At Camp Bastion, combat surgeons fight to keep troops alive

A British soldier who was wounded from a bomb blast is comforted by the grip of a fellow soldier at the Bastion Hospital in Helmand province Afghanistan. Photo: Nelvin C. Cepeda.

Gretel Kovach of The San Diego Union-Tribune reports from a recent visit to the combat hospital at Camp Bastion, adjoining Camp Leatherneck in Afghanistan's Helmand Province. She and her photographer, Nelvin Cepeda, arrived on a busy day on which the hospital staff worked until well past midnight, operating on 18 patients for a total of 38 hours of surgery in four operating rooms.

Quantum leaps in battlefield medicine made during a decade at war have contributed to a more than 90 percent survival rate at the British-run facility, which includes a rotation of U.S. Navy doctors among its international staff. The hospital is on the British base in Helmand province adjoining Camp Leatherneck — headquarters for 20,000 U.S. Marines who make up the bulk of the NATO coalition in southwestern Afghanistan.

Many Camp Pendleton Marines have gotten their last look at Helmand from Bastion hospital, which is the busiest trauma hospital in Afghanistan.
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As the U.S. military was ramping up in Afghanistan two years ago, Defense Secretary Robert Gates promised troops stationed there that medical providers would be pushed closer to the point of injury so they could administer critical care within an hour, as they were in Iraq.

Today Pentagon officials say that “golden hour” standard has been achieved in Afghanistan, where patients are transported to advanced stateside military hospitals in as little as three days, versus a month or more on average during the Vietnam War.

At Bastion, fresher blood products administered in a one-to-one ratio to replace lost blood reduce the risk of lung problems associated with using saline. Two powerful 64-slice CT scanners produce three-dimensional images of the organs, bones and vascular system, helping doctors pinpoint the most severe injuries rapidly.

[U.S. Navy Cmdr. Angela] Earley and her American team began their deployment at Bastion in October the same month that Camp Pendleton’s 3rd Battalion, 5th Marine Regiment took command in Sangin, an intensely violent area of Helmand province.

They performed about 60 leg amputations and more than a dozen to the arm, hand or groin in October. “We had trial by fire very quickly,” Earley recalled. “We had to step it up... to get over the shell shock of what we were seeing and try to save these guys’ lives.”
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For them, the perseverance of the 3/5 Marines despite heavy casualties was heroic inspiration. “It kept us motivated to keep going,” Earley said. “No one should have to lose so many.”
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The U.S. medical team at Bastion was fortified during their tour that ended two weeks ago with the knowledge that they saved lives and improved battlefield care each day they served in Afghanistan, when they helped rewrite treatment guidelines.

“It is unfortunate we have to see so many young men getting hurt for this,” Earley said, but as a trauma surgeon, “this is professionally the most rewarding thing I have ever done.”

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