Snag apache helicopters trip 70 kilometres southeast of Kabul — and you open a prevent terrain once dubbed “The Gates of Jihad”. Logar Province, on the border with Pakistan.This is Taliban territory. We property at a Forward Operating Base — deliveredinto the very personal, encountering crusade of America’s “Generation Y’. Most of those now crusading and dying herewere still in school when George Bush affirmed war on terror roughly nine long years ago.The Obama Administration has said a huge troop surge to finally overcome the Taliban.But more boots on the anchor, entails more fatalities. I don’t take “peoples lives” for awarded, becausedeath environs me. It’s trauma in a tent — as they engage tosave lives in this deadly combat zone.It’s a personal conflict, it’s feeling conflict, it’s, you know, trying to keep parties alive. We attach the US Army MEDEVAC crews, doctorsand nannies engaged in what can be a dangerous and harrowing task…Welcome to M* A* S* H … 2010. This is the canvas and plywood nature of the8th Forward Surgical Team. Leading this small group of physicians, nannies and medics are surgeonsMatt Hueman and Bryan Helsel.This isn’t my first rodeo. I’ve done this before. I’ve, you are familiar with, ran at major trauma centres. I trained in Los Angeles County Hospital whichis a major place of damage. And it’s not that it doesn’t affect you, it’sjust you learn to cope and you learn to interval yourself. You have to bepassionate to represent these parties to be all right, but you also have to have a bad memory.For Matt Hueman — the army is his life.He participated at 17 and has depleted 16 years trainingas military officers and surgeon to be here. And business is brisk. We’ve been the busiest Forward Surgical Team, not only in Afghanistan — but Iraq and Afghanistan. In merely 10 months, their big tented hospitalhas received a staggering 600 trauma disputes. It’s designed to do damage domination surgerywhich entails save someone’s life so that they can get further in the evacuationsystem to get exhaustive surgery. It’s about to get much busier. The Surge willsoon push US and Coalition troop multitudes beyond 150 thousand.Their tells: to take the fightto the Taliban. But first they’ve got to secure the deadlyroads — riddled with improvised explosive devices or IED’s. Well, scarcely a stone’s throw away from theoperating theatre over here, more garrisons and escorts are preparing to head out in theirhuge MRAPs — mine resistant patrol vehicles. It’s now mid winter in Afghanistan, and thisis usually a occasion when there is a traditional lull in the fighting, brought about by thebitterly cold weather. This time last year, there was a metre ofsnow here.But not this year. It’s unseasonably heated — and that aims the Taliban are stillout there, laying IED’s, designating attacks, and for these chaps, that intends, more fatalities. Dust off 43… Dust off 45… 43, 45 Are youguys 19 kilometres to the North? Ready for retirement urgent MEDEVAC…Roger 43. When youget that order, you sounds MEDEVAC, you’re not thinking about the dangers so muchas you are thinking about that case, you know, you don’t know who it is.It could beyou know US, Afghan, small children … As the Blackhawk MEDEVAC choppers scramble– the word is all bad. We’re gonna need a torso luggage on the groundthere.” A massive explosion has just destroyed anMRAP. Two soldiers are dead — three wounded.Are they Americans? Yes they are Americans. I don’t want one guystaring at his dead sidekicks the whole time. You got a body bag underneath your accommodate, sir? As they shore, the gang expects an attack.On the foot apache helicopters are highly vulnerable — and the Taliban know it.I’m really nervous now…There’s one dude sauntering back and forward in that house rightthere — with an RPG? Yeah, I insure him. I don’t see the RPG — but yeah I assure him there. High-pitched overhead a pilotless surveillance dronecaptures in real age these personas of the medivac. Vigilant for any sign of ambush. I actually wish they’d hurry up.The Americanshave spent $32 million dollars replacing their vulnerable Humvee vehicles with thousandsof MRAPS. That MRAP’s in bad shape.The Taliban simplybuild bigger bombs.IED’s now account for 60% of all Coalitioncasualties. The living and the dead are loaded onto separate helicopters for the flight home. Must have been a big one to mess that MRAPup like that. How tough is it to deal with what’s goingon in the back of the aircraft that you’re flying? I mean you’re picking up some terriblydamaged people? Honestly, I don’t look back very often. I’m quite tender hearted , notthat I can’t, I necessitate if I need to I do, but I focuson flying. For the wounded, it’s now a scoot against theclock to hit the so-called Golden Hour. The Golden Hour is when the person has aninjury, within the firstly two to five minutes there’s a certain number of people who willdie that are not saveable. The next hour is where a lot of parties, if they don’t get toa place that has surgical capability and the full range of taking care of them, will dieas well.So the Golden Hour really wonders those peoplethat are saveable if you’re able to get them to a plaza like a forward surgical team withinthat hour. Precisely seven minutes earlier, the wounded aredelivered into the pass of the surgical crew. At a discrete distance — the body suitcases arealso emptied. 