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Volume 3,  Number 37              October 19 - 25, 2003            Quezon City, Philippines

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Theatre Of War

By Rory McCarthy
The Guardian UK

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Almost every day brings news of another US death in Iraq, but we hear almost nothing of the hundreds - maybe thousands - wounded by Saddam loyalists. In a rare visit to an army hospital, Rory McCarthy glimpses the victims of a hidden war

The first they hear of Specialist Brian Wilhelm is an indecipherable crackle over the walkie-talkies. It is an early October afternoon and the Black Hawk pilots and paramedics of the 54th Medical Company, one of the US army's medevac units, are lounging in a small, chilled wooden hut. A camouflage net shades them from the relentless sun and the comforts of Gatorade and chocolate snacks tempt the young soldiers to forget for a moment the bloody trials of postwar Iraq. On a small television the medics are watching re-runs of Scrubs, an US sitcom about overworked junior doctors. The helicopter pilots, with a swagger all their own, are playing Black Hawk Down, a shoot 'em up computer game based on the infamous American military operation in Mogadishu a decade ago which left 18 of their comrades dead.

"First up," shouts the voice on the radio, calling the priority medevac team to work. A convoy from the army's Eigth Infantry Regiment has come under attack yet again just outside this base at Balad, in the heart of resistance country north of Baghdad. A soldier is down, alive but badly wounded. A smoke flare marks the exact spot by a pontoon over the Tigris river. It's a "hot LZ", says the voice on the radio: the Iraqis are still shooting.

This is the hidden story of America's military adventure in Iraq. From their heavily barricaded offices in Baghdad, the US army's public relations operation did not announce the attack last week on Wilhelm. It did not describe how the Black Hawk pilots risked their lives to retrieve him and bring him to the emergency room of the 21st Combat Support Hospital at Balad where some of the army's finest nurses, medics and doctors saved his life. It did not describe the pain he is suffering, the agony his family is going through or the fact that Spc Wilhelm will never be a soldier again.

More than 320 US troops have died since America invaded Iraq, but hundreds more have been injured in the line of duty, many so seriously that they will be disabled for life. This is the price the commander-in-chief, George Bush, asked of his troops when, after the fall of Baghdad, he challenged Iraq's many resistance fighters into battle. "Bring them on," Bush declared on July 2. And on the fighters came, their attacks ever more sophisticated and ever more deadly. According to the military's official count, up to six soldiers are now killed each week in Iraq six months after the fall of Saddam Hussein, and at least another 40 are injured.

The military has never admitted the total number of soldiers injured so far, though the figure appears to run into the thousands. At the combat hospital in Balad, one of a handful of military medical centres in Iraq, a total of 1,088 patients were admitted for treatment between May and the end of August. As many as 916 had to be evacuated, although not all suffered combat injuries (soldiers who break their ankles in football games are also sent home to recover.) One report last month said 6,000 US soldiers had already been evacuated home, of whom more than 1,000 were designated "wounded in action" - twice the toll for the first Gulf war.

Six minutes after the first call, the Black Hawk helicopter is in the air, racing just a few hundred feet above the canals and brown fields of Balad towards the smoke flare. At the pontoon, heavy reinforcements in Humvees and armoured personnel carriers have already set up a perimeter. A medic on the ground has bandaged Wilhelm's leg, encased it in a splint and attached a white paper to his flak jacket reporting the injury: "RPG blast to left leg."

The convoy hit a makeshift bomb in the road and was then hit by a rocket-propelled grenade and rifle fire. Spc Wilhelm lies on the stretcher in pain but still conscious, propping up his head with his right arm, dirt in his fingernails. Blood is starting to seep through the stretcher.

Twenty minutes after the call the helicopter lands back at the base. Specialist Chris Shirley, a cheery ambulance driver with "God Bless America" scribbled on his helmet, helps lift the stretcher off the Black Hawk. Minutes later Wilhelm is lying on trolley five surrounded by doctors and medics inside the emergency room tent. A nurse carefully places his bloodstained flak jacket and uniform into a black plastic bag as the doctors prepare him for surgery. Within just an hour of the first call, the young soldier is already on the operating table.

In the opposite corner of the emergency room tent stand a group of sullen soldiers, among them the patient's company commander, Captain Kevin Ryan, 29. It is the seventh time in recent weeks that Ryan has stood here waiting for news of an injured soldier from his company. Frequently he spends the night by their bedsides, comforting young men trained to believe in their own invincibility, and then returns to his company at dawn to prepare them for another day of patrolling. "It pisses most of them off," he says. "There is really nothing we can do except try and prevent it the next time. After an incident like this we get everybody involved back together and piece together what happened and see how we can handle it a little better next time."

