Training Afghan Medics: The Language of Healing Pt7

Lisa’s Diary 2014

Captain Lisa Irwin

Captain Lisa Irwin

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 Dari 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.

 

29 Apr

left behind

As I sit in my tent typing this it feels very odd as everyone else in the tent is packed up and ready to go back home. The Med Group personnel are changing over so it is out with the old and in with the new, apart from a small number of people that will endure like me. Many of the people going have become my friends and I shall miss them, and most of the Med Dev team have changed over so there will be a period of adjustment for all of us. My new OC (Officer Commanding) is a good bloke so I think we will work together well and the new CO (Commanding Officer) of the hospital seems to be good too, and he understands the importance of what the ANSF Med Dev Team does and will support us in our endeavours.

The new team are bedding in to their roles at the moment so the atmosphere at Shorabak is very different when we go over; the guys are finding their feet and our Afghan colleagues are assessing them and seeing how they work. It takes a bit of time to develop a good relationship- and the previous team had an excellent relationship with the Afghan medics and doctors- so I am sure in time the atmosphere will be as it used to be. There is some continuity with me still being here as 2 IC (Second-in-command) and our 3 British clinicians will not change over for a few more weeks. It does feel as though I am being ‘left behind’! I will go through this again in July too as most medical personnel only do 3 months at a time out here so later in the year I shall witness another changeover.

Hi, I’m Lisa

 

I got to meet Al Murray, who was performing a show.

I got to meet Al Murray, who was performing a show.

I was lucky enough to see Al Murray perform when he came out here recently. More than that I also got to meet him in his dressing room before the show. I stumbled somewhat over introducing myself as I thought ‘Hi I’m Lisa’ was perhaps a little too informal, but ‘Hi I’m Captain Irwin’ was too formal. So, instead I looked a bit of an idiot when shaking his hand as I said ‘Hi, …….I’m………Lisa’! The show was excellent though, including the 2 support acts. I haven’t seen many shows whilst deployed, as I haven’t been in the right place at the right time, but they are always excellent for morale so well done to the artists that volunteer to come out.

7 May

There has still been little kinetic activity (fighting) out here, as the Afghans and insurgents have been focussed on harvesting the poppy, so that has meant few casualties. The harvest finished recently and there still hasn’t been much of an increase. It is a difficult one as we are glad that less people are being hurt but it also means less opportunity for the team to mentor the Afghans in difficult medical situations. There have been instances of casualties arriving at Shorabak whilst we are there and that happened again recently with one of the medics telling me ‘casualties are coming’ as the ambulance pulled up at the Emergency Department door. The casualties were 2 ANA that had been burned when a cooking pot exploded. We watched how they dealt with the casualties, who mainly had burns to the arms and face, and interjected with advice on occasion, and the casualties were dealt with promptly and efficiently. It perhaps was not how we would do things but their way worked for them and the casualties received appropriate treatment and are now recovering well.

With our time left out here rapidly reducing we need to make the most of every opportunity that we have to mentor so that we can leave the ANSF trauma care in as good a state as possible. To enable that we sought permission to mentor at night too and that permission was recently granted and was enacted tonight. An ANSF casualty came in to Bastion via helicopter and his injuries were such that the ANA doctors in Shorabak would not quite be able to manage him on their own but would be able to with some of our team mentoring them. After several phone calls made by my OC and I the casualty was transferred over to Shorabak, a small team of mentors was sent over ( with Force Protection) and I am happy to say that the case went well and the casualty is now recovering. It was the first reactive mentoring case carried out at night and the team, plus everyone else involved with ANSF Med Dev, felt it was a step forward in the mentoring process.

14 May

The past week has been a bit of a blur as I have been very busy. Not only have I been busy with the usual tasks of my job but I also volunteered to teach basic Dari to anyone interested in the Medical Group (though primarily the ANSF Med Dev team). Dari is not my best language (Pashto is much easier for me) and I am not a qualified language teacher, but the classes seem to be well received and the small things that I teach enable the team members to communicate better with their Afghan colleagues and thus help to develop their relationship.

An Afghan Warrior is treated by Afghan medics.

An Afghan Warrior is treated by Afghan medics.

We had a day last week when there was an influx of ANSF casualties presenting both to Bastion Hospital (having been evacuated by ISAF helicopter) and to Shorabak Hospital. The first I was aware of the casualties coming in was via a phone call at approximately one in the morning which necessitated me dressing quickly and heading in to work. There I met the OC and our clinicians waiting for the casualties to arrive. The next few hours passed in a blur of phone calls, discussions about treatment and where the casualties needed to be treated (ie did they need to stay in Bastion or did Shorabak have the capability to manage them) and a host of other things. Suffice to say I had 2 hours sleep that night (my OC had less!) and still worked a full day the next day. I think I was running on adrenaline!

This week my OC and I were introduced to an Afghan Major General who commands the ANA 215 Corps (the ANA we work with belong to his Corps). As usual I was wearing my headscarf, which he commented on as good because it showed my respect for their culture, and I had a conversation with him and then gave him a brief on the Shorabak hospital and its capabilities- all in Pashto. At times I was uncertain if I had the correct word but I looked to the interpreter who nodded at me to carry on and the General listened intently and thanked me for my brief. The interpreter reassured me it was good Pashto and I felt really pleased. My language ability has definitely improved during my tour- although I am far from fluent I can definitely get by.

I shall be moving to a new job next week to cover someone’s R&R and I think it will be another varied and interesting job- even if I am only doing it for 2 weeks. It involves working as an advisor with some of the Afghan Doctors who are responsible for training frontline medics, to ensure ANA casualties receive the correct care when they are first injured. It will enable me to develop a deeper understanding of the whole casualty care piece, from point of wounding to receiving treatment at Shorabak (or in some cases at the moment in Bastion) and so I am looking forward to it very much. Particularly as the doctors appear to know of me and are looking forward to working with ‘Touran Leila’, as I am known in Shorabak (Touran is Dari for Captain, Leila is my ‘Afghan’ name).

 

Pt1: Lisa’s Diary 2014

Pt2: Lisa’s Diary 2014

Pt3: Lisa’s Diary 2014

Pt4: Lisa’s Diary 2014

Pt5: Lisa’s Diary 2014

Pt6: Lisa’s Diary 2014

Read Lisa’s previous blogs from 2010/2011:

Lisa’s Diary 1: October-December 2010

Lisa’s Diary 2: January-March 2011

Training Afghan Medics: The Language of Healing Pt6

Lisa’s Diary 2014

Captain Lisa Irwin

Captain Lisa Irwin

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 Dari 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.

 

13 Apr

Hard to say goodbye

Today was a momentous day for me, my eldest son turned 21! Being in the military can be really hard at times as you want to be able to share special occasions with family and friends and the separation can be tough. However, the wider military family are very supportive of each other and we all know how difficult it can be so there is a lot of understanding and support. We are actually quite lucky now as the military has become pretty good at welfare provision. We have internet and telephone access, and even when I was working at small remote check points on my last tour I was able to make calls via a satellite phone and not feel completely cut off from home.

There has been a definite reduction in insurgent activity over the last few weeks, despite the Afghans holding their elections. The Afghan Government increased operations conducted by their security forces and it seemed to work, with relatively few casualties coming in. However a few days ago one of our interpreters phoned to say they were expecting a number of casualties injured by an IED.

Initially it was difficult to get a clear picture of what had happened and when the casualties were expected but after a couple of minutes of speaking to my interpreter he handed the phone over so I could speak to the ANA Colonel in charge of the incident myself. Well, my Pashto isn’t bad but trying to conduct a conversation over the phone, without the cues of body language and gestures, is quite difficult! However, to my relief (and, I think, the Colonel’s) I understood what he was telling me and realised that the casualties were several miles away, coming by road. I relayed the message to the Bastion hospital command team and asked the interpreter to call me when the casualties arrived.

Several hours later in the early hours of the morning, he rang back to tell me the casualties had made it to Shorabak and there were two that the ANA doctors were concerned about. I quickly got dressed and hot-footed it to the hospital (thankfully only a few minutes from my accommodation) and informed the night staff that the ANA were requesting to transfer two casualties to us for examination. A couple of phone calls later we had the go-ahead to receive them. One was not too sick and was returned to Shorabak after being examined but the other had multiple injuries and needed an urgent operation. Thanks to the expertise of our medical staff, and to all those involved in moving the casualty to Bastion, he is now recovering.

17 Apr

The lull in kinetic activity has continued so we have seen few casualties either at Bastion hospital or at Shorabak. Those that have presented to Shorabak have been managed competently by the Afghan clinicians and medics and moved as soon as possible to Kabul to receive further treatment if required, or to recuperate. In terms of mentoring, the best teaching opportunity is when a case comes in that is suitable for reactive mentoring but that also enables us to conduct other teaching sessions with the clinicians and medics simultaneously, though it can sometimes be difficult to hold their interest!

We are now coming up to the handover/changeover of the Bastion hospital personnel, which also means most of the personnel in the mentoring team. It will be hard to say goodbye to people that have become my friends but I know they are all hugely looking forward to going home. I shall be the continuity (although the new doctors have been here for almost a month already) so it will be very important for me to keep communication flowing in the team and for me to look out for them. They will be working in a strange environment and most of them will never have worked with ANA before, so they are facing quite a challenge. However, I am sure that they are looking forward to it as much as I was, and I will be able to reassure them that it is an interesting and challenging, if at times a little frustrating, role.

Pt1: Lisa’s Diary 2014

Pt2: Lisa’s Diary 2014

Pt3: Lisa’s Diary 2014

Pt4: Lisa’s Diary 2014

Pt5: Lisa’s Diary 2014

Read Lisa’s previous blogs from 2010/2011:

Lisa’s Diary 1: October-December 2010

Lisa’s Diary 2: January-March 2011

Training Afghan Medics: The Language of Healing Pt5

Training Afghan Medics: The Language of Healing Pt5

Lisa’s Diary 2014

Captain Lisa Irwin

Captain Lisa Irwin

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 Dari 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.

 

31 Mar

Rest and recuperation

I have been lucky enough to have been able to go home for almost two weeks’ rest and recuperation this month so I haven’t been over to Shorabak as much as usual over the last few weeks. It was lovely to go home though and see my fiancé and children. I also managed to go up to Scotland to see my parents and siblings, but driving to visit everyone did mean that I was almost glad to come back to Afghanistan for a rest!

My fiancé and I managed to go and see our wedding venue in Scotland and it is lovely so we are both really happy and looking forward to the big day. I also managed to fit in a shopping day with my daughter and bought her bridesmaid’s dress. She looks absolutely beautiful in it and without doubt will overshadow the bride, but as the bride is me, and I am a very proud mum, I do not mind at all!

Happy New Year!

Whilst I was away there weren’t many casualties so things quietened down a lot for the team, and in particular for my Commanding Officer and the Sergeant Major who was covering for me. The team continued to go over to Shorabak on routine visits to carry on with mentoring tasks but there were fewer reactive mentoring cases. My R&R also coincided with a few changes on the team and we now have a completely different set of clinicians. The General Surgeon, Orthopaedic Surgeon and Anaesthetist changed over as doctors do shorter deployments than the other team members, so there were some new faces when I returned. They weren’t completely new to me though as I had met them when training prior to coming on tour.

Customary Afghan food to celebrate the New Year.

Customary Afghan food to celebrate the New Year.

When I was on R&R Afghanistan celebrated its New Year (their New Year is usually around 21 March) so before I went on leave I made sure that the team were aware of the relevant cultural practices and had plans to take some food to Shorabak to share the New Year celebrations with our Afghan colleagues – and importantly that they also knew how to say ‘Happy New Year!’ in Pashto. The Afghans had a two-day holiday to celebrate the occasion so the team didn’t go over on the actual day but celebrated with them when they returned to work afterwards.

A cake decorated with the Afghan flag and the words 'Happy New Year'.

A cake decorated with the Afghan flag and the words ‘Happy New Year’.

When the team arrived at the medical centre they were taken to the ANA Colonel’s office and as is customary the food was set out on a cloth on the floor. The team sat cross-legged on the floor (not always easy for Westerners!) and ate the food with their hands, which is traditional Afghan custom. I was told by the team that the food was delicious, which I was not surprised about as I shared meals with Afghan families several times during my last tour.

The ANA hospital personnel were also very appreciative of the cake that the team had commissioned for them (pictured). It is always good to share these experiences with our Afghan colleagues as it shows an understanding and appreciation of their culture which is something we must always remember.

Observation sangar collapsed

Although casualties have been fewer of late I have still been called in on occasion when an ANSF casualty is en route to Bastion to arrange for transfer of the casualty to Shorabak where possible. Dependent on the extent of the casualty’s injuries the mentoring team will often go across to assist the ANA clinicians. Sometimes we get calls from the hospital in Shorabak asking us to review patients that they are concerned about, which involves bringing them over by an escorted ANA ambulance. One such casualty came in to the hospital a couple of days ago; he and several of his colleagues had been injured when an observation sangar collapsed. The ANA medics had noticed that this patient’s condition in particular seemed to be deteriorating and asked for the help from the Role 3 hospital at Bastion. On arrival he was assessed as having suffered a crush injury to his chest which had probably caused air and/or blood to escape in to the chest cavity, which was making breathing difficult. Further tests revealed the initial diagnosis to be correct so the team in ED prepared to insert a chest drain to rectify the problem.

The ANA medic who had brought him over asked if he could watch the procedure as it would be a good learning experience for him – with the added bonus that he spoke some English and could act as an interpreter. I stayed too and translated from English to Pashto to the medic, who was then able to translate my Pashto into Dari for the patient (my Dari is pretty basic). It was a slightly unusual set up but it worked! It certainly tested my language capability as I had to explain every step of the procedure; not only so the patient knew what was happening but also so the medic understood what was happening. I think my brain was fried afterwards!

Pt1: Lisa’s Diary 2014

Pt2: Lisa’s Diary 2014

Pt3: Lisa’s Diary 2014

Pt4: Lisa’s Diary 2014 

Read Lisa’s previous blogs from 2010/2011:

Lisa’s Diary 1: October-December 2010

Lisa’s Diary 2: January-March 2011

Training Afghan Medics: The Language of Healing Pt4

Lisa’s Diary 2014

Captain Lisa Irwin

Captain Lisa Irwin

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.

 

7 Mar

The past week has been a challenging one for the ANSF Med Dev Team and a tiring one for me.  We have been busy with routine visits to Shorabak when possible but also busy doing some reactive mentoring.  The Shorabak hospital has been relatively quiet so the guys in the team carried out teaching on things such as airway management rather than direct patient care and encouraged the Afghan medics to carry out necessary reorganisation of equipment.

Whilst the guys were teaching my role was a little interpreting, chatting to everyone to maintain relationships and assisting in teaching.  I had a book of Afghan poetry which was written in Pashto, and I showed it to some of the patients as I know that poetry is an important part of Afghan culture.  They were surprised that I had such a book and even more surprised that I could to read it. I read some poems to patients who were unable to read (in the past many Afghans were unable to attend school) and they really appreciated it. It was such a simple thing but elicited a warm response from everyone in the hospital, patients and staff alike.

VIP visit

Ed Milliband visited the hospital at Camp Bastion.

Ed Milliband (left) visited the hospital at Camp Bastion.

We had a VIP visitor to our team in March.  Ed Milliband was visiting Bastion and as he was coming to the hospital he visited our team due to our mission being considered important.   He seemed a personable man and listened intently as my OC, Fletch, explained exactly what we do and introduced the rest of the team.  He seemed interested in our role but I am sure that is a skill that all politicians quickly develop!

Preparing for surgery

As the week progressed the ANA were due to start a large military operation and therefore we started to prepare for a potential increase in casualties.  As the casualties started to come in I was frequently called in to the hospital to be there as the casualties were brought in by helicopter.  Once the casualties arrived I waited for the doctors to decide if the casualties could be treated at Shorabak, or remain in Bastion, for those who could be transferred I co-ordinated the transfer of the casualties to Shorabak.  Some of them were suitable to be transferred without the team going over to mentor and others required mentoring.  Our aim is to take over cases that are slightly complex and useful for us to mentor in order to increase the Afghan doctors’ knowledge and confidence, but not so complicated that they may be overwhelmed or not yet have the capabilities needed.

The current set-up is a bit like a field hospital, and the new hospital being built will not be ready before July, so it would not be fair to the doctors or the patients to send over cases that are currently too complex.   One of the first suitable casualties required abdominal surgery, and the operation was more complex than had been done at Shorabak before.  However, the patient was assessed to be stable and suitable for transfer.  We decided to take over only the team members that were needed, rather than the whole team, and gained permission to stay over slightly later than normal (our working hours in Shorabak can be restricted depending on the security situation).  So the smaller team, with our Force Protection, headed over.

