Back home in New Zealand

February 20, 2011

Home! The first thing that I notice is ‘the green of the pastures’ as I travel down to the Waikato. Great contrast to the brown and white of the Afghan earth with its snow, in winter. The trip south to my beloved Hamilton and family gave me time to reflect upon where I had been and what I had just done. Afghanistan as a doctor with the New Zealand Defence Forces. A year ago I would never have thought it possible that I would be ministering medicine in a war affected region, and in a country that has known centuries old conflict through the battles of Genghis Khan, Muhammad Babur and both the English and Russian Armies in the last one hundred years.

 

I had left Bamyan city in Bamyan Province on the 12th of January, and come via the military transport system in Afghanistan to the Middle East and then via a long flight back to Auckland. I can’t really remember what the flight home was like for I was still energised by the experiences of living at Kiwi Base with a whole bunch of New Zealand men and women with common cause. 18 hours in the air gave me a lot of time to think about those moments that would forever be remembered by me.

Firstly, the countryside that Kiwi Base was in. PT Hill overlooked the military encampment in the immediate distance. Further, was the Hill of Gholghola, where Genghis wrought such terrible violence that it became known as the ‘City of Screams’. Further still were the cliffs that overlooked Bamyan and which were now marked by the empty spaces of the Taliban vandalised Buddhas. I walked between the two of them over my last week in the region. I was showing my replacement Medical Officer, Jordan Baker, around the region. Showing him some of the sights for which the region is famous. On the way we had a pleasant guide who spoke little English, though through our interpreter he filled in the details of the history of Buddhism in the region and how important the region was as a crossroads to and from regions east and west. He pointed out another smaller third Buddha and then a fourth, or baby, Buddha – both also destroyed in the violence of early 2001.

Looking out from the cliff-face, snow covers the fields in the rivets of a late autumn ploughing. It has almost gone from most of the fields but does lie quite heavily higher up on the higher hills. Jordan is loving his first views of the region, for he has travelled little before and all this ‘newness’ is so energising to him. Me, I love showing him the various sights but at the same time admit to a great sadness that I am about to leave the town and its history.

 

At the small ‘female’ Buddha we are able to walk up and over it by way of steps that remain in the walls. There are three levels to our tour, each higher than the last and each with numerous caverns that housed priests through the ages – even the Taliban, in the early years of their occupation. Some of these caverns were citadels and many have the remains of paintings blackened by the fires of their destruction. Still others had smoke on the ceilings where the insides of the caves had been burnt out. Such destruction. It makes me pause in reflection and in sadness. Un-necessary. Certainly not the way to win ‘hearts and minds’ of the local Hazaran population.

 

Secondly, the people and the village of Bamyan. This was best felt by me when I got a few members of ‘the crew’ together, including Allan, Ra, Steve and a pleasant interpreter called Gee (which was short for some intricate Afghan name that seemed such a waste when ‘Gee’ explained him so much more admirably) and we walked on a ‘dismounted patrol’ into town to wander around the bazaar. Along narrow tracks that the locals use to pass over fields now brown due to the winter, but normally lush and green in the summer. The dust swirls still with every footprint on a dry, still day. In the distance the new snow is on the hills and the locals will be pleased again with the nurturing of the soil. Into town and along the dark side of the street, where the sun never seemed to reach in the winter months. So many shops open today.

It is Friday and the locals are all out doing their shopping – men and women, though never together unless they are family or married. Men sewing away at shoes brought to them for repair. A lot of shoe shops abound, mainly with second hand shoes and not occasionally many that are just single shoes – who wants them, I wonder. Clothes shops, with women inside under burkas doing the dealing with the men owners. Outside other men pushed wagons with sacks of coal. Boys run by with bananas for sale and still others came up to us to ask for ‘baksheesh’.

