Education

Shown are a couple of the 2 dozen posters on medical anatomy in Dari and English. These are posted around the conference room where lectures are given. This helps the daily seminars being given by LCDR Charlie Barnes, our ER nurse mentor. He's training small groups in CPR and ICU care. Our team arranged covering the cost of the framing so these will be permanent and durable.

Not Smart Part II; Air Force Band

Yes, those are unrestrained, unhelmetted soldiers riding on top of the truck cab. I guess they figure a skull fracture is a badge of honor.
Shown is the roving Air Force Band, doing a 3 day stint at gorgeous Camp Stone. They played pop tunes from the 60's to the 80's. Very entertaining and the first live show here ever.

Desert climate

The photo shows a black flag, indicating curtailment of all outdoor exercise due to a wet globe bulb temperature of 90 or higher. It was 97 today, May 10th. More to come. Flags go from white or no flag (no limits) through green, yellow, red and black. Add 10 degrees if wearing body armor. At Fort Riley last summer, we were in body armor when it was over 100 with high humidity. And lived to tell about it.
The hot arid climate also causes dehydration. Coupled with the high mineral content of the well water, the 4 year old boy shown has kidney stones. We will try to get him to a hospital with the capability of treating him properly.

Books Without Borders appeal

Books Without Borders is ready to send 75 boxes of medical books to multiple locations in Afghanistan but still needs about $4000 to cover shipping. We tried working with Operations Independence with only a bit of success. Please consider supporting. The books will go to all the area hospitals and the medical school in Herat, thus helping now and in the future. Thanks!

All checks need to be payable to Postmaster. The address to send the check is:
UCLA Medical Alumni Association
c/o Valerie Walker, Director
James West Alumni Center
Box 951397
Los Angeles, California 90095-1397

Here is the BWB link: http://www.medalumni.ucla.edu/bookswithoutborders/bookswithoutborders.shtml Anyone who makes a gift of $100 or more will be added to the Website as a Program Donor.

Pinpoint of light at the end of the tunnel

We have been Boots On Ground for 250 days. We landed in the Combat Zone officially last 29 August when we reached Manas AFB in Bishkek Kyrgyzstan very early in the morning. We are supposed to be out of the CZ No Later Than this coming 29 August, probably sooner. We have also learned the names of our replacements who have just started training for deployment. My Afghan counterpart, Col. Azim, is deputy commander of the hospital and expressed his wish that I stay another year. Nice compliment, but...

Distinguished Visitor

On Saturday May 3, we received a visit by Dr. Mujadade, shown in the picture. He was the first president of Afghanistan after the Soviets left over fifteen years ago and represented the true return to democracy. He now is the head of the national senate. I had the privilege to shake his hand; his English is excellent.

Another celebrity look-alike

I think he looks like Chuck Norris.

Progress; Safety first

Afghanistan sharply divides the sexes through culture, and under the Taliban girls and women were forbidden employment, education and the vote. There are now women in senior government and military positions although the numbers are still small. Shown is the newly appointed assistant chief of nursing, the woman on the left. She previously taught nursing and is well respected by her colleagues here. She will oversee the day-to-day duties and work of the nursing staff. Herat has many schools for girls now and the universities admit most who apply. The country has a national women's day as well.
Also shown is me in the "Gator" we use for hauling stuff around the FOB. Even though it's very slow and low to the ground, we wear hard hats and high visibility belts. The ANA soldiers however never wear goggles, helmets or seat belts. We currently have several badly injured soldiers in the hospital due to vehicle accidents. Maybe in 20 years...

Revolution Day

Today is a holiday in Afghanistan that celebrates the departure of the Soviet army in 1989. Lots of speechs and parades around the country.

Books for Soldiers, Thank you Library Jane!

We just received a shipment of paperbacks from Library Jane and the Blount County (TN) Friends of the Library. They worked with Books for Soldiers and sent us some good reading. So I'm a sailor, not a soldier; we DO know how to read. Many, many thanks.

Another Web Article

We are periodically visited by the Combined Security Transition Command Afghanistan, CSTC-A (see-stikka) who coordinates the efforts to improve security and rebuild the country for the coalition. A recent visit by their public affairs folks generated the article about the hospital at www.cstc-a.com/News/2008%20news/0804012-Navy%20and%20ANA%20hospital%20staff%20team%20up.html. I am reviewing a patient in the ICU with the chief of surgery, an excellent orthopedic surgeon. This is my fifth appearance in web articles since coming here.