When we arrived at the hospital the casualty was already in the operating theatre being prepared for surgery so the surgical team scrubbed up and went in to mentor the ANA doctors carrying out the operation.  Meanwhile one of our nurses and I went in to the ward to see how many patients there were and make sure everything was up to date. I chatted to the medics and patients that were there, including two patients who remembered me talking to them in the Emergency Department in Bastion hospital – I suppose a blonde, white woman speaking to them in Pashto probably makes me quite easy to remember!

As the operation progressed I was frequently checking on progress to see if we were going to be OK for time.  I also reminded the Afghan medics that they needed to prepare a bed space for the patient to return to when he came out of theatre, with oxygen, monitoring equipment and other such things that a complicated post-op patient would need.  Once the surgery was complete, the patient was taken to his post operative bed for overnight monitoring and care, and we were able to return to Bastion – the team satisfied with a job well done.  The drive back to Bastion was slightly surreal as I had never driven through Camp Shorabak in the dark before but other than feeling slightly more vulnerable we didn’t encounter any problems.

8 Mar 2014

Talking to the patients on one of the ANA hospital wards at Camp Shorabak.

Talking to a patient on one of the ANA hospital wards at Camp Shorabak.

The next day was almost a repeat of the previous day, with several more casualties coming through, some of whom remained in Bastion hospital and some of whom were transferred to Shorabak.  Of the ones transferred to Shorabak another required abdominal surgery so again the team was stood up to go over and mentor the case.  This time the as the surgery was ongoing there was another casualty with a gunshot wound to deal with, so three of us cleaned, irrigated and dressed his wound.  We then moved him to the ward but no sooner had we done that than word came through on the radio that the Afghans were bringing in 3 seriously ill casualties evacuated by their own helicopter.

Immediately I started chivvying the Afghan medics to make sure the Emergency Department was set up to receive them as the medics haven’t yet fully grasped the concept of preparation and tend to be more reactionary.  At the same time I had to keep an eye on how the surgery was progressing as I was aware that we had a limited time in Shorabak.  Eventually it became clear that the operation wasn’t progressing as planned and that we needed to take the casualty back to the hospital in Bastion, and at this stage there was no sign of the Afghan casualties.  So after numerous phone calls and radio messages we loaded the casualty into an ambulance and we all returned to Bastion.

Casevac’d for needing to pee!

The next morning as I sat at breakfast reflecting on the past 2 long days my phone rang again as more ANSF casualties were en route.  No relaxing breakfast for me then as I headed in to work.  There had been an IED incident that resulted in a number of casualties and some were on their way to Bastion.  On arrival the most seriously injured were immediately taken in to the Role 3 Hospital Emergency Department for assessment and treatment but one casualty appeared to have only minor injuries so he remained in the ambulance while he was assessed, as it appeared likely that he could be transferred straight to Shorabak.  However, although the assessing doctor couldn’t find any obvious injuries the casualty was still grimacing in pain.  Unfortunately due to the number of casualties all the interpreters were busy with other injured Afghans and so I climbed into the ambulance to speak to him to see if I could find out where he was in pain.  Quite quickly I discovered the source of his extreme discomfort….he had an extremely full bladder and was desperate for the toilet! Once he had been able to pass urine he was absolutely fine (apart from a slightly sore back).  Possibly the first time someone has been casevac’d for needing to pee!

After yet another full and busy day I eventually crawled in to bed, exhausted.   I suppose this is how my life is going to be for the next few months, with me taking advantage of any breaks I can get but acutely aware that I can be called in at any time.  I wouldn’t have it any other way though as I enjoy the challenge and variety that the role can bring and I really enjoy being able to interact with the Afghan personnel and hopefully positively influence them.  It may be small steps but I really do feel that my job, and more importantly the work of all of the ANSF Med Dev Team, is making a positive difference.

Pt1: Lisa’s Diary 2014

Pt2: Lisa’s Diary 2014

Pt3: Lisa’s Diary 2014

 

Read Lisa’s previous blogs from 2010/2011:

Lisa’s Diary 1: October-December 2010

Lisa’s Diary 2: January-March 2011

Training Afghan Medics: The Language of Healing Pt3

Lisa’s Diary 2014

Captain Lisa Irwin

Captain Lisa Irwin

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.

24 Feb

We have had a testing few days as a team, after some Afghan patients presented at Shorabak with rare conditions including  acute leukaemia, a brain tumour and some kind of systemic infection that caused hydrocephalus (fluid on the brain). Two patients died despite our best efforts, which was very sad, but there was some benefit as we were able to explain to the Afghan health workers in Shorabak how important it is to carry out regular patient observations and to act on any irregularities.

We had a couple of good cases for reactive mentoring this week. One of the casualties had surgery following an IED strike but was otherwise stable so I helped to co-ordinate his transfer to Shorabak and set up the team to go over with him. Whilst surgery was being carried out in the Shorabak operating theatre I acted as an interpreter on the ward and in the laboratory, as we only had one local interpreter with us and he was needed in theatre. I was really pleased that I was able to interpret most things and I used my nursing experience to encourage the Afghan medics to ensure they had all they needed, and were ready, to receive the casualty on the ward once he came out of theatre.

While I was there I helped another patient who had become quite distressed. He is an ANA soldier with a good record for finding IEDs who had been caught in a blast, suffering facial injuries. He was concerned about his sight and the fear of long-term damage was making him anxious for his future. I held his hand and tried to explain that the healing process would take time. He calmed down but it was an upsetting conversation.

On a lighter note my relationship with the Afghan medics and the local interpreters goes from strength to strength. One of our interpreters recently came back from leave and told me he had brought some gifts back for the members of the team that were dear to him, and I was one of them! He then presented me with a lovely watch which was so thoughtful and a lovely surprise. One of the medics was trying out his best English to try and tell me how much he liked me, so at the end of our conversation (which had been in Pashto) he said to me ‘Goodbye, I love you’! It was very sweet but I’m not sure that was what he really meant to say! Still, whilst there are difficulties associated with my role, I am still really enjoying it and loving the challenges it brings.

1 Mar 14

This week has passed very quickly. I have been across to Shorabak with the team every day except Friday (we don’t routinely go across on Fridays due to it being their religious day) and in the last week the Shorabak hospital has been quite calm.  There has been a small, but steady, number of patients and the Afghans have been coping with them.  Occasionally when we visit our doctors may advise their doctors on the most appropriate management of some of the cases but generally they have been able to cope on their own. However, there haven’t been many major trauma cases recently so our input hasn’t been required as much when it comes to patient management. 

It has been a useful week for the team though as we have been able to use the time to encourage the Afghan medics to ensure their departments are well stocked and organised and to carry out some teaching. I meanwhile, either assist with interpreting when teaching is going on, or go on to the ward and talk to the patients.  Generally I am incredibly well received as the patients really appreciate a woman being able to speak to them in their own language and like to tell me about what happened to them (most patients suffer injuries due to IEDs or gun shots) and talk about their life and their family.  They are always very curious as to how I learned to speak Pashto and constantly tell me what a difficult language it is. I agree with them on that!

While it is generally quiet at the moment ISAF still stand the chance of suffering casualties, which has happened on occasion in the past month. Any death from the coalition hits everyone hard.  On previous tours I have been to repatriation ceremonies and I have always found them to be deeply moving, whether the soldier concerned was known to me or not. It is a difficult aspect of the job.

I have been particularly fortunate this week to have been asked to help with one of the Afghan children on the ward here.  The boy, who is aged around 14 (many Afghans are unsure of their actual age as birth certificates generally do not exist), suffered major leg injuries in an IED explosion while playing with his brother. He is naturally grumpy given what he is going through, so I was approached to perhaps do some reading and writing with him to try to occupy him.  I had helped with his nursing care before so he knew me and he and his uncle, who is his guardian, were pleased to see me.  My initial session was about establishing his level of literacy. He was illiterate, which is not uncommon in rural parts of Afghanistan, so I just spent the first session teaching him to read and write the first 5 letters of the Pashto alphabet (which has 42 letters) and to read and write his name.

He seemed interested and happy but I wasn’t entirely sure as he was also in some discomfort and so concentrating was difficult. However, the following day lots of the hospital staff kept congratulating me on the change in him and how good my intervention had been. After I had left he spent ages painstakingly writing and rewriting his name and showing the staff his achievement. I am so pleased that I was able, with something so simple, to put a smile back on to his face.  I have since been back and taught him the whole alphabet, some basic maths and made him laminated alphabet and picture flash cards and he has been thrilled.  He excitedly tells everyone ‘She is my teacher!’, though in Pashto so only I know what he is saying, and shows everyone his work. He is due to be discharged to an Afghan hospital soon but is keen to continue so I have made some more work books for him to take with him. It has been so gratifying to be able to help him in this way and I am glad I was given the opportunity.

Pt1: Lisa’s Diary Week 1-2 2014

Pt2: Lisa’s Diary Week 3-4 2014

Read Lisa’s previous blogs from 2010/2011:

Lisa’s Diary 1: October-December 2010

Lisa’s Diary 2: January-March 2011

Training Afghan Medics: The Language of Healing Pt2

Lisa’s Diary 2014

Captain Lisa Irwin

Captain Lisa Irwin

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 14: 26 Jan

Work has been gathering pace as I completed hand over and was handed my issue mobile. Friday is the Muslim religious day so we don’t go over to Shorabak for routine training and utilise the time to do team admin and training. However, this Friday our plans went awry as an ANSF casualty was brought in that we felt was suitable for transfer to Shorabak- he had a gunshot wound to an arm and a resultant fracture. I then had to kick in to action and phone all the relevant cogs in the wheel to ensure transfer of the casualty from our ambulance, to an ANSF ambulance and then to Shorabak; at the same time I had to notify the team members that were required and ensure we were ready to go. By the time we got over to Shorabak the casualty was already in the operating theatre and the Afghan team were ready to go, so the guys from my team went in to mentor them through the surgery.

The surgery turned out to be slightly more complex than first thought and took several hours but we managed to assist the ANSF surgeons in stabilising the casualty. Unfortunately he had suffered major damage to a blood vessel and so had to be returned to Bastion for more complex surgery, but the ANA surgical team did their part very well and it was felt that it was a useful mentoring opportunity. Whilst that operation was ongoing another casualty was brought in by their evacuation chain and went in for surgery immediately after the other came out. On that occasion the ANA surgical team were seen to be more than capable of coping so we left them to it and returned to Bastion. Whilst the ANA may not have the resources that we have I am most impressed with their ability to overcome such issues and work hard to save their fellow warriors.

Due to my role in theatre, and the fact that I am female and a reservist, the combat camera team came to talk to me yesterday with a view to me being involved in some kind of documentary/media piece. I was more than happy to take part but had to have several photos taken and wasn’t particularly comfortable with that- I hope they got my best side!

Day 25: 6 Feb

What is going on with the weather out here? The days were getting sunnier, the nights starting to get shorter and the temperature was getting warmer so I was looking forward to not so cold nights and warm sunny days. How wrong could I have been? Helmand has had its first snow in 12 years and it is absolutely freezing! I must admit Camp Bastion covered in snow is a sight I never thought I would see. I wish it would go now though as getting out of a lukewarm shower into a cold ablutions tent is not a pleasant experience! I went back to Shorabak for the first time in a few days today (security meant it wasn’t possible for a few days) and it was good to get back.

The staff in the Treatment Centre all remembered me and many came up to me saying ‘Leila (my ‘Afghan’ name) you are back!’ and some were hugging me in greeting. I was very pleased by their reaction as it shows how accepting they have become of me. A hug in greeting from an Afghan is not at all unusual once they know you and count you as a friend or good acquaintance. However, they are often a little more reserved about giving a woman a hug which is understandable given their culture. I am really pleased that they are happy to see me and like to talk to me as developing relationships is a key aspect of my job and doing so will give me more ability to recognise if something is wrong. If they regard us as friends then they are more likely to want to protect my team and I from the risk of harm.

Working with the ANSF in their camp does bring risks but good relationships with our Afghan counterparts is the best way to mitigate that risk I was also able to chat to several of the patients today, as many of them spoke Pashto, which at the moment is easier for me than Dari. After the small talk about family, weather, where they lived/were from etc we then spoke about their injuries (one had been shot, another injured by an IED) and their continued struggle to secure their country against the Taliban. I find their resilience amazing and in some way inspiring. Afghans are incredibly resilient people who – as they are quick to tell you – are used to decades of war and fighting, and they are pragmatic too and just get on with things. Those I spoke to emphasised that they are very proud of their country and want to do all they can to protect it for their friends and family. They do not agree with the Taliban’s methods and motives and want, as do all Afghans that I have spoken to, to be able to live in a secure country and support their family. They aren’t asking for much.

Day 26: 7 Feb

I wasn’t detailed to go to Shorabak today but I had some reports to catch up on and some general admin to do so I managed to stay busy enough. I also had a telephone interview to do with Army media back in UK to talk about my experiences as a reservist and my role out in theatre at the moment. It is going to be published in a newspaper supplement as part of International Women’s Day (March 8th). The combat camera team are planning to come over to Shorabak in the next week to take some photographs of me at work to accompany the article. That leaves me with the dilemma of which head scarf to wear….only joking- though I do have a selection as I have some from my last tour and I bought a new one when I got here. It is still bitterly cold here- so much so that we have had a few personnel injured by slipping on ice. That is not an injury pattern that we normally associate with a deployment to Helmand. Perhaps in Kabul yes, as it frequently snows there in winter, but not down here (we are quite a long way South of Kabul). Most days are cloudy too so the sun isn’t managing to get through and lift the temperature. Having done two previous winter tours though, I do know that once the sun does start to come out it usually warms up pretty quickly and in a few weeks we will be starting to complain about the heat! I have never done a summer tour though so I am not sure how I will cope with the intense heat in July/August. Ah well, I will have no choice but to get on with it!

Day 30: 11 Feb

The past few days have been frustrating for me and my team. Unfortunately the threat state was raised so mentoring was put on hold. That meant we had a couple of days free; although in reality few of us were stood idle as the nurses and doctors in the team offered themselves to the hospital as extra hands/advisors, and myself and my OC caught up on essential admin. I too offered my nursing skills to the ward as two children are being treated there at present. They were happy for my help, especially as I could speak to the children in their own language. Seeing the injuries that some children sustain out here is very difficult- those particular children had been seriously injured by an IED whilst out playing and I find the indiscriminate nature of IEDs really hard. There has been so much suffering caused to innocent people who just want to be able to live a secure life.

I have also managed to organise some extra language training for me at the Education Centre here in Bastion with an Afghan tutor. It is an asset I need to make the most of as there will be no such facility in a few months time when the draw down properly kicks in. I have started my fitness campaign proper too, I am determined to regain a good level of fitness and in the back of my mind is that I will be wearing a wedding dress in October ( my fiancé and I have finally arranged the date!) and I want to look as good as I can! Today the restriction on us going over was lifted and so we were able to send three quarters of the team over. I remained behind as it was felt prudent not to send too many people until we had assessed the atmospherics over there. I ended up being quite busy as we had several ANSF casualties brought in to the hospital by helicopter this morning, not long after my team had left for Shorabak. Before they arrived the reports indicated that some were seriously injured and one not as badly (most due to an IED, one had been shot).

I gave the Liaison officer who organises the transportation of the casualties from Bastion to Shorabak a call to give him a heads up and called my team who were over there working to let them know. I then remained in the Emergency Department as the casualties were all brought in and assessed, in order to determine if they were potential cases for transfer to Shorabak. Not being experienced in trauma care (thankfully it is pretty rare in paediatric nursing in UK and blast injuries are pretty rare in the UK full stop) I found it fascinating and also a real eye opener. There were lots of people involved in caring for each casualty and their knowledge and experience was evident as each team dealt with their allocated casualty.

I have been told that the Role 3 Hospital in Camp Bastion is the best trauma centre in the world and watching the guys at work I could see why. As it turned out the hospital director assessed them as requiring the specialist care that the Role 3 hospital in Bastion can give them due to the severity of their injuries, so everyone in the ANSF Med Dev team was stood down. I had a lovely, and interesting, evening tonight as I have been invited several times to take tea (chai- green tea) with the hospital interpreters and I managed to make the time tonight. They were really pleased to see me and we sat down and talked about family, jobs, poetry (considered very important in Afghan culture) and life in general. Nearly all the conversation was in Pashto, with the occasional help for me when I couldn’t remember how to say something or understand what someone had said to me. I was really pleased that I was able to talk with them for over an hour on a number of subjects. All that work at the language school is finally paying off! They have invited me any time and I intend to join them as often as I can- but I shall try to get my family to send some Scottish food that I can take with me to thank them for their hospitality.