The doctors report to him that Wilhelm will live and will probably keep his badly damaged left foot. They cannot quite believe Ryan is back in the hospital. "He has had an inordinately high number of soldiers that have ended up here," says Colonel Carol McNeill, deputy commander of nursing. "He has brought them through the moment that decides whether they are going to live or die and he has made a difference."

The problem facing American infantrymen is the resistance fighters' weapon of choice: homemade bombs, known in military parlance as improvised explosive devices (IEDs). They are artillery shells or grenades hidden by the roadside and detonated from the bushes with a command wire as a US convoy passes. The blast forces the convoy to halt and then the fighters open fire. "We return fire but they have got the choice of ground. They get as many shots off as they can and they back off," Ryan says. Soldiers now stuff sandbags into the flooring of their Humvees for protection from the bombs and otherwise hope today is not the day the medevac is coming for them.

The 21st Combat Support Hospital (motto: "Fear Not") is a peculiar honeycomb of white, air-conditioned tents built around a corridor that connects the emergency room to a pre-op tent and then to two fully collapsible operating rooms. Spread out on either side are wards for intensive and intermediate care. There are seven surgeons in the unit and a host of other medical staff including a dentist, a psychiatrist, a physiotherapist and even a dietician. Most are on active duty - full-time soldiers put through medical training by the army and taught to handle gruesome combat injuries. Specialist Robert Burrell, 32, a phlegmatic medic with nine years' service in the military, was one of the first to treat the injured infantryman. A photograph of Burrell's two young daughters is among dozens of family snaps pinned up on the wall in the emergency room, next to the incongruous "Peace and Love" posters, a timetable of the five different religious services held each week and a calendar that counts down the unit's time left in country: 158 days to go.

He attends the chapel every Sunday, says grace before each meal, chats regularly with the chaplain and has no truck with the post-traumatic counsellors who suddenly materialise in the hospital after particularly heavy days. "We sure see some ugly stuff in here - guys who come in from the field, bleeding all over and with 15 bullet holes in them," he says. "We see all the shit that the rest of them don't want to see."

Others among the medical staff are reservists, Americans who joined up as students to pay their way through $120,000 medical schools and who are now giving back their time to the army. Now they live far from home, work 12-hour shifts and spend part of nearly every night sheltering in the bunker from the regular mortar attacks. Major Gordon Olsen is an orthopaedic specialist who runs a small private practice in Heber City, Utah, where the most serious injuries he sees are riders who have fallen off their horses. "Before I came over, watching the news I was rah-rah and here we go," he says. "Now I am just thinking, this needs to stop and go away. When talking to my wife at home, you know, people just hear about a few casualties a day and it doesn't sound like a big deal. But when you see a 19-year-old kid with his leg barely hanging on, that one alone is a big deal."

Yet what most of the medical staff in the hospital find the biggest challenge is not the horrific injuries they see every day but the fact that they must also treat Iraqi prisoners. In one recent case an American soldier died from his injuries, while on the trolley next to him the Iraqi suspected of attacking him was treated for his wounds, operated on several times and eventually pulled through. "There are times when you take these guys in, take care of them and they are going to live and that is really hard," says Captain Eric Ritter. "I know what these guys have done and you have got to remind yourself they are patients. But every day our guys are out there getting hit."

There are nine Iraqis recovering in the enemy prisoner-of-war ward, all of whom have been injured by US troops. Two armed military policemen guard the door. Ather, 24, a taxi driver, was shot in the hand in a scuffle after troops found a gun in the back of his car. Doctors at the hospital performed a complicated operation on his hand, which is now held together with several pins. "We didn't do anything wrong. We were just driving to Baghdad and we had a gun in the car to protect ourselves from thieves," he says. "I was happy that Saddam has gone but I'm not pleased with what has happened to me." Like all the other patients on this ward, once he has recovered he will be taken in for questioning at a US detention centre, probably at Baghdad airport.

In a ward next door nurses are treating a young Iraqi girl, Aya, six, who suffered severe burns to her back after she fell into a clay oven apparently scared by a low-flying American helicopter. There was little the local hospital in Balad could do for her and her father, Faris Abdullah, is plainly overjoyed that his daughter is being so well treated. But every day outside the base there are long queues of Iraqis desperate for similar treatment. Some of the soldiers even mutter their own private criticism that such Iraqi civilians benefit from their medical care.

The news for Wilhelm is good. After more surgery he will probably be evacuated first to Landstuhl regional medical center in Germany, from where most are sent on to the overcrowded wards of Walter Reed army medical centre in Washington. The doctors tell Ryan to go back to his tent and rest. His soldier won't be out from surgery for a while yet. But Ryan wants to stay and the nurses prepare a bed for him next to Wilhelm in the intensive-care ward. In the quiet after the terrible casualties, there is little encouragement to question the reasons for war. "We are here doing our job. It is part of the risk we take," he says. "If being in the army was easy, there would be a lot more soldiers around."

October 13, 2003


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