 

Steve had an endless supply of pens to give out to the kids. Men sitting in chairs or merely crouched beside the gutter partaking in chai, talking and watching folk just wander and meander. Men whose weathered faces, reflecting the harshness of living in this unforgiving land, appear to be carved out of leather: cheeks with valleys and vales, eyes hidden under an overlapping eyebrow bristling with honest hair and mouths often hidden in a bread that spreads with laughter. Their ‘Shemagh (Afghan Scarf)’ wrapped around their necks, over their faces and upon their heads seemingly part of their bodies, whilst around their midriffs were huge rugs to shelter from the cold.

Drifting by were the women also – in white or blue burkas. Still others without the over-face mask but with a scarf over their heads and around their faces, and perhaps an end of it held loosely to mask their mouths. No women were without some facial add-on; unlike the young girls enjoying their freedom whilst they could.

 

Orange sellers. Ever present mobile phone shops – a glut of them, with no one in them but there in all their glitzy glory. Material shops. Hardware shops every 5-6 shops, selling pots and pans and plastic jugs that are used to carry water for ablutions after toileting. We pass a potato naan shop stall. They look delicious and we all decide to buy one of these. This will be lunch – potato cut and placed on a thin pancake wafer. The potato is grated and placed in the middle of the mix, and then the three sided blend is rolled and put into a deep fry. Rather different and rather nice. One was enough and the cost was 10 cents for one.

 

Wander down by the river, and along the stalls in this region – fruit stalls, butchers shops with just the trachea and lungs remaining for sale and hanging from the corner of the shop – outside. A man selling nuts and dried fruit allows me to take his photo. Always photos to snap for the memory bank. Along another side street know locally as Titanic – shoes shops and kids toys, and … shoes. Ra was fixated by the shoes and so we went past many shops only to have him disappear as he would go and have a look. He never decided, he just liked to look at them and chat with the locals at the same time.

 

The sound of young music from stalls by the side of the road and from the nearby shops selling radios, music and all its paraphernalia. People would watch us pass but I do not recall seeing a malignantly disposed grimace – smiles and the right hand (always the right hand) drifting up to the heart with the salutation ‘salaam’… always the men, and young boys practising. Dear Lord, how I just loved to look and to reflect and to just wonder how these folk were living every day… in the rain and snow and bitter cold. Still the gnarled and crusted hands would come forward for me to shake – usually so gently, and with honest feeling. It would be hard not to be touched in some way.

 

Restaurants, up steep ladders and perched atop roofs of shops below, serving their only dish – kebabs, rice, sort-of meat soup, with slices of tomato, onion and a chilly on a side dish… they are dried around the edges indicating to me that they have been cut and prepared many hours before and the alert goes out quite strongly for me… DON’T EAT!!

In the street, cars with no exhaust-system spew out smoke and zoom along the road at a speed that makes the mouth drop in bewilderment. No seat belts and door handles that have been roped to the vehicle main frame indicates further to me DON’T DRIVE IN THIS ONE! Cops in their olive green suits drive by in their ford 4-pers pick-ups faster, for no good reason other than to drive fast and scare the locals. Kamaz truck belch and vomit benzene fumes, as they carry their wears through the distance of tar-seal, men in turbans perched on their roofs, their cargo or riding high in the cab. Small kids don’t even bother watching the sight of such massive movements anymore. They’re more interested in our baksheesh.

 

The third and final image of my deployment is of the men and women that I worked with. What an honour to have been with them. All ranks, high and low, showed me a respect that I was honoured to receive. Their military side as they talked of various missions. There serious side as they talked of their families back home and how much they meant to them. Their ribald side as they shared jokes, some spicy and some not, with me. They are well lead by their CO, Lt Col Fox, and they are well protected by all the various units that accrete to form the Company for this operation known as CRIB 17. I will miss each and every one of them.

 

The Medical team at Christmas From L to R: Leon Frampton-Leigh, The Doc, Kirk Blumers. In Front: Cat Brown

 

 

Finally, salutation to those in the medical team, each of whom needs a mention. Leon (the Nursing Officer) who worked so hard to develop a respectable and respectful RAP for us yet still smiled at the end of it. Blu, what can I not say about him! This guy was amazing. I loved his clear brain and his thinking, and the support he gave me. This gut IS ‘the stuff’. The medics, boy did their knowledge impress me: Cat (a star medic who needs to go to a higher level – poor thing, I have probably STILL spelt her name wrong), Kim (a gentleness with her that expressed her caring spirit), Mike (hardy and military in mind), and Holly (thrown in to so many situations, coming out richer for the experiences).

