Afghanistan – The Patrol

November 15, 2010

Chinook helicopters

‘So what’sit like Blue?’ said I to our Chief Medic. ‘Whaddya mean, Doc?’ says Blue. ‘What’sit like to go out on a Patrol?’ I enthused.

I was keen to find out about this, for whist we are very much doing the best to look after the ‘hearts and minds’ of the local Hazaran population, here in Afghanistan we are still very much an Army and as such have a military role in protection and defence.

Blue sat me down, and told me all about the patrol that he had just come back from.

“We were around 34 soldiers and our patrol consisted of Kiwis, and our American Cousins. We also had interpreters and members of the Afghan National Police and I was responsible for the health and trauma management of any casualties.

Early on Monday morning we got uplifted by Chinook helicopters from outside our Forward Operating Base in the north of Bamyan Province. These huge choppers landed on uneven ground that looked pretty impossible to get down on, we were waved on in lines and sat down a little uncomfortable as we still had our packs still on. Out the back of the helo the tail gunner hung over the end of the ramp. To the sides of us, two gunners took care of their respective arcs of vision. Up and away, the birds took off with an escort of four apache gun ships. Our destination was to a ‘landing zone, LZ, some distance away. The flight was exhilarating and, for me, it felt like I was truly part of a multi-national patrol.

We initially flew low over a village called Do Abi where there had been reports of some insurgents (or Taliban) setting up ambushes for us to walk into. The intent of our ‘fly by’ was to show them that we weren’t afraid of them and that we were ready to step up to confront them, and defend ourselves, if we had been attacked.

Over Do Abi we went, and then ascending the huge valley adjacent to the town we flew to a high altitude drop zone (DZ) on the far East of Bamyan Province.  In the second bird my section waited for the first one to land and deploy its forces, so that we could deploy ours. We circled around the DZ and then came in to land between a couple of close peaks and onto a small, narrow plateau. As soon as we were off the Chinook, up goes the ramp and she is away. A couple of Apaches made a low pass to clear the peaks for our advance and then they are gone, leaving us in the silence of the forbidding Hindu Kush mountain range. I looked around at the  steep and unforgiving terrain, wondering how we would go at this altitude, but we Kiwis are a fit bunch and we seemed to just step up to this patrol opportunity.

 

Blue on patrol

We quickly determined our battle orders, and then advanced up a steep valley. I figure that we were about 3000 metres above sea level at this point, so the going was pretty stressful on the ‘ole lungs’. An occasional stop to pause and look around at the stunning mountain range, before we got to our first waypoint.

On we go, and up higher and higher along a goat path higher still we track, finally arriving at our night-time location, approximately 3500 metres above sea level and right on the border with the next eastern-most district and within 2 kms of a village that we were keen on observing.

Our security and observation posts were set up for the 12 hour night. At this time also, I went to check up on the health of all those in the patrol. Had to put an IV into one guy who was a little dehydrated and who had a low BP. Then we hunkered down into our night routine, and the silence of the mountains was incredible and unforgettable. I could hear my heart beating and as it did so, I had this unbelievable feeling of being alone atop the world. Truly amazing and very humbling.

The intention for our patrol at this point was to observe any activity in the area. At this height we had a good chance of spotting any movement in the region.

A good nights sleep for me in my warm sleeping bag on the ground and then the next day we were up and gone by 0715. Going down the way that we had come up, first we headed down a steep narrow river valley and then we began the steepest descent I have ever walked or patrolled. It was truly amazing that no-one was lost off the steep 1 in 2 hillside at any stage of the patrol back. The track was barely wide enough for our boot prints. Looking down the drop off to my side took my breath away such was the depth of the ravine, but for all that we reached our pick up point relived that we had made it in one piece and in good health, save for a few bruises, blisters and abrasions.

For me, a challenging and rewarding patrol to have been involved in. I saw and participated in the multi-faceted aspects of a modern army patrol, and certainly it was a privilege to have been the Medic for it.”

 

'Blue (Kirk Blumers) and Marc sorting out the medical gear having just completed the 'dance of the patella hammer'.

I casually mentioned that I would like to meet my staff in the First Aid Clinic at 4 PM. They looked at me as if I was from outer space. Blue, the chief medic, said that he and the other staff members did not know what I was talking about. I paused and then said ‘you know, where we have our daily meetings, just before dinner’.

