Battlefield care: Afghan National Army’s medics, surgeons in Helmand
 By Cpl. Austin Long , Regional Command Southwest
  Afghan National Army medics with the 215th Corps load an ANA patient onto a C-130 Hercules aircraft at Camp Bastion, Helmand province, Afghanistan, Oct. 14. (Marine Corps photo by Sgt. Tammy K. Hineline)
 **CAMP SHORBAK, Afghanistan –** Beneath the humming lights of the small surgical ward, Dr. Abdul Wahid and Dr. Najib Ismat removed bandages from the injured Soldier’s head and examined his wound. The Afghan National Army Soldier had been injured by a roadside bomb. The surgeons worked diligently to clean the wound, examine his body for shrapnel, and bandage the wound with dressings to prevent infection. For the Soldier, triage represented a simple procedure and a few days of rehabilitation at Camp Shorabak’s medical clinic. For the Afghan National Army’s 215th Corps, triage represented years of hard work and training. **Taking the medical lead** Earlier in the year, U.S. and coalition forces transitioned to a supportive role in Helmand province and handed over responsibility for security to the Afghan National Security Forces. As coalition forces decreased their footprint, the responsibility for providing medical treatment to injured Soldiers was shouldered by the Afghan National Army’s medics and surgeons. Advancements in battlefield care, the construction of surgical and medical treatment facilities, and the addition of transportation resources have helped grow the 215 Corps’ medical unit into a self-sufficient and effective resource for battlefield operations. **Routine battlefield care** When an Afghan Soldier suffers an injury for any reason on the battlefield, the first medical personnel to treat the injury is the unit’s field medic, an enlisted Soldier equipped with the skill-set to aid and assess those wounded or ill. The field medic serves as an intermediate lifeline to get the patient from the battlefield to a medical facility where a surgeon or doctor can treat them with higher echelons of care. Prior to the establishment of a trained medical corps, units would randomly select an ANA Soldier and designate him to first-aid. His basic treatment for any injury was to apply either a tourniquet or bandage to a patient’s wound and get them transported to a brigade-level medical facility for further treatment. Starting in 2010, unit medics receive two months of formalized training in Kabul at the Armed Forces Academy of Medical Sciences before checking into their units. There, medics learn hands-on trauma care techniques for stabilizing casualties on the battlefield. The two-month course teaches medics the primary lifesaving steps - stop the bleeding, check for breathing, and treat for shock. A patient’s chance at surviving begins on the battlefield with the type of treatment he receives from the medic. Now that they have more training and support, medics are able to make a bigger impact on the probability for a patient to survive long enough to receive care at a clinic or surgical ward. The 215th Corps currently has more than 150 field medics serving throughout Helmand province, including Sgt. Abdul Qadir Momand. Momand has served as an Army medic for five years and has witnessed the evolution of battlefield care. He said he has seen the Army’s capabilities change over time and he believes Army medics will only get better. Momand said he understands the role he and fellow medics serve in the future of the country and he takes pride in having that responsibility. “I feel great knowing I am helping a casualty and getting him to better care when I am out with a unit on the battlefield,” said Momand. **Performing surgeries at clinics and on the battlefield** Irregular warfare has defined Afghanistan since the beginning of the Soviet-Afghan War in 1979. Today, guerilla tactics are still common practice and they are the primary methods used by insurgents to disrupt military operations within Helmand. Improvised explosives devices (IEDs) are one of the most commonly used weapons in the region and many of the injuries the ANA Soldiers sustain from these roadside bombs require some type of surgery. Following medics, ANA surgeons are the next echelon of care for Soldiers receiving injuries in combat. Surgeons are versatile and can administer care ranging from cleaning shrapnel from a wound to amputating a patient’s limb. Most of the Army surgeons studied at Kabul Medical University and have years of experience in treating patients with battlefield injuries. Throughout much of Operation Enduring Freedom, the 215th Corps has relied on Coalition forces at Camp Bastion or surgeons in Kandahar or Kabul to perform major operations; however, this year the unit built a surgical ward on Camp Shorabak to treat their own casualties. The design of the surgical ward is rudimentary at best - a small, tan tent placed inside an old warehouse. But inside, the surgeons have state of the art medical equipment and are able to conduct simple and complex battlefield surgery. The surgical ward is designed to be mobile, however, due to the limited number of surgeons and resources, it remains stationary at Camp Shorabak, said Petty Officer 2nd Class Nathan Horning, the 215th Corps Security Forces Assistance Advisor Team lead clinic advisor. “The end goal is to have a team of surgeons and medics dedicated to a mobile surgical unit who can move throughout Helmand and perform lifesaving surgery on Soldiers who need immediate medical care before being transported to a clinic or hospital,” said Horning. **The Shorabak Clinic** Rehabilitating injuries is important and increases a patient’s chance of survivability after being injured on the battlefield. Following a Soldier’s surgery, the 215th Corps moves them to their clinic adjacent to the surgical ward on Camp Shorabak. The building is small, but allows medical personnel to treat and monitor approximately 25 patients at once. The clinic is equipped with an x-ray room, a dental office, and a pharmacy. In November, a new clinic is scheduled to be built and will provide more room for monitoring post-surgery patients and a larger triage center for mass-casualty situations. For Sgt. Maj. Ahmad Zaki, the 215th Corps clinic sergeant major, the new clinic is both needed and warranted. There are more than 18,000 Soldiers with the 215th Corps throughout Regional Command Southwest. Zaki said it’s because of the high number of Soldiers in the area that the clinic needs a hospital to work out of in order to eliminate not having enough room for new and recovering patients to be treated at the same time. **Air evacuations** After coalition forces have withdrawn from Afghanistan, the Afghan National Air Force will play a key role in the future operations of the 215th Corps’ medical community. The isolated clinic will not only rely on Air Force pilots to transport patients from the battlefield, but also to keep deliver a steady cycle of medical supplies. Recently, a team of ANA medics from the clinic at Shorabak accompanied six Afghan patients on a C-130 Hercules transportation mission to Kabul. The medics provided the patients with en route care. This was the first time an Afghan C-130 was used to transport patients who needed en route care. Coalition pilots flew the aircraft with an Afghan Air Force pilot was present to learn and observe. ANA Sgt. Ajmir Azizi, a 215th Corps medic, was one of the medics responsible for transporting the six patients. Azizi said transporting patients by airplane was much better than in an ambulance because it made his job of tracking vital signs and monitoring patients easier. He also said he felt safer while traveling and there was more room for moving from patient to patient. The casualty evacuation is an example of the future of medical care in Helmand Province, said Zaki. Zaki said with more support from the Afghan Air Force, more patient transportation would be done this way allowing his clinic to have space available for treating new patients. “The air evacuations are going to be the focal point for us to transport patients in big numbers, regardless of their type of injury,” said Zaki. **The future of medicine at Shorabak** According to Lt. Cmdr. Andrew Stegall, 215th Corps SFAAT lead medical advisor, the future of medicine in Helmand relies directly on the growth and advancement of Afghan National Security Forces throughout Afghanistan. “The medical advancement can keep pace with ANSF forces as they can continue to grow,” said Stegall. “Already the clinic here has improved so quickly over the past four years. They’ve already outgrown some surrounding clinics in other provinces, which gives me the comfort and encouragement for the future of the 215th Corps medical community.” ANA Colonel Mohamad Agah, the 215th Corps lead surgeon, said he believes the future of the 215th Corps is clear. “If my medics and medical staff continue doing as well as we have been, we will continue to have success with our patients surviving and returning home or to the fight,” said Agah.