Captain Sush Ramakrishna is the 3 Medical Regiment (3 Med Regt) Medical Officer attached to D Company, 40 Commando, Royal Marines, in Kajaki. Here he writes about being a medical officer on the ground in Kajaki.
Being told to report to the Commanding Officer in the afternoon, I was nervous as to what was in store for me. I was positive that I hadn’t messed up on my exercise in Kenya. Had I not done enough time in the Medical Centre? Later, standing in front of the CO with three other colleagues, I realised it probably wasn’t a dressing down. We were told that we were being penciled in for an operational tour in Afghanistan. This was great news for me. I had joined the Army as a doctor, but serving on operations was the carrot. We (the doctors from 1 Med Regiment in Münster) were then attached to 3 Med Regiment who were based in Catterick. The pre-deployment training involved us travelling between Germany and the UK for various courses and mandatory briefs. The New Year saw us in Catterick, embedded into our new unit, and the best part was the weekly training in the snow-covered hills of Yorkshire. You would be forgiven to think that we were training for a winter tour. Sending us to Jamaica or Barbados for acclimatisation for a summer tour of Afghanistan should be on the agenda for the new Cameron-Clegg government!
We were welcomed in Afghanistan by sandstorms and temperatures of over 40° C. The first week involved attending more briefs which consisted of useful tips and war stories of the guys who had spent the last few months out here. It did get a bit tedious – endless horror stories and sometimes reality was taken out of context. But, we were professionals and keen to go out on the ground. I was sent to Kajaki to be the Medical Officer for D Company 40 Commando, Royal Marines, along with two medics.
Flying over the Green Zone of Helmand Province, one could mistake this place for a holiday destination. Yes, I was finally here. I arrived as the previous company of 3 RIFLES were moving out. The first few reminders of reality were the mortars being fired at random in the middle of the night – fortunately by us. One’s initial reaction when asleep was to reach for the body armour and slide underneath the bed, but later I got used to the loud explosions. I managed to find a real bed with a mattress and acquire a fan for my room. This could be the Hilton of Kajaki?
The medical centre in the FOB is a concrete building able to accommodate a trauma bay, medical stores and the living quarters of the medical team. The whole company is involved in going out on patrol and can end up 5-6 km away from the base. It is therefore vital for their Medical Officer to go out on the ground to be near the troops in case there are any unfortunate incidents. I traveled initially in an ambulance, very much like an NHS ambulance. But, later it was decided they weren’t a good idea and we switched to quad bikes instead! I am always with the Company Sergeant Major. We deal with casualty extractions, treating the patient and calling in the helicopter.
It gives the troops on the ground the reassurance that there is good medical cover right behind them.
It is great to go on foot – or rather quad – patrols. It has greatly improved my soldiering skills and given me a better understanding of infantry tactics. I have also been able to meet the locals working in the fields and the members of the Afghan National Police (ANP) who lead the patrols and work in the Observation posts, providing good intelligence and liaising with the local farmers. I was born and grew up in India and can speak Hindi, as well as understand Urdu. I can therefore communicate with some of the ANP personnel who also speak some Urdu. Many picked up Urdu during their time in exile in Pakistan when the Taliban regime had taken over their towns and schools.
These guys are keen to work for the right reward, even when they don’t actually receive it. Some haven’t been paid by the government for two months but they rarely complain. Their ambition is to see their country better run. That is the real motivation which keeps them here doing their job. They do not lack courage for sure, nor hospitality. The cups of Chaai (sweet green tea) and Dudey (local bread) are always offered to the ISAF guys even when they have not eaten anything themselves. They are a proud bunch of guys and the future of the country might well lie in providing the right training and incentives for them.
On a lighter note, they are as vain as many men and always demand moisturizers to improve their skin and thicken their wild hair!
Being on the front line is exciting as it gives you the feeling of being in the midst of things. But, when someone is injured, the reality is very different to what you would imagine. My first casualty was a man with a gunshot wound to the leg. Everything went so fast. I thought the treatment and extraction only lasted a few minutes but actually it was more than an hour.
We learned some things from that incident and tightened our procedures. I felt it was very important that we had had a medical officer on the ground.
There is nothing like a routine day on operations, especially working in the Med Centre. Teaching and training my medics is one of the highlights of my week – it gives an opportunity to re-learn things and assess their level of expertise and knowledge. I go through various scenarios with them. We were unfortunate to have to deal with fatalities following an ANP vehicle involved in an IED explosion. This happened in the middle of the night. The med team was stood to and we received two casualties. Unfortunately, both were dead on arrival. They had suffered horrific injuries. The third casualty which followed had been in the back seat and had facial injuries and lower limb injuries. We moved quickly to get him to hospital. We realised that communications between the ANP and us had to be improved for future incidents.
During my time at Kajaki, I have managed to pick some new things – a hairy pet which could be mistaken for a slug growing as a moustache!
The CSM (Curator of Shifty Moustaches or Company Sergeant Major) seems to have okayed it. I might be fine as long as I stay away from the wrath of the RSM (Regulator of Shifty Moustaches or Regimental Sergeant Major)! As the gym is a stone’s throw from the med centre I train about 4-5 times a week. I am now the proud owner of a smoking pipe with cherry-flavoured tobacco. With more practice, I might have the panache to keep up my moustache. On a finishing note, I just found out that Arthur Conan Doyle, an Army surgeon when based in Kandahar (during the early Afghan wars), found his inspiration for Sherlock Holmes (was he knighted for that or his service to his profession?) while he was in Afghanistan. I am still staring at the beautiful starlit sky waiting for my inspiration!