 

A final image for me and the last entry into my diary: ‘Wonderful autumnal views of the region and have noticed even in the least few days, the lack of leaves on the trees. Way in the distance were the snow capped hills looking down on us. Beautiful views!! Every morning, I see the sun tipping the hills. I take this to be my welcome to my day. This will be the essence of my memory. Now it is time for home and my family. This has been a ‘most great trip’ – and one that I was delighted to have been part of!!

A hospital visit was always going to be ‘on the cards’ for me. I wanted to go and see what facilities there were there, and also to see what (if anything) we could do to help. It’s easy, I know, to say that ‘we are keen to help’ from the rather exalted position that we are in – in Kiwi Base – because we have everything we can possibly need and on top of this there is always the capability of being able to ‘call in’ an aircraft to transport a really unwell case to the American Hospital at Bagram Air Force Base. Here, the local population do no have this facility and so we at KB are keen to provide whatever we can to assist the local medical and health services. As it is now getting extremely cold, with the temperature today at minus 15 degrees, this would appear to be an ideal time to visit and take some of the many bags of woollen gear and toys that folk from NZ have sent over here to present to the local patients and their, usually, mothers. Who better to visit the hospital with than the Padre,

Steve Clarke (Chief petty Officer) and Allan Kelly (administration Officer here at the camp). The three of us have been involved in a lot of visits to various schools and health clinics around this region and so it was with pleasure that we visited the Bamyan General Hospital. Having said that these three guys have been all very tolerant of my energies in wanting to dash off and see things. I have this sort of ‘places to go – people to see’ and ‘not here to foxtrot with spiders’ mentality. In the wagon and off we go to the hospital. Through the gates, part the vehicle and we walk to the director’s office. Well, Padre and Allan and I walked, but Steve is a navy man and he walked like he was on a shop in a storm, swirling from side to side in the corridors. A quick meeting with the Hospital Director, Sarjo Kanji (who is from The Gambia in Western Africa), and then it is ‘off’ to the paediatric wards to see the kids.

Son, Father, Padre, Doc, alan, Steve, Hospital Manager

Up the stairs we go – there are shoes lining the entry door as we go in. The management do not require us to take off our shoes, but I am rather embarrassed about this as the locals do and so, I feel, we should but Sarjo says ‘no need’ so we don’t. Through and under a rug hanging over the door, it is starting to get quite cold outside during the day now and the barriers to the weather are gradually going up in the community. The smell of the halls, as we go into the wards, is of smoke from the coal- fired heaters in all the rooms and wards. In to the ‘acute baby room’.

One of the nurses in the ward

Mothers are with their kiddies, and immediately they turn away – as is their custom when men walk into a room. We give dolls and knitted woollen booties out to the babies, wherever possible, or their mothers. Long time since I did this for my children so I struggle a bit to undo the bow around ‘the feet’ part of the booties – much mirth amongst my compatriots. The mothers accept the gifts in silence. Occasionally one or two smile and say ‘tashikor’ (thank you), but mainly they respond with an expressionless face and take the clothes or dolls and put them by their babies or children. Some cover up their faces and turn away from us. We expect this, as this is what happened the first day that I came into the hospital a few months ago. For all this, however, we realise that our gifts are indeed needed and valued.

'How do I put these on?'

In to the next ward and the same thing happens – we walk around the beds – 15, of which none are empt. A doctor is doing a ward round. He speaks English and does not mind us bustling through. I stop to chat with him. He was educated in Kabul, and he stops to tell me a little of the illnesses as we pause over a kiddie who has pneumonia, and malnutrition. The doc says that the main diseases are these two conditions, plus diarrhoea – the latter in summer and the former two in winter. Logical really. He is OK with us going around giving the children toys.