Day 39: 20 Feb

The past week (well just over a week) has been pretty busy so I haven’t had much time to myself. The weather is warming up and that historically has tended to mean more operations on the ground being carried out. It certainly seems to be the case now as there have been numerous ANSF casualties coming in to Camp Bastion and direct to Camp Shorabak and as a result my services have been required several times to co-ordinate patient transfer. Sometimes I have been involved in sending casualties from Bastion to Shorabak and at other times casualties have come in to Bastion whilst I have been with the team working at Shorabak, and I have co-ordinated them being received in to Shorabak Emergency Department. Not all casualties that have been sent to Shorabak have required mentor input as some had injuries that the Afghan doctors are more than capable of dealing with on their own; whilst others required a little guidance from us initially and we were then able to let the Afghans deal with the situation themselves. For 4 days in the past week I was in charge of the mentor team as my OC had taken a small number of the team up to Kabul to recce the Kabul Military Hospital.

We need to fully understand the capability of such a hospital so that we can understand the likely capability of the hospital currently under construction in Shorabak and therefore tailor our expectations and mentoring accordingly. I was quite happy to be left in charge (and so I should be really!) as I am really gaining an understanding of the role, how we operate, and the numerous personalities I need to liaise with and work with. Plus I now have a good understanding of the numerous bits of paperwork and reports that go with the role. I find that I am working quite long hours (as is common for many people out here), with little or no time off, but as it is interesting and often challenging work I don’t mind at all. If casualties come in late and I am called in to the hospital I find I am rarely tired as the adrenalin kicks in and I become focussed.

A casualty coming into the Emergency Department certainly sharpens the mind. I am involved in the whole process; from the initial report of an incoming ANSF casualty, to the helicopter coming in, and then the casualty being transferred by ambulance to, and assessed in, the Emergency Department, right through to the decision about treatment and onward care. There have been times when we have faced particularly difficult challenges; in particular there have been cases where the Shorabak team have wanted to send casualties to us as they have felt the casualties required the level of care that Bastion can give.

Unfortunately for a variety of reasons we have not been able to accept them. The Afghans have surprised us by then coming up with their own solution to the problem and saved the patient. We have been very impressed by that and they have seemed very proud of themselves- justifiably so. I continue to be surprised by the resourcefulness of the Afghans and they in turn continue to be surprised by my knowledge of their language and culture, so it is an interesting relationship. I am glad that I will be working as part of the mentoring team until the new hospital opens so that I am able to see our (and their) hard work come to fruition.

Pt1: Lisa’s Diary Week 1-2 2014

Read Lisa’s previous blogs from 2010/2011:

Lisa’s Diary 1: October-December 2010

Lisa’s Diary 2: January-March 2011

Training Afghan Medics: The Language of Healing

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

Filming close quarters combat in the third dimension

Herrick 18 Stories

Capt Mau Gris. Sgt Barry Pope RLC (Phot)

Capt Mau Gris. Sgt Barry Pope RLC (Phot)

Captain Mau Gris is team leader for the British Army’s Combat Camera Team (CCT) based in Afghanistan throughout the summer 2013 as part of 1 Mechanized Brigade. Op Herrick 18′s CCT also includes Sergeant Barry Lloyd – video cameraman – and Sergeant Barry Pope – photographer.

‘Spray and pray’

With Lloydy gaining a bit of fame in for his 3D filming (he’s been interviewed by BBC Radio Merseyside) I thought it was time to talk about our 3D filming, so far, in this blog.

Last week, I found out that the Brigade Reconnaissance Force (BRF) were going to the Close Quarter Battle (CQB) range to practice their skills. So I set up a day to go down and capture them in action.

CQB ranges are pretty claustrophobic and seriously intense; as they are made to replicate urban warfare. Though for Helmand this is a thing of the past it’s still practiced, and it is ideal subject matter for a bit of 3D action. To give you an idea – here is a video we made on Close Quarters Marksmanship:

[http://youtu.be/OGetZAelPbg]

The ranges are set up in a kind of winding alley format, with lots of corners forcing the guys to practice the drills. They face all the problems that might happen in the real thing and they have to deal with them as they go.

With the perfect subject, we set about assessing gear that the production house 3Dizzy had given us. We’ve been given a p2, which is a large standard news camera, which has a large 3D lens on it. Advantages of this – great HD quality footage with complete control. Downside – very awkward to move with and fricking heavy. We also had a 3D Helmet camera, which had the opposite qualities – easy to use, but no monitor to watch the footage, to use military slang; a ‘spray and pray’ camera. We also had a 3D handycam which was in the middle of the two.

3D filming of close quarters marksmanship. Sgt Barry Pope RLC (Phot)

3D filming of close quarters marksmanship. Sgt Barry Pope RLC (Phot)

3D filming of close quarters marksmanship. Sgt Barry Pope RLC (Phot)

3D filming of close quarters marksmanship. Sgt Barry Pope RLC (Phot)

Close quarters marksmanship being filmed. Sgt Barry Pope RLC (Phot)

Close quarters marksmanship being filmed. Sgt Barry Pope RLC (Phot)

Close quarters marksmanship being filmed. Sgt Barry Pope RLC (Phot)

Close quarters marksmanship being filmed. Sgt Barry Pope RLC (Phot)

3D filming of close quarters marksmanship. Sgt Barry Pope RLC (Phot)

3D filming of close quarters marksmanship. Sgt Barry Pope RLC (Phot)

3D filming of close quarters marksmanship. Sgt Barry Pope RLC (Phot)

3D filming of close quarters marksmanship. Sgt Barry Pope RLC (Phot)

On 3D cameras you have an additional elements of ‘convergence’ and ‘depth budget’ to consider alongside the ordinary considerations such as exposure and framing. Simply put these are controls for whether something pops out at you from the screen and how three dimensional something is. Too much can actually ruin a shot or even make it ‘illegal’ according to broadcaster standards.

With all this to consider Lloydy and his Holiness (Sgt Pope) were really earning their pay on this shoot. As the producer I had to concentrate on holding my tongue and getting them the time they needed to do the job, as well as not ruining their shots by accidentally walking into them, which I have done more than once. Don’t ask me how, it just happens.

3D filming of close quarters marksmanship. Sgt Barry Pope RLC (Phot)

3D filming of close quarters marksmanship. Sgt Barry Pope RLC (Phot)

We set up Lloydy with the big camera as he’s the specialist video guy, getting the tough arial tracking shots from an observation deck. Then his Holiness got the nice, tight shots on the handycam, we are hoping to show the results later in the year! Drop me a line in Twitter if you want to know more.

Filming from the Hospital

I also promised to talk to you about the difficulties of shooting in the Camp Bastion Hospital. From a producer’s perspective – it is about the clearances and preproduction you have to go through – for legal reasons actually filming patients is a no go, you can get their permission afterwards and in the UK but because of the nature of this environment it’s not always possible to track people down after they have left.

ISAF are teaching the afghan doctors and surgeons more advanced medical techniques to enable them to look after and care for the more seriously injured soldiers. Sgt Barry Pope RLC (Phot)

ISAF are teaching the afghan doctors and surgeons more advanced medical techniques to enable them to look after and care for the more seriously injured soldiers. Sgt Barry Pope RLC (Phot)

ISAF are teaching the afghan doctors and surgeons more advanced medical techniques to enable them to look after and care for the more seriously injured soldiers. Sgt Barry Pope RLC (Phot)

ISAF are teaching the afghan doctors and surgeons more advanced medical techniques to enable them to look after and care for the more seriously injured soldiers. Sgt Barry Pope RLC (Phot)

Working in the hospital. Sgt Barry Pope RLC (Phot)

Working in the hospital. Sgt Barry Pope RLC (Phot)

Also in that environment were people are very aware of cameras, you often have to contend with people messing up the shot by trying to avoid being in it. Or trying to stop you because they have not been told that you have permission. That said if you do go through the pain – the shots of the work people are doing there are worth it. Nothing worth anything is ever easy.

See you next time guys. Take it easy.

Read Mau’s other blogs here: Capt Mau Gris

Follow Mau on Twitter: @mau_gris

Lisa’s Diary 2: January-March 2011

Captain Lisa Irwin is a Territorial Army Officer, currently deployed to Afghanistan as a Female Engagement Team Commander. The second three months of her diary are presented here, covering January to March 2011.

To view the most recent entries, click here.
To view the entry for the first three months, click here.


2 January 2011

Firstly Happy New Year! My New Year was spent in the Passenger Handling Facility at Kandahar waiting to board a Hercules C130 for my onward flight to Bastion after flying from RAF Brize Norton (via RAF Akrotiri, Cyprus). Not really how I expected to be seeing in the New Year but to be honest New Year on tour really is just another day. On my last tour I spent the evening in the EFI in Bastion and taking part in sober karaoke – at least my being stuck in Kandahar saved the guys from having to put up with my singing attempts this tour!

It was lovely (and unexpected) to be at home for Christmas; the travel chaos caused by the great British weather thwarted my attempts to travel back to theatre and so I was able to spend the festive period with my family. Christmas Day, however, took an unexpected turn when my 17-year old son tripped and fell through a glass door which resulted in 3 hours in A&E and 8 stitches in his hand. Still, I was glad that I was home to look after him and my nursing skills were put to good use. I travelled back to Brize Norton on 27 December to try and get a flight back to Afghanistan and ended up being stuck in a cold, foggy Brize for 2 days as there was no seat available until 30 December! I was glad to finally get my journey back to theatre properly underway, even though it still wasn’t completely smooth and I had to overnight in Kandahar. Eventually I made it back to Bastion and from there to the FOB.

I’m now back in FOB Shawqat, having only just managed to get on the helicopter last night due to confusion over timings. Trying to run to get on a helicopter wearing body armour and helmet and carrying a 70lb bergen, patrol sack and weapon is not much fun. Especially when the said helicopter is a Sea King with a couple of high steps to try and climb in. However, despite much cursing I made it and am now officially back to work.

I arrived back to the FOB to 8 parcels (from friends, family and old work colleagues) which was lovely – lots of goodies for me to share with all the guys. I also brought back several goodies for the guys myself and so the teasing about me doing a half tour and avoiding coming back etc was minimised! I stress that was not my reason for buying the goodies, most of them had been bought and packed before my first abortive attempt at getting back to theatre.

I’m now in the midst of planning my movements over the next 3 months (until the end of tour), looking at where I may be of most benefit. I know I need to try to go back to the women who were willing to engage with me on previous occasions and have identified (after advice from experts on our area of operations) other areas where I may be able to have a positive effect. It is a little frustrating that I am the only one doing this job (originally it was planned to be a team of people but time and other constraints have meant that it couldn’t happen that way this tour) as there is so much I would like to do and not enough time. Every potential engagement has to be planned, the movement to and from the PB or CP had to be factored in, and I have to ensure that my plans tie in with the relevant company as I need their guys to patrol with me. However, I truly believe this is a worthwhile role and one that can make a difference in the long term. I know that it may be difficult for people to see the benefit after this tour as I am really just laying the ground work but I comfort myself that we all have to start somewhere and, as the saying goes, from little acorns large oaks grow.
8 January 2011

It’s almost like I’ve not been away and R&R never happened, time at home with my family seems like a distant memory. Still, it did recharge my batteries and female engagement seems to be progressing better than I thought possible at the start of the tour.

Last Monday saw me going out to a local shura, along with our Cultural Advisor, Helen, who is a Pashto speaker. My attending the shura was a follow up to the first shura I attended on tour and I was hoping that my little Pashto may persuade the elders to allow me to speak to their women (last time I met them they said no as I didn’t speak any Pashto). Unfortunately it was a vain hope! The elders were adamant that any engagement with women would have to take place in their own compounds (ie no gathering of women) and I had to be accompanied by a female interpreter. Helen would love to help me but she doesn’t have long left on tour and has many other demands on her time and skills so this may be something that has to be put on the back burner for now. It is a shame as the village seems to be progressing well; it has a busy, thriving bazaar, a new ANP station, and is about to have a temporary school erected so that the children (only boys unfortunately, but that is frequently the case) can be educated again. The old school will soon be demolished (well, soon in Afghan terms could take several months!) and a new, permanent school will be built on the same site.

Whilst waiting for the shura to begin Helen and I talked to some bazaar owners (actually Helen did most of the talking, I was mainly listening and trying to work out what they were saying – thrilled whenever I understood something!) The bazaar was very busy with lots of adult males, teenage males and male children – but not one female in sight. I’m not sure if that was because people knew there was an ISAF patrol around the bazaar, as that would definitely prohibit females coming into the area, or if women generally don’t go to this particular bazaar. It is something that is difficult to assess as the presence of our troops can affect normal behaviour but I do know that culturally rural women cannot go out of the home unless accompanied by a male relative.

Helen’s ability to speak Pashto fascinates locals wherever she goes, no doubt even more so because she is a female soldier, and walking about with her is like being with the Pied Piper. The young men and children crowded around us desperate to ask questions, to ask about our families (Are you married? Do you have children?) so photos of my children were once again passed around. Helen is usually told that at the age of 30, not yet married and no children, she is past it! In Afghan culture it is rare to be unmarried by late teens. I had some pens with me to distribute to children but could see that there were so many children in the bazaar that it would not be possible without causing a riot – especially as Afghan children do not politely wait to be handed a pen. They just charge at you snatching whatever you’re handing out , trying to grab as many as they can. If I misjudge the timing of handing anything out it can be quite scary! That is why I tend to donate pens etc to schools or give them to parents when I have been engaging with a family.

Helen and I carried out another engagement with the midwives in the District Centre Health Clinic. As the Health Clinic is close to the FOB we were driven there by security contractors, which meant I did not have to tie soldiers up for a couple of hours, and the contractors provided security whilst we conducted the engagement. The two midwives were really pleased to see us and had stayed behind after work so that they could talk to us. We talked about women’s health issues concerning pregnancy and birth and I was able to find answers to health questions that, as a paediatric nurse and mother, I had concerns about. Unfortunately we ran out of time as one of the midwives husband’s came to collect her from work (the women are not able to drive themselves around, they must be escorted and, therefore, need to have family support for their role). I could have spoken to them for hours. I’m not sure that Helen felt the same as translating medical terminology was very challenging for her- a lot of the conversation was carried out by mime! We gave the midwives a small gift of sample sized perfume, hand cream and shower cream, which they seemed to like. As we left one of the midwives said we should go to her house for tea, which would be great, but I was unsure about the logistics of it. It’s not like we could just pop round for a brew! However, later that same evening she phoned Helen, again asking us to go for tea, so I have liaised with the Coy that operates where she lives, so that we can patrol with them to her compound and they can provide a cordon, and we are therefore planning to go for tea next weekend! The engagement with these midwives offers excellent potential for further engagements with other women and the opportunity for me to gain a good insight into the lives of Afghan women. I am very excited!

This week it was also brought to my attention that male elders had asked at a shura in another area about starting a sewing cottage industry for their women as they had heard about a similar project elsewhere. It is great that the men are interested in something for their women, something that can give the women a future and if managed properly can be sustainable. However, it is not just a case of handing out equipment – I need to talk further to the males to ensure everything is handled properly, to gauge and manage their expectations, and also speak to the women to ensure it is what they want and that they will be capable. It is a hopeful sign though for the future of Afghanistan.


22 January 2011

I’ve escaped Shawqat and am back out doing the job I came out to do. I’m at a check point (CP) so it’s back to rations, going to the toilet in a plastic bag and outdoor showers. I’ve been sharing a bunk with a big Fijian who’s snoring sounds like a tractor starting on a cold morning – so sleep has been a little difficult. At least the weather is improving and it’s warmer in the daytime, but it’s still freezing (literally) at night.

I was brought here by Mastiff, an excellent Protected Mobility vehicle that has proved its worth time and time again out here, several have hit IEDs and in the main the occupants of the vehicles have escaped with minor injuries.

On my first afternoon here we visited a compound that housed a cotton processing factory as the Development Advisor (an American lady) located with the Battle Group is looking at opportunities for Afghan economic development. All present at the meeting introduced themselves and I introduced myself in Pashto, much to the delight of one of the elderly Afghans present. I did reiterate that I only understood a little Pashto but whenever I understood some of the conversation (unfortunately not very often) and nodded understandingly, or spoke to one of the children present, he smiled broadly telling everyone that I understood Pashto! The cotton factory was a very small business and in terms of a Western factory it was barely a factory at all and looked more like a farmyard, but it worked and it employed several people and there is the possibility for expansion.

