Camp Bastion Hospital gains “Gold Standard” new facilities

Britain’s largest base in Helmand Province, Afghanistan, yesterday officially opened two state of the art CT scanners. They were launched by the Director General Army Medical Services, Major General Michael von Bertele QHS OBE L/RAMC, who said: “These scanners are the gold standard in trauma care. They allow the staff to accurately identify the injuries a patient has and then give them the right care as quickly as possible.”

The two new scanners and the new building which houses them form a contract worth £2.8m which was awarded to the contractors KBR in February as part of an Urgent Operational Requirement (UOR). The buildings are built to stringent NHS standards, including backup power, air conditioning and lighting. To have two of these machines dedicated to trauma care would be the envy of many NHS Hospitals.

The new 64-slice CT scanners in Camp Bastion Field Hosital


The scanners are General Electric 64-slice scanners, capable of over 10 times more detail than the existing equipment in only a fraction of the time. This means that casualties can be treated much faster. In addition, because there are two scanners, there is a natural redundancy should one go unserviceable due to the hostile environment that Afghanistan presents. The new scanners provide a more resilient capability that is more modern, reliable and better supported than that currently in service.

The scanners are used in a number of ways, from scans following head injuries to full vascular reviews following IED blasts. This allows the doctors to see any internal injuries prior to surgery. The greater definition provided by the new equipment will allow a much better and faster diagnosis of a patient than exists currently.

Surgeon Commander Richard Graham, a consultant radiologist, examines images from the new scanners

The hospital has two consultant radiologists who diagnose patients once the scans have taken place and five radiographers who run the machines. Surgeon Commander Richard Graham, a Royal Naval Reservist who usually works in Bath, is one of the radiologists. He explained the importance behind the new scanners: “These machines are a very important addition to the hospital which allow us to carry out much faster scans and reduce the time that a patient must wait before potentially life saving surgery. These scanners give us a much higher definition to work with and we can have a rough diagnosis within two minutes. Because this is the next generation of equipment the patient also receives a lower dose of radiation than previously and is therefore even safer to all involved.”

Photos: L/Cpl Bray USMC

Ten miles from the Taliban, one of the world’s best hospitals

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.”

Two girls blown up by callous Taliban bomb saved by hero Brits

TWO little Afghan girls horrifically injured by a Taliban bomb have been saved by the determination and skill of a group of caring British soldiers and medics.

Three-year-old Kamila and pal Wasila, six, nearly died after accidentally triggering an improvised explosive device (IED) as they played outside their home in Musa Qala, Helmand Province.

Kamila took the brunt of the blast, suffering severe head injuries, while Wasila's stomach was ripped open by molten shrapnel causing liver damage.

Kamila's horrified father was on the scene in seconds and scooped up the girls and took them to Musa Qala District Centre, certain that coalition troops there would help.

But the injuries were so severe that they alerted a four-man British Medical Emergency Response Team, staffed by doctors and nurses, which raced to help in a Chinook chopper.

The girls were then flown to a hospital at Kandahar Airbase.

Kamila was placed in an intensive care unit where doctors feared the worst. The blast had paralysed her on her entire left side and brain damage left her unable to express emotion.

But the tender care of a British neurosurgeon, who had volunteered to serve in Afghanistan, along with his Canadian and American colleagues changed that.

After weeks of treatment Kamila and Wasila recovered. Doctors were even able to help Kamila show her emotions again - and she got back her cheeky grin.



The British neurosurgeon who cared for Kamila - who cannot be named for security reasons - said: "The majority of people I have treated are children under 15 years, and the most common injuries have been as a result of IEDs.

"It's great when it works out, as in this case. It makes it all worthwhile. But it takes the whole team to make it work, fantastic intensive care unit support, nursing staff and physiotherapists, especially as the hospital is not scaled for humanitarian medical aid."

Another doctor who treated the girls said: "Before Kamila arrived, we had a young boy with similar injuries who died, so we were all very nervous about the chances of recovery. After initial treatment, the signs were not good, as Kamila could not move her left side and was unable to express emotion.

"Although there were to be further complications, Kamila is now interacting with the people around her and even smiling.