Food illness/poppies

The Afghan army base here had its third episode of intestinal problems affecting over 200 recruits all at once. Same pattern and cause as the prior 2 episodes: the meat was undercooked, transported to a remote dining facility and then sat for a few hours before mealtime. Some of our team, the hospital leaders, the officer in charge of food, the corps surgeon and colonel in charge of logistics spent the morning touring the facilities. Shown is the butcher shop; not pleasant but I will spare the details here. We visited the kitchen and saw that they considered "well cooked" to be the raw side of rare. We drafted up (again) over a dozen recommendations. Maybe the corps commander will implement more than the 2 he agreed to last time.
Shown also are some wild poppies. Afghanistan's southern provinces supply the majority of the world's raw opium from poppies, and the Taliban sell it to raise money for their insurgency. Narcotic use is against their faith, but it seems okay if they can make money from it... The poppies pictured are not the opium variety but seemed symbolic.

Words of Wisdom

Posted in the hospital: it translates as "Use your wealth for your health; not your health for your wealth".
The hospital is really hitting its stride as an acute care hospital. The ICU is usually full now. The ER was flooded with 5 injuries from a roll-over pickup truck accident. The ANA soldiers aren't good drivers, don't wear seat belts or helmets and the roads are poor. That said, the staff rose to the task and managed everyone quickly. The usually-quiet radiology room cranked out at least 20 x rays in 2 hours. Well done! We're so proud!

Greening of Afghanistan

Shown is "Camel Thorn", or kharn in the Dari language. It grows wild and is green only in the spring. The local sheep and goats can survive on it, even when it appears brown and withered in the hot summer. The other picture is a thriving rose bush planted near the ANA clinic. There is a great deal of planting and gardening going on, including by the new recruits. We've even seen small plots of grass. These are watered by well water and seem to be doing well. I was also shown some low-growing vines and was told it is the national flower of Afghanistan; it's honeysuckel! Nice smell and sight that reminds me of home.

Old fashioned building methods

Shown is a mud brick wall and the bricks being made on site. Straw is mixed in mud, the mud is dumped and trowelled into a form, the form removed and the bricks sun dried. The wall will surround the expansion of the interpreters' camp.

Appeal

See my Feb 26 post about Books Without Borders. Books Without Borders is ready to send 75 boxes of medical books to multiple locations in Afghanistan but still needs about $4000 to cover shipping. We tried working with Operations Independence with only a bit of success. Please consider supporting. The books will go to all the area hospitals and the medical school in Herat, thus helping now and in the future. Thanks!

All checks need to be payable to Postmaster. The address to send the check is:
UCLA Medical Alumni Association
c/o Valerie Walker, Director
James West Alumni Center
Box 951397
Los Angeles, California 90095-1397

Here is the BWB link: http://www.medalumni.ucla.edu/bookswithoutborders/bookswithoutborders.shtml Anyone who makes a gift of $100 or more will be added to the Website as a Program Donor.

ICU is open!

Incredibly, the ER and ICU were unopened and used as storage when we arrived 7 months ago. If not for our efforts, they would remain closed. The ER opened 4 months ago and is gradually looking more like an ER. The ICU took its first patient yesterday, and the second, shown, today. To open it in grand style, the patient today had a cardiac arrest, which we were able to recover. I paid a visit this evening and the patient is hanging on, albeit on a ventilator and potent drugs.
Also shown is me with the chiefs of medicine and surgery, who are the key practitioners for the ICU. Progress!

Back in Herat

8 cities, 5 days. I left DC early on the 1st and joined hundreds of other military at Atlanta. We took off on a jumbo jet that evening and made a stop in Ireland for refueling before landing at Kuwait International the following evening. 1 and a half hour bus ride to the US base where we slept overnight. Those for Afghanistan then saddled up late in the afternoon; we were told we would get to Bagram (central A-stan) via Kandahar (southern Astan, Manas Kyrgyzstan (several hundred miles north of Astan), then back to Bagram in central Astan. Instead, they deplaned us in Kandahar where we stayed overnight, then flew to Bagram. Landed at Bagram late at night in pouring rain, and settled down to sleep. Now to get to Herat... Not too many flight to Herat so we finagled a ride to Kabul which has daily flights to Herat. Stayed overnight yet again, and finally got to Herat Saturday. I'm not sure what time zone my bod thinks it's in. So, DC to Atlanta to Shannon Ireland, to Kuwait to Kandahar to Bagram to Kabul to Herat. Not fun.
Pictures shown: Iraq from 35000 feet, best way to see it. We passed over it on our flight from Ireland to Kuwait. The other shows a Tim Horton doughnut shop, part of the chain and national icon in Canada. Lots of Canadians at Kandahar so they had to have a Tim Hortons. About 30 people were waiting in line each time I went by. And yes, they have a hockey rink there too.