Mothers and their babies

 

Interpreter Baby whose mother died and Grandmother

I stop by the bed of a woman who has her face partially covered. I ask the doc what is wrong and why is the child in the ward. He says that the child’s mother died in childbirth (in Afghanistan the maternal mortality rate approximates 25%) from haemorrhage, and that the woman with the child in his  grandmother. The woman lives at Yakawlang which is a long way away – 4-6 hours due East by vehicle. She is so far away that there was no chance of preventing any calamity and this is obviously what occurred. Fortunately the child is a boy, says the doc, as girl children do not get much of a ‘look in’. I look at the child again, and he is very pale – probably he has anaemia due to his mother bleeding to death.

Ra giving a doll

Meeting the Paediatric Staff

We finish giving our gifts and feel the better for it. The ward-manager says to us how happy he is because of what we have done, so perhaps we did something good today. Whilst toys are rather a ‘little thing’ to give … I think that they meant something to us, also, in giving them on behalf of our country-folk back home in NZ.

Jason and Nate

January, 2011. It is a lovely day today. The ‘sun is sunning’ AND the ‘birds and birding’ AND the ‘cooks are cooking’. Nearly three months into our deployment here in Afghanistan and these guys still put out meal after stunning meal. I remain amazed at their ability to plan, prepare and cook up 300 meals at any one sitting per day. (Sgt) Jason Gillespie from Palmy North and (Cpl) Nate Turfrey (Hawke’s Bay) were quite upbeat about their roles when I went to see them, this morning, the beginning of January. I guess that they have to be, cos by now they have had to develop a daily routine that sees them get up at 0500 hours to start a day’s toil that will go through to 1900each night. Stuff that, says I! Minus 15 degree with a wind howling outside, I defy anyone to arise that early to bounce into the day’s work.

These guys have to, for their job is undoubtedly one of morale. Good food – good morale! It follows on a cold winter’s day doesn’t it? Still it puts a lot of pressure on the kitchen staff to perform, and they do… day after day, meal after meal. Their only rewards being either a grunt of some wayward appreciation from a hungry soldier or a purposeful memo of thanks for a notable meal that always gets a smile of appreciation from the ‘lads with the ladles’.

Lunch involves a variety of at least 7 meats together with veges and fresh salads. Food from all over the world comes to us on this mission: Germany, NZ (lamb – what else), Canada, US, Malaysia, and so on… and of course Australia.

Dinner time is the same, but with yet another ‘7 meats’ preparation. Christmas meal involved huge planning over the two days prior to the meal fest that we all totally enjoyed, as well as cooking regular meals for a regular day’s work in Kiwi Base.

Then on top of this, the guys have regular sentry and airfield security duties to undertake as part of their army deployment mission. Its hard work. I’d not want to do it, but the training that they receive from Joint Service Caterers in Waiouru prepares them for this task and they are the better for it. They are doing what all soldiers want to do, and that is work in theatre on an operation. What better one to work on then this one here in Bamyan? Not only do they get to do their job, but they are also training and working with local Afghanis teaching them our ways of ‘life, living and the magic of Kiwi Cooking’!!’

 

Women in Blue

January 10, 2011

Blue            and white
Burkas,

mask women hiding

Themselves from outside eyes viewing
Tranquil times

or tense, turbulent

Occasions that speak too honestly
Of that which happens at home?

Walking along tracks

time-worn, through fields,

Wending a way –
down, bazaar beckoning
Attractions displayed, for sale, in myriad forms
Along clear course
to meander,  to ponder,
Sometimes to purchase, mainly to wander
Silently – as an observer wonders, in silence.

ON THE ROAD TO NAYAK

December 8, 2010

Saturday was another bright and sparkling day outside, but seriously cold in the shade. The morning had registered minus 14 and I had just finished doing my daily walk of ‘one kilometre’ around the perimeter of the camp. Breakfast was my usual cereal and coffee and I was just settling down to do the day’s tasks. A knock on the door and the Colonel came to the RAP.