The following morning we patrolled back into the village to meet women living in one compound at the request of the compound owner. The Rangers at the CP had told him that a female soldier was coming to talk to women and he was keen for me to talk to his wife. Fortunately the husband allowed me to communicate through our male interpreter, although he had to remain outside the women’s room, but the men of the compound stayed throughout the engagement too and had a tendency to dominate the conversation, as is often the case. Three families lived in the compound so I was talking to three women. The women are not used to talking directly to Westerners and were very shy but by engaging with them I learned a lot from them about education, health and the needs of women. I talked to them about the Health Initiative that will be coming to their area and both they and the men in the compound were keen to take part with the husbands saying they wanted their wives to be educated. As I left the interpreter told me that I was the first ISAF female the women had seen and they were incredibly happy that I had made the effort to talk to them about their lives and their issues.

The next day I went back to see the same women to take them some small gifts (a radio, some hand and face cream and pens for their children) but when we arrived at the compound we discovered the men had gone out for the day. However, to my surprise the women still invited in the interpreter and I, set up a shura mat and we all sat out in the centre of the compound and talked, with the women not even covering their faces. They were very happy that I had come to see them again and grateful for their gifts, though they were obviously a poor family and were asking if I could get clothes for their younger children as they were only wearing upper garments. When I think of all the items of clothing we discard in the UK, to families such as these it would be a godsend.

After we left their compound we patrolled to another compound where we thought I may be welcome. On the way we noticed a young adult male closely watching and following the patrol so the Sgt challenged and searched him. As this was going on his father approached and on being told what his son had been doing, and that his son had tried to resist us searching, his father cuffed him severely about the head – a normal practice in Afghan.

The next family I engaged with lived in a large compound with a central building that had ornate windows. The family had set up a shura rug in front of the door to the women’s room so that I could sit and engage with the women in the compound whilst the interpreter was out of sight of the women. The women were pleased to be able to talk to me and again I spoke about the Health Initiative and the family was keen to participate so I am hoping that I can return next month and ensure the Initiative is brought to their area. After the meeting closed we moved back to the CP as the lads had another patrol to do in the afternoon, I was not required so was going to do some admin – such as have a shower and (hand) wash my laundry.


26 January 2011

My admin afternoon ended up being a little disconcerting. Once my laundry was washed I hung it out to dry and then went to read a book. Laundry takes ages to dry in winter when ringing by hand – I wrote to Soldier magazine on my last tour suggesting that old fashioned mangles would be useful in CPs and PBs but it was not felt to be a good idea. Having spent ages trying to wring out clothes by hand I still maintain it would be good (and my CO agrees with me!) I had hardly sat down when we heard gunfire close by and it transpired that the afternoon patrol was in a contact on their way back to the CP, with one of the call signs pinned down in a ditch. I sat in the Ops room listening to events as they unfolded willing the guys to get back OK. After sporadic gunfire, and one of our sharp shooters engaging the enemy, the guys made it back – very sweaty, out of breath and most of them laughing! Another patrol, another contact I suppose. As long as everyone makes it back OK then all is fine.

That evening I moved to another CP as the CP commander believed the locals in his area may facilitate female engagement. However, on patrol the following morning it became evident that the locals were not going to be on side. The males put up a variety of arguments as to why I could not engage with their women, and whenever we offered a solution another objection was raised culminating in their reasoning that the women would not be able to talk to me because they were not educated and so would not understand me! We realised we were flogging a dead horse at that time so returned to the CP. I shall try to get the idea of female engagement introduced to shuras in the area and maybe, slowly, the men will allow me to meet their women. Whilst on patrol I saw a small child with a severe laceration to his left eyelid, which his brother said had been caused by razor wire near the ANA check point. It needed steri strips but when I tried to treat the child he became upset and as no adult was present I had to leave the child untreated, I couldn’t force him to have treatment. It’s frustrating as I had the capacity to help but the child seemed unconcerned about the injury and not in any pain.

On return to the CP I based myself in the Ops room to write up my patrol notes. I could hear the radio in the background and realised a fairly large, prolonged contact was going on. As I listened I became aware that the guy on the net (radio) under contact was someone that I have become particularly close to during this tour. Listening to events unfolding was even worse than the day before as it was particularly prolonged and I care for him, but he’s out there doing his job and I know that he, and all the boys (and girls – myself included) wouldn’t have it any other way.

I spent some of the the remainder of the day in the small gym that had been built in the CP (practically every CP or PB has some form of gym even if it’s very Heath Robinson) and then packed my kit for my next move the following morning. Dinner that evening was lovely, the guys had clubbed together and bought some potatoes from a local ($40 for a medium sized bag!!) so we had chips. Beats rations any day.

The next morning I moved to CP Silab, on the Western border of our Area of Operations (AO). The move was via PB Samsor where we were in time for a lovely breakfast – funny how important good food becomes out here. I suppose it’s one of the few pleasures we get. Once at Silab I met the guys and discussed potential female engagement. I wasn’t patrolling until the next morning so took the time to chat to the lads and the one female (medic) in the CP until I went to bed.

We patrolled the following morning to some compounds near to the CP. The compounds are inhabited by nomadic Kuchni people who only live there for 6 months of the year, the remaining 6 months they move about with their cattle. The land about the compounds is relatively barren as it is on the edge of a desert and therefore seemed very exposed and isolated. As we patrolled to the compounds we passed a burial ground; initially I didn’t realise what it was as from a distance all I could see was lots of brightly coloured flags fluttering in the breeze and silver reflective flags/markers. As we drew near I began to see burial mounds and some headstones, the first time I have seen a burial area in Afghanistan. We ensured throughout the patrol that we did not encroach on to the burial ground.

The first compound we approached was reluctant to allow me to engage as I had no female interpreter. Eventually the male elder said he would relay my questions to the women but in practice he answered most of the questions and no actual female engagement was possible! Frustrating but at least he tried to meet me half way. The second compound was initially no different but the elder said his wife had a problem with her arm which I offered to look at as a ‘Doctor’ (I used to try to say I’m a nurse but to many Afghans anyone with even basic medical training is a Doctor and that is what they understand so I go with it). He was still reluctant saying that the women in his compound would be scared of the way I was dressed but when I offered to remove helmet and body armour he was happy for me to go in, providing I wore a headscarf. Luckily I usually carry a headscarf with me in acknowledgement of their culture.

The women in the compound were, as most women are, pleased to see me and talk about their issues. The conversation was limited as I had no interpreter but I was able to attempt engagement and I also examined the wife’s arm. I could see nothing wrong with her arm so gave her husband some advice on pain relief via the interpreter, and I gave the women some small gifts at the end of our engagement. The one thing both compounds asked for is a clean water source as there is no well in their area, so I promised I would look into it when I got back to the Battle Group and see if it would be possible to help. I have now passed it on to the guys that deal with such projects and maybe their help will be forthcoming.

As I type this I’m waiting for my next move. I’m going out to a different area with D Coy (my last few days have been with C Coy) where I’ll be used to help search compounds and hopefully be able to conduct some female engagement when I’m in the compound. It’s an area that the Battle Group have not really worked in so it has the potential to be ‘interesting’ but so far I’ve managed to avoid a contact so maybe my luck will hold!


4 February 2011

As I write this I’m sitting in the coffee shop in Bastion 2 enjoying a cappuccino, but it’s not where I want to be. At this moment I should be out on the ground on an Operation with D Company but unfortunately my plans were thwarted by me having an accident in one of the Check Points that resulted in me being casevac’d (casualty evacuation) by helicopter back to Camp Bastion.

I’ll start from the beginning. On the morning of 26 January I was up at 0500 as I had been told my transport out to the Check Point from where I’d be working with D Company was at 0730. I was up that early because I wanted to try and complete all my patrol reports before I went back out on the ground. The reports I complete are sent to Task Force Helmand for analysis, plus I forward any relevant bits to interested parties such as our Military Support and Stabilisation Team (MSST), our Regimental Medical Officer (RMO) or our Development Advisor (DEVAD), so I want to make sure they are completed as soon as possible so that any points can be followed up. However, 0730 came and went and no transport. It transpired I’d been given duff information and the next transport would be at 0900 hours, so I duly turned up at 0840 to be told ‘No room for you on this move, Ma’am, next one’s at 1330’. And so it went on throughout the day – on the bus, off the bus as we say in the Army, until eventually I was moved to the Check Point by Husky (a Protected Mobility Vehicle) at 1700 hours. All I can say is that I was glad I had relatively minimal kit (because I was going on an Operation I only took essentials, which meant a relatively light Bergen and a day sack, plus obviously rifle, body armour and helmet) as I lugged it backwards and forwards several times that day!

When I arrived at the Check Point I was quickly orientated, it didn’t take long as it was tiny, but organised chaos was going on all around me as it was in the process of being changed from a Check Point to a Forward Operating Base (FOB). In order to do this the Royal Engineers were extremely busy carrying out various forms of construction. I was introduced to my tent mates – a female medic Lucy and a male nurse, Phil. I knew Phil as I met him when I was on OPTAG (a week of that training all soldiers have to complete prior to deployment) and again on my mobilisation course. It was good to see a familiar face so we sat and had a chin wag over dinner. One of the lads had made chilli for everyone and it was good too. I was asked if I would do a sangar stag whilst there and as the lads were being hammered for stags I was more than happy to do one. That meant that later that night I found myself climbing in to one of the two sangars for a couple of hours. It felt a bit nerve-wracking doing sangar duty at a check point. I know I’ve done several sangar duties at FOB Shawqat but around there is very benign and very little happens, that might not be the case at a Check Point. As the sangar was situated right out on a corner of the Check Point, 3 sides looked out on to the surrounding area and left me feeling quite exposed and vulnerable. However, I rapidly settled down and began to enjoy the solitude, using the night vision equipment to scan the area and the solitude to think about things. When I have time to think my thoughts always drift back to my family, wondering what my children are up to, how things are back home, and also how they will be when I get back. At the moment I have no job to return to which is worrying but I am applying/have applied for several Full Time Reserve Service posts so I am pinning my hopes on being successful with one of them. As the sole provider for my family I need something.

As my shift ended my replacement arrived, I wished him a quiet shift and then attempted to manoeuvre myself down the sangar’s Hesco steps – unfortunately not very successfully. I misjudged the depth of the last step (the depth of the steps all varied slightly) and went ‘arse over tit’, clattering to the ground, and immediately I knew I was in trouble. The pain in my ankle was excruciating and I lay on the ground, in pain, unable to move. I tried to shout to the guy that had replaced me in the sanger but the noise of nearby generators drifted over me and drowned out my cries. After 10-15 minutes of trying to shout and no-one coming I started to flash my head torch on and off and eventually a couple of the lads came and helped me to the Medical Tent. Initially I told Phil and Lucy that I would be fine and any treatment could wait until morning, I’ve gone over on my ankle before when out running and though extremely painful to begin with it settles down fairly quickly so I thought this might be a similar situation. I was wrong. The pain began to come in waves and before long I couldn’t bear it. Phil came to assess the injury and felt that I’d probably broken my ankle as it was swollen and incredibly tender, and I was in a lot of pain. A 9 liner (casualty report, called 9 liner as there are 9 lines of detail about the casualty detailed in the report) was sent to BG HQ (Battle Group Head Quarters) and a casevac (casualty evacuation) was requested. Initially I was a relatively low priority but, as time went on and my pain worsened, I was cannulated and given IV morphine and my priority status was increased (though still not urgent, compared to some of the injuries sustained here a broken limb is nothing). The morphine did its job and I managed to sleep fitfully until morning when the effect was wearing off so Phil gave me a little more until I was evacuated late morning.

To ready me for the casevac I was strapped to a stretcher, all my belongings gathered together, and when we knew the helicopter was on its way I was placed, strapped to stretcher, on the back of a quad trailer. The quad was driven out to the emergency Helicopter Landing Site (HLS), in this case in a very rutted field so I felt as though the stretcher could be thrown off the quad at any minute, to meet the helicopter as it touched down and I was rapidly loaded into the back of the helicopter and handed over to the USMC aircrew medics. The flight to Camp Bastion was very short and on landing I was moved by ambulance to the hospital and was there within a couple of minutes. The hospital staff were excellent, I felt a fraud presenting with nothing more than a potentially broken ankle, but I was afforded the same excellent standard of care as all casualties. My ankle was x-rayed and fortunately not broken so I was then discharged, on crutches, for physiotherapy and rehabilitation. I have damaged ligaments in my foot which, though very painful, with physio and rehab should heal relatively quickly and I can get back to doing my job. After 2 days the bruising came out in spectacular fashion but the swelling started to go down and I was able to abandon the crutches. I was thankful crutches were no longer needed as the uneven surfaces out here make walking with crutches very difficult! I’m now on day 4 of rehab and it is going well. The rehabilitation facilities here are excellent so I have 3 hours of fairly intense rehab every day, exercises to improve the mobility of my foot as well as general body conditioning exercises to make sure my whole body is strong – the PTI (Physical Training Instructor) is making me work hard. People pay a lot of money for good personal trainers and I’m getting it for nothing! Before I can go back out to the FOB, and ultimately out on patrol, my rehab has to progress to the point where I can pass a FOB test – a fitness test where situations encountered on a patrol, such as jumping over a ditch, are simulated. The test is carried out wearing body armour and carrying some weight to ensure it is realistic. If my recovery continues at the same pace I am hoping that I will take the FOB test next Wednesday and be back out to the FOB as soon as possible. I can now verify, from personal experience, how good our casualty procedures are and what good facilities we have, I’m just so glad it wasn’t broken and I didn’t need to be evacuated (aeromed) back to UK (the next bit in the casualty chain) and with luck and a bit of hard work I’ll be back out on the ground soon.

Captain Lisa Irwin with an Afghan baby

Captain Lisa Irwin with an Afghan baby

14 February 2011

Today I went back to the village I visited at the start of tour as the Officer Commanding (OC) the company covering that area felt it would be ready to engage with the Female Engagement Team (FET). I went to attend a shura and to promote FET to key elders – however the plan backfired slightly as none turned up! Afghans do have a tendency to come to meetings when they feel like it and also to work to ‘Afghan time’ which for UK military personnel, who always work to the “five minutes before” rule, can be incredibly frustrating. The Afghan concept of time management is no surprise to me as I have also lived in Cyprus and the Cypriots adopted a very similar way of living- perhaps it is something to do with living in a hot climate!

I was beginning to feel very pessimistic about female engagement in this particular village as this was my third attempt at engagement with no positive result, but the Afghan National Police (ANP) officers at the police station where the shura was meant to be held were more than happy to sit and talk to me and the OC, resulting in us being there for 3 hours. The police officers were fascinated by my attempts to talk to them in their own language, and fascinated by my being female – unfortunately sometimes too fascinated as they did have a habit of talking to my chest not my face. I was, however, able to talk to some of them about their lives in the village and about the possibility of engaging with their wives in the future. Initially they were uncertain about the idea, stating that their wives didn’t need any help with anything, but I spoke to them about the Health Initiative and they seemed to be in agreement that it might be good for their women to attend training. Talking to them allowed me to gather information on their opinion of the government, local healthcare, schooling for girls and women ANP officers. To my surprise they were supportive of women joining the ANP (though in all likelihood not their women) as it would make female searches more culturally sensitive. There are female police officers in Lashkar Gah, the Provincial Capital, but I think it will be a long time before rural Helmandi women are anywhere near being able to join the police – or even want to. At the end of the meeting all the police men were keen to have their photo taken with me – quite disconcerting! I now have some idea of how it must be to be a minor celebrity!

I was then moved (by protected vehicle) to a small Check Point where another shura was meant to be held. The Check Point was housed in a small compound and the courtyard in the compound was a mud bath due to the recent heavy rain.  However, it wasn’t as bad as some of the other Check Points and Patrol Bases. Some guys attending the shura had come from a Patrol Base that was about a foot deep in muddy water. The shura was again a no show, but some local nationals did come with compensation claims. If ISAF damage any local property then the owner will be compensated providing he (or incredibly rarely she) has some form of proof of ownership. Locals do sometimes do present with fabricated – and sometimes bizarre – claims and then are sent away empty handed.

