Doctors and Nurses at War

by Lisa McGarry

In most Armed Forces, battlefield casualties are taken to hospital for surgery and treatment. But the British fly top doctors and paramedics straight out to the battlefield in a special military ambulance with armed guards – taking the ER directly into war zones to save time and lives.

In a new three-part documentary series for ITV1, Doctors and Nurses at War follows NHS trauma surgeons, paramedics and nurses who have volunteered for three months with the British Armed Forces in Afghanistan.

The volunteers, members of the Territorial Army 203 Field Hospital Unit based in Cardiff, are all experienced trauma specialists.

Each episode focuses on different characters – following them through training, from their regular jobs in the NHS, to the battlefield.

The programme makers were given unprecedented, first-time access to Britain’s Field Hospital in Camp Bastion and its battlefield ER to follow a number of NHS medics as they experienced warfare – some of them for the first time.

Doctors and Nurses at War reveals all the tension and drama of one of the world’s busiest ERs, where the trauma specialists battle to save the lives of British Service men and women and Afghan civilians.

Programme one follows the NHS volunteers as the complete their training, arrive at Camp Bastion and face their first challenges – from treating soldiers injured by landmines to victims of suicide bombers.

Everyone at Camp Bastion must be armed. For people who are more used to saving lives than taking them, this is a stark reminder that they are now at war.

Capt Sue James, a grandmother and former NHS children’s nurse who is heading to Afghanistan for the second time, says: “I think the worst part of going away is going to be leaving the family. My grandson is only two weeks old, so that’s going to be really difficult.”

But it’s not long before Capt James finds another child to care for – a one-year-old boy who has been badly scalded by boiling water in his mother’s kitchen.

She says: “When little baby Basha came in you think, ‘Gosh, if this had happened to my grandson, Thomas, it would be absolutely devastating.’”

The man with the task of commanding the volunteers is full time army officer and Falklands war veteran, Col Phil Hubbard. He says: “Today they join for very different reasons than they would have done 10 or 15 years ago. They know, they listen to the news, so they can see the challenges. So what brings people to that?

“I think it is the attraction of using their skills in an environment that is unusual to them and they want to challenge themselves.”

Lieut David Hawkings, an NHS trauma nurse and father of three who is renowned for being handy with an iron, says: “I just feel, personally, I’ve got things that I can offer. I feel it’s something that we’re able to give back – particularly to our front line service personnel.”

Lieut Hawkings has come to Afghanistan with his best friend, Capt Simon Lawrence, an NHS radiographer who has already been to both Iraq and Afghanistan.

Both men are extroverts and, as Lieut Hawkings dances around ironing in his underwear, Capt Lawrence provides a mock commentary, whispering: “Here we are in the accommodation of the soldiers. By observing them closely we can see them in their natural habitat.”

But even Hawkings and Lawrence’s good humour is shaken with an explosion outside the camp – close enough to concern the garrison, and its medics…

The explosion was a suicide bomb at a British army checkpoint. One soldier has been caught in it and is brought to Camp Bastion.

The soldier’s hands are burned but otherwise he’s unhurt. However the experience has been a wake-up call for everyone.

“They certainly put a dint in our pride that day,” says Capt Lawrence, “And they nearly came and put a dint in us as well.”

Outside Bastion, on the front line, first aid is given by armed combat medical technicians who accompany every patrol. Twenty-five-year-old L.Cpl Tom Storey is one of them.

As L.Cpl Storey patrols the streets of Musa Qala, a small town north of Camp Bastian considered to be one of the most dangerous places in Afghanistan, he says: “Even when someone comes up the street with a motorbike or a push bike, or someone comes up with a wheelbarrow, anything that you think might have explosives in it, you’re constantly on edge.”

With suicide bombers of all ages routinely used by the Taliban, even young children pose a possible threat.

“You’re scared all the time”, says Storey, “And anyone who says they’re not scared, in my own personal opinion, is lying.”

Casualties are recovered from the front line by a Chinook helicopter – the British Military equivalent of an air ambulance. On board are hospital doctors, paramedics and armed soldiers. Uniquely, all on board teams are led by a highly qualified consultant – no other country’s Armed Forces do this.

Lt Col Pete Davis says: “What it does essentially is take the emergency room to the patient. Our wounded patients or casualties in Afghanistan are 35 minutes flying time away from Camp Bastion. Those patients would die if it wasn’t for the medical team in the back of the helicopter.”

Back in Musa Qala, Lance Corporal Storey’s worst fears have been realised. A suicide bomber has struck in the heart of the town.

Returning from Musa Qala with eight wounded civilians, four of them young children, the air ambulance comes under fire from Taliban machine gunners 500 feet below.

Having made it through the enemy fire, most of the casualties are able to be stablised by the doctors at Camp Bastion. But one, a five-year-old girl named Raheema, is barely clinging to life. Her left hand was blown off and shrapnel has penetrated her stomach and other hand.

Junior surgeon Hugo Gutherie has already amputated most of Raheema’s left arm, but now must watch and wait to see if enough has been done to save her.

The presence of the casualties from the suicide bomber means others must leave the hospital to make way for them – and to Nurse James’ distress that includes baby Basha.

She says: “To watch them walking up there [out of the camp] was devastating. Because you’ve nursed them, you’ve given them all the treatment, you’ve given them all the love and care and attention that you possibly can and now it feels like you’re abandoning them.”

Back on the ward, five-year-old Raheema has recovered consciousness and her fighting spirit is capturing hearts all around the hospital – including that of her surgeon.

Usually, civilians are moved to an Afghan hospital as soon as they are out of danger. But Raheema needs urgent skin grafts if the use of her remaining hand is to be saved. This can only be done in Camp Bastion, and Dr Gutherie is keen to do it.

Dr Gutherie is not alone in his desire to give Raheema further treatment, his fellow doctors support him. But before they can help the doctors must convince the man who controls the ERs beds, Lt Col Nigel Heal, to bend the rules…

After much debate and discussion, Lt Col Heal concedes: “If we can keep the bed state somewhere between green and amber, and it’s in green at the moment, the hope is that we can hold her and do what we can. If we were to take a hit with casualties and the bed state flicks to red, then we do have to get everyone out.”

But, while Dr Gutherie and Senior Surgeon John McMaster begin the life changing skin grafts, the ER goes on red alert as another young girl is brought in, critically ill following a road traffic collision.

Trauma nurse, Lt Hawkings says: “It’s coming up to 28 years I’ve been in the NHS. But I have never seen such trauma in children as I’ve seen out here.”

Dr Gutherie says: “What we do is quick thinking, fast acting and there isn’t room for passengers.”

“If you’re not able to perform in that environment, then, you shouldn’t be in that environment.”

Tuesday, 3 February 2009, 8:00PM – 9:00PM