Tuesday, January 12, 2010
Ross Lydall - Evening Standard
It may be in the middle of the Afghan desert but it is one of the best hospitals in the world.
With British soldiers in active combat against Taliban insurgents barely 10 miles away, and the threat of hidden improvised explosive devices (IEDs) yards from the perimeter fence, that is exactly what Camp Bastion field hospital needs to be.
Two days ago, all 10 of its surgical beds were occupied when simultaneous IED attacks resulted in serious injuries to American and Danish soldiers.
It is a place where lives are saved seemingly against all odds.
Yesterday, its operating theatre again saw a sudden but intensely disciplined burst of activity when a US Black Hawk touched down on the landing pad outside —appropriately named Nightingale — with another seriously injured soldier.
The hospital is run by 70 US Navy medics and 135 experts from the UK, 75 of them the cream of the NHS who volunteered to serve in Afghanistan.
They are drawn from the 256 City of London squadron, one of 10 Territorial Army medical regiments.
They serve for three months, with Colonel Peter Gilbert, a Rochester GP, in charge.
Such are their skills they kept alive a British soldier who was so seriously injured that he required 274 units of blood in under 24 hours.
By comparison, a civilian hospital considers it exceptional to use 10 blood bags on a patient.
“Undoubtedly a couple of years ago he would have died,” said Col Gilbert. “In the end he wasn't even an amputee.”
Col Gilbert's team is also responsible for the Chinook helicopter evacuation of casualties from the battlefield.
“At this moment the hospital is one of the world's leading trauma centres,” he said.
“People who just a couple of years ago would have been expected to die on the battlefield now survive. We have unexpected survivors because we have focused treatment on the ground.
“We used to talk about the golden hour' in trauma. Now we talk about the platinum 10 minutes'. It's about saving these guys' lives in the first 10 minutes. Otherwise you can't do anything.”
The use of IEDs by the Taliban has meant many leg injuries for British soldiers, but also for Afghan locals and their children who step on the devices. Camp Bastion treats them all — and enemy combatants as well.
The key is often being able to swiftly apply a tourniquet to the wound. Soldiers now go out equipped with one or two tourniquets each.
Together with a substance that helps blood congeal and can be applied by troops on the battlefield, this halts almost certain loss of life and gives the medics a chance to save the soldier.
Once serious casualties are stabilised they are flown to Selly Oak military hospital in Birmingham.
The demands on Col Gilbert's team skills have been increasing, but 256 Squadron is due back in the UK soon, as its tour comes to an end.
It has been a bloody year for British troops in Afghanistan, with 108 losing their life in 2009.
Ministry of Defence figures show there were 1,169 field hospital admissions between January 1 and December 15 last year, more than 150 more than the previous year. Of those, 480 were wounded in action — more than double the number in 2008.
The squadron had only three days' overlap with the outgoing medics on arrival at Bastion and had to fit in seamlessly.
In the last few weeks, both Gordon Brown and David Cameron have flown in to see their work.
One key difference with their jobs in the NHS is the greater time they can spend on each patient, with consultants and anaesthetists waiting at the hospital door for injured soldiers to be ferried from the Chinook.
“The NHS will never be able to do that,” Col Gilbert said. “While we are out here our whole lives are focused on giving the best care to these guys as they come off the back of the ambulance.”
'It feels like I'm making a difference'
Nurse Danielle Mackie (pictured above) normally works in the casualty unit of St Thomas' Hospital in Lambeth.
But since qualifying as a Territorial Army soldier, the 28-year-old, pictured right, is also able to save soldiers' lives at Camp Bastion.
“This is my first deployment,” she said. “I have really enjoyed it. Hospex [the training facility] prepared us really well.
Seeing some of the injuries they mocked up for us really helped. When we did see them for real it wasn't such a shock.”
During training, soldiers who had lost limbs in conflict acted the part of casualties.
At Bastion, one of her most upsetting cases was when a British soldier died after being run over by a vehicle he was repairing.
“That was heartbreaking, unnecessary,” she said.
Asked whether the suffering and the war could be considered futile, she added: “These guys come in. If they're that badly injured, they know they have done a good job. Because it means that much to them, it doesn't seem that futile to me.
“I prefer it out here. I feel like I'm making a difference. At home in England there are not that many times you have been able to say you have saved a life.”