Once the meeting had concluded I was moved again to a different Check Point where I was to remain for a couple of days so that I could get out on foot patrol and hopefully conduct some female engagement. My accommodation in this place was the medical ISO container (big metal box) which on cold nights is like sleeping in a fridge. I was given a small kerosene heater for the ISO but the CP didn’t have any kerosene so were running the heater on diesel which meant that it only gave out minimal heat, enough to take the chill off the air but certainly not enough to warm the container.

Fortunately I purchased a wonderful sleeping bag on R&R and on cold nights it has been a lifesaver. I was orientated to the Check Point (CP), given a quick brief on actions on (ie what to do if anything such as a contact or medical incident occurred whilst I was there) and then had dinner – back to 24 hour ration packs, yummy (not!). I was also given my stag time for stagging on in the Ops Room, listening to the radio and responding to anything relating to the CP call sign.

I was up the next morning at a reasonable hour to be ready to go out on patrol after breakfast. Initially we were just going to patrol out to compounds to speak to people living there and gain information about them (Human Terrain Mapping) but the plan was altered when we were also tasked with providing protection for engineers who were carrying out some work near to the CP. As we set off the day was starting to warm up, the sky was blue and cloudless and, due to the recent rain, the fields were green. It was quite a nice sight – until I saw the muddy, rutted and deep puddle riddled road we were walking down. However, as usual we weren’t on the road for long before moving onto small tracks and ridges along irrigation ditches, through muddy fields and over yet more irrigation ditches. It was certainly a test for my healing foot, which it passed but grudgingly.

The first few compounds we stopped at had no men in them as they had gone to the bazaar for the day. Through the (male) interpreter we asked the nephew of the men if I could engage with the women in the compounds but he wouldn’t allow it. Frustrating but not unusual. However, the next compound we approached invited me in, but on my own as they wouldn’t allow a male interpreter to talk to women. The woman of the compound was keen to talk to me but although my Pashto is much improved the conversation was generalised as my vocabulary is limited. I have tried to improve my ability to report on the conversation by procuring a tape recorder which I have placed in a pouch in the front of my body armour. I then record the conversation and play it back to the interpreter later to see what I missed during the engagement. It’s not a perfect solution but it helps. The woman I spoke to was 40 years old and had 7 children, her eldest son being 24. When I told her I was 42 she remarked on how good my skin was for my age. Afghans tend to age prematurely, probably from the harsh conditions that they live in, so many Afghans have expressed surprise at my age. All the money I have spent on moisturisers must be paying off! She told me her husband and one of her daughters were unwell so I offered to see if I could help in any way but it transpired that the husband was 80 years old (very old for an Afghan male, whose average lifespan is 42) and his ill health was due to his age. The daughter’s situation was pitiful, she was 15 years old and blinded by cataracts and spends all her time lying on a rug in the compound unable to properly interact with her family. I tried to speak to her and held her hand to let her know I was there, it reminded me of nursing severely disabled children when in UK, and my heart went out to her. However, there was nothing I could do to help. The mother said they had taken her to Pakistan for treatment but it was obviously unsuccessful and I could not help but be moved by her plight, her future will be very limited.

I managed to gain access to 2 more compounds during the patrol and spoke to several women, in both instances I was again on my own as the male interpreter could not enter but I seemed to manage to have some form of conversation and the women seemed to appreciate my efforts. The patrol then moved off to form a screen (the protection) for the engineers as they worked on culverts near the CP so we had to remain in place for some time. Whilst we were static I was surrounded by children and young men curious yet again at a female soldier and even more curious when I spoke Pashto to them. The children asked constantly for chocolate and pens but there were too many of them for me to start handing out the few pens I had in my bag – it would have been bedlam. Once the engineers had completed their work we moved back in to the CP. In the CP I watched our security camera in the Ops Room in disbelief as locals swarmed around the newly-banked culverts trying (and succeeding) to pull out small bits of the metal supports in the Hesco Bastion that the engineers had installed. It is frustrating as we are trying to rebuild for the Afghans and sometimes as soon as we have completed works locals pull it apart to take what they can.

I was invited to have dinner that night with the ANP officers co-located in the CP. They were living in an ISO so feeling it would be rude to refuse I went there with one of the Rangers and the 2 interpreters not really sure what to expect. Dinner was served in the ISO where the ANP slept, with us all seated on a rug, and the ANP commander was keen to talk to me about various things. The food was a chicken stew (of sorts) served with local flat bread and whilst the bread is lovely and the stew sauce was nice I didn’t eat much chicken as Afghans cook the whole bird, bones and all, which I found a bit off-putting. I had to eat some though as it would have been rude not to. The drink accompanying the meal was a pot of goat milk flavoured with small pieces of cucumber and/or melon. It was actually quite palatable and reminded me of tzatziki. After dinner we talked about family whilst taking chai, with me again showing the photos of my children, and then talked about religion and life in UK compared to life in Afghanistan. It was certainly an interesting experience.

The next morning I was again on patrol, this time to the local village. I was lucky enough to be invited in to 3 compounds but again I had to go in on my own as my male interpreter could not enter. One of the compounds I entered was very dilapidated and the family seemed to have few possessions but as I spoke to the woman she told me that her husband was an ANP officer and the family had been burned out of their former home in Musa Qala by Taliban. I felt desperately sorry for her and have arranged for one of the patrols to revisit and take the family some blankets and a radio, items that we can give to locals as part of stabilisation. Whilst in another compound one of the children came in with a badly-cut heel whilst I was taking chai with the women so I took out the medical kit that I always carry and cleaned and dressed the wound. It is always satisfying to be able to give immediate help. During the patrol I went in to one of the private clinics in the village to talk to the doctor running the clinic.  In this particular village the GIRoA clinic was poorly thought of and many locals attended this private clinic so I felt it would be good to see what facilities the clinic had and how well trained the doctor was. The doctor was extremely accommodating and happily spoke to me and showed me round the clinic. While I was there a sick baby was brought in and as my interpreter had told the doctor that I was also a doctor I was invited to examine the baby. Fortunately the baby was not too sick and the doctor and I came to the same conclusion, so the father was given paracetamol for the child and took the child home. I managed to have my photo taken holding the child, trying to be careful not to be weed on again as I had been when holding a baby earlier in the tour!

Once the patrol had finished we moved back to the Check Point where I then radioed through to Company HQ to determine my next move. Whilst waiting for the OC to decide where I would go next I decided to cook dinner for all the guys in the CP. As we had little variety in rations and no gas or oven (ie the only way to cook was over a hexamine cooker) I had to be a bit inventive and eventually managed to make a tuna fish pie and a steamed jam sponge. I was extremely pleased with the sponge as I had to guess quantities and we only had powdered egg, and no electric whisk, but it turned out to be a nice light sponge. The lads were impressed anyway!


18 February 2011

The following morning I was woken abruptly and told I had 10 minutes to get ready as my lift was on its way. Fortunately I had most of my kit packed away anticipating the move so I was quickly dressed and in the vehicle which took me to another, much smaller, Check Point. On my arrival I was shown to my bed space, I was sharing a room with 3 guys. Not really a problem but it was a little bit smelly – there was a slight whiff of unwashed feet!! I quickly determined that the Check Point was only manned sufficiently to carry out vehicle check points (VCPs) and did not have the capacity to patrol so I immediately questioned the purpose of my being there. It transpired that the OC felt it would be useful to have a female presence on VCPs to deter insurgents from using women to smuggle items and that I might be able to engage with women as I searched them. I understood the need for female searchers and was quite happy to act in that role for  a couple of days as that would get the message out that ISAF was able to search females, but I did not think it would be an opportunity for engagement. I was proved right as the few females that I searched were very hostile and upset, their male relatives even more so, so I didn’t even attempt to engage with the women as it would have been pointless. The male relatives were so incensed about the searching (unfortunately we had no screen for the women as the VCPs were not permanent ones) that they turned on the young local male interpreter and almost reduced him to tears.  After 2 days I radioed the OC and asked to be moved as I could achieve no more at that CP but that afternoon more soldiers were sent to the CP so that patrols could be conducted from it so the situation changed. There was to be an operation (Op) the next morning, searching suspected Taliban bed down locations, so I volunteered to go as a female searcher. I had  found on a previous Op that I could engage with women in compounds when I had searched them. The patrol commander felt that was a good idea so I found myself getting up at 0300 the next morning (having also done a radio stag during the night) to go on the Op. We intended to search the compounds at first light before any males had gone to the mosque.

We left the check point very early, with me carrying a day sack containing my usual kit plus a heavy battery I’d been given to carry and a spare metal detector.  It’s at times like that when I’m glad I trained hard before I came out on tour and made sure I could carry a reasonable amount of weight. I could cope fine but I knew the day sack would feel much heavier by the end of the patrol. We patrolled in the moonlight to a nearby Patrol Base to meet up with another call sign and our ANA (Afghan National Army) partners and after a quick brew we set off to the compounds. It can be a little disorientating patrolling in the dark, especially as I had no night vision equipment, but the moon was fairly bright so I was able to cope well.  I could not see all the guys in my patrol though, only the guy in front and the guy behind, and I was regularly checking to ensure the guy behind me was still with us. Whenever we stop and ‘go firm’ it is essential to make sure that the guy behind knows when we start to move again, ensuring that no-one is left behind, as it can be easy to miss people getting up and moving in the dark. Before first light both call signs (groups) were in position ready to enter the suspect compounds. Initially the ANA went in to the compounds, followed by a couple of our guys and our interpreter, and I waited with the remainder of the patrol in the security cordon but it wasn’t long before I was called forward to search women and the women’s rooms. Most of the women I encountered were OK about being searched and happy to engage with me afterwards, though the male interpreter again could not enter so I was on my own. However, in one compound the woman was petrified and had tried to hide herself in the corner of a small room that looked like a store room. I had to search her so squeezed into the room and explained why I was there and assured her again and again that I was a woman. Initially she allowed me to start to search her but as I moved down to pat down her legs she became hysterical, moaning and keening and desperate to get away from me. It was upsetting but I had to conclude the search so I quickly finished and left her alone as no amount of verbal reassurance from me was going to make any difference. Nothing was found during the searches but it appeared that Taliban had used a small outbuilding as a bed down location. Searches over, we patrolled back to the CP and I snatched a few hours sleep before a call sign arrived in vehicles and transported me back to Shawqat.


23 February 2011

I’ve now been back in Shawqat for a couple of days. It’s good to be back to hot showers, flushing toilets and good food but I’ve been trapped in BG HQ for the 2 days typing up reports and I’m also back to sanger stags. However, there was some good news waiting for me on my return, my application for a Full Time Reserve Service post as a Cultural Advisor was successful so later in the year I shall be commencing a 3 year contract. It means completing a 15 month Pashto course before yet another tour of Afghan but I am looking forward to it and am so relieved that I have a job. I’m also looking forward to becoming semi-fluent in Pashto and coming out here again but next time being able to properly converse with the Afghans I meet. In the meantime I shall just get on with the job in hand at FOB Shawqat. Still, I anticipate not being here for too long as I’m hoping to be used as a female searcher on another, much bigger Op in the near future.

1 March 2011

I have just come back in from my second air assault Operation, but this one can only be described as awesome! We were conducting a Battle Group air assault into an area right at the southern edge of our area of operation, somewhere we haven’t really worked before. The Op started with rehearsals on Saturday in Camp Bastion, basically all patrol multiples practising getting on and off the helicopters, and then the Op for real was on Sunday. I was going on the Op with A Company 5 SCOTS, to be used as a female searcher and when doing so I hoped to try to engage with the women I encountered. The Op was only to be a short one (36 hours) so we had to carry everything we required for that time on our backs and, as it can still be cold at this time of year, warm kit was essential, plus at least 4 litres of water, rations, medical kit, spare ammunition and my influence items (gifts I give to the women). My day sack was pretty heavy at 40lbs, but that was nothing compared to the weight some of the boys were carrying. Then again, a 40lbs day sack, body armour weighing minimum 35 lbs, rifle (9lbs) and helmet, is more than enough for a 42-year old mum of 3 to be lugging through extremely muddy fields!

The morning of the Op was an early start as usual; up at 0450hrs, quick wash (which was disturbed by 3 ANA soldiers who did not understand the sign on the door saying female ablutions! They ignored my Pashto and English asking them to get out – it transpired they only spoke Dari of which I know nothing), breakfast and then bussed across to the flight line.  The patrol multiples were placed in ‘pens’, with the pens corresponding to the helicopter each multiple was to fly in. It was a cold morning, but fortunately dry, and spirits were high as we waited for our time to mount up on to the helicopters. Everyone knew that this Op was fairly significant in its scale, one of the biggest air assault Ops for quite a while and the biggest that the Royal Irish have done since the Second World War. Even I felt like an excited child on Christmas morning as we waited to board. We were in for a relatively long wait though, and a slightly anxious one as we all wanted the helicopters to be in working order, but one by one the helicopters were cranked up and all ready to go. We were given the signal to mount up and once the troops were on board all 12 helicopters took to the air. It must have been a pretty awesome sight; 12 troop carrying helicopters, accompanied by Apache gunships as escort, rapidly moving through the skies to insert us all for the Op. From my position inside a Chinook it looked pretty spectacular as I could see several helicopters behind and alongside us and at intervals the helicopters would fire off chaff (flares to deter missile attacks on the helicopters) which could be seen as a bright orange flare streaking past. At exactly the predetermined time the helicopters simultaneously landed and over 200 soldiers poured out of the helicopters onto their designated landing zones. As my helicopter landed I was concentrating on making sure I exited properly as it was quite a drop from the tail gate and I wanted to ensure I didn’t go over on my weak ankle again, but I successfully jumped down and ran into my practised position. Once all troops were on the ground there was a slight pause to make sure we were all in place and 12 helicopters lifted into the air and moved off as one. Even the most battle hardened soldiers amongst us found it a thrilling experience – that’s the sort of thing I joined the Army for!

After the lift had moved off all the patrol multiples shook out and prepared to move. My call sign (grouping of soldiers) was providing the screen to the South of the operation so we were one of the last multiples to move. Only 10 minutes after we had begun to move the first shots were fired, about 200m from our position. I was surprised as it would be unlike insurgents to engage us with so many boots on the ground, but it quickly transpired that there was no enemy activity involved and it was in fact an Afghan National Army (ANA) soldier shooting a dog! The movement forward was initially very slow and we had to go firm several times to allow other multiples to move ahead of us and create a gap. The weather was deteriorating with a harsh cold wind blowing right across us and then a shower of hailstones rained down on us. At that moment it felt like it could be a very long Op. Once we were given a target compound we began to move forward with purpose but the ground dictated the pace and as the area in which we were working posed a high IED threat we patrolled away from tracks and obvious routes. This meant trudging through wet, muddy fields and jumping over, or climbing through, several irrigation ditches. The going was quite treacherous as the sticky, clay-like mud became more and more slippery as the patrol moved through it. The weight the guys were carrying made things even more treacherous as we were sinking into the mud with every step. I wasn’t anywhere near as bad as some; there were Counter-IED (C-IED) guys in our multiple who were carrying all the equipment required to carry out controlled explosions or exploit IED finds and their bergens were so heavy I could barely lift them. Most people fell at least once, including me as I fell when crossing a small ditch. As I tried to step across, the piece of earth that was my launch pad crumbled away pitching me forward, but fortunately I only fell to my knees preventing myself from falling face first by using my rifle as a crutch. Eventually we came to the first compound of interest and I entered the compound along with 2 Afghan National Civil Order Police (ANCOP) officers. The ANCOP officers carried out the initial compound search and then I searched the women’s room. I usually find that the ANCOP, ANA or Afghan National Police (ANP) are appreciative of my presence as it is much more culturally sensitive for women to search women. Once I had searched the women’s room I asked if I could talk to the one woman in the compound and she said she was happy to talk and her husband allowed the male interpreter into the room with me. However, when I sat down to engage with her she seemed scared and most of the conversation was with her husband, despite my best efforts to talk to her and draw her in. She did say that she was happy to see a female soldier and that she had never seen one before. The main concern of the family was the security in their area, they had little freedom of movement due to insurgents being in the area and GIRoA currently had little influence in the area which means that there is no very little in the way of government facilities such as schools and clinics. I assured the family that ISAF was now focussing on their area to push out insurgents and enable GIRoA to bring development to the area.

The remainder of the operation continued in a similar vein with the women I encountered in every compound willing to speak to me with the male interpreter present. One woman I spoke to was a widow and she and her daughters were fascinated with me and my lifestyle asking questions about my life in the UK. They also commented on my ‘lovely pale skin’ and I told them how ironic that is when many people in the UK are desperately trying to get brown skin!

