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We worked really hard to do the best we could for them; Nigel Heal is one of the many Welsh health professionals who have cared for British soldiers serving in Afghanistan. This is his account of a demanding deployment running the field hospital in Camp Bastion.

Byline: Nigel Heal

IARRIVED in Helmand after a long flight which started at RAF Brize Norton. I spent my first night in a huge hangar, in a bunk bed, unsure who was sleeping above me and my colleague in the next bed, which was the first empty one she found.

Next morning we all trooped out to the shower block which, with running water and flushing toilets, was a luxury by operational standards.

I spent two days on safety briefings and weapon handling to ensure my ability to stay safe in Helmand.

The hospital in Camp Bastion is prefabricated, with running water, air conditioning and electrical lighting. We had what was referred to as a four/two/four capability - four resuscitation bays, two theatre tables and four ITU beds. Alongside that we had two 15-bed wards and a fully-equipped primary care unit.

The lab did most of the routine stuff you would expect of a small hospital including a very well-stocked blood bank.

The staff worked a variety of shifts and, together with quite a few other key staff, I worked an average 18-hour day every day. All staff were on call at all times, able to respond to any major incident or mass casualty calls.

The front end of the hospital responded to some amazing demands with all the professionalism I expect of soldiers and officers, converting four resus bays to up to eight when the situation dictated and rapidly caring for their casualties and moving them on to either theatre, ITU or wards.

I saw combat medical technicians (CMTs) on their first deployment giving very respectable performances. Unlike other professions who normally work in healthcare, our CMTs come from a huge variety of workplaces and it is unusual that they have any clinical experience.

The theatres often worked long hours with periods of no activity in between, and ITU and the wards received whatever came their way.

We saw some very tragic and disturbing casualties - young men, boys really, whose lives were changed irrevocably in a fraction of a second. Some lost their legs and arms, others did not survive the contact, with either a bomb blast or firearms.

I saw a range of emotions from a very upbeat guy telling me he wanted the best artificial leg we had, to the guy in the next bed falling apart in uncontrollable tears.

A young Warrior armoured fighting vehicle commander had a quivering lower lip when I had to tell him of the death of his driver. He then had to write the eulogy for the repatriation ceremony while he was still in a hospital bed himself.

Towards the end of my tour I would find myself walking to the hospital praying to God we would have just one day without a trauma call.

The pace of work was relentless, but the guys turned in each shift ready for the challenges ahead and presented when they realised the tempo was going up to see if they could help out.

I saw some amazing work - people who really came into their own in the name of the main effort, which was to treat and care for any casualty regardless of nationality.

There were the locals, coalition forces, and Taliban who all came to the hospital when injured. They were all ages, from a baby in complete cardiovascular collapse due to meningosepticaemia - just 36 hours later she was on her way home - to a 12-year-old girl with severe burns accompanied by her father. Her mother was at home looking after her younger brothers and sisters - her mother was just 23.

Fathers always accompanied children and males accompanied relatives - women were not allowed out of the village unless for medical care.

A young boy who had been caught up in a blast, fracturing his lower leg, was admitted on his own. For two days we had no idea who his relatives were and he said very little, even to our interpreters.

It transpired he had been the initiator of the blast - a human bomb who was able to get close to a military checkpoint with his arms raised in the air only for his young conspirator to initiate the device he was wearing by remote control.

Camp Bastion is huge and provides everything including, sleeping accommodation, cook houses, gyms, internet suites and telephone rooms, church, lecture rooms and operations rooms.

The gyms provided chilled bottles of water and you were never far from a cook house, no matter where you were.

This was a sharp contrast to the forward operating bases, which are situated around Bastion within an hour's flying time in a Chinook. This ensures that the medical emergency response team can get to a casualty, stabilise them and fly them back to Bastion within the golden hour.

These bases have limited electricity, no air conditioning, no running water and deep trench latrines. Depending on the forward operating base, it was by no means unusual that they would come under attack on a daily basis. Personnel would return fire but by the time air assets had deployed to the area the attackers were long gone.

We lived in luxury compared to those living outside of Bastion. For them, coming into Bastion was a treat and did much to lift morale. It was a time when they could eat a hot meal they hadn't prepared themselves and the food was fresh as opposed to from a ration pack.

During my time running the hospital there were a few things that stood out - especially being informed there was an incident, which inevitably meant someone was in trouble.

An injured service person is like an injured brother and we all felt it. We all worked really hard to do the best we could for them. The hospital was second to none.

Clinical timelines were far superior to the UK given we had no backdrop of other activities, illnesses and inappropriate attendees.

Nigel Heal is the Officer Commanding Clinical Squadron of the Territorial Army's 203 (W) Field Hospital. He is also a clinical support nurse at NHS Direct Wales

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ACTION MAN: Nigel Heal saw a range of emotions, and tragic and disturbing casualties, when he was in Afghanistan PICTURE: Richard Swingler PREPARED: The operating theatre at the military field hospital Camp Bastion, Helmand Province
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Title Annotation:Features
Publication:Western Mail (Cardiff, Wales)
Date:Feb 1, 2010
Words:1051
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