Training Afghan Medics: The Language of Healing

Captain Lisa Irwin

Captain Lisa Irwin

Lisa’s Diary 2014 – Week 1-2

Captain Lisa Irwin is a REME Reserve Officer currently on a three-year Full Time Reserve Service commitment with the Defence Cultural Specialist Unit.  She has spent 15 months learning Pashto and Dhari before deploying to Camp Bastion to be the 2 IC of a team of medical personnel set up to mentor Afghan medical personnel. This is her third tour of Afghanistan and her second blog, as she blogged during her last tour in 2010/2011, when she was deployed as a Female Engagement Team Commander.

Day 1: 12 Jan  

So here I am again, just over two and a half years since my last deployment, on a flight to Afghanistan for another tour. As I type this I am actually en route, flying as a passenger in a C17 aircraft, along with 15 other people and a Sea King helicopter! There is plenty of room to move around so we are actually quite comfortable (though not quite first class!), but there are no windows for us to see out of so nothing to look at. It will be quite a long journey as we have two stops and at one of them we have a stopover of several hours to allow the aircrew to rest, so mainly I plan to sleep!

So who am I and what am I doing?

I am Captain Lisa Irwin, a 45 year old mum of three who is a Reserve Army Captain in the Royal Electrical and Mechanical Engineers (REME). I have deployed twice before; the first time as a SSgt Artificer (Vehicle Mechanic running a workshop) and the second time, after commissioning, as a Female Engagement Team Commander (out on the ground in the Nad-e-Ali area of Helmand patrolling with the ground troops in order to engage with local women). I am currently on a three-year Full Time Reserve Service contract (effectively a Regular Officer but on a short term contract) and during my contract I have spent 15 months studying Pashto, the language mainly spoken in Helmand, in order to deploy as a Cultural Specialist with the Defence Cultural Specialist Unit (DCSU).

Originally I was meant to deploy on the ground, so that I could engage with locals and assist ground troops with understanding the dynamics of local people in their area of operation. However, as our mission in Afghanistan is drawing to a close we are no longer carrying out ground operations so that role no longer exists. Fortunately for me a different, and probably more interesting and exciting, opportunity arose and I am now deploying as the second in command of a team of medical personnel working with the Afghan Security Forces (ANSF) to assist them in setting up their own centre for treatment of their severely injured casualties in Helmand. I am probably well suited to the role as not only am I a linguist but I also have a medical background (I trained as a paediatric nurse after giving up engineering when my children were small).

As a result I have had to also do a crash course in the Dari language (I did a 22-week course in three weeks!) as the ANSF mainly speak Dari rather than Pashto. The role should be interesting and working in close proximity with ANSF will bring its’ challenges, but I think my pre deployment training and previous operational and civilian experience means I am well prepared for the task.

In Shorabak, next to ANA ambulance

In Shorabak, next to ANA ambulance

Day 6: 18 Jan

I am now settled in to my accommodation and have finished the initial training that is compulsory when you first arrive in to theatre. This training is a remind and revise on some things (such as first aid and shooting) and an update on the situation in theatre and how we need to act out here. Most things are similar to that which I was taught before so I feel on familiar ground- but I must remember where I am and not become complacent even though this is my third tour. I have met the guy I am replacing and some of the outgoing mentoring team, and I will start handover proper tomorrow. I have also met friends of mine already out here which is good, it is nice to meet up and grab a coffee together.

Tomorrow will be my first opportunity to go over to the ANSF camp, Camp Shorabak, and meet the Afghans we are mentoring. I am very much looking forward to that. I am really hoping this job is interesting and rewarding as I am out here for almost 9 months. I will get R&R (a break when I get to go home for 14 days) but it is still a long time to be away from my children and my fiancé.  I have been made aware that there may be other taskings for me that sound quite interesting, and will get me out of Camp Bastion, so I am hoping that they come off to add a bit more variety. Whilst Camp Bastion is a huge place, and at the moment we have excellent welfare facilities (I say at the moment as they will start to shrink as we pack up to leave), being here can still feel quite restrictive- we can’t just walk out of the front gate!