By mid-afternoon on the first day we had to take over a compound so that we had somewhere to stay overnight. It is always preferable to take over an occupied compound as it is very unlikely that there will be IEDs placed within it, although we do still check most of the compound. However, taking over an occupied compound does mean that we have to displace the resident family for the night. They are often not keen but once the financial recompense is made clear they are usually happy to decamp to a nearby friend or relative’s home and it is also made clear to them that should any damage occur whilst we are in the compound they will also be compensated for that. Once in the compound work began on sorting out sentry positions, filling sand bags to provide some cover in the sentry positions (on the compound roof) and identifying ablution locations etc. All of us carried the WAG bags (plastic toilet bags) with us so we wouldn’t have to leave any unpleasant surprises behind. Once the compound was set up then everyone set out their sleeping area and water was heated so we could heat up our ration pack meals. I was sleeping in what was essentially a store room, with 6 of the guys in there too so it was a bit of a squeeze, but we had roll mats and sleeping bags so most of us were comfortable enough. I had been put on sentry from 20 00 hours so I managed to grab an hours sleep before my turn came.

It was pitch dark when I got up to go on sentry, with no moonlight at all. I had to climb on to an oil drum and then try to drag myself up on to the roof. It was no easy task and after much effort and cursing (and sometimes giggling at how rubbish I was though it would have been no problem were I not wearing body armour) the outgoing sentry had to come across and unceremoniously haul me up. It was very disconcerting being on the compound roof in pitch darkness. I felt incredibly exposed and unable to see anything at all with the naked eye so I regularly scanned the area with night vision equipment. Part way through my sentry duty a thunderstorm started so I was lying watching the forked lightning in the distance, and also watching illumination flares that were put up every now and again. At one point it also started to rain but fortunately for me the rain wasn’t heavy. Unfortunately for the guys going on duty later on the rain increased in intensity as the night progressed resulting in several soggy soldiers.

The second day began with us planning to move off early to destroy an insurgent hide location but as we moved toward the location a request came over the net (radio) for the C-IED team to deal with a suspect IED. An escort arrived to take them to the device and the remainder of our multiple had to go firm and wait for another multiple to come to us so that we could join them. We went firm beside a compound and watched as the other multiple approached us across an incredibly boggy ploughed field. One by one the sticky mud sucked the guys in and it was quite entertaining watching as they sank in the field up to their knees and struggled to move. We weren’t able to go to their aid so all we could do was watch the show! It was also a little disconcerting as had they been contacted (ie shot at) they had no cover and would have been sitting ducks. Fortunately they managed to get out of the field and once they had joined us, and dealt with all the leg pulling they inevitably got, the patrol continued on. Eventually, just before dark, we were cleared to move back to a CP location where everyone was meeting up to get helicopters back to either FOB Shawqat or Camp Bastion.

By the time we reached the CP we were all hungry and dying for a brew so it was a relief to see a hot meal (a bowl of instant noodles, and though not normally my favourite fare at that point it was delicious) waiting for us. Once in the CP we had a 2-hour wait for the airlift out so most people stood around chatting about their experiences on the Op. The helicopter extraction felt incredibly surreal as the Helicopter Landing Site (HLS) was in a field outside the CP and walking out to the field felt like I was almost blind. We couldn’t use torchlight as we did not want to advertise our presence and I had no night vision equipment so I had to blindly follow the guy in front and hope the ground was OK. It was a little nerve-wracking as we had to cross a bridge over a canal and although I could hear the water rushing along the canal I couldn’t see it and nor could I see the edges of the bridge. As we waited for the Chinook to come in I could hear an Apache hovering nearby providing security for our extraction but could see absolutely nothing. I couldn’t see the Chinook when it came in to land, although I could most definitely hear it, until just before it touched down. As soon as it was wheels down we quickly moved in and then it took off and within minutes I was back in Shawqat. Back to normal toilet and a hot shower- bliss. I did feel for the 5 SCOTS guys as they still had to tab back to their CP and there would be no hot shower for them.

I shall now be in Shawqat for a couple of days so I can complete reports and do some essential admin- including giving my rifle a thorough clean as it became incredibly dirty during the Op (although I did try to keep on top of it during the Op, as a functioning rifle is the soldiers best friend).

4 March 2011

My stay in Shawqat was much shorter than planned – not even 24 hours respite and I was on the move again. I moved to one of the CPs I was at about a month ago where I had successfully engaged with several families, as we intended to hold some Health Initiative training there and I was hoping to interest women in the initiative and persuade both them and their male relatives to attend. If I could drum up enough interest then we proposed to hold training at two separate sites, one for the males and one for the females. The CP commander informed me on my arrival that my return was fortuitous (not his exact words!) as the locals had been asking the patrols when I was coming back- something I was really pleased to hear as it shows that Female Engagement is beginning to work. I knew that progress throughout my tour could (and more than likely would) be painfully slow but to have locals asking if I am coming back, and fully accepting my role,  is a huge step forward.

Once out on patrol many of the locals recognised me and were keen to say hello and have a quick chat, with the kids surrounding me again clamouring for pens, chocolate and to talk to me. I was able to distribute several pens as many generous people from my home town of Brechin had donated pens to my local paper, The Brechin Advertiser, to be sent out to me and to date I have received 1 ½ mail bags of pens to give to local children.

The first compound I went into was one that I was invited into on my last trip to this particular village and the family were pleased to see me again, offering me bread and chai and the girls in the family trying to touch my hair. Unfortunately the conversation was limited due to my limited Pashto but the family did tell me they would all like to come to the Health Initiative training which was positive.  I engaged with another two families during the first day, with them appreciative of my attempt to converse with them in their own language. Maybe too appreciative as one of the male elders asked me to stay in Agfhan and become his third wife! Amid much banter I told him I had to decline as he couldn’t afford me. Again both families were keen to come to Health Initiative training.

After the patrol was over we returned to the CP where I set up my bed for the next few days. The rain started (again) and the CP was a mud bath riddled with deep puddles. I was sharing a room with two guys and though not too uncomfortable the roof was leaking in a few places (fortunately not directly over any of the beds) so all that could be heard in the room was a steady drip, drip. I managed to sleep though as patrolling can be physically hard work so I’m usually fairly tired at the end of the day.

The next day we were to patrol in the afternoon so I spent part of the morning preparing the evening meal for everyone in the CP (shepherds pie followed by apple crumble). As it was all prepared one of the guys not coming on the patrol had to just put them in the oven (a metal oven that sits on top of the gas stove) and the plan was that we could come back to a hot meal, much to the amazement of many of the guys who are not normally quite so organized. That is obviously the mum in me coming to the fore.

During the afternoon patrol I spoke to several males who were in the fields or near their compounds telling them about the Health Initiative which was to take place the following day. Most people were interested and said they would try to get their womenfolk to attend, but many also asked me for advice about health issues as I was patrolling. I was invited into a compound to engage with some women but the engagement was a little chaotic as there were at least 35 excitable people in the compound (men, women and children) and I was trying to engage with them with my limited Pashto as the male interpreter was not invited in. It was still a positive engagement though and again they were interested in the Health Initiative. I have also started talking to all Afghans I engage with about first aid treatment for burns as their initial instinct is just to get the casualty to medical care but that can sometimes take up to an hour, during which time if first aid is not given the burn will get worse. Burns is a common injury among Afghan children as lighting fires for cooking and heating is often a child’s responsibility, and during December some children brought into Camp Bastion hospital died because of their burns, so I am hoping that simple first aid advice may help mitigate serious injury or death.

Dinner that evening was a success, with the guys really appreciating the apple crumble. However, the weather forecast for the following day was for heavy rain so I doubted the Health Initiative training would happen. My doubts were unfortunately correct and the following morning the local elders spoke to the CP commander to tell him people would not attend due to the weather so it was postponed to a later date. I was deeply disappointed as it would have been my first proper gathering of a group of Afghan women but it is not cancelled, just postponed, and will take place as soon as it can be rearranged (weather permitting). I therefore returned to Shawqat to complete more reports, carry out basic admin and dry out my very soggy feet!

17 March 2011

Happy St Patrick’s Day – very apt as I’m serving with 1 ROYAL IRISH! We had a parade today where we were presented with shamrocks to wear in out corbeens (head dress), a tradition for Irish soldiers, by Lord Eames.  The chefs went all out this morning too in honour of the occasion and we had a proper fried breakfast with fresh rations, including soda bread, instead of the usual fried spam and tinned sausages. A good start to the day.

The weather has completely changed out here now, this country really is one of extremes. The temperatures have recently been in the low-30s but less than 2 weeks ago we had driving rain, cold and the whole place was a quagmire. Now it’s bright sunshine, almost unbearably hot some days (patrolling in the heat with all your kit on is no fun – thank God I’m not on a summer tour) and the place is becoming a dust bowl again. The better weather unfortunately also means that insurgents are trying to come back to fight but we (1 ROYAL IRISH) are working hard, in conjunction with Afghan Security Forces, to deny them any chance of gaining a foothold in our area again. The lads have worked hard to increase security in Nad-e Ali South so that locals can live their lives in relative normality, so we don’t want to allow that to disappear again.

Female Engagement has also moved on apace. I held my first female shura (gathering of women) this week with over 25 females turning up. The shura was held to teach the women about health, including antenatal, delivery and postnatal care. It was very well received and the women even listened to the section about contraception, most of them grinning widely! Many families have lots of children, partly due to the mortality rate of under-5s, but the Afghan Government wants families to space out their children which should decrease the poverty I have seen as I have patrolled. However, many people that I have spoken to maintain that they want to have large families so I think it is something that will take time to change. I try to emphasise that spacing out children allows the mother to have better pregnancies and stronger, healthier children, but I think locals will take some convincing!

At the same time as the female health training a male shura was held to educate the males and about 80 attended. The health training is very well received wherever it has been carried out and the hope is that those who attended will pass on their new-found knowledge to their friends and relatives. I was so glad that both sessions were well attended as I had spent several days patrolling in the area, speaking to locals to message them that the Health Initiative would take place, and whilst many said they would come until the actual day dawns you can never be sure how many will turn up. In fact, as we left the CP to set up for the shuras it initially looked like very few would turn up as the first few locals we saw said that no-one would be ready and could we come back later?! We weren’t able to reschedule so decided to run it for the few that were there but word quickly spread round the village until both sessions were fairly crowded – a good result all round.

Whilst patrolling in the village prior to the shuras a vehicle stopped beside the patrol and the driver said that he had heard about me and my role and that his wife would like to meet me. As he lived almost 1km from the village in which I was patrolling I was unable to visit that day but I intend to program it in if I can, as it is extremely positive that people are coming forward to ask for FET to visit them and that the message of Female Engagement is spreading. This particular local was ex-Taliban so I don’t want to go in to the compound on my own but it is a good influence opportunity and the conversation could certainly be interesting!

I discovered last week that my job profile for this tour was sent to the media to coincide with International Women’s Day so stories appeared in several national newspapers and I was on BFBS TV news. I knew nothing about it until people starting getting in touch telling me I was crated (if your photo or name is published you have to buy the guys a crate of drink – obviously not alcoholic out here!). So far it’s cost me over $40, but maybe my kids will appreciate their mum being famous!

It has been decided that I will not end my tour on the original planned date. I was due to leave on 5 April but my replacement would not have been here yet so I was asked if I would stay for an extra 11 days so that there will be FET continuity for 45 Commando (who take over from 1 ROYAL IRISH) and I can give a proper handover to my replacement. Fortunately my wonderful parents have stepped up yet again and are happy to hang on to my kids for a bit longer, though the kids aren’t too impressed. I have mixed feelings as though I’m longing to go home to my family I didn’t want to leave without a good handover because I have worked hard to make progress and I want my replacement to be able to continue to progress. Still, it’s not too long and I can still say I’ll be home next month- just a little later than I anticipated.

It is weird seeing people starting to leave theatre and the Marines of 45 Commando coming in. I will have to adapt to the way they talk again (my last tour was with 3 Commando Brigade), they refer to the toilets as the heads, a brew as a wet and the cookhouse as the galley (plus numerous other differences!). Still, it will be interesting working with them again, if only for a short while. I am planning to go back out on the ground again from Monday, working with Ops Company doing some searches so that may be interesting – it may also be very hot! It’s all part of the job though and I just have to get on with it, and to be honest I am so glad I got the opportunity to do this role as it has been fascinating, challenging and fulfilling.

Lisa’s Diary 1: October-December 2010

Captain Lisa Irwin is a Territorial Army Officer, currently deployed to Afghanistan as a Female Engagement Team Commander. She’s been keeping a diary, the first three months of which are presented here, covering October to December 2010.

Back in May I received a call from my unit, 102 Battalion REME (V), asking if I would be interested in a post in Afghanistan as a Female Engagement Team Commander. I had previously expressed an interest in another Afghan tour as my last (in 2008/2009) had been successful – I’d learned a lot and tested myself against my regular peers and not been found wanting. I had also been commissioned since my last tour so I knew I would be facing a very different challenge – whatever role I was given. I was not sure what “female engagement” entailed but expressed my interest immediately – and then Googled it! I discovered that the US Forces had been directed by General McChrystal (since succeeded by General Patraeus) to set up female engagement teams in order to communicate directly with Afghan women. The future of Afghanistan lies in engagement with the local population (gaining their support and trust) and working with them so that it can become a self-sufficient country. If we aren’t communicating with Afghan women we are not communicating with 50 % of the population, and male soldiers are unable to communicate with local women due to Afghan culture. The Americans seemed to be having some success and I was excited at the opportunity to be part of the British implementation of these teams. The opportunity also arose at an opportune moment, as my civilian contract as a paediatric nurse was not going to be renewed due to NHS budget constraints. Having made sure that my family were supportive of my intent (my three children, aged 17, 15 and 9, would once again need to be cared for by my parents whilst I was away), I asked for my name to be put forward. So eventually, after several training courses and much to-ing and fro-ing,  I was mobilised, passed all my military assessments (such as fitness, medical and shooting), and became a regular soldier once again!

Thursday 21 October 2010

Day 1 in theatre after a long trip! I was supposed to fly on Tuesday but on arrival at RAF Brize Norton I was told we were delayed until Friday. I was upset as I could have had more time at home with my children had I known, but not really surprised as I’m aware that the air bridge is under immense strain coping with all the flights to and from Afghanistan. However, a few days stuck in Gateway House (the RAF ‘hotel’ at Brize Norton) were my immediate future. As it transpired another flight was put on and we flew on Wednesday morning. The flight was via Minhad (Dubai) and although I slept for most of the early part of the flight when I woke I was looking out onto amazing terrain. The desert was both beautiful and harsh and made me think of Afghanistan; despite serving there in 2008/2009 I saw so little of the country- was Afghanistan as forbiddingly beautiful? Was my role for this tour really going to help the people of Afghanistan and ISAF? I was starting out with so much hope, but also much trepidation. I was unsure of exactly how I could  accomplish the task I’d been given but I desperately wanted it to be successful. I knew there were detractors who doubted the worth of female engagement but to me it seemed to be an obvious area that had not yet been fully addressed and that, if approached in a sensitive manner, could further security and success in Afghanistan. At Camp Bastion I met some of 1st Battalion The Royal Irish Regiment (1 R IRISH – the Battle Group I’m attached to for the tour) and was soon ensconced in their accommodation in Bastion 2 – across the road from a lovely coffee shop! The rest of the day was about catching up on sleep, orientating to Camp Bastion ( it has changed a lot in 18 months), doing a small amount of phys and ‘squaring myself away’ for the next day. And I managed to phone home!

25 October 2010

It’s cooling down a lot here, in fact it is now pretty cold at night and doesn’t really warm up until 10 in the morning. It will get a lot colder though, my last tour was a winter tour and we had some extremely cold nights. It makes you think twice about getting up in the middle of the night to go to the toilet as it can be a bit of a trek and you need to wrap up to venture out to the toilets! The contrast in temperatures can be quite extreme but I am thankful I’m not on a summer tour. When I get out on patrol with the guys to go and engage with Afghan women at least the temperature will be bearable so having to carry kit weighing in excess of 70 lbs will be more manageable. I have now completed most of my RSOI training. The training is interesting and relevant with guys coming in from the ground to update us on some of the best drills to carry out and tips to manage risks. Yesterday was a full day on counter IED (Improvised Explosive Device) as obviously it is a prevalent threat out here. It is comforting to know that our drills can save lives and there are ways to counter the threat. I can assure you the lecturers and directing staff had my full attention! I admit the threat is something that has concerned me but the skills of the soldiers on the ground reassure me. Although I’m sure that the first time I step out of the FOB I will be incredibly apprehensive, I know that our soldiers are incredibly well trained and have been assured that the guys will look after me.