"We consider Kamila our miracle child. She was such a morale booster, because we see so many kids that don't make it."

Lieutenant Andrew Jelinek, from the Household Cavalry Battle Group operating in Musa Qala, said: "IEDs laid by insurgents take a terrible toll on innocent civilians.

"They have had a deadly effect on British and coalition forces but it's the ordinary Afghan people that are hit the hardest.

"Unfortunately children are the frequent victims of Taliban IEDs and, sadly, the story of Kamila and Wasila is far from unique.

"It's only thanks to the work of British soldiers that there are not more incidents of this kind.

"Back home we worry about our kids' safety when they go out to play, but here it's on a different scale.

The dangers the kids face when they are out playing are life and death. The Taliban just don't give a stuff about them.

"They plant these bombs knowing kids might set them off but they just don't care."

Kamila's dad stayed with the girls throughout their treatment, but is anxious about returning home for fear the Taliban will suspect him of consorting with the enemy.

This week tearful staff said goodbye to the girls, who hitched a ride back to Musa Qala on a British Chinook returning for a routine task. They will now receive further medical care from their nearest Forward Operating Base.

The perfect antidote to Anjem Choudary's Islamist poison

It's the Taliban, not British troops, who are persecuting Muslims in Afghanistan - as the story of a gravely ill six-year-old shows, says Liz Hunt.

By Liz Hunt from the Telegraph

There are few uplifting stories to come out of Afghanistan, but The Daily Telegraph reported one of them yesterday and it was a joy to read. It was also a perfect antidote to the poison being spread by Anjem Choudary, the leader of a radical Islamic group, who this week accused British forces in that country of "war crimes and many atrocities".

The story centred on a six-year-old boy, Rahmadullah, who was close to death when he was airlifted to a hospital at the British military base at Camp Bastion. He was suffering from pneumonia, lapsing in and out of consciousness, and deteriorating rapidly. Initially, doctors were baffled by his condition. They told his father Neknazar, a farmer from a remote area of southern Afghanistan, that the boy had only a 10 per cent chance of survival.

He was put on a ventilator while tests continued; eventually tetanus was diagnosed and the appropriate treatment begun. When Neknazar had to return home, nursing staff adopted the little boy temporarily. They fed him the bourbon biscuits he'd developed a taste for, sat with him while he watched his favourite film, Finding Nemo, pushed him around in his wheelchair, and comforted him when he cried for his father.

Major Sue Snaith, a reservist at Camp Bastion who normally works as a specialist oncology nurse at Great Ormond Street Hospital, described Rahmadullah as "one of our miracles". Given the usual workload for her colleagues – dealing with the bloody aftermath of the improvised explosive devices that have claimed the lives of or horrifically injured scores of British servicemen – one knows that she did not use the word "miracle" lightly.

Today, Rahmadullah is making a full recovery – evidenced by that impish grin for the cameras. Neknazar's relief is also unmistakable, and his gratitude heartfelt. "My son is happy now," he said. "The doctors and nurses have been fantastic. My son would have died if I had not brought him here, so of course I am very pleased."

Contrast those smiles and words with the cynical antics of Mr Choudary. He is behind plans for a demonstration in Wootton Bassett, the Wiltshire town that has become a symbol of our renewed appreciation of the courage and sacrifice of British troops in Afghanistan. In a cynical gesture that mocks the solemn repatriation ceremonies that take place there all too frequently, and belittles the grief of bereaved families, Choudary's followers plan to parade empty coffins through the streets, to highlight the "persecution" of Muslims in Afghanistan and Iraq.

Yes, Muslims are being persecuted in Afghanistan – but British troops aren't guilty. It is the Taliban who are responsible for so many of the atrocities against civilians and so many of the deaths.

Talk to any British serviceman with experience on the front line, and they'll tell you of the futility of trying to win hearts and minds when locals live in terror of the repercussions that even the most minor fraternisation can bring.

As for Rahmadullah and his father, one can only hope that basic compassion for a young child will safeguard them from any form of retribution when they return home. The irony, of course, is that his illness need never have occurred in the first place. For there used to be a vaccination programme in southern Afghanistan for tetanus and measles – until the Taliban put an end to that, too.