‘Oh’ said Leon, the practice nurse ‘you mean at the RAP at 1600 hours’. ‘I muttered something like ‘um, OK … RAP, should I know what that is?’ Both Leon and Blue looked at each other and then turned to me and voiced in military unison ‘Regimental Aid Post, Doc, Jeez’! I looked away, downcast for I have been trying so hard to get up to the mark with my acronym checklist. It was evident that I was going to have to try harder, so I resolved each morning as I was going for my 4 km walk around our Kiwi Base to do my ABC’s in the rather unique Army alphabet. I say unique because it is like a secret code and I have found that when folk have been in the army for a few years, then they forget what the acronyms stand for but just understand what they mean. Thus while they know that ‘Doc, get the RSR to go to town in the NMV for 4 pers NMB 2100 hours RTU NLT 2200 hours’ means ‘Off to town, Doc’, I don’t and I look at Leon and Blue, my face screwed up in bewilderment. He added ‘yeah, the way to town is 6400 mls’. By now I was desperate. It was only 0700 yet I had the rest of the day still to go!

I have been here in Kiwi Camp now for three weeks and am gradually, with the obvious exception being the one that I have mentioned above, getting used to the routine of the camp. Working in the RAP, yes… got that one right, with Leon and Blue is good value. My own knowledge in trauma medicine has been hugely raised but these two lads. Leon is a great value as a nurse and takes his position very seriously and Blue is a veteran of many a campaign over the last 10 years and has heaps of knowledge about military medicine. When these two guys ‘gear up’ for a campaign they have so much gear on them that they resemble mutant ninja turtles. They can hardly walk for they have so much lifesaving gear on them; yet, this gear is an essential part of the role that they have in the field.

I found this out further when I first went into the RAP. Lying in the floor was this medic, Mike, wrapped up in a plastic stretcher like he was an Egyptian dummy. He was sort of grunting as Blue stood over him and pulled hard on the straps to ‘secure him’, so I was told. To me, poor old Mike looked like he was going blue, so with a sweep of my arms I stammered ‘stand aside, the doctor is here’ and proceeded to cut and slash the bounds that were holding poor Mike in such a constrained manner. Happy that I had freed Mike in 12.5 seconds I stood back and gasped ‘phew, that was a close call –we nearly lost him’. Blue looked at me and slowly waved his head in a sort of ‘I don’t believe what I have just seen’ way and Leon just buried his head in his hands. Mike was sort of relieved, and turned to Blue saying ‘yeah well, now I know what it feels like to be saline in a syringe’.

I was not a little happy at these comments and so, smiling, attacked my next task with great gusto – preparing the medical kits for urgent deployment in the field. I have to say that, as I am not immediately involved in day to day emergencies in travel and tropical medicine secure in my office in Auckland, I could perhaps have been considered a little rusty. This however did not dampen my enthusiasm and with great foreplay I proceeded to brandish various instruments around me in cunning display that both Leon and Blue thought perhaps were little overstated. Mike, whom I had thought was firmly ‘on my side’ became alarmed at how close I came to electrocution with my, now famous, ‘Ballet of the ECG monitor’ and the equally dramatic sequel ‘Two stethoscopes and an intraosseous drill’. This last display has now gone down in the annals of the New Zealand Army as the most courageous display by a doctor in a time of bored tension!

Unit Medical Status: Whilst it is easy to jest about aspects of my location and of the relationship between me and my staff, be very clear that the men and women who are the medics up here in Bamiyan are extremely serious about the work that they do, and the preparation that they must undergo to achieve it. I am continually surprised at the knowledge that they have and the level of medical care they are capable of in the field and that is expected of them. I am very thankful that we have not had any contact with the Taliban insurgents but if we do then I have to record that I have high confidence in their abilities – morale is extremely high within our unit, I am proud to say, and it is my joy to guide it in remaining so.

I salute the work of Leon (Nurse), Kirk (Senior Medic), Mike, Kim, Holly and Cat (Medics) with the Kiwi PRT (Provincial Reconstruction Team) here in Bamiyan, Afghanistan.

Climate Situation: Over the last week it has gradually been getting colder and during the week of October 25 the temperatures have been dropping steadily, from the highs of 20°C when I got here three weeks ago – down to a predicted 10°C tomorrow WITH SNOW expected! Quite understandable when it is considered that we are at altitude 2800 metres where the environment is dry, barren and desolate outside Bamiyan township. It is definitely time for the winter woollies!

 

A Young woman herding goats