28 October 2010

Day 8. Once I’d completed RSOI (Reception, Staging and Onward Integration) training I could have had a couple of days off prior to flying out to the FOB (Forward Operating Base). However, although Camp Bastion has probably trebled in size since my last tour it is still not a metropolis and entertainment was not really available! I therefore went to the hospital to see if my paediatric nursing skills could be of any use for the two days. The hospital had two local children in, so they were happy for me to work a couple of shifts and it was useful to them and beneficial to me – it helps me to keep my skills up and as 99% of Army nurses are adult nurses (after all, their primary role is to care for our injured soldiers) my paediatric skills were useful to them. I really enjoyed the two days. It was an eye-opener for me, as I had certainly never nursed a child who has had a gunshot wound before. It is unfortunate that children are sometimes caught up in the fighting – a sad consequence of what is happening out on the ground. I know that our soldiers do all they can to avoid civilian casualties, especially children, but the insurgents do not have the same values. The children only remain in Bastion Hospital until they are well enough to be transferred to an Afghan hospital but whilst in Bastion they, and their family, are very well cared for. It is difficult, however, to care for a child and family when there is a language barrier. I do have some very limited Pashtun but it brought home to me how little I do know, something that I aim to remedy whilst in the FOB. In the ward I used interpreters when possible, and I will be using an interpreter to engage with Afghan women, but I still feel it is important, and only polite, to try to learn some of the language of the country that I am in. I guess we’ll see how I have progressed by the end of tour!

2 November 2010

Day 14. I was temporarily resident at a CP (check point) near a village called Zarghun Kalay (kalay means village), north of FOB Shawqat, as I was asked to take part in an operation.  We travelled from Shawqat in a small convoy of Jackals – open-topped vehicles specifically designed for the terrain and situation out here.  The journey was a relatively short one, made longer by it being necessary to check some points along the route for improvised explosive devices (IEDs) – a permanent hazard out here.  Driving through the countryside it was easy to understand how Afghanistan was a popular holiday destination for the adventurous traveller in the past – around the green zone (where the bulk of the insurgency is in Helmand) it is beautiful countryside with fields, trees and flowers and numerous canals and irrigation ditches. It is such a shame that conflict over the years has torn the country apart, however, there is some hope as our mission is to help it get back on its feet again. On arrival at the CP I was orientated to the facilities. The toilets were ‘thunder boxes’. When using one, you place a special plastic bag over the toilet seat and the bag and contents are burned after use (it’s actually a lot better than it sounds).  The shower consisted of a solar shower bag, hung from a gantry in a wooden/hesco shower enclosure with no roof. It was actually lovely showering at night looking up at the stars, as the stars seemed much more intense. Cooking facilities were very basic and in the main it was ration packs, with some ‘all in’ meals where someone in the company cooks for everyone using the 10-man packs. These meals can be quite inventive!  The accommodation was a room within the compound which would have been relatively comfortable as the Afghans knew what they were doing with their compound construction, the thick walls ensure the rooms stay cool in the heat of the day and remain warm at night. However, the compound was plagued by mice! All night I could hear them running around and at one point one fell out of the ceiling and bounced off my head! They seemed to be ninja mice too, as they were incredibly adept at taking food from traps without setting them off! I was introduced to the guys as the Female Engagement Team (although most of the time it is just me, so I’m obviously not a team!) and I explained to them my intended role out here. Most people I meet assume I’m out here specifically to conduct female searches, and my role is much more than that.  However, as male soldiers should not search females I am viewed as an asset if searches are required (understandably so).  Providing the searches are part of a ‘soft knock’ (ie we are not entering the property through force) which will enable me to meet Afghan women and begin to engage with them. Yesterday I took part in my first-ever foot patrol.  We patrolled into Zarghun Kalay to conduct a shura (a meeting of village elders). This gave me an opportunity to assess the viability of female engagement in the area, and allowed me to be introduced to key local leaders. Zarghun Kalay seemed to be a relatively benign environment. Most of the locals were pleased to see the patrol as we passed and many interacted with members of the patrol.  The children were following us, giggling and laughing, with one of the main sources of amusement being that I was a ‘shadza’ (female).  The shura was fairly well-attended and the men were quite receptive to my presence.  The major topic was the requirement for the redevelopment of the village school as it was destroyed by Taliban some years ago.  It’s an issue that we were well aware of, and which was in hand – but things out here can move frustratingly slowly and it can be hard to make the villagers understand the lack of progress.  Historically ISAF had taken on such projects but now these projects are the responsibility of the District Council, and ultimately GIRoA, as the Afghan Government must be seen to take the lead now and in the future. Towards the end of the shura I asked the elders if they would allow me to speak with their women.  I had already shown photographs of my children, impressing upon them that I was a mother and not a third gender, which is how Afghans tend to view female soldiers! However, it was evident that under no circumstances would I be able to engage with females in Zarghun Kalay without a female interpreter – a commodity that is in short supply.  However, I have been encouraged to continue engaging with the key leaders in the hope that I will gain their trust and they will agree to me meeting women from the area with a female interpreter at a later date.

3 November 2010

I was initially meant to be going out on an operation but my services ended up not being required so I remained in the CP and did radio stag – 4 hours on, 4 hours off.  Surprisingly tiring, but very necessary. It was peculiar seeing the guys as they left for the op. I wanted to be with them and found staying behind difficult.  I had already formed a bond with some of them and had never experienced watching guys go off on an op before.  To them it was just another op but it was an unsettling experience for me. One that I will become used to over time I’m sure.

4 November 2010

I was taken back to Shawqat on Wednesday morning, not quite feeling myself but not sure why. I returned to my tent to find it occupied by US Marines – not an unpleasant surprise for me, but not sure how they felt when I barged in! I had been moved whilst I was away but no-one had managed to tell me. Wednesday afternoon was therefore taken up with me moving all my kit to the new tent.  I think I will feel like a traveller for most of my tour anyway as my job will take me here, there and everywhere – I’ll be living out of a day sack most of the time. By Wednesday evening I was in the isolation area of the medical centre with a high temperature, feeling shivery and definitely not well!  Diarrhoea and vomiting was suspected but thankfully it was just a random 24-hour virus and I was fine by Thursday afternoon.

5 November 2010

Bit of a drama today, one of the guys was standing in the vehicle park minding his own business when he was shot in the arm. Luckily for him it was a ricochet, not a direct shot, so whilst the bullet lodged in his arm the damage was not too serious. The injury did necessitate a trip to the hospital at Camp Bastion though for removal of the bullet and I believe he has a broken bone. That should be a good war story for him! For me life in BG HQ was back to normal, trying to plan visits to the companies in order to go out on patrol in their area, to attend shuras and to try to gain the trust of locals to further female engagement, and identify opportunities to engage.  I sensed that this job may be frustratingly slow, at least in the beginning, but I’ll have to be patient as attempting to force engagement will be counter-productive. Patience will have to be a virtue of mine on this tour.

7 November 2010

Today was mainly Operation TABLE day. The tent I have been moved to has no furniture so I told the girls I share with that I would utilise my ‘skills’ and make us a table.  I went over to the LAD (where the vehicle mechanics work) and bits of old packing crates and pallets were screwed and nailed together throughout the afternoon by my own fair hand, with the guys watching dubiously. By dinner time I had made a fairly good table. The girls were impressed anyway! I also used my time today to attend some training in the Medical Centre. The Medical Officer was teaching some of her Medics refresher training on the use of splints and traction devices and going over spinal, pelvic and femur (thigh bone) injuries. She invited me to join in and it was very useful and made me use the old grey matter to remember my anatomy and some of my initial nurse training.  I aim to gain as much medical training as I can while I’m here, as not only is it good for me, but furthering my medical knowledge and abilities can be advantageous should there be any casualties whilst I am out on the ground.  The more of an asset I can be to a patrol the better.

9 November 2010

Day 21 found me on the move again. I moved to Patrol Base (PB) Samsor, south of the FOB, in the afternoon so that I could meet guys from the company there and identify potential female engagement opportunities. I did my first sentry duty yesterday morning and it wasn’t too bad, at least it was light for most of it so there were things to look at and as the sun rose in the sky it was starting to warm up.  It is getting pretty chilly at night now. It felt quite odd just looking out from the sangar watching the locals starting to get up in the morning, coming out of their compounds to go to the toilets in the bushes (sanitation is non-existent for most locals) and begin to open up their shops for business.  Often it is young/teenage boys that can be seen opening up the shop, driving the tractors and generally working in the family business.  There were numerous dogs roaming around in packs too – dogs are not viewed by the Afghans in the way that we view them and are generally not loved family pets. I did some more medical training yesterday and by virtue of my nursing skills/qualifications and the extra medical training I am to be given extra medical equipment to take with me when on patrol. I will be somewhere in between a team medic (someone with a bit more medical training than the basic first aid skills that all soldiers learn) and a combat medic (the Army’s’ paramedics). I am pleased to be able to learn more and be of more use but obviously I hope that I will not need to use my new found knowledge and skills as needing to use it usually means one of our soldiers has been hurt.

13 November 2010

I returned to Shawqat today from a successful sojourn to PB Samsor. I went on two patrols and took part in a search operation and I actually managed to conduct some female engagement – which I was really pleased about.  On my first full day in the PB I went out on two reassurance patrols, one in the morning and one in the evening.  These patrols are conducted to reassure locals of security, to ensure we have eyes on what is happening on the ground and are aware any changes in atmospherics in the area, and for information gathering. We vary patrol routes for our security so the patrols necessitated walking through very muddy fields, jumping over ditches, climbing over walls, wading through water-filled irrigation ditches and for me, at one point, almost falling over backwards into one. I was saved from a completely ignominious soaking by the patrol commander who grabbed me by the helmet and unceremoniously hauled me out!!  Now I understand why we do all those assault courses when training, and I’m so glad I was only carrying basic kit on patrol (which weighs a minimum of 60lbs). Some of the lads have to carry much more.  Again, the patrol was followed by numerous children all clamouring for ‘chocolate’ and ‘kalam’ (pen) and giggling when they realised I was a woman.  We do try to give the children small gifts when on patrol so most soldiers do carry some sweets or pens. I intend to purchase sets of felt tips so I can give a pen to each child when I’m patrolling as it gets the children on side and the more we engage with the locals the more chance we have of wining security for this country. Day 2 in the PB saw me going out on an operation with the guys. We had some intelligence that indicated a possible IED factory in the area, so we conducted an operation to search some compounds. I was to be used as a search asset as I can enter rooms where women are and male soldiers cannot. My hope was that I might be able to use the opportunity to engage with some females. We were not entering compounds by force so it was hoped that engagement may have been possible. The operation began with reveille at 0300, an ungodly hour to be getting out of your nice warm sleeping bag, especially as it’s starting to get really cold at night. We then moved to a concentration location where all the troops met up, confirmatory orders were given, and we moved off just after first light. It was expected that we may encounter some Taliban resistance so I was mentally preparing myself for a contact – ie being shot at and maybe having to return fire.  We managed to progress fairly quickly and I searched two compounds that had women and children in. The first compound had 3 women and 9 children and the women seemed hostile and suspicious of me, however, I entered their room wearing my helmet which I now realise was probably not a good idea. Nothing suspicious was found and though the male of the household was happy to talk to us he stated that I could not talk to his women unless I had a female interpreter with me – something that will be a recurring theme in this conservative area. The second compound I visited housed 3 women and 6 children and the women were still reluctant to interact but acknowledged my apology (my limited Pashtu). When I searched the room there was a dome of blankets on the room, the elderly lady present lifted the blankets to show me that a baby was sleeping under them. It was a dome constructed of sticks that had been placed over the sleeping baby (who was tightly wrapped in a papoose), the baby had one blanket directly over him and at least 3 blankets laid over the dome. I couldn’t help wondering if this potential overheating of the baby could contribute to the high rate of infant mortality in Afghanistan as overheating is a contributory factor in cot death.  Something for me to look into and perhaps we could educate women about the risks. The final compound we entered was inhabited by a poor family and the male of the family was happy for me to talk to his wives using the male interpreter- at last a breakthrough!  I talked to the women about their lives, how they felt about ISAF, health care and their children.  I had a cuddle with a 6 month old baby, and as I was urinated on I can confirm that they don’t have nappies! I also gave some small toys to some of the children. The eldest wife was 28 but looked much older, however that is usually the case out here.  If I’d had 9 children by 28, whilst living in poverty, perhaps I would age prematurely too.  She asked me to look at one of her children who was sick, which as  paediatric nurse I was happy to do, but on examining the child I told them that she needed to see a Doctor.  She had a grossly distended abdomen and I’m not qualified or competent enough to diagnose from the limited examination I was able to do.  Unfortunately seeing a Doctor costs money and requires a trip to Lashkar Gah as there is no local health care, it is therefore highly unlikely that the child will receive the care she needs. On leaving their compound we were close to returning to the Check Point from whence we started, but we heard gunfire and a call sign (another patrol) approximately 500m north of us was in a contact. We therefore had to go firm in case we were needed to support them. However, after approximately 30 minutes wait our services were not required, much to the disappointment of the guys in my call sign, so we moved back to the CP and then back to the PB. As a search operation it was successful and for me it was a success as at last I managed to engage with an Afghan woman.  Here’s hoping it leads to more. Tomorrow sees me move to Bastion for a 5-day language course so I won’t have much to report for a while, however, I am really looking forward to the course as not being able to converse with the locals at all makes me feel like I’m working with one hand tied behind my back. However, I’m well aware that my knowledge after a 5 day course will still be limited- but it’s got to be better than the little Pashtu I have at the moment.

21 November 2010

Last week saw me attending a week long Pashto basic language course in Bastion. The course was run for all Female Engagement Team and attached personnel and was attended by 10 females. It was well run and I now feel a little more confident about attempting conversations with locals. I have been practising with some of our interpreters and intend to practise every opportunity I get. Whilst on the course we met up with USMC female engagement team personnel to hear how they carry out female engagement and their anecdotes were really interesting and gave me lots of ideas.

The day we left for Bastion we received the sad news that one of our boys had been killed in an IED blast. He was only 22. The vigil was held whilst I was in Bastion and I was also able to attend his repatriation (where the coffin is placed on the plane to go home). Repatriation ceremonies really bring home the harrowing experiences some of the guys have to go through out here and as a mother of a 17 year old boy myself I find it heart wrenching. I couldn’t help but cry.

I’m now back in FOB Shawqat preparing to go on another operation. I have a very full diary this week with several visits planned, including one to a school, a local health initiative and a shura. The days should fly by. I’m due to go on R&R soon (10 days) so I’ll be home with my children before I know it- I can’t wait.

