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Michael Cleverly: In Iraq, a multinational network treats wounded Iraqi civilians

Michael Cleverly

The world needs to know how cowardly these terrorists are. They willfully shed the blood of innocents, causing slaughter, in an effort to draw attention to themselves. They have no cause, no raison d’etre. They are plain and simple cowards!

Lt. Col. Charles Fisher M.D.

For some time now I’ve been sitting on some new material from Lt. Col. Fisher, a Green Beret physician stationed in Baghdad. Now that Bush’s war seems to be literally blowing up in his face, I think it’s time to share Dr. Fisher’s sentiments.



In this age of instant information, we at home get reportage from the war pretty much as situations evolve. And the media are not just reporting to us; they are reporting to the people they’re reporting about.

The voices we hear coming out of Baghdad are either the administration’s party line, or what reporters think the American public has an appetite for.




Naturally the people on the ground over there have their own take on things, and some of them would like to have a voice. To this end I’m glad to occasionally pass on Dr. Fisher’s comments.

Press coverage of the suicide car-bombing of the U.S. intelligence headquarters in Erbil (Sept. 10) principally recounted American and coalition military casualties and then went on to American losses in other parts of the country. Those were not the only victims that day.

According to Scherezade Faramarzi of the Associated Press: “A suicide car-bomber struck the U.S. intelligence office here, killing three Iraqis, including a twelve year old boy … Forty-one Iraqis were hurt in the bombing, which destroyed several homes in the neighborhood … The wounded included children from nearby houses and Iraqi Kurdish guards.”

What follows is an e-mail conversation among U.S., coalition and non-aligned physicians.

MEDICAL REPORT: This child, Sali S Jamal, 5 years old, sustained multiple severe injuries involving scalp face left eye and presented with head injury as well. Both forearms were severely lacerated and crushed, in regard right arm and forearm there was severe damage and loss of all soft tissues on the anterior aspect of the elbow and forearm, the wound was about 15 x 30 cm in dimensions with complete skin loss anteriorly, cut of flexor gitorum superficialis and profunda muscle, complete cut of ulnar nerve median nerve ligated radial artery at wrist level and nearly all muscles were crushed on the volar aspect of the forearm.

Multiple wound debridment was done in the theater under general anesthesia.

In regard left forearm there was severe lacerated wound 10 x 20 cm on the medial and lateral aspect of the forearm, with extensive damage to skin and soft tissues, proper wound excision of dead tissue, debridment was done under general anesthesia. Patient also received a perforated wound of the left eye.

Dr. Yousif R. Muhammad

The child faces danger of loss of arm or hand, and is in need of a surgeon who can do reconstructive surgery of nerves. An ophthalmologist’s expertise is needed for treatment of the left eye, ideally one who does trauma surgery. The burn wounds and damage to surface skin over an estimated 10-15 percent of the body could develop infection. There is the danger that the damage to muscles and tendons could overload the kidneys. This patient must be watched carefully.

Ophthalmologist report follows.

Dr. Giorgio,

Italian surgeon of Qandil NGO,

Dr. Peschke,

German family physician

To whom it may concern:

This child has a perforated wound of the left eye including corneal and anterior damage causing a soft sunken eye; suturing of the corneal wound done by 8.0 vigril silk stitch and reform of anterior chamber. P.T.O. by air done; subconjective Garamycin injected; She has possible vitreo-retinal complications which needs possible vitreo-retinal surgery which is not possibly done in Iraq. This child has a perforated wound including corneo-scheral part of R eye with total hypheoma. Suturing of the wound done by 10-0 nylon reform of anterior chamber by air P-T-O. Sub conjective Garamycin injected. Possible vitreo-retinal problem with lens subluxation is present which needs vitreo retinal surgery which can’t be done in Iraq.

My best regards,

Dr. Gailin Rasheed Almufti

Dear MAJ Carey:

I will meet Dr. Walid, if he can come, this evening and discuss the matter with him. Hope we find an acceptable solution for this case.

