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

Female bandmaster swaps music for mentoring in Kabul

Female bandmaster swaps music for mentoring in Kabul

Bandmaster in Afghanistan

Warrant Officer Class One Esther Freeborn, Bandmaster from the Corps of Army Music

Part 2

Warrant Officer Class One Esther Freeborn is a Bandmaster in the Corps of Army Music. She has performed music at venues around the world and in front of Royalty on many occasions. She is now assigned to work with the Afghan National Army at their Officers’ Academy in Kabul.

International World Women’s Day at the Afghan National Army Officer Academy

Two months in – five to go

Well, I am in my second month at Camp Qargha and everything is going well. My fears of coping in this small vicinity and with a small amount of comforts have been allayed. We are very lucky to be able to receive post from friends and family, and from internet companies that will deliver to a British Forces Post Office. Receiving post generates enormous morale for everyone here, whether you have received a letter from a loved one, or a box full of toiletries from your mum. It’s amazing how grateful you can be for a nice bottle of shower gel!

Women’s Day

At the beginning of March, I was very honoured to represent our site at the Afghan National Army celebrations for International Women’s Day. It was amazing to see how many women were involved in the Afghan Armed Forces, including the first Afghan female pilot. The Afghans are obviously very passionate about Women’s rights and quite insistent on developing roles for women in all services.

Generating lesson plans in multiple dialects

I have many responsibilities here at Qargha, but mainly deal with the production and development of lessons for the Afghan National Army Officer Academy. As you can imagine the lessons for its 42-week course consist of anything from Foot Drill to Afghan Military Tactics. The British Army and partner nation forces mentors immerse themselves in the Afghan doctrine (policy) and write the lessons. Obviously, the lessons are written in English, and, although the Officer Cadets learn English as part of their course, all lessons have to be translated. The Afghanistan population speaks many different dialects, often depending on what part of the country they are from. Dari and Pashto are the two most spoken dialects, but the Academy has chosen for all lessons to be in Dari. Although I cannot speak Dari (apart from ‘hello’ and ‘how are you’), I find that I can recognize certain words and I have even learnt how to write ‘hello’ – سلام.

Command tasks at the Afghan National Army Officer Academy

Command tasks at the Afghan National Army Officer Academy

Small location could drive you mad

It is amazing how many different people you meet whilst on operations, in a camp that is only the size of a few football pitches. As I mentioned previously, there are partner nations here, such as Australian, New Zealand, Norwegian, Danish and American who perform many different roles.

I have to say, my favourite section is the dog section. I have a Springer Spaniel called Tyler and I miss him very much; fortunately I am able to visit the dog compound and give all the dogs a fuss.

esther3

Kenzie the Springer Spaniel who used to visit me. He has now gone back to Camp Bastion

I think the most interesting part of the job is being able to talk to the Afghans, both military and civilian, learn about their families, what type of house they have, and even the type of cars they drive (usually a Toyota!) It is only unfortunate that we are unable to explore the surrounding areas a bit more, and see life on the streets of Kabul for ourselves. Nevertheless, I am content with my surroundings and the beautiful view of the Kabul mountains as the snow slowly melts in the gradually warming spring weather. The job is not too bad either!

Read more CAMUS blogs

Find out more about the Corps of Army Music

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

Returning to civilian life: Back in basic

Captain Mau Gris began this blog when he was team leader for the British Army’s Combat Camera Team (CCT) based in Afghanistan throughout the summer 2013 as part of 1st Mechanized Brigade on Op Herrick 18. 

Captain Mau Gris on the road to civilian life

Captain Mau Gris on the road to civilian life

Mau returned to the UK at the end of September 2013. The rest of his blog will focus on leaving the Army and going back to the life of a civilian. For Mau, this includes going back to university – trading his helmet and combats for a mortar board and gown.

Transition angst

I can only imagine the kind of angst and worry those with a family to support must experience as they go through the transition to civilian life.  For me with no dependents or mortgage there is a low level buzz of anxiety, drawn from looming unemployment and being out of my Army comfort blanket.