‘Would you like to come over to Nayak tomorrow morning, Doc? Going over there to check our FOB (Forward Operating Base) facilities and a good idea for you to do the same with our medical resources. Interested?’ Well, was I what? I had been in camp for some days now and was looking forward to ‘a look outside’ the gates.  Excitedly, I got my packing quickly done for the anticipated trip. All the goodies that I would require to take with me, but hopefully would not need. I say hopefully because although this area of Nayak, which is 4-5 hours over to the east of Kiwi Base is supposedly safe and secure, though we were not going to take any expectation of this as being definite. We knew from experience that Afghanistan is always a territory that we needed to assume could become dangerous, either geographically due to wind and snow trapping us … or from an equally ominous insurgents’ point of view.

The next morning, there I had it – my gear all laid out. I felt as though I had seriously missed something as this task was quick and complete. This was not like I would have done at home – fiddling around with equipment and trying to decide which was the ‘best shirt to take’ or which series of bandages were more appropriate. I had totally surprised myself by being ready and fully equipped with all that I may have needed: fully kitted out emergency medical response bag, my sleeping  bag, my camera pack and some warm clothes and huge big puffer jacket. It was going to be rather cold where we were going and I wanted to be well prepared for any cold weather eventuality.

0845 and I am ready. I drag all my baggage out to join the rest of the team. The Commanding Officer  smiled at me – ‘I see that you have not learned minimal packing is best have you Doc’, he commented on looking at what I thought was rather a compact set of gear. Just five sort-of-little-compact packs and baggage. ‘Next time we’ll get a special vehicle for you!’  He dipped his head and I took this to mean OK for this trip but not the next. Phew, I was lucky. Otherwise it would have meant that I take out my wool fleeced nightie and my possum skinned hot water bottle – just kidding! I would never carry either of these items on an army deployment, even though my Darling Wife suggested that I take them and my own cuddly pillow!!

Get together, we do and attend the trip’s briefing. This is to explain to all what we are expected to experience on the journey. Invariably it gives us in the patrol an idea of the terrain that we are going to go through and any risks that we need to be wary of: new roads, any snow… that sort of thing. A final check up on our numbers – 10 of us, each with different yet essential tasks for the journey – then we are away.

We are off and it feels so good to be going through the front gate and out into the local community. Through the town of Bamiyan and along its sole tar-sealed road and then past the two huge spaces where the Buddha’s on Bamiyan used to be until the Taliban destroyed them and then through and onto the mayhem of the country roads.

The scenery is unique and wonderful, and never fails to draw me to it. Dust and dirt fly as we pound the bumpy and thumpy roads. To the sides people are going about their normal days: donkeys taking produce to market or to sale, some carrying children but never women; women walking three or more steps behind their men folk. ignored and never acknowledged any salutation in friendship until they are permitted to; young kids waving to us with a sideways back and forth rocking movements; and small stalls beside us on the road with a couple of men tending them  and selling their product trying to make the day’s sales.

Ahead of our driving and in the interminable dust, the potholes of the road demand caution and a low threshold for swerving at any obstacle that may stumble into our route’s path.

To the sides of us the hills to the east of Bamyan town thrust up into the skyline. They are huge hills on either side of us down here in a valley. There are fewer people now as we wander further from the township. Ironically the road starts to get better, for contractors have begun tar sealing on the road between Bamiyan and Nayak, and have decided to start the road midway between the two towns. The logic of this tends to baffle me somewhat. Why not start at a major town and go out from it. Nah, cant figure that one out!

Through the cleft at the end of the first deep valley, and  the hills push higher and higher as I crouch below the window to look upwards. Shadows of the valley cut across the shafts of light that are able to penetrate deep into cold and bitter shadows. The road is gravel but is really very good and we are able to travel without physical discomfort, though dust still trails us and prevents us from opening the windows to breathe. Fine dust that gets into everything – eyes, clothes, machinery (the car inside is covered in a fine layer of particulate dust. I don’t breathe too deeply!


