week after his wounds were received. In that case his family were able to be with him during his final days."
Read the full text of Lt-Col Davis's dispatch at www.scotlandonsunday.com/dispatch.pdf
Scotland
To save lives, staff are urged to volunteer blood that can be pumped straight from their veins into a sterile bag and then instantly into a waiting patient.
It is far worse than a Saturday night in the A&E of the Southern General Hospital, Glasgow, and Peter Davis should know.
In his civilian life, he is a consultant at the Southern, often dealing with the aftermath of drunken fights, road crashes and a steady stream of stabbings and slashings.
But as Lieutenant-Colonel Davis, of the Royal Army Medical Corps, he is currently based in Afghanistan's lawless Helmand province, and his job is a constant struggle to save the lives of soldiers and civilians caught up in daily battles with Taliban fighters.
In a moving and exclusive dispatch from the troubled province, Davis describes both the horror and the absurdity of being a medic at war. He stresses he is just part of a dedicated team of doctors and medical support staff battling to keep alive a steady flow of casualties from fighting described as the toughest endured by British forces since the Korean war in the 1950s.
His role is both to treat casualties as they arrive as well as lead helicopter emergency medical response teams that fly out to battlefield incidents. "The helicopters are armed and the situations are dangerous," he writes.
Davis, a 43-year-old married father of three, has been in Afghanistan for a few months but has already seen more major injuries in that time than he would working for three or four years in the NHS. Some of the injuries are rarely, if ever, seen in UK hospitals: limbs ripped off by explosions, high-velocity bullet wounds to the head or neck, and blast injuries.
Although the tented hospital they work in has the best of equipment and staff, their labours have to take place in all-enveloping dust.
"We might as well be on the moon," he says. "The camp has been deliberately constructed in the middle of nowhere for security reasons. The sand has the consistency of talcum powder and the dust gets everywhere."
Even in an Afghanistan war-zone, however, it appears there is no escape from petty bureaucracy. "A recent environmental cleanliness survey of the wards within this hospital reported that the floors were 'dusty.' No kidding!" he declares. "Even the deployed military is not immune to the bureaucratic audit that beleaguers the NHS."
In recent weeks more than 28 British servicemen - including 14 aboard an RAF Nimrod reconnaissance aircraft from Kinloss - have been killed in the fight against the Taliban.
Camp Bastion is on a remote and barren desert plateau that can only be reached by helicopter or Hercules transport aircraft.
Temperatures reach 45C in the afternoon and occasional sandstorms whip up the dust and make movement in and around the camp unpleasant, says Davis, from Fintry, Stirlingshire, who is a regular soldier but works at the Southern when not deployed with the military or training.
Reasonable working temperatures within the hospital can only be maintained by a series of industrial air-conditioning systems.
"Although the hospital is housed in a tent, the hardware of the emergency room, operating theatres and intensive care unit is the same as you find in an NHS hospital."
In an apparent dig at NHS management, he adds: "In many cases, it is superior equipment, and maintained to a higher standard than in many British hospitals."
Davis reveals that the helicopter medical response teams can be deployed to any part of the battlefield, up to 45 minutes flight time away.
"Patients can receive advanced life support at the scene or in the back of the large troop carrying helicopters on their way back to the hospital," he says.
"Every medevac mission is a calculated risk for the operations staff. On occasions helicopters have returned with bullet holes in the fuselage and even damage to the rotor blades caused by ground-to-air fire from the Taliban.
"However, the lives of several British and Afghan soldiers have been saved by my colleagues through this service. For others, their injuries have been made more bearable through the administration of powerful pain relieving drugs and other procedures.
"For the soldiers there is the powerful boost to their morale - the so-called 'moral component' of warfare - in seeing a senior doctor arrive at the front in order to commence their treatment."
Back at the hospital a different kind of help is often needed. Despite the maintenance of a huge blood bank for the number of expected patients, supplies are sometimes still short or of the wrong type.
In some cases, patients had received massive blood transfusions - in excess of 10 pints - but were still in danger of bleeding to death.
Davis writes: "On four occasions now we have had to activate what is termed the 'volunteer blood donor panel' to save some of our patients.
"Volunteers from amongst the men and women at Camp Bastion have been pre-screened (to ensure that their blood is free from disease and dangerous antibodies) and they allow themselves to be called upon to give fresh blood in an emergency. Crucially, their fresh blood contains the precious clotting factors that will enable their critically ill comrades to survive their surgery and intensive care.
"Not surprisingly, there is no shortage of volunteers. Their blood is literally taken from their veins by a drip into a special sterile bag, and then given fresh into the veins of the injured soldier. On each occasion, a life has been saved."
Davis says the hospital is not authorised or equipped to serve the general medical needs of the local population but anyone caught up in the fighting is treated, including the enemy.
"Occasionally, however, 'pure humanitarian assistance' is sanctioned. "One recent example is that of a young Afghan boy whose lower leg was severely injured through detonating an anti-personal landmine left from the Soviet occupation of Afghanistan. He underwent a series of operations to ensure that he could continue to walk on his injured leg."
Davis concludes: "There is a great professional satisfaction and reward in the successes that have been achieved at this field hospital. As I write this, I can say that each UK serviceman that has reached British Military Hospital Helmand alive has left here alive.
"One soldier who was transferred out of Afghanistan to another specialist centre died a week after his wounds were received. In that case his family were able to be with him during his final days."
Read the full text of Lt-Col Davis's dispatch at www.scotlandonsunday.com/dispatch.pdf
Scotland
posted by madtom at 1:11 AM
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Hmmm.
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