Also being back at school on the wrong side of 30 was never something I planned. In reality my TV Journalism MA is more like being back in basic training. Which isn’t a pleasant idea, I didn’t make a great start in training. I turned up with long hair on the first day, which was a massive error.

A lot of people resettling won’t have to do what I am doing. For most, the CTP package which I also did, should be good enough to launch them into a job provided they do the leg work. Failing that, there are loads of people who can help. The key is knowing what you want to do.

Know the area you want to be in

I know the area I want to be in, which has lead me to where I am now.

Fortunately like most Forces personnel resettling, I am not quite at square one. My job as a Combat Camera Team leader has given me practical understanding, experience and transferable skills. The problem is knowing how valuable they are, where to apply them and how much they are worth. If anyone knows please tweet me!

For now, the course gives me purpose, and I am in the right place. The shared interest and passion makes journalists more like the soldiers then either would like to admit; once you get past the stubble and dress state. These would have any RSM howling at the moon and lashing out with pace stick in hand.

Army vs civilian life

Never having worked in the real world, unless you count a summer as an Punter in Cambridge, I increasingly find myself using the Army to make sense of the new civilian environment. In my MA, my lecturers are the DS (Directing Staff). Experienced practitioners in the industry who will teach me the ways of the job. The only differences are physical and environmental.

My first Army DS was a 6ft 4 Yorkshire man with a shorn head, who’d deliver ‘instructions’ and ‘encouragement’ like enemy machine gun fire and with similar effect. Often peppering the platoon with wisdom when we were up to our webbing in water in some godforsaken Welsh ditch.

My Masters Directing Staff is a 5ft something and a former BBC journalist. From a cosy lecture theatre, she delivers her wisdom couched in amongst anecdotes. They are different, but they are teaching you what to expect in the job. And like basic, this is the start of the job as I see it.

Jack Nicholson.

Jack Nicholson. ‘You can’t handle the truth’!

The difference is in the principles

For all the similarities the two jobs are very different at their core. The core of any profession is in the principles and doctrine they teach. Army principles are different from journalistic principles. It is here that the problem lies for service leavers as they resettle.

Army leavers often feel themselves to be the only ones in the workplace applying principles to their work, other than the ‘look after number one’ principle. For me it hasn’t reached this yet – my problem is one of ‘openness’ versus ‘need to know.’ That classic argument summed up by Jack Nicholson – ‘You can’t handle the truth.’ An issue that has gotten me in a little bit of trouble before.

In truth I am still trying to resolved this as I want to hold on to some of the stuff the Army instils; but not at all costs. Just because there is truth in the saying ‘you can take the boy out of the Army but not the Army out of the boy,’ I think you can choose what part stays.

Next time… Out into the real world -understanding BBC Newsnight through the Army.

The BBC Newsnight studio

The BBC Newsnight studio

Read Mau’s other blogs here: Capt Mau Gris

Follow Mau on Twitter: @mau_gris

Bittersweet return: Helmand to home, soldier to student

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.

For us it is the end of the end

For me it really is. Our new team had arrived, our kit was handed over and the requisite briefs were completed. Our job here was over. For me it is the last post I will hold as  a British Army officer. It’s weird even writing it. Believe it or not I have even delayed writing this, because it feels that once I do it is real.

We were some of the first to leave as 1 Mech slowly transforms into 7 Armoured. It happens in parts. A new fresh face untouched by six months in the Afghan desert here; a new tactical recognition flash there. There is always a bit of teasing as soldiers hand over. You see the guys on their reception briefings in their fresh kit, and mutter ‘crowbags’, and they just tell you to ‘get the hell out of my seat.’ This time there is a bit more sympathy – nine months is a long old time.

Then before you know it with the regulation RAF faff, you are on the plane home. A pit-stop in Cyprus is the only thing between you and the rest of your life. From my previous experience it’s at this point you have a peak inside that mental box, into which you put all that stuff you said you’d deal with later. This tour has thankfully left that box empty as far as I can tell. But there are those initial fingers of worry poking me about what the hell I am going to do when I leave the Army. As the C-17 rumbled on I looked around the plane and wondered what the rest were thinking.