Day 7: 19 Jan

A day of ups and downs:-

The main up was finally going to Shorabak (the Afghan National Army (ANA) camp) to meet the Afghans my team are mentoring. The guy I’m taking over from introduced me and when they heard I could speak Pashto (and a little Dari) several came over to talk to me. They seemed thrilled that I could speak their language and many of them wanted to speak to me. I had also decided that I would wear a head scarf when working with them in deference to their culture and many of them commented on how nice it was and how much they liked it. All positive stuff. Another up was the outgoing hospital staff putting on a little entertainment this evening as they had formed a choir. The singing was great and there was some joke telling and also leek eating (raw leeks) as it was a Welsh unit. Great fun was had by all I think.

Remembrance parade 2013- with my youngest son Sam

Remembrance parade 2013- with my youngest son Sam

The down was a phone call with my 13-year-old son with him sobbing his heart out for 10 minutes which resulted in a few tears from me too. I know he is happy at his boarding school (usually) and that the school is used to this as all the children have a parent in the forces, but I still feel so guilty and wish I could be with him to give him a hug. Sometimes the separation from your family is so hard. My daughter has also been quite ill since I left (paramedics had to be called) and will probably need an operation in the future so that is playing on my mind too. My problems are no worse than others though and I know if things were serious then the there is a system in place that would get me home. So I just need to get on with the job in hand.

Day 10: 22 Jan

My handover continues and I am starting to get a handle on what the job entails and the numerous personalities I have to liaise with. It will take me a while to remember names but at least I know their faces and can hopefully put them in to the context of the appropriate job! Yesterday I went over to Shorabak again and was again very well received. The rest of my team were talking to their Afghan counterparts and finding their feet reference their task for the next three months (although I am here for eight-nine months most of the team are here for three, a few for six).

At the moment it is all about developing relationships and an understanding so that we are able to effectively communicate with, and thereby mentor and advise, the Afghan healthcare team that we are mentoring.  We will face challenges; one being the language barrier (although we have excellent interpreters), and my own language skills will hopefully prove useful, another will be trying to remember that we cannot expect the Afghan medics to work to the same standards that we are used to.  They do not have the same facilities and nor do they have the same level of training, such as nursing degrees or even the same level of literacy, but our job is to try to bridge the gap where we can and help them to help themselves.

As long as we remain flexible and believe in what we are doing I believe we can be successful and make a positive difference. A major challenge is difficulty acquiring sufficient blood products required for some operations, but we are working on a solution with the Afghans. They are setting up an emergency donor panel so that it will be possible to transfer 1 or 2 units to a patient immediately after donation, so we are looking forward to a case where a suitable patient presents and we can mentor them doing a transfusion. One aspect of our role is what we refer to as ‘reactive’ mentoring. At the moment we are still bringing some ANSF casualties in to Camp Bastion via our helicopter casualty evacuation chain.

When such casualties arrive at Bastion we try to send them to Shorabak where possible so that their own medical chain can treat them. Should such a casualty present to the hospital in Bastion one of my roles is to be at the hospital to arrange for the casualty to be transferred to Shorabak for treatment, if it is felt that the Afghan medical staff will be able to successfully treat them. At the same time I would activate a number of my team and take them over to Shorabak to mentor the Afghans as they treated their casualty.

Not all ANSF casualties arriving at the hospital in Bastion are suitable for transfer at the moment, although we are working with the Afghan medical team to increase their capability, so I may be called to the hospital as a casualty arrives and once their situation becomes clear I, and the team, may be stood down.

Read Lisa’s page: Captain Lisa Irwin, Medical Mentor

Read Lisa’s previous blogs from 2010/2011:

Lisa’s Diary 1: October-December 2010

Lisa’s Diary 2: January-March 2011

2 thoughts on “Training Afghan Medics: The Language of Healing

  1. Pingback: Training Afghan Medics: The Language of Healing pt2 | The Official British Army Blog

  2. Pingback: Training Afghan Medics: The Language of Healing Pt3 | The Official British Army Blog

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