We occasion villages to either side of our travel 500 yards away, built into the hills. First the wall built of clay-mud brick, sometimes old and sometimes new and occasionally a mixture. This is probably a reflection of personal finances. The style is adobe-like. Red-brown clay that is reinforced with fibres of hay and twig. Kids swirl around the boundaries and women are seen to drift between their familiar inside and out as they tend to their duties.

 

 

Female children up until teenage tend to the washing of clothes and dishes down by a stream, if there is no nearby water pump.

Boys are helping with the donkeys or farming or gathering of wood. Men with their turbans swirled around their heads, often masked over their mouths and noses to cover from the dust, walk along the road with donkey or not, or tend to the shopping in the bazaars.

Bang, right in the middle of nowhere, we are driving on tar seal. About 10 kms of it. Bizarre though what a difference this makes to our travelling comfort. Just as I start to nod off in the warm comfort of our vehicle’s back seat, with a crash I am fully awake to the bumping and pitching of the rutted  road again. Back on the gravel. The dust swirls in front of our vehicle and thus-wise we travel through to the town of Nayak. Nestled in a pleasant valley, it is a safe area for us to travel to as the local population are doing for themselves so very much better now that they feel a security supplied in part by the NZ forces in the region.

 

(Left) Master Sgt Trevor Pittman (Centre) Dr Marc Shaw and (Right) Squadron Leader Steve Hall (NZ Air Force)

  • The time is around 2000 hours – our Malaysian Colleagues are having their celebration of EID which is the equivalent of our Christmas. Leon comes across to me and says that he has just had word of a serious injury to one of our American Colleagues. ‘A neck injury is coming in within a half hour’, he says. So, we prepare for the injury in the best way that we can. The patrol that the man is with is quite far away and we are not able to get too much detail from the initial radio contact. He arrives and we step into action: history of ‘was in a patrol vehicle travelling at 55 kms / hr, with the usual ‘in car’ prevention – seatbelts and the like. The vehicle crested a hump in the road and the patient sitting in the back of the vehicle whacked his head on its roof. Due to the unexpected nature of the impact, the patient’s head then slammed into the back of the seat in front and the side window on his left. He was pretty seriously knocked around, and the first response of the team on patrol was to stabilise his head so that no further injury could occur. For me, as the Doc, the serious part was that our man had developed reduced movement in his left hand and pain on the left side of his neck radiating down to the left arm. This was a pretty severe discomfort. Although he denied being knocked out, there was significant evidence that he had developed concussion. My concern was that our patient has sustained a fracture of the cervical spine in the neck.
  • Well, with such a diagnosis as a possibility, we then had to get our man to a higher medical facility for radiology and further neurological assessment. Now was the time for me, as the Doc, and for Leon, Blue and the other members of the medical team to ‘step up’ and prepare the case for evacuation to Bagram. It was time for me to report to the US Command about our patient, their soldier. I addressed them with the standard ‘we have a situation here…’ and then proceeded with the objective assessment of their warrior.  I then continued to tell them exactly what was going to happen and how it should pan out with their help in ordering a casevac. At this stage I got a bit ahead of myself and threw in a few newly learned acronyms by mistake but the US officers were very tolerant of my errors an then proceeded to throw in a few of their own. I was on slippery ice here – but fortunately no one noticed my improvisation, such was the intensity of the communication. An aircraft was ordered up and it was arriving quite soon.