The journey home begins

The journey home begins

Decompression, beer and a show

Fifty tired soldiers got blinking off the plane, and were told to get into ‘civvies’ ready for the organised fun, something the Army loves. It was odd seeing the boys out of camouflage. His Holiness (Sgt Pope) had gone for a glaring yellow tee shirt, Lloydie for some functional sports gear. Then it was down to the beach, a bit like any at a moderately successful holiday resort, except quieter. No one is trying to sell you some moody ‘Ray-Bans’, and there is a priest cutting around trying to ‘chat’ to you. Me and the boys steered clear, opting for some competitive inflatable wrestling instead.

Cyprus stop-over

Cyprus stop-over

Here is where the proper decompression starts, on the oversized inflatables in the sea. But not before your annoying mandatory swim test which everyone gets a little bit competitive about. Then after a few hours, it’s on to the equally isolated Bloodhound Camp for mandatory briefs, followed by strictly four beers and a CSE entertainment show.

This bit was very different from my first experience of decompression. First time round the ‘4 can’ rule was more like guidance, so we all got drunk. This time, however, we were a small group, compared to the 200 that normally go through. So we consumed our first beers in a large draughty hall, playing pool whilst the friendly mental health nurse and the padre wandered around chatting to people.

It was at this point that I got a subtle hint at how padres go about taking a peek in that mental box to see if their help is required. I had just been crowned Pool champion of the CCT, much to Lloydie’s and His Holinesses’s annoyance. When I got challenged by the Padre, he kicked my arse with a bit of divine intervention. In the process we got to chatting about the tour. Naturally he wanted to know what I had found tough. So I told him and slowly I realised he was probing to see if I would hold anything back.

Pretty clever,  generally nothing clams someone in the armed forces up quicker than being asked what scared / disturbed them. But what was tough? I would say that 99 per cent of all Army stories are based on toughness or tough situations. We can chat about those forever. It was only a small thing, but I think it is symptomatic of a growing awareness of the mental health side within the Army and how to deal with it. It gives me hope one day all those who suffer will be treated in time.

Sgt Barry Pope and Sgt Barry Lloyd

Sgt Barry Pope and Sgt Barry Lloyd

Goodbye boys

For me, this tour will leave only good memories, unlike others. Be it at the sharp end with the boys from the Brigade Reconnaissance Force or sitting quietly on the HLS with the boys, telling some ‘dits’ and killing some time, it’s been incredible. There was a little anxiousness there because of the imminent career change, and really I guess I am slightly nervous that once you leave that extend family of the Army, who understand what you’ve done / seen etc, then the issues arise. I have seen it in some of my friends.

These worries chattered away in the back of my head, but didn’t affect what turned out to be a really entertaining evening provide by the CSE guys. All the officers were singled out for derision by the comedian (standard) and the music was excellent. The four beers were consumed without any drunkenness ensuing. Everyone went to bed in that kind of cloud of happy tipsiness that was no doubt intentional by the staff of Decompression.

We woke up with just a hilly bus ride and an aeroplane journey standing between us, our loved ones and the rest of our lives. We arrived at 3 o’clock on a Friday, and I was then ‘in my own time.’ I collected my bags and with more than a little sadness, said goodbye to the boys. For the past six months had never been more than three metres away from them. And, I am proud to have serve alongside them.

I am now officially ‘resettling.’ To compound the strangeness I am starting a Masters course in TV journalism. So that I can keep doing what I am doing at the moment. I am going to keep writing about it but it is going to be weird jump. I hope you stay with me. Soldier to student…. hmmm.

Decompression starts here

Decompression starts here

Read Mau’s other blogs here: Capt Mau Gris

Follow Mau on Twitter: @mau_gris

An artist abroad: Back into the swing of things

Captain Sophie Whitaker, 39 Regt RA. Image by Cpl Si Longworth RLC

Captain Sophie Whitaker, 39 Regt RA. Image by Cpl Si Longworth RLC

Captain Sophie Whitaker is a serving war artist whose main job is to provide Joint Fires Targeting support to Task Force Helmand on OP HERRICK 18. As a member of 74 Battery (The Battleaxe Company) 39 Regiment Royal Artillery – attached to 1 Royal Horse Artillery, Sophie works in the Brigade Headquarters, Lashkar Gah, where she finds time between an often hectic schedule to put pencil to paper.

