Hitch a helicopter ride 70 kilometres south
east of Kabul — and you enter a forbidding terrain once dubbed “The Gates of Jihad”. Logar Province, on the border with Pakistan.
This is Taliban territory. We land at a Forward Operating Base — delivered
into the very personal, confronting war of America’s “Generation Y’. Most of those now fighting and dying here
were still in school when George Bush declared war on terror nearly nine long years ago.
The Obama Administration has ordered a huge troop surge to finally defeat the Taliban.
But more boots on the ground, means more casualties. I don’t take my life for granted, because
death surrounds me. It’s trauma in a tent — as they fight to
save lives in this deadly combat zone. It’s a personal conflict, it’s emotional conflict,
it’s, you know, trying to keep people alive. We join the US Army MEDEVAC crews, doctors
and nurses engaged in what can be a dangerous and harrowing task…
Welcome to M*A*S*H… 2010. This is the canvas and plywood world of the
8th Forward Surgical Team. Leading this small group of doctors, nurses and medics are surgeons
Matt Hueman and Bryan Helsel.This isn’t my first rodeo. I’ve done this before. I’ve,
you know, worked at major trauma centres. I trained in Los Angeles County Hospital which
is a major place of trauma. And it’s not that it doesn’t affect you, it’s
just you learn to cope and you learn to distance yourself. You have to be
passionate to make these people get better, but you also have to have a bad memory.
For Matt Hueman — the army is his life. He joined at 17 and has spent 16 years training
as an officer and surgeon to be here. And business is brisk. We’ve been the busiest Forward Surgical Team,
not just in Afghanistan — but Iraq and Afghanistan. In just 10 months, their small tented hospital
has received a staggering 600 trauma cases. It’s designed to do damage control surgery
which means save someone’s life so that they can get further in the evacuation
system to get definitive surgery. It’s about to get much busier. The Surge will
soon push US and Coalition troop numbers beyond 150 thousand. Their orders: to take the fight
to the Taliban. But first they’ve got to secure the deadly
roads — riddled with improvised explosive devices or IED’s. Well, barely a stone’s throw away from the
operating theatre over here, more patrols and convoys are preparing to head out in their
huge MRAPs — mine resistant patrol vehicles. It’s now mid winter in Afghanistan, and this
is usually a time when there is a traditional lull in the fighting, brought about by the
bitterly cold weather. This time last year, there was a metre of
snow here. But not this year. It’s unseasonably warm — and that means the Taliban are still
out there, laying IED’s, setting ambushes, and for these guys, that means, more casualties. Dust off 43…Dust off 45… 43, 45Are you
guys 19 kilometres to the North ?Ready for departure urgent MEDEVAC…Roger 43.When you
get that call, you hear MEDEVAC, you’re not thinking about the dangers so much
as you are thinking about that patient, you know, you don’t know who it is. It could be
you know US, Afghan, a child… As the Blackhawk MEDEVAC choppers scramble
— the news is all bad. We’re gonna need a body bag on the ground
there.” A massive explosion has just destroyed an
MRAP. Two soldiers are dead — three wounded.
Are they Americans? Yes they are Americans. I don’t want one guy
staring at his dead buddies the whole time. You got a body bag underneath your seat, sir? As they land, the crew expects an attack.
On the ground the helicopters are highly vulnerable — and the Taliban know it.
I’m really nervous now…There’s one dude walking back and forward in that house right
there — with an RPG? Yeah, I see him. I don’t see the RPG — but yeah I see him there. High overhead a pilotless surveillance drone
captures in real time these images of the medivac . Vigilant for any sign of ambush. I really wish they’d hurry up.The Americans
have spent $32 billion dollars replacing their vulnerable Humvee vehicles with thousands
of MRAPS. That MRAP’s in bad shape.The Taliban simply
build bigger bombs. IED’s now account for 60% of all Coalition
casualties. The living and the dead are loaded onto separate helicopters for the flight home. Must have been a big one to mess that MRAP
up like that. How tough is it to deal with what’s going
on in the back of the aircraft that you’re flying? I mean you’re picking up some terribly
damaged people? Honestly, I don’t look back very often. I’m pretty tender hearted, not
that I can’t, I mean if I need to I do, but I focus
on flying. For the wounded, it’s now a race against the
clock to beat the so-called Golden Hour. The Golden Hour is when the person has an
injury, within the first two to five minutes there’s a certain number of people who will
die that are not saveable. The next hour is where a lot of people, if they don’t get to
a place that has surgical capability and the full gamut of taking care of them, will die
as well. So the Golden Hour really reflects those people
that are saveable if you’re able to get them to a place like a forward surgical team within
that hour. Just seven minutes later, the wounded are
delivered into the hands of the surgical team. At a discrete distance — the body bags are
also unloaded. 520 US and Coalition troops were killed in the past year — the deadliest
in the conflict so far. But all attention is now focussed on saving
the living — doing all they can in the golden hour. We provide 21st century intensive care,
critical care for patients that would otherwise die. I mean
there’s no way around, some of these people would have died.
