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Friday, July 29, 2011

Australia to boost medics serving in Afghanistan

Canada has had great success with civilian medical professionals in Afghanistan.... maybe the Aussie"s should look at this option.

Flight Lieutenant Jo Darby with US Navy administrator Lieutenant Commander Ron Schoonover. Picture: Gary RamageSource: The Daily Telegraph
PRESSURE is building for Australia to boost medics serving in Afghanistan as the Canadians and Dutch leave.
The priority need is for trauma specialists at the new Role Three hospital at Kandahar airfield where just a handful of Australian medical staff work in support of the US run facility.
Adelaide RAAF doctor Squadron Leader Jo Darby, who undertakes shifts at the trauma unit in between her duties at the Australian camp, said medical teams working at the hospital treated all patients as if they were their own nationals.
"We really appreciate their efforts ... we owe a massive debt to the US Navy guys," Flight Lieutenant Darby said.
Most seriously wounded Australian troops are treated at the Kandahar facility before being transported to Germany or back home for specialist care.
Flight Lieutenant Darby said it would be greatly appreciated if Australian trauma teams could be permanently based at the facility when the 35 Canadian and Dutch specialists depart in November this year.
"It is going to be a manpower juggle," she said.
During a visit to the hospital, administrator US Navy Lieutenant Commander Ron Schoonover said that it was as busy as the top seven trauma hospitals in the US but was only one-tenth of the size.
The hospital treats up to 260 trauma cases a week and averages well above 150-a-week with its three operating theatres often occupied around the clock. 
"The mission won't change and when they go we will be short-staffed," he said.
Flight Lieutenant Darby is the medical officer at Camp Baker, the Australian headquarters at Kandahar airfield. She also spends about three days a week working at the trauma facility.
"It is a great opportunity because there is nowhere else like this," Flight Lieutenant Darby said.
According to Defence there has been no formal request for Australians to replace the departing medicos.
"It is important to note that the health care provided to deployed Australian personnel will not be diminished by the departure of the Canadian doctors," it said.
Meanwhile, coalition medical staff across southern Afghanistan are bracing for an influx of casualties as insurgent suicide bombers prepare to attack civilian targets.
On War Blog: Military Chaplains in Afghanistan Part II
KANDAHAR AIRFIELD, AFGHANISTAN - MARCH 21: U.S. Navy Chaplain LCDR. Charles Hodges photographs as doctors perform brain surgery on an Afghan civilian on March 21, 2010 at the military hospital at Kandahar Airfield in southern Afghanistan. Chaplain Hodges is stationed at the hospital and also serves as the photographer for the medical unit. As part of his job, he also comforts wounded patients and counsels medical staff who often deal with a heavy caseload of patients, many suffering from traumatic injuries.

Date: Mon. Aug. 13 2007 11:46 AM ET
KANDAHAR, Afghanistan — They are the battered and broken. Afghanistan's war wounded arrive at the Canadian Forces trauma hospital on the Kandahar base on a daily basis.

Capt. Helen Wright, a family doctor for the military when at home in Calgary, says this is a different kind of practice.
"I have seen far more acute traumas in the six months," she says, "than certainly I have seen in my entire training and likely more than I will ever see in my time back in North America."

In the past six months, about 400 patients have passed through the front doors of the hospital and into the capable hands of multi-national medical teams. The teams include both military and civilian doctors.

The hospital's commanding officer, Col. Colin MacKay explains that civilian doctors are needed. "We have civilian surgeons here right now, because with the Canadian military right now, we have a shortage of uniformed surgeons at the present time."

This is, after all, Canada's first combat field hospital since the Korean War. Subsequent peacekeeping missions have not pressed the military's medical services the way they are being challenged now.

Coalition soldiers, Afghan security forces, Taliban fighters and the civilians caught in the crossfire, ncluding numerous children, all have been treated here.

"I have to say that I have been quite taken by the amount of damage that can occur to a human being in a conflict like this," MacKay told CTV News. "And it is difficult to see the soldiers, both Canadian and multi national partners, the Afghan security forces and local nationals that have become victims of the conflict."