520 US and Coalition troops were killed in the past year — the deadliestin the conflict so far. But all attention is now focussed on savingthe living — doing everything they can in the golden hour.We provide 21 st century intensive attend, critical care for cases that would otherwise die. I meanthere’s no way around, some of these parties would have died.Too numerous soldiers wounded on Afghanistan’s remote battlefields were bleeding to deathbefore contact surgery at the large-hearted armed hospices. So last year Army surgical teamswere moved much closer to the fight — to beat the Golden Hour.You watch the TV demonstrate M* A* S* H and you think about them trying to make dowith what they have. And I think that’s really what we’re doing here.For those who make it here alive — often with horrific gashes – there’s now a 98% luck of existence. A young girl soldier gathered from the wreckageof the MRAP has several ruptures. For her compatriot, Sgt.Adam Sandifer — hit by themassive concussive smash – the hurts are less clear.We try and get the chest and pelvis within the first ten minuteswith all the other things that we do, like checking the airway, making sure that theyare breathing, concluding sure they have a pulse, get an IV in — doing an ultrasound makingsure they don’t have blood in their abdomen. Matt Hueman and Bryan Helsel both served inIraq — they’re well- practised in treating IED victims. But this is a different war with differentinjuries. So even though they’re hasten in the newarmoured MRAP’s, they still can suffer severe traumata? They can, and it’sdeceptive, because it tends to be internal injuries so, you are familiar with, in my last-place deploymentwe would see amputations, substantial above the knee amputations, with the Humvees.Inthis deployment the leg still appears to be functionally intact, but it’s still a significantinjury inside and we have to figure that out” and sometimes it’s more harder to figure out.When you guys acre, you vanished up in the air like this and came straight-from-the-shoulder back down? Yes. And then did it stay on its pedals the wholetime or did it roll over? I no, exactly was almost like the inside of the section comingapart. I’m just trying to figure out so I know what to look for with people’s traumata. Everyonein here was like they’re doing OK, alright — so you just hang tight.Without the MRAP’s, the toll would be much higher.Most of these soldiers that come in now after excessively violent, huge IED’s that leave hugecraters that are usually would have killed them, or injured them.I would say most ofthem walk away now. Adam Sandifer is exhausted — to contemplatethe random nature of conflict — why he lived and two friends in the same vehicle died.The dead are laid out in the foyer. Those met are stilled by anger and surprise. Thegrieving and a dignified, flag-draped send off will follow Out on the flight row — the MEDEVAC crews are back on standby.Acting commandant is 27 year old Captain Nissa Brodman, a graduate of the elite West PointMilitary Academy.I do elevate the humanitarian aspect. For me it’s what I truly feel drawnto. I did go to West Point. I actually wanted to bea doctor, my class rank wasn’t high enough to become a doctor which actually culminated upbeing a blessing because then I diverged to aviation and in flight full re-branched tomedical service to fly MEDEVAC because I, that’s what I really was necessary to fly and herewe are.I’m fairly spiritual and every Saturday nightI go to Mass. It’s my lane of dealing with that, so you definitely see it, it’s in your face all the timeI would say I’m the mom. I get tantalized a little about being the mom, but I think that’sa good thing. I imply I do my best to care for the people I work for, you know.We all do symbols once a week or so. We usually pick out every now and then a good one andhang it up. What does it say? Thank you for fighting for our country — even though it may mean death. He’s in 5th grade.I went really lucky getting placed now. Devon Bundy was just out of the 5th score himselfwhen it all started back on 9/11. Now he’s part of the Gen Y army that’s inherited the”War on Terror”. He’s our youngest soldier in the platoon.He’s a commo guy, so he makes sure that we receive every mission.How old-fashioned are you? 19. And how long you been in the army for? A little under two years now.And you’re here