Too many soldiers wounded on Afghanistan’s remote battlefields were bleeding to death
before reaching surgery at the big military hospitals. So last year Army surgical teams
were moved much closer to the fight — to beat the Golden Hour.
You watch the TV show M*A*S*H and you think about them trying to make do
with what they have. And I think that’s really what we’re doing here.
For those who make it here alive — often with horrific injuries – there’s now a 98%
chance of survival. A young female soldier pulled from the wreckage
of the MRAP has multiple fractures. For her comrade, Sgt. Adam Sandifer — hit by the
massive concussive blast – the injuries are less clear.
We try and get the chest and pelvis within the first ten minutes
with all the other things that we do, like checking the airway, making sure that they
are breathing, making sure they have a pulse, getting an IV in — doing an ultrasound making
sure they don’t have blood in their abdomen. Matt Hueman and Bryan Helsel both served in
Iraq — they’re well- practised in treating IED victims. But this is a different war with different
injuries. So even though they’re travelling in the new
armoured MRAP’s, they still can suffer severe injuries? They can, and it’s
deceptive, because it tends to be internal injuries so, you know, in my last deployment
we would see amputations, significant above the knee amputations, with the Humvees. In
this deployment the leg still appears to be functionally intact, but it’s still a significant
injury inside and we have to figure that out” and sometimes it’s more harder to figure out.
When you guys landed, you went up in the air like this and came straight back down?
Yes. And then did it stay on its wheels the whole
time or did it roll over? I no, just felt like the inside of the compartment coming
apart. I’m just trying to figure out so I know what to look for with people’s injuries. Everyone
in here looks 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 extremely violent, huge IED’s that leave huge
craters that would normally would have killed them, or maimed them. I would say most of
them walk away now. Adam Sandifer is released — to contemplate
the random nature of war — why he lived and two friends in the same vehicle died.
The dead are laid out in the foyer. Those gathered are stilled by anger and shock. The
grieving and a dignified, flag-draped send off will follow Out on the flight line — the MEDEVAC crews are back on standby.
Acting commander is 27 year old Captain Nissa Brodman, a graduate of the elite West Point
Military Academy.I do prefer the humanitarian aspect. For me it’s what I really feel drawn
to. I did go to West Point. I actually wanted to be
a doctor, my class rank wasn’t high enough to become a doctor which actually ended up
being a blessing because then I branched to aviation and in flight full re-branched to
medical service to fly MEDEVAC because I, that’s what I really wanted to fly and here
we are. I’m pretty spiritual and every Saturday night
I go to Mass. It’s my way of dealing with that,
so you definitely contemplate it, it’s in your face all the time
I would say I’m the mom. I get teased a little bit about being the mom, but I think that’s
a good thing. I mean I do my best to care for the people I work for, you know.
We all get letters once a week or so. We usually pick out every now and then a good one and
hang 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 got really lucky getting put here. Devon Bundy was barely out of the 5th grade himself
when 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 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 parents make of that? They weren’t thrilled — but they got over
it now. There’s little time for reflection – the MEDEVAC
crews are soon back in action. A US patrol has found 16 year old Mohammed lying in a
ditch critically injured with a gunshot wound 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 wary, and with good reason. In Kabul recently the Taliban rigged an ambulance
as a car bomb. Another suicide attacker posed as a doctor. Why is he brought to this tent?
He’s brought here because he is not a US citizen — so we strip him all down and make sure
there is no unexploded ordinance. The people are important — but also the equipment
— because we can’t replace the equipment so we try and make sure that they’re all good
to go before we take them inside.That’s a potential threat is it?
It is. You just never know. News that Mohammed was shot by Afghan police
worries the Surgical Team commander, Captain Ben Wilhelm.Wait a minute, he’s from Ghazni
but also he’s says he’s from Logar? But now he say I’m from Ghazni Province…
I think he was shocked — he said that I’m from Logar Province.
His father’s name is Khalil. And my alarm bells start going off. What concerns you about
this case? Well… when they’re iffy on the information it could mean any number of things.
Could be completely innocent, could be just the pain talking. But on the other hand it
could be he was doing something he shouldn’t have been doing — and that’s how he got shot,
so.Potentially Taliban? Potentially… I mean there’s plenty of illegal
activities that go on in Afghanistan that have nothing to do with the Taliban too, I
mean he could have been running drugs or whatever else, so.
He’s clear — he doesn’t pose any immediate danger to us so we are going to take care
of him just like we would a US soldier, but it sets off alarm bells when they don’t seem
to either know where they are coming from or don’t seem
to have a consistent story. We’ve had a number of enemy prisoners of war
come through — confirmed Taliban. We’ve had some that were shot by our guys and we’ve
had a few who’ve blown themselves up planting IED’s.
This is what happens when you’ve got a third grade education and you are dealing with highly
technical explosives. It is difficult, but you have to, again, find
a positive way to deal with that and you have to set any kind of emotional animosity you
have aside and see them not as the enemy but as a patient.