25 November 2010

What a difference a week makes! The small amount of Pashto I was able to learn (and attempt to build on through speaking to our interpreters) last week in Camp Bastion made a big difference to me being able to engage with local women. I have just come in from 3 days out on the ground and managed to talk to 22 women- amazing! I’ll start from the beginning. I was asked to go on an operation conducted in our area so that the guys had a female searcher with them. Taliban were known to operate in the area and full searches often cannot be carried out because males cannot search women. If a soldier attempts to go near to a local female she will try to run away and become very distressed. The operation started in the early hours of Tuesday – I was woken at 0230. We were inserted by helicopter- my first ever air assault. It was a surreal experience sitting in the back of a Chinook in near-total darkness knowing that we were flying into an area where insurgents had been operating very recently, and quite possibly were still operating. Jumping off the back of a helicopter on to a freezing cold field is not the most pleasant experience I’ve ever had, especially as I was carrying sufficient kit to live out for 3 days – approximately 70lbs. I’m not complaining though, as I’m well aware that most of the guys have to carry a lot more. Once off the helicopter the patrols formed up and moved off. We had several compounds that we had to search, with soldiers from the Afghan intelligence forces searching first. As they searched the compound the women and children were placed in a room where I searched them (including the children as weapons and ammunition have been hidden on children in the past), and once the search was complete I was able to attempt conversation with the women. Most were surprisingly happy to talk to me – if it was me and my house which had just been searched I’m not sure I would be communicative! They seemed happy that I was talking to them in their own language. I just wish I knew a lot more as their replies were often long and spoken very quickly so I was only able to grasp some of what they were saying. I showed most women and their children photographs of my own children and they loved to see them. Some women wanted me to stay for ‘chai’ (tea) but I didn’t have time, and some gave me hugs as I left. We carried out several patrols and searches over the three days. Patrolling is, for me, a peculiar entity- as a REME soldier it is not something I am used to, as my role has always been to fix vehicles. Patrolling is essentially several people going for a ‘walk’ around the local area, however, whilst ‘walking’ you are constantly scanning around for anything unusual that may indicate IEDs or insurgents in the area (as we are taught in training ‘absence of the normal, presence of the abnormal’). Your back and shoulders constantly ache from the weight of the kit, and you are always looking for cover (ie a ditch) in case the patrol is contacted. For the guys the prospect of a contact is just a normal part of the job, for me it hasn’t happened yet so I have no idea how I will react. I know the guys will tell me what to do so I just hope I can keep my wits about me and do as I’m told! As we were staying out for three days that meant sleeping out and surviving on rations. The nights are much colder now so sleeping outside is an experience. Thankfully our winter sleeping bags had been brought out to us by vehicle (they are too big to carry, once you have water, rations, ammunition, a change of clothes, warm kit and medical kit in your day sack you can’t fit much else in) so I was able to sleep in relative comfort and in a way it was quite nice sleeping out under the stars. However, getting out of my warm sleeping bag at 0430 to go on patrol was not very nice – it really is literally freezing at that time in the morning but you can’t wear lots of warm kit as you know it is going to get warmer, and if you are contacted and have to move quickly you would soon be far too warm. Rations are not too bad nowadays, they are much improved and are much more palatable. However, I still only ate 3 lots of ration packs (beans and sausages) over the three days as I wasn’t in the mood for much else! I think patrolling for 4-6 hours dulls your appetite, especially when it is warm. The women I spoke to were mainly from poor families and their main concern seemed to be security. They were pleased to see ISAF and felt that our presence was bringing them security. They did not support the Taliban/insurgency as all they wanted was to be able to live their lives in peace. Their children were unable to go to school as the local school had been destroyed by the Taliban, and insurgents in the area use some of their compounds as firing points which inevitably brings trouble to their homes. Another major concern was health; many women said that the health clinic in the local village was not very good which meant that they needed to go to Lashkar Gar to see a doctor – not always feasible as they had little money. One family asked me to look at their baby as they said he had diarrhoea and he was only a couple of weeks old. I examined him as best I could (I’m a children’s nurse, not a paediatrician) but he was not dehydrated and did not appear sick so I was able to advise the mother (with the aid of an interpreter) to carry on breastfeeding but if she was to give him- or any of her small children- water, she should ensure that it was cooled boiled water. Most of the families I visited did not have access to wells so they draw their drinking water from nearby streams, streams that contain animal and human effluent and fertiliser overflow from the fields. Diarrhoea is one of the biggest killers of young children in rural Afghanistan so whenever possible we try to educate people about drinking water. Some women that I visited attempted to supplement the family income by sewing and embroidering and selling their products in the local bazaar, but they struggled to purchase materials and therefore made little money. Part of the remit of female engagement is to encourage and facilitate such activities so I spoke to some women about forming a sewing co-operative if we provided them with start up materials. They were very interested in such a project so I am hoping to take it forward and revisit them in the future. For me the operation was very successful and really made me feel that my job is worthwhile. Even if all I can do is offer verbal support and advice I am still reaching out to local women and nearly all were pleased to see me. I hope this can be replicated in other areas as my tour progresses.

28 November 2010

I have hardly had time to draw breath since returning from the last operation. I woke the morning after with aching legs and shoulders. The numerous patrols and the tab (walk) back into FOB Shawqat from out on the ground had taken its toll. The body armour cannot be described as remotely comfortable but it is obviously very essential. One of the lads survived a contact earlier in the tour because the side plate in his body armour deflected a bullet. Immediately I went into work I had numerous reports to write and then started planning my next engagement. I was assisting the Regimental Medical Officer (RMO) with the implementation of a Health Initiative which would involve us teaching local health professionals a Health Education program, covering topics such as hygiene, pregnancy and birth, diet and disease prevention. Most of Friday was spent going through the publications we would use to teach the programme, roughly translating it from Pashto and Dari into English (with the aid of a skilled interpreter), so that we were familiar with the text and would know what to teach. As is usual when in Shawqat the working day did not finish until after 9, and I was due to be on stag (sanger duty) at 0200, so I crawled into my sleeping bag as soon as I could hoping to get some decent sleep before stag. In the evening your sleeping bag is the best place to be anyway as it is getting really cold at night and our accommodation has no heating at all. I’m going to get myself a woolly hat and fingerless gloves when I’m home on R&R so that I can be warm when reading in bed! When my alarm went off at 0135 I really did not want to climb out of my warm, cosy sleeping bag. It felt so cold when I got up. However, I was quickly dressed (in a full softy suit which, whilst being warm, makes me look like the Michelin man!) and ready for duty. I spent most of the time alternating between looking around the area of the sanger using the night vision equipment and moving around trying to keep warm. There was not a soul to be seen, so thankfully my stag was uneventful. Later that morning (after a couple more hours sleep and almost oversleeping) I met up with the RMO and our Cultural Advisor (a British Army Officer who speaks Pashto and advises the Commanding Officer (CO) on cultural matters) and we were taken to the local Health Centre. There we met their health professionals, which included two local midwives who seemed to be strong, well educated women. The aim of the project is that these health professionals will then educate health care workers throughout the district, who can then disseminate the information to local men, women and children in their area. We talked them through the booklets that detailed the program, with me covering the sections on antenatal care, care during delivery, and postnatal care. There was much mirth from all present when the booklet showed a picture of a man hanging out laundry so that his pregnant wife could get some rest, in this patriarchal society such a thing is unlikely to happen! The section on contraception also met with some mirth, but the midwives said that some women in the more permissive areas do use contraception – in some circumstances their husbands have even asked about it. However, in the more rural areas it is unlikely that contraception will be used, rural families still tend to have a large number of children, 10-14 is not uncommon. On Sunday the Education Officer, Lt Claire Westerman, and I conducted a visit to a local school. I had been told that the school had female teachers and female pupils so would be ideal for female engagement. As is always the case out here such visits need to be planned as security is required for the move to the location, and a security cordon is needed for the duration of the visit. The school was in A Coy 5 SCOTS’ area, so I planned the visit with them so that we could patrol out with them and they could provide the cordon. Claire was looking forward to the visit as not only was it interesting from her perspective as an Education Officer, but it was also to be her first patrol, plus it gave her a chance to practise the Dari she had learned on  3 month course pre-deployment. We were taken to a Patrol Base (PB) in Ridgebacks (heavily protected wheeled vehicles) to meet up with A Coy 5 SCOTS, given a patrol brief and then we were off. Fortunately it was a short patrol to the school (again through fields and across irrigation ditches –  I’m going to be pretty good at obstacle crossing by the end of the tour), especially as I was carrying a day sack weighed down with pens, pencils, notebooks and skipping ropes to give to the school, in addition to my usual patrol kit. We were greeted by the school Principal who was keen to impress on us how well the school was doing but also how much better it could be with more support. There were 6 female teachers, which was good to see, and many female pupils, which in this conservative area is unusual. Many schools educate only boys and families do not expect their daughters to be educated. The Afghan government are trying to encourage families to send girls to school but it I think it will be a slow process, change will not happen overnight. The Principal was concerned about security (as are most people that I speak to), especially as the Taliban do not want girls to be educated and so intimidate pupils, teachers and their families. It is very much to their credit that the teachers continue to provide education and seem to be very committed. The school has a roll of approximately 400 pupils but only 3 small classrooms with no desks or chairs; the children sit on a carpet for their lessons. Due to the lack of space the school had 2 satellite schools but these do not have carpets or windows, the  pupils will freeze as winter progresses. I have reported this to partners attached to the Battle Group who may have the resources to help. The pupils were bright and alert, the school seemed well organised and all were very happy to see us and keen to engage. Most of the children questioned said they would like a professional career when they grow up, with the girls saying they wanted to be doctors and the boys engineers. Photographs of my family were once again very popular, I even showed them a short film clip (on my camera) of my 15 year old daughter singing Fields of Gold (she is a good singer- and I can assure you has not inherited her ability from me!), which they found fascinating. I have shown it to locals to date and they all love to see it- perhaps I ought to warn my daughter that she may be famous out here!! Despite my lack of singing ability Claire and I asked if we could teach the children an English action song and before long all the children joined us singing ‘Head, Shoulders, Knees and Toes’. They thoroughly enjoyed it and to me it was a lovely sight. The engagement finished with us taking chai (tea) with the male teachers and presenting the Prinicipal with some gifts of pencils, notebooks and skipping ropes for the children. Many children are from poor tenant farming families who are unable to even purchase a pen or pencil for their children. I also discussed the teachers taking part in the Health Initiative that we had initiated in Nad Ali Health Centre as they are the ideal people to get health messages to children and their families. The Principal was keen to engage so the RMO is now liaising with relevant personnel to try to make it happen. It is always better to strike while the iron’s hot! The Military Stabilisation Support Team (MSST- a team of personnel that work on projects to improve conditions and facilities for locals) representative with us had radios to present to school staff so Claire presented the radios to the female teachers who were smiling and grateful. Unfortunately I was unable to record the presentation in any way as it rare for Afghan women to be allowed to be photographed. The school visit was fascinating and heart warming and made me feel that there is real hope for the future of Afghanistan. Once the visit was concluded we patrolled back into the FOB. Claire and I celebrated a successful visit by having a film night in our tent in the evening; we watched Four Christmases on my laptop which reminded us that it is almost the season. It’s easy to forget that out here. It was cold though, I was wearing my full softy suit (much to Claire’s amusement!).We are trying to make our tent more homely so I think I need to have another furniture construction session – however, R&R is now very near (I fly to Camp Bastion tomorrow ready for onward flight(s) home) so it will have to wait until I return. I have constructed a rough bench and I have put up some Christmas decorations sent by my wonderful Mum so it is starting to look better. We do our best to make our tent look like a home from home, family photos are up and the table I made is still very sturdy and well-used. Claire uses it more than I do as she is a very competent artist and has been doing some painting in the evenings. She tends to paint images of locals as they often have interesting, craggy features and to me the paintings would not be out of place in a gallery. That’s the interesting thing about coming out here and meeting and working with new people, everyone has different skills and abilities and it is often amazing the attributes that people have. So I’m off to Bastion tomorrow. I’m so looking forward to going home and seeing the kids. It’s only been 6 weeks since I’ve seen them (after R&R I’ll have a 14 week stretch to do before I see them again)  so they shouldn’t have changed too much. However, my eldest seems to gain an inch in height every time I don’t see him for a couple of months- he’s now 6’ 2” and still going. It is hard for some of the guys as many of them have very young children (some of them born shortly before we came on tour) so I feel for them; and for their wives getting on with things back home. I suppose I’m lucky as my children are older and will not change too much in my time away, plus they understand what I’m doing out here. However, the flip side is that they are also old enough to watch the news and understand the risks and although I tell my children that there is little risk to me I am going out on the ground, so there is some risk there. However, I trust the guys I’m with and they know their drills so I do not worry and nor should my family. I understand though that it is always much harder for those left behind than those out here, families are unable to fully envisage what our lives are like out here and whilst we just get on with the job they must always have a nagging worry about the risks. I really believe though that the role I have out here is a worthwhile one and can make a difference, my contribution may not be earth shattering but little by little, bit by bit, I believe this country can get itself on its feet again.

Captain Lisa Irwin pictured with local Afghan boys

Captain Lisa Irwin pictured with local Afghan boys

2 December 2010

I’m now in Camp Bastion anxiously keeping an eye on the news, as I’m due to fly home tomorrow for my R&R and am meant to be flying into Edinburgh airport. At the moment it’s still closed so I keep checking the news and the internet to see if there’s any change. I will be OK if I have a bit of a delay but I’m not sure if the kids will be as understanding, but there is nothing I can do to change the situation. Mad how the UK seems to fall apart in adverse weather conditions. The kids are happy though as they’ve not been to school for over a week- however, I’m not sure my parents feel the same!!

As I type this the girls I’m sharing my temporary accommodation (temporary for me but not for them) with in Bastion are putting up their Christmas decorations which consist of a white 2-foot Christmas tree, bits of tinsel and some balloons. Most of us will have some form of daft head dress to wear on Christmas day too, I’m sure I can buy something particularly garish whilst I’m home for me to wear. I had hoped that I might get R&R over Christmas this tour as I was out here Christmas 2008, but it was not to be. We will just have an early Christmas when I’m home.

I was flown back to Bastion from the FOB on Tuesday, everyone is flown back in plenty of time to ensure there is no way we’ll miss our R&R flight, but it means a lot of hanging about. I contacted the hospital again and offered my services and so I worked a shift in the Intensive Care ward. I was helping to nurse a young boy who’d been in a vehicle that had hit an IED; both he and his younger brother were seriously injured. I’m not an ITU specialist and so I felt I was well out of my comfort zone but I was still able to give a lot of assistance to other nurses and it was a good learning experience for me. The little Pashto I now have meant I was able to communicate a little with the boys’ father and with the boy I was caring for, until his condition deteriorated and he had to be reintubated. It is such a shame that civilians, particularly children, are caught up in the conflict out here. IEDs are non-specific weapons and insurgents that lay them are well aware that they may kill or maim their own people but evidently don’t care. The locals are lucky that they can be treated at the hospital in Camp Bastion, it is an excellent facility with well trained and incredibly dedicated staff.

14 December 2010

That’s my R&R almost over. It goes by so quickly, and is absolutely hectic. Rest and recuperation it really isn’t, not for most soldiers I think, as everyone hopes you will catch up with them in the little time you have. I seem to have spent most of my time driving here, there and everywhere. Still, I was home to see my daughter perform in pantomime, and to organise and host (and act as a bouncer at) her 16th birthday party. We also took advantage of the early snow and I took the kids skiing today at Glanshee, great fun and lovely to spend the day with all three of them (luckily Connor had no lectures at uni). One advantage of living in Scotland is skiing practically on your doorstep. I’ve also had my Christmas dinner, my parents cooked an early one for the whole family, and I feel like I’ve done nothing but eat!! I need to get back to Afghan to lose weight!

Whilst home I spoke to my local paper about my job in theatre and explained about the children not being able to go to school and constantly asking for pens. The paper has asked people to donate pens to be sent to me that I can pass on to the children I see out in theatre so I may be inundated with parcels in the New Year! I was asked to give a presentation on my role to some of the local primary schools and the children seemed very interested. I think I got the message across about how little most of the children in Afghanistan have and how we are trying to help them and their families. However, they were probably more excited to see pictures of helicopters and weapons – typical kids! The teachers said they enjoyed hearing about Afghan and everyone, teachers included, learned a lot about life out there. I must have made an impression as one of the mums told me that when her son was asked by a relative what he wanted for Christmas he said ‘Peace in Afghanistan’!

20 December 2010

I should be back in Afghan now but the weather has stopped me getting back. I went to Edinburgh airport Friday to fly to Heathrow and that couldn’t happen due to the ice and snow. I spent the night in a hotel and returned home on Saturday as it was obvious I wasn’t going to fly then either. Since then I’ve been almost constantly on the phone trying to call British Airways and RAF Brize Norton but can’t get through. My friends and family think I should be happy to be stuck here but perhaps surprisingly I’m not, I can’t relax knowing I should be back out there doing my job. I have, therefore, given up on flying and have booked a train ticket for tomorrow- not as convenient (if flying had been feasible) but hopefully I’ll get to Brize and manage to get on a flight to Afghan.

23 December 2010

The train journey didn’t get me to Brize either! The first train broke down on the way to Edinburgh and the second train wasn’t arriving due to problems on the East Coast main line. After 5 hours gibbering in the cold at Edinburgh station I gave up and came back home, especially as it was still not definite that if I made it to Brize I would have a flight to Afghan before the Christmas break. I have now had official confirmation that I am not going anywhere until 27th December earliest so I can now relax and enjoy my extra time with my family. My children are over the moon – but the extra time here is costing me a fortune as I’ve now gone a bit daft and bought them extra stuff for their Christmas stockings. I still feel torn though as I bought things for the guys back in Shawqat to make their Christmas better and many of them I would now count as friends and so miss them. My tent mate, Claire, is doing a marathon round Shawqat on Christmas Eve (97 laps of the FOB- she puts me to shame!) and I would have loved to be there to support her and run a couple of laps with her. However, I am definitely not complaining and shall make the most of the bonus time with my family – BUT I am also itching to get back and get on with my job!

Lisa’s Diary continues here.