VIDEO: Camp Bastion Field Hospital, Helmand Province, Afghanistan

BBC report from Camp Bastion Field Hospital

Helmand surgeon tells of her fight to save lives - Telegraph

By Sean Rayment, Defence Correspondent

Every morning – usually just after 7am – the pager strapped to her waist bleeps into life, warning the trauma team at the British Army’s field hospital in Helmand that a severely injured patient is inbound on a Chinook helicopter

The wounded are often young soldiers, usually the victims of an improvised explosive device (IED), with one or more of their limbs missing.

In recent weeks the casualty flow has been unrelenting, as British and Nato troops involved in Operation Panchai Palang – meaning Panther’s Claw – battle with the Taliban in central Helmand. Since the start of this month, 21 soldiers have been killed and dozens more have sustained life-changing injuries.

On Thursday, the MoD is due to publish new casualty figures which will reveal the number of soldiers killed during the first half of this month. It will include those injured on July 10, the worst single day for British forces so far. In one 24-hour period eight soldiers were killed and more than 30 were wounded, some severely, in a variety of attacks around the province.

While front-line troops are tackling the Taliban with bullet and bayonet, back in the safety of Camp Bastion, medics are waging a different but equally important daily battle: trying to keep alive soldiers whose injuries are so severe that just a few years ago they would have proved fatal.

Speaking from the field hospital in Camp Bastion, Surg Cdr Stapley told The Sunday Telegraph: “The demands are constant. Every day, we usually have a trauma call in the morning, first thing, that is when we are notified a casualty is coming in. Casualties are a daily occurrence, sometimes two, three, four times a day.”

The Royal Navy surgeon, who has completed three tours of Iraq and two in Afghanistan, says the injuries now being sustained by the troops are “horrific”.

“The injuries have become more severe than when I was here first, in 2007,” she said. “Each one is horrific but my experience helps me deal with them both professionally and psychologically. The injuries can be shocking but your main aim is to treat the patient so you have to put that behind you and you have to treat the patient and hopefully they will survive.”

In the past 10 days more than 157 people have been treated at the hospital for conditions ranging from battle shock and heat exhaustion to amputations and bullet wounds.

Mass casualty events are now common. Surg Cdr Stapley recalls that she worked for 33 hours over a 35-hour period shortly after arriving in Afghanistan five weeks ago. “We were having continuous casualties coming in every few hours and some of those required immediate surgery. Events like that are not unusual here, the time went actually very quickly – you do get use to working long hours.”

Surg Cdr Stapley’s decisions often mean the difference between life and death. If the victim’s limbs are badly damaged, she has to decide, and quickly, whether or not the arm and leg can be saved. “In many cases that decision has already been made for you because you are often dealing with a traumatic amputation,” said the orthopaedic surgeon who joined the Royal Navy in 1987.

Much has changed since 2007, when Surg Cdr Stapley, who has a long-term partner, first arrived in Helmand. Then the medical centre was housed in a tent. Today troops are treated by medics from Britain, Denmark and the United States in an air-conditioned field hospital with eight intensive care beds and two wards that can treat 25 patients.

The nature of the fighting in Helmand has also changed in that time.

Gone are the pitched battles with the Taliban which typified combat between 2006 and 2008, these days troops are targeted by suicide bombers and booby traps.

Those who survive are often left crippled, blind or brain damaged. Since 2006, 52 servicemen and women have lost one or more limbs, six have been paralysed and another seven have lost the use of one or both eyes.

Hundreds more have sustained lesser injuries and have often returned to the battlefield days, some times hours, later. Treatment at the medical centre is not restricted to members of Nato. The Afghan national army and police are also treated, as are civilians who get caught up in the fighting.

“We treat the Taliban as well, if required. The Taliban are just normal people. Many of them are grateful, many are scared. I don’t know what they have been told [about] what might happen in one of our hospitals but we treat every patient the same and to the best of our abilities and I think they are surprised that they get such treatment, and I hope they take that message with them.”

Away from the blood and gore of the operating theatre, Surg Cdr Stapley relaxes by going to the gym, eating or reading a book. “But most of all I try and sleep – that’s pretty important.”