I was granted several days access to observe how things are done at the hospital. For people who have laboured here saving lives and limbs, it was a story they wanted told and it is an experience I will never forget.
"Role 3," as the hospital is called on the base, happens to be a collection of containers and plywood rooms that house several trauma bays, two operating theatres, an X-ray room, CT scanner, a lab and about 13 beds in three rooms that make up the wards.

"We have a very small compact facility that has tremendous capability," MacKay said. "It has many of the capabilities you would find in a hospital back in Canada."

On this day, the badly injured are Afghan National Police, victims of a Taliban ambush. At least eight of them were killed, two are in trauma bays and one is already in the operating room. In all, some 30 people have assembled, including specialists, doctors, nurses.

Lt. Tobi Barter, a nursing officer, says: "Some days you hear the communications, and you may have four or five patients coming in. They all have amputations, missing body parts and you never know what to expect day to day."
While it seems chaotic, amid the shouts for X-rays, fluids, vital signs, there is order and humanity.
"For the most part, we are able to help them recover from those injuries and see them go out the door and that's very rewarding," MacKay says.

It's also rewarding for the civilian specialists, who answered military ads in Canadian medical journals for civilian volunteers.

"It's been a thrill," says soft-spoken general surgeon Dr. Vivian McAlister from London, Ont. "The quality of care is identical and the organization is fantastic. I think the civilian practice has a lot to learn from the way the military can handle these situations."

"We frequently cancel patients at home and declare we are unable to look after other patients and their care will have to be postponed -- this never happens here"

Winnipeg radiologist Dr. Daniel Lindsay is on his second rotation at the hospital.

"I think the Canadian military thought outside the box," he said, "and I think they were very creative and they took a huge risk on people like myself coming over here."

Lindsay was one of the first civilian specialists to work with the military medical services in Kandahar.
"We have this view of soldiers as if they are not human and they are some kind of machine. There is a tremendous amount of humanity here and a big part of what is happening here, isn't just looking after the troops out there, a big part is looking after the Afghans."

When injured coalition soldiers come to the hospital, for the most part they only stay a day or two until they are transferred from Kandahar to care facilities elsewhere or at home. But the Afghans, security services, and civilians stay longer.

"This is a clean hospital for a dust bowl in the desert," says orthopedic surgeon Dr. Dave Puskas from Thunder Bay, Ont.

But it's not the kind of environment where patients would want to stay if they had another option for surgery, he said.

A specialist at repairing bones, Puskas is no stranger to trauma injuries, car accidents, fights, or falls but even he is learning new terminology in Afghanistan.

"I heard this phrase recently -- biologic shrapnel, so shrapnel meaning a secondary missile, but another person's body part. That was something new to me," he says.

On the table in the operating room is an injured Afghan army soldier. Puskas will repair a wound to the man's left arm and he will help Dr. Steve Bureau, an oral surgeon from Calgary, repair a terrible wound to the man's lower jaw, the result of a Taliban bullet.

"One centimetre deeper, one centimetre lower, and we wouldn't be operating, that's for sure," Puskas tells CTV News as he gowns up.

Bureau is the only one of five civilian specialists on rotation at this time, who has served in the military. He was a dentist in the Armed Forces until 1996. He left for private practice and became an oral surgeon about eight years ago.

"I got an email through the Canadian Association of Oral surgeons that the Armed Forces was looking," he says.
So he called an old military colleague and was in.

There seems to be a brief, quiet pause in all the activity on the trauma floor. But then U.S. army doctor Aaron Saguil informs the medical teams that new casualties are on the way.

"We have to get out of our comfort zone," he says, "We have to be very creative and not be afraid to tackle something a little different."

Bureau replaces the Afghan soldier's shattered jaw with a metal plate. Two days later the soldier will leave, a little sore, but on the mend, and most importantly -- alive.

Curtains are drawn on one of the trauma bays where hospital staff had tried to save the life of one of the afghan police, but his injuries were too severe and he would not recover.

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