And that person needs your help right now. So we had multiple small bowel injuries and
we 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 contamination
and not actually trying to fix it definitively at the first operation actually allows patients
to do even better. It turns out Mohammed is no insurgent — just
a 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 infection
rates so high — that to be admitted can be a death sentence. For our local nationals we have less capability
of moving them to another facility for definitive care, and we recognise that we probably provide
the best definitive care here. This is a war fought 24 hours a day. Poor night visibility has grounded the combat
helicopters — but MEDEVAC flies regardless, and we tag along. Saving lives sometimes means flying blind. We return to where the MRAP was destroyed
earlier in the day. The Taliban have since fired rockets at a
crew sent to recover the wrecked vehicle. A combat engineer has been accidentally sprayed
in the face with battery acid — in the dark it’s impossible to assess his injuries.
He’s delivered to the surgical team …where, at the end of what’s been a very
long, hellish day 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 just beyond the helipad
and the hospital lies the future. A year ago — this was an outpost of fewer
than 300 troops — already there are 2000 in this camp — and in not long from now there’ll
be anything up to 20 thousand — all part of the surge.
Already the Americans are building a runway that will soon be able to land long distance
jets and there are very permanent structures now being constructed all around the compound.
You really do get the impression that the Americans will be here in Afghanistan for
a long time to come. And one of the toughest battles ahead lies
in winning the hearts and minds. Last year was the deadliest for civilians, with more
than 2,400 killed. US medical support for Afghans is intended
as a morale booster. Forty per cent of the casualties treated by the surgical team are
Afghan troops or local civilians. But this American goodwill takes a battering
every time a boy such as 14 year old Arif becomes a statistic — and be warned this
is confronting. He said that an American patrol, and Afghan
national patrol, came into the valley — and the children playing with stone together
– and they threw out the stone on them. Suddenly national army attacked on him — and they
shoot him.So the patrol shot him for throwing stones?
Yeah – not American people. Afghan people.With the Americans? Yeah.
Arif was shot six months ago. Every week since then his brother has brought him in for treatment. The initial entry of his wound was through
his arm here — he has a broken arm here… and that’s really the only thing that hurts
him right now. So if you touch his arm at all that’s what
bothers him. The wound went in through his chest –and then in his spine — so he’s paralysed
from about here down. I’m afraid that it’s probably a terminal thing We try and make it as comfortable for him as we can. I mean his wounds are pretty devastating
wounds. For the doctors — sanctuary lies behind a
plywood door. This is their escape from the relentless stress of surgery. Afghanistan
is left behind outside the tent. This is home? It’s Mardi Gras on drugs. I
think it’s holidays gone bad in here. Sometimes you just need to decompress.
Like the other night, we were in there operating for 12 hours and we came back and watched
a couple episodes of a TV show just to kinda unwind so you can go to sleep.
I have this fire hat that was from his second birthday, and I have some other nick-knacks
that my wife sent and some of the pictures that she sent me underneath. So that’s what
keeps me going. Their tent is packed with reminders of life at home and – not surprisingly
– it’s here, away from the hard focus of saving lives, that raw emotion can surface.
You know that there’s US trauma coming in and when the MEDEVAC helicopter lands
and you see 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 brother, is it
one of their friends, I think that makes it really difficult.
It also makes it really rewarding, because I feel confident that we’ve taken care of
people as best we can, and have gotten them to a point where if they were able to be saved,
we were able to save them. Ahead, lies a hot, even deadlier summer. As
the surge begins, one former American commander estimates U.S. casualties will be as high
as 500 a month. I’m dreading it because I hope that we can keep up. Hope that
we have enough crews for every wounded soldier out there. Our biggest worry is that we’re
needed more than we are able to perform or we don’t have enough guys or enough crew members
or enough aircraft to perform our mission. Another day, another MEDEVAC — we join Nissa
Brodman on a mission to evacuate an American soldier with spinal injuries. 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 this
is a just war. But you do sense a deep war-weariness now permeating 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 mean if it’s just going to go on and on.
What’s with the fire? We just sit around and enjoy it, and kind of talk — it helps decompress
a little bit . Matt Hueman is a career officer — passionate
about surgery and the Army — but he now openly questions the direction of the war.
I’m enormously proud to be here. Having said that, I think that in terms of the objectives
of the war, I always felt that I supported whatever the President would say, and I would
go here. I know that I have a clear mission as a physician, as a surgeon, to put soldiers
back together again. I’m not sure that it’s always been communicated in a way that all
of us can understand what we’re doing here. In both Afghanistan and Iraq.
I think it’s clear that the overall picture makes sense of, OK, we were attacked and this
is the place where the attack emanated 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 makes sense to me. And if it
doesn’t make sense to me, then does it make sense to the average solider that’s going
out there and risking their life. But while ever soldiers continue to risk their
lives — the medics will be there to save them. The radio alert — a reminder — that
the war drags on relentlessly. It’s a MEDEVAC request —
so we just started having fun. So I guess we are going to be back to work
here pretty soon. Just have to figure how to put this thing out — somebody have a fire