How quickly time is still flying by, I have now been back at work for just over two weeks and my handover will be here in another two. Now fully re-charged and re-energised I will endeavour not to succumb to what is most commonly known as the R&R blues – a condition that affects 99.9 per cent of personnel returning from the joys of a restful R&R to the high tempo and routine of OP HERRICK. Determined not to allow this to creep in, I hit the ground running and I felt as if I had never left. It was actually a pleasure to see the familiar faces that I have been working alongside for the past five months and listening to their experiences on R&R with reinvigorated spirits and renewed enthusiasm… although this rapidly faded into the general routine hubbub of the working headquarters.

Bold and bright painting

My $3 Afghan engagement ring

My $3 Afghan engagement ring

Time certainly wasn’t going to drag during my first week back as my Battery Commander (BC) was due on his R&R and therefore I would have to cover some of his tasks and staff work. With a comprehensive set of handover notes – all rigidly hyperlinked and absolutely foolproof.  My  BC has now returned and I managed to accomplish the tasks I was set and await the next drafting for various pieces of staff work to include; the Relief in Place (RiP) , handover and normalisation FRAGOs  (Fragmentation Orders) , a Post Operational Report, and a Mission Exploitation presentation. All of these are essential to ensure that our handover to the next brigade is professional and informative to provide a seamless transition from one to the other. The Post Operational Report and Mission Exploitation are key documents to enable all the lessons learnt from our tour to be collated and discussed to improve our capability and deployment for the future.

But enough about staff work…

This blog’s painting is referenced from a photograph of two Afghan Uniformed Police (AUP) women on the ranges conducting pistol training. I wanted to create a bold and bright painting by laying a brilliant orange background in contrast with the blue of the AUP uniform and the dark blue/ coal shades of their head scarves. These women are in training at the Lashkar Gah Training Centre (LTC) which is the centre of excellence for police training in Helmand Province – where over 2,000 Afghan Nationals are trained each year  to become policemen and women. Their skill and courage is highly commendable, and their will is strong as they persist to be able to provide their own security – an Afghan solution to an Afghan problem, as is the running theme of OP HERRICK 18.

Paint was drying far too quickly

Painting outside with photo reference

Painting outside with photo reference

The painting starts life out the back of my tent but with temperatures still reaching 37 degrees Celsius during the day, I couldn’t spend much longer than 20 minutes outside – particularly as the paint was drying far too quickly! Here you can see I managed to get a quick wash of colour on the background before I turned into the shade. I am struggling to find the time to paint as my shift doesn’t allow time during the day, and at night; now sharing a tent often means the lights are out by the time I get back off shift. However, a fellow artist in the headquarters – the Brigade Movements Warrant Officer (BMWO) has regularly booked out one of the small conference rooms in the evening after 2100hrs, and so after hours we both sit down for an hour to paint. Although this does compete heavily with my gym time!

Tented accommodation

Tented accommodation

Times of change are noticeably prevalent as I am one of two OP HERRICK 18 females remaining in our tent, whilst the others have all moved to the transit as they start their handovers with their replacements now occupying their former bed spaces. The ratio of red rats (7 Bde )  to green triangles (1 Mech Bde ) is rapidly increasing as they filter through their RSOI and start to find their way around the headquarters. I admire their enthusiasm, for some this is their first tour and for others they are seasoned veterans already. But I don’t envy them, nine months is a long time, and I’m glad my six are coming to an end now.

Selecting artwork for the coffee table book

AUP women WIP

AUP women WIP

AUP women WIP

AUP women WIP

 

In addition to routine staff work I am in the process of selecting all the artworks from across Helmand; from paintings, pencil drawings, photographs and poems, for the production of the OP HERRICK 18 Operational Art coffee table book.  A number of professional artists have deployed with various members of the Brigade during Op HERRICK 18 including; Graeme Lothian, Matt Cook, Hugh Beattie and Michael Alford to name a few.  I have had a fantastic response from the soldiers of the Brigade and certainly have my work cut out with over 500 submissions to filter through. They will all be presented to the Brigade commander and his panel in the coming week. Throughout this sorting process, I have also managed to design a poster to be distributed amongst the Brigade and soldiers are already signing up for their memento. Copies of the book will also be available to the general public – so look out for information on the British Army social media pages if you want one!