already? Uh-huh.What do your mothers move of that? They weren’t exhilarated — but they went overit now. There’s little time for thinking – the MEDEVACcrews are soon back in action. A US patrol has experienced 16 year old-fashioned Mohammed lying in aditch critically injured with a gunshot weave to the hip.He’s bleeding a little bit more, but as far as pain wise he didn’t seem to be too bad.The medics are attentive, and with good reason.In Kabul recently the Taliban rigged an ambulanceas a car bomb. Another suicide attack posed as a medical doctor. Why is he brought to this tent? He’s to come in here because he is not a US citizen — so we strip him all down and make surethere is no unexploded guide. The people are important — but also the equipment– because we can’t replace the gear so we try and make sure that they’re all goodto go before we make them inside.That’s a potential threat is it? It is. You precisely never know. News that Mohammed was shot by Afghan policeworries the Surgical Team commander, Captain Ben Wilhelm.Wait a hour, he’s from Ghaznibut likewise he’s says he’s from Logar? But now he say I’m from Ghazni Province…I think he was scandalized — he said that I’m from Logar Province.His father’s figure is Khalil.And my alarm bells start starting off. What worry about me aboutthis case? Well … when they’re iffy on the information it could mean any number of things.Could be completely innocent, “couldve been” time the suffering talking. But on the other hand itcould be he was doing something he shouldn’t have been doing — and that’s how he got shot, so.Potentially Taliban? Potentially … I necessitate there’s plenty of illegalactivities that go on in Afghanistan that “ve got nothing” to do with the Taliban extremely, Imean he could have been running dopes or whatever else, so.He’s clear — he doesn’t pose any immediate danger to us so we are going to take careof him just like we would a American soldiers, but it adjusts off alarm bells when they don’t seemto either know where they are coming from or don’t seemto have a consistent story. We’ve had a number of enemy prisoners of warcome through — corroborated Taliban. We’ve had some that were shot by our people and we’vehad a few who’ve blown themselves up planting IED’s.This is what happens when you’ve got a third evaluate education and you are dealing with highlytechnical explosives.It is difficult, but “youve got to”, again, finda positive way to deal with that and you have to set any kind of feeling animosity youhave aside and visualize them not as the foe but as a patient.And that person needs your help right now. So we had multiple small-minded bowel hurts andwe tried to figure out where we could combine those together.What we’ve learned in the last decade — as a community — is that just removing the contaminationand not actually trying to fix it definitively at the first enterprise actually earmarks patientsto time even better. It turns out Mohammed is no insurgent — justa boy caught in the crossfire. His only lucky break – that he was brought here.In much of Afghanistan advanced medical care is non-existent — with hospital infectionrates so high-pitched — that to be admitted can be a death sentence.For our regional nationals we have less capabilityof moving them to another facility for exhaustive help, and we recognise that we probably providethe best exhaustive care here. This is a war campaigned 24 hours per day. Poor night visibility has grounded the combathelicopters — but MEDEVAC flies irrespective, and we tag along. Saving lives sometimes means flying blind. We return to where the MRAP was destroyedearlier in the day. The Taliban have since fuelled projectiles at acrew sent to recover the wrecked vehicle. A engagement engineer has been accidentally sprayedin the face with battery acid — in the dark it’s impossible to assess his injuries.He’s delivered to the surgical crew … where, at the end of what’s been a verylong, hellish era there’s finally some good news.He’ll make a full recovery.It feels like I’m drowning…This does not go on Facebook! ” Well, just out here only beyond the helipadand research hospitals lies the future. A year ago — this was an outpost of fewerthan 300 troops — already there are 2000 in this camp — and in not long from now there’llbe anything up to 20 thousand — all one of the purposes of the surge.Already the Americans are building a runway that will soon be able to land long distancejets and there are very permanent organizes now being constructed all around the compound.You actually do gave the impression that the Americans will be here in Afghanistan fora long time to come. And one of the most significant engagements ahead liesin prevailing the hearts and knowledge. Last time was the deadliest for civilians, with morethan 2,400 killed. US medical support for Afghans is intendedas a morale booster. Forty per cent of the