  • Blue, Leon and I readied our patient for the flight by considering the further practical issues such as how the man would travel and with what medical support, pain relief, intravenous support and the like. Good pragmatic medical sense.
  • Then we get the word that the aircraft is overhead and whoosh, we hear it. I get around some guys to help me (Sqd Ldr Steve Hall, Allan Kelly and Master Sgt Trevor Pittman) and we truss our patient up in a blanket and with a ‘silver heat-retaining blanket’ around him. On a stretcher and spinal board he goes, and then onto our portable ambulance we transfer him down to the nearby airstrip where the plane has just landed, in the dark. Brilliant stuff!
  • Fortunately not a very cold night tonight. We wait on the airfield for the plane to come up to us. Meanwhile deployed on the field are our troops to secure and protect our airfield and the perimeter of the aircraft. THIS is very impressive – they have strategic points covered and are there waiting for my patient. We get the word from the Sgt-Major and drive off to the ‘airframe’ (Army talk for ‘an aircraft’) in the distance – we cannot see it at this time, just hear it! We travel with out headlights on and see before us dust rising but no plane – it is in the darkness. We are aware of something huge in front of us. An occasional speckle of LED lights presents itself to us. An about turn and then a quick reverse back to the down-ramp at the back of the plane. I look around and am so impressed with the professionalism that I see before me. In a perimeter around the craft and with hot aviation fuel odours in my nose, there are a number of persons, fully armed and with aviation helmets on, on either side of the ramp. They are guarding our presence. I grab my corner of the stretcher and up the ramp we go to deliver the patient. One of the medics comes over and I give him the update ‘We have a situation here …’ They are happy with my presentation, and with a quick ‘farewell’ to our patient I head back down the ramp to our vehicle. We drive off into the dark, with the aircraft quickly disappearing. Just the sounds of the props remain.
  • Back down the airfield just in front of the camp entrance we pause and wait for the plane to take off. Shortly after, it does – night-time take off and very impressive. The whole imagery of the evening with our patient and the transportation of him to the aircraft was something that will never leave me – VERY professional and absolutely exciting to be part of!

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.”

 

Overlooking Bamiyan Town


The cool day is sun-filled right across the hills of the Bamiyan valley, to the snow that adds a frame to the remarkable picture’s scene. The Padre (Ra) and Allan Kelly, a civilian such as myself, and I head off to the nearby Foladi Valley. The journey to our planned destination was anticipated to take around 40 minutes . It was to the farthest medical clinic up the valley, but I don’t think any of us anticipated the state of the roads that took much negotiation and rocky-road manoeuvres. Our caution in thusly travelling was countered by the speed of the local police who seemed to be on ‘blue light flashing’ every time they took to passing us on the  rutted dusty roads.  Cautiously we drive, and an hour later we feast our eyes on a most lovely village that looked as though it was from way back in ancient Medieval times.  We were presented with often huge houses that had stunning walled architecture, and which gave home to 5-6 families living there. The walls of these not unattractive constructions were made of mud – brick or stone and concrete.  Often they had lattices on windows and sometimes there were occasional windows blocked in to conserve warmth against the bitter cold.

The narrow streets of this village gave the image of quaintness as women walked the streets with their chadors, the days washing perched in perfect balance upon their heads. By the sides of the road and thrusting like fingers into the ploughed fields were water-trails nurturing the land and all the village’s washing, at the very least – dishes and clothes, seemed to be done in such water courses. 6-9 inches deep these tracts meander delicately and rather picturesquely across fields and along poplar lined fields planted in rows to stake out boundaries or emphasise forests. Just beautiful,  and made more so as we were lucky enough to travel to the region the day after there had been rain and so there was little dust – even the trees had shed some of their dust and were another  cleaner, purer colour today.  Children were playing in mud and in the streets, whilst some were doing the dishes for their parents. All stopped to look at us as we passed and most would run away to prevent photographs being taken, yet everywhere we looked to snap another image told ‘a thousand words’ and we wanted to capture them all.

Finally we found our destination medical clinic that had over the last week been taken over by the International Red Crescent (IRC ) and  we were told that it had a Doctor, a Nurse and a Vaccinator. A couple of packages of goodies –  woollen clothes, dolls, and toys made by generous Kiwis back home –  that we gave  to the clinic  prompted smiles in gratitude. This was the only reward that the Padre, Allan and I could ever have wanted. A few photos on the way back, man and donkey, women walking the roads, children by the sides of the roads and scenes of a majestic country present themselves to us in the winter’s sun heightened , again, by the reflection of the snow upon the hills.

