Kandahar: The harsh reality of combat medicine

Lieutenant Soren Hall (far left) and Captain Simon Ainsworth (far right) work with other members of the MMU to resuscitate a casualty. WN 08-0046-09

The New Zealand Defence Force (NZDF) has a two person medical mission in support of the Canadian led Multinational Medical Unit (MMU) based at Kandahar Air Field (KAF), southern Afghanistan.

It is a relatively new mission for the NZDF with the current team being only the second rotation, deployed in April 2008 for a six-month tour.

The MMU provides the highest level of medical care available within the southern Afghanistan area of operations.  It receives casualties directly from the point of injury and also receives transfers from other smaller medical units who have casualties requiring higher medical intervention.

The current NZDF team comprises of Captain Simon Ainsworth (Royal New Zealand Nursing Corps) and Lieutenant Soren Hall (Royal New Zealand Army Medical Corps).  Both members are currently posted to 2nd Health Services Battalion (NZ) working within the Forward Surgical Team and Evacuation Platoon.

Capt Ainsworth’s background is in the area of trauma and emergency nursing whereas Lt Hall spent eleven years as a medic before training as a radiographer.  Both say that this deployment is a “mountain top” experience that stands out as a highlight in their careers. 

“To be able to apply your training and experience within a combat environment and care for casualties who have combat injuries is just not possible within New Zealand; as such the MMU is the perfect place to gain this experience,” Capt Ainsworth says. 

The pair say the MMU is a busy place with a constant stream of casualties coming and going from the hospital.  While rostered shifts are worked, all staff are also on call. They are called in regularly to receive new casualties coming through the trauma bays.

“The unpredictability and tempo of war means that the numbers and types of injuries are not always known before arrival.  The reality that some injuries are not survivable is also a lesson learned very early in your time at the MMU,” says Lt Hall.

Seven different nations working within the MMU facility based in Kandahar Air Field (KAF) reflecting the many nations of the wider International Security Assistance Force (ISAF). 

“This multinational environment is an opportune area to share different approaches to patient care and military practices,” says Capt Ainsworth.

They say the environment is harsh and adds a different dimension to life and work at the MMU, with a fine dust covering everything.  Wind and vehicles stir this up leaving it hanging in the air and decreasing visibility.  With summer arriving, temperatures are also rising with midday consistently being over 50*C. There is no rain during the summer but sand storms are common.

As the air field is the dominant ISAF base in southern Afghanistan, its locality and size often see it  targeted by insurgents in the form of rocket attacks.

“The fact that not all casualties make it as far as the MMU is reinforced when attending Ramp Ceremonies,” they say.  “Fallen soldiers are remembered and honoured for the sacrifice they have made in trying to support the people and government of Afghanistan.  These ceremonies are attended by all nations and are incredibly sombre and moving occasions.”

“The mission based at KAF is a fantastic opportunity for members of the NZDF to expand their knowledge and understanding.  The lessons, challenges and experiences will be taken back to the NZDF and will aid in the ongoing refinement and improvement to the medical care that is provided,” say Capt Ainsworth and Lt Hall. 

“Deploying to Kandahar exposes you to the harsh realities of combat medicine. It is a challenging environment both physically and mentally.  The challenge now is to continue building on this knowledge in the future rotations to come,” they say.

ENDS