casualties treated by the surgical squad areAfghan units or local civilians.But this American goodwill takes a batteringevery time a boy such as 14 time old-time Arif becomes a statistic — and be warned thisis confronting. He said that an American patrol, and Afghannational patrol, came into the valley — and the children playing with stone together- and they threw out the stone on them. Suddenly national military assaulted on him — and theyshoot him.So the patrol shot him for propelling stones? Yeah – not American beings. Afghan people.With the Americans? Yeah.Arif was shot six months ago. Every week since then his brother has brought him in for care. The initial entering of his curve was throughhis arm now — he has a broken arm here … and that’s really the one thing that hurtshim right now. So if you touch his arm at all that’s whatbothers him. The wound ran in through his dresser –and then in his prickle — so he’s paralysedfrom about here down. I’m afraid that it’s probably a terminal thing We try and make it as comfy for him as we can.I mean his wraps are pretty devastatingwounds. For medical doctors — sanctuary lies behind aplywood door. This is their escape from the relentless stress of surgery. Afghanistanis left behind outside the tent. This is home? It’s Mardi Gras on dopes. Ithink it’s holidays gone bad in now. Sometimes you precisely need to decompress.Like the other night, we were in there operating for 12 hours and we came back and watcheda duo episodes of a Tv just goes to show to kinda unwind so you can go to sleep.I have this fervour hat that was from his second birthday, and I have some other nick-knacksthat my partner direct and some of the pictures that she transported me underneath.So that’s whatkeeps me leading. Their tent is compressed with remembers of soul at home and – not surprisingly- it’s here, away from the hard focus of saving lives, that raw feeling can surface.You know that there’s US trauma coming in and when the MEDEVAC helicopter landsand you realize the soldiers sort of turn, you know, congregate and sort of be worried about, worried about them, because you know they’re worried about them as their friend, is itone of their friends, I think that represents it really difficult.It too builds it truly rewarding, because I feel confident that we’ve taken care ofpeople as best we are able to, and have gotten them to a pitch where if they were able to be saved, we were able to save them. Ahead, lies a hot, even deadlier summer. Asthe surge begins, one onetime American commander approximates U.S. casualties is gonna be a highas 500 a few months. I’m dreading it because I hope that we can keep up.Hope thatwe have enough crews for every wounded soldier out there. Our biggest upset is that we’reneeded more than we are able to perform or we don’t have enough chaps or enough crew membersor fairly aircraft to act our duty. Another era, another MEDEVAC — we attach NissaBrodman on a mission to evacuate an American soldier with spinal traumata. Combat stress, and the pressure of constant deployments to Iraq and Afghanistan are taking their toll.Most of these young soldiers joined up after 9/11, expecting to fight. They believe thisis a precisely battle. But you do sense a late war-weariness now penetrating through the ranks of America’s”Gen — Y” army.I hope that there’s an end in sight, because why else are we doing this? I make if it’s just going to go on and on.What’s with the fervour? We only be standing and enjoy it, and kind of talk — it helps decompressa little bit. Matt Hueman is a career officer — passionateabout surgery and the Army — but he now openly questions future directions of the war.I’m profoundly proud supposed to be here. Having said that, I think that in terms of the objectivesof the campaign, I ever felt that I substantiated whatever the President would say, and I wouldgo here.I is a well-known fact that I have a clear mission as a doctor, as a surgeon, to settle soldiersback together again. I’m not sure that it’s always been communicated in a way that allof us can understand what we’re doing here. In both Afghanistan and Iraq.I think it’s clear that the overall painting realise sense of, OK, we were attacked and thisis the place where the attack started from. But in terms of what we’re doing here now, it’s not clear to me that we have an overall end point that fixes smell to me. And if itdoesn’t make sense to me, then does it make sense to the average solider that’s goingout there and risking “peoples lives”. But while ever soldiers continue to risk theirlives — the medics will be there to save them. The radio alerting — a remembrance — thatthe fight drags on relentlessly.It’s a MEDEVAC request –so we just started having fun. So I suspect we are going to be back to workhere pretty soon. Just have to figure how to give this thing out — somebody have a fireextinguisher ?.