'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

 

 

One of the many young local boys on his donkey

Around 1200 we land at the Bamiyan airport.  Day 1, week 1.  After a trip of over 36 hours I arrive on a dust blown airstrip in Bamiyan City, North West of Kabul. Out the plane I tumble with an improvised technique that immediately stamps me as being non-military. I know this, for all the military folk turn away from me and murmur to each other with shaking heads. Finally I decamp and present myself in the best possible light to the amassed audience who are by now tittering away with hidden guffaws.

I look around me. My goodness this region is amazing. History thrusts itself into my eyes. Alexander the Great, Genghis Khan, and Marc Shaw, Doctor!  Being a civilian doc for the NZ forces in the region is a personal delight and I feel very honoured to have been given the chance to be here again. Again, because I came here for the first time over 30 years ago, before the Russians and the Taliban. Then, there was a small town that had some of the most majestic of monuments: two Buddha’s carved into the rock face of the nearby slopes overlooking Bamiyan Town in Bamiyan Province. Now there are two huge holes where they were, for the Taliban in their designer vandalism bombed them out of their thousand year benevolence overlooking the population of the region.

I am relishing the thought of caring for the NZ forces here, and also assisting the local health politic as I can. Frankly I was scared still when I first got here, but after five days am now settling in to the routine of the place rather well. The men and women based here are fully supportive of having a civilian in my role and go out of their way to smile and be friendly, though having said that in all probability most are probably still chuckling at the way that I arrived here!  Not being familiar with a military way of life the first that I have to do is understand that acronyms are essential communication. It takes awhile to master them and many a time I sit bewildered in meetings as all around me nod their heads in understanding at the one true word of English in every sentence and a polyglot of letters that surrounds it. Yesterday I tried to show my abilities at understanding this new language as I spoke with a few acronyms in a sentence or two that I proudly presented to the CO. I thought that he was rather impressed actually, but then the Sar’Major came up to me later and said ‘what was all that about Doc?’ Distraught I went to bed later that night and rolled over the pages of a textbook that I have called ‘Understanding how the Military talk’. I got to line two before I fell asleep.

The only thing that I am not to keen about here is the bloody dust. Gets into everything, and so I have to cover up my computer and electronic gear day and night for micro-molecules of this dust penetrate deep into every room. My quarters are OK. First thoughts when I saw them were of how quickly I could get back home again, but I have moderated this now as I have flashed my personal comfort references around the room: photo of the family, photos of me mates back home and a New Zealand flag proudly hoisted on the wall above toothbrush and my towel rack. Am feeling quite patriotic actually!

Have been out and about the town and the scenery is beautiful. My first look around Bamiyan and the sights stun me with their difference and their beauty: young boys and smaller girls wave at us with energetic sideways motion of their hands as we fly past – I wave back for it seems a crime not to acknowledge this friendliness, men in turbans and with full beard who lead their donkeys or ride them to a destination known only to them, women working the potato fields hurrying to get the crop in before the snow starts to fall in about a months time, passage through the bazaar with groups of men tending stalls most of whom are drinking the local tea, or chai, as they talk, often gesticulating with arms thrown into the air in a moment occasioned with laughter.

Willow trees line the town’s sole tar-sealed street giving momentary respite from the dust and a calmness to travel that otherwise would pitch and roll with each rut of the time-worn pock-marked road. We pass building after building. Some in good state but with dust colouring them beige, and some rising from the dust as ruins that history keeps a better record of. Around the town there are fairly steep hills on either side. But looking above these hills and the haze of those travelling the roads, I see the range of the Hindu Kush in the back-ground looking down upon us like the ‘all-knowing sage’. Rising to over 5000 metres, as I am entranced by it I am also reminded of the severity of living in this most ancient of lands.

First week at the office! What a week. It is good to be here and amongst these people, both my own kind and the Afghanis. I have much to learn from both, and I reflect upon this as the silence of each night beckons me to rest. Slowly, gradually, I will prove that up am up to the task expected of me in this demanding role.