Best,

Raz

Dear Dr. Raz

Thanks very much for this report and summary of the cases. We appreciate that. In addition to Sali ” the case in urgent need of evacuation abroad, there is a 7th case: Soran Jabbar. Dr. Waleed said he wanted to show those records to the Ophthalmologic Group to determine whether they could help him, or if he needed to go abroad. We are all very relieved that those 5 cases have reached better help. At the same time we are anxious for Sali, the worst case. We will greatly appreciate any progress on her as soon as possible.

Thanks and best regards,

MAJ Carey Blake

Dear all,

Finally we managed to hand over the five cases that came from Erbil to Alwasitiy Orthopedic and Reconstructive Surgery Hospital at 11:00 today. We try to follow the cases there, though Dr. Walid has already managed to secure the required beds and a doctor and a nurse to accompany us to the landing field as a medical team and guide for smooth running of the morning task. I would like to thank Jim Fikes and his team for the nice arrangements in term of air transportation and picking facility in the LZ port and bringing together the surface transport possibility as well. Charles Fisher and Dr. Saeed Haki have done a nice job arranging the ambulances ready for this purpose. However Dr. Walid explained the cases as follow:

” 26 year old male with shell injury of left mandibulla which needs removal of the foreign body and fixating of the fracture.

” 8 year old with fracture of the left forearm cat-wrist plus affected radial and ulnare arteries. The case needs reconstructive surgery.

” 33 year old male with left ear auricula defect, which needs reconstruction.

” 13 year old female with trauma of left forearm that needs reconstructive surgery.

” 13 year old male with broken right elbow and left forearm. His left damaged eye is hopeless for treatment. The possibility for prosthesis will be consulted with Ibn Alhaitham Eye Teaching Hospital.

I take this opportunity to thank MAJ Carey; Leon and his team that made Dr. Walid’s mission possible, smooth and effective. Dr. Walid, orthopedic surgeon of Alwasity Hospital kindly agreed to proceed to Erbil and evaluate the cases. He, besides accepting the above mentioned cases in their hospital, advised that the sixth case who suffers multiple face and hand injuries that require microsurgery is better off to be evacuated somewhere out of Iraq (we got complete files from Kamran yesterday).

Best,

Raz

Carey:

I just talked with Jim Fikes and Said Hakki. They said that they would have ambulances available by 0915. Jim will work with Said in the AM to coordinate getting them past security and to LZ Washington; it looks like things are a go from this end. Glad we had the opportunity to help you.

Best,

Chuck

I know you need ETA tomorrow. The ambulances should be standing at the Washington LZ around 0945. The Chinook will leave Mosul between 7 and 7:30, arrive Erbil between 7:30 and 8. Figure a half hour on the ground and an hour and a half flight. That’s what I’m told.

Gentlemen, thank you so much for your rapid response! It is so uplifting to know you guys are there and care.

Hope to see you soon,

Carey Blake

Here is how Dr. Fisher summed up the preceding exchange:

“This is an example of the true team effort to save life and limb that we do here on a daily basis … A multidisciplinary, multinational, multi-organizational team came together in a matter of hours to arrange a helicopter medevac, a clearance to land in a secure zone, ambulances and their clearances to the secure zone, a hospital and receiving surgeons to accept the patients, etc. Many of these individuals have never met face to face, yet reached out and grabbed each other to save lives. It is a privilege to serve with such fine human beings.”

During the Vietnam War the Nixon administration would keep score, with something called a body count, as to how many of the “enemy” we killed on any given day. As outre as President Bush’s foreign policy is, I doubt if he’s stupid enough to go down that road. I suspect the Democrats might bring it up once or twice over the next year. This because the war is allegedly over and the only bodies that are being counted are American.

For Americans, it will continue to be almost impossible to keep score. What we should keep in mind is that for everything that seems utterly broken about the situation in Iraq, there are good men and women who find a way to make some things work.

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