Op HERRICK 18 Art Book Poster

Op HERRICK 18 Art Book Poster

With only three weeks remaining I am incredibly excited already about the prospect of going home and enjoying my post operational tour leave! I also have a new job to look forward to on my return …more details on that in my next blog. And to finish this blog, here is the finished painting of the AUP women.

AUP women finished painting

AUP women finished painting

Look at Sophie’s page

Find out more about Army Arts Society

50 Shades of Green

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.

You can’t put a price on R&R

‘Absence makes the heart grow fonder’. Now whilst I don’t believe this in general, an absence of several months does make you appreciate things you might otherwise take for granted.

You cannot beat the first time you lay eyes on the UK countryside after a prolonged time in the desert. Everything is so green and lush; the smells so familiar and comforting. The taste of that first beer. Underlying that, and most often taken for granted, is that sense of order and safety that is often missing on operations.

Green, green grass (and trees) of home.

Green, green grass (and trees) of home.

Under UK skies again.

Under UK skies again.

Picking your rest and recuperation (R&R) date is a luxury I have not had on previous tours. Being part of a small team has it’s benefits. The question is then is when to go? If you get it wrong your work and relationship with those around you can be affected.

Too early and you come back with more than you have done, left to do. A morale sapping situation, in which you watch everyone else get excited before they go off knowing you still have to push through to the end.  You become a bit of a misery guts.

Too late and you end up climbing the walls and generally getting a bit ratty because working longer than 3 months straight is a long haul. I have experienced both, having gone way too early on my first and way too late on my second tour. So I was ready to make an informed choice.

Ditching the Army regulation footwear for a couple of weeks.

Ditching the Army regulation footwear for a couple of weeks.

Then I got told I had an important wedding ‘that I could not miss; not even for Queen and country.’ So ‘too late,’ it was again. If you’’ve read this blog before you’ll know that the boys (Sgt Pope and Sgt Lloyd) had taken their R&R and were back by the time I was due to go and I was going back solo.

I was ready for mine by the time five months had rolled by. After the obligatory delays, stop overs and reshuffles, I made it back. There is something about seeing British soil for the first time after a long time in Afghanistan. A large weight that you weren’t aware you were carrying, lifts. A blissful moment of stepping off the aircraft into a damp Wednesday morning, entirely mundane.

There is that rush you get in every airport over the world, collecting baggage, clearing customs and the heart-warming scenes of long-separated loved ones reunited. I met my parents, as is tradition, and then met my brother, who came up from London for a meal. The sense of being home reinforced by the quintessentially British streets of Oxford and poor restaurant service.

Beer tastes so good when you've not had any for months.

Beer tastes so good when you’ve not had any for months.

Following that I caught the train home with my bro. Some would advocate going straight out to see friends for a bit of a party, but I find big crowds sketch me out a little when I first get back. Plus, nothing good ever came combining five months booze free with over excitement in London.

So I had my beer in the garden. I had a Sol, as it was the only thing I could find in the fridge. No drink matches the first one back, and there were many over R&R.

Most of R&R passed in a blur. I vaguely remember being dressed as a Spice Girl, and had a lovely relaxed stay in Zurich (not at the same time!)

Too soon it was time to dig out the combats again for the trip back to Helmand. There was the standard antisocial check-in at 0400. I had the nice surprise of finding out that Si Longworth, a fellow Army blogger would be sharing the journey back.

Regardless of how well you planned for your return, there is that feeling in the pit of your stomach of walking into the unknown. A distilled version of that was experienced at the start of tour. As it happened, his Holiness (Sgt Pope) and Lloydie, were all over it.

A couple of days later and it’s like you were never away, although there is a renewed energy that was not quite there when you left. There is a slight debate in some circles about the value of R&R, it is a constant drain of manpower and a logistical strain on the ‘air bridge’. But, then, how do you put a price on R&R?