On the road again

Hard to tear myself away, but I'm heading back. Great two weeks of leave with some boating, canoeing, long walks, wildlife, cherry blossoms, the National Kite Festival, lots of good food and time with family. Just over 4 months to go to start the return home.

Nat'l Cherry Blossom/Kite Fests

Today starts the annual cherry blossom festival in DC. Japan gave several cherry trees to the US early in the last century. They have proliferated along the Potomac River and Tidal Basin. Each year sees a 2 week festival to herald the blooming and start of spring. Today is also the national kite festival with hundreds of kites around the Washington Monument. Shown is a pirate ship kite floating in front of the Monument. Gorgeous day for a walk.

Florida wildlife

The most common critter on base in Afghanistan is the common fly, but we saw plenty of goats, sheep, camels and donkeys. It's a bit different in Florida. Shown are animals seen on our various outings like an anole (small ubiquitous lizard}, a snake and a couple of small hermit crabs.

Leave is a wonderful thing

Great being home and with my honey. We've done some boating, cooked good food, ate at the officer's club, lots of hiking and exploring and even saw many hermit crabs. Also one blue crab. Too small to eat. I paid a visit to my home command and enjoyed visiting. I will head back to the mountains and desert soon but it feels great now.

Blue Angels

Pensacola is the home to the Blue Angels aerial demonstration team of the Navy for 60 years. They start their season in March and have practices at their home field. So, we headed over to the air station along with a few thousand others to see the show. Very loud and very cool.

Leave

Well, just had to stop at the McDonald's in Kuwait first. Anyway, about 2 days of travelling that included 22 hours of air time in C17s and a DC10, I am back in the US. Many thanks to Pam Duncan for the pickup and loan of vehicle. We have had great family time with lots to eat, beach walking, visiting the Naval Aviation Museum, and canoeing on the Blackwater River. Afghanistan seems and is 7000 miles away.

If it's 3 AM and Sunday, we must be in Ireland

7 hour flight from Kuwait and on the ground in Shannon, on St. Patrick's eve! 2 hour refueling and crew change. Then over the pond being chased by the sunrise to Atlanta. Almost there! The Duty Free shop is open but I decided Guinness flavored chocolate doesn't appeal.

Travelling sucks, but...

Day seven of going home for leave. First we took a little 12 seater plane to the main airbase in Afghanistan. Spent several days there getting briefed on what to do in the leave process, but mostly doing nothing. Then rode a giant old C17 to one Gulf country and switched to another C17 to another Gulf country. Arrived after dark and then had another leave briefing from 1:30 to 2:30 AM. The sun has now risen (2 hours of sleep) and one more brief. We will have our bags inspected then wait several more hours to..... GO HOME! Hoorah!

In Memory of Pat Tillman

Pat Tillman was a professional football player. After 9/11, he left football and joined the the elite Army Rangers. He died of friendly fire in Afghanistan and is remembered here with the naming of the USO center in his honor

"Fashions"

There are several local merchants with shops on base, open every day. Back at Camp Stone, we only have a weekly bazaar. Shown are a couple of their concepts of men's fashion. So, there's the red shirt, lightly patterned jacket and paisley-oid tie. Then there's the velveteen jacket with a nice, shiny nap. Watch out Paris! The new fashion capital is here!

Mountains

I must have 30 pictures already of the mountains surrounding Bagram Air Force Base. The base is at 4800 feet above sea level and on an large flat valley. The surrounding mountain ranges go over 15,000 feet and it takes your breath away; well, maybe the altitude adds to that. To the east, the Hindu Cush range starts and is part of the Himalayas. Cool. The weather on base is very dry and daily temp ranges from about 40 at night to 65 in the daytime.

Warning! Bagram foot bridge

Cute. EOD means explosive ordinance desposal. That's what we used to call the bomb disposal teams. 20 year old Russian tuna sounds pretty dangerous.

Leave!

Why is this man smiling? I am going home for a couple of weeks. It will take about a week to get there, 2 weeks at home, and then about a week to get back. Any deployment of 9 months or more gets the 2 week break. By the time I get back, we will be down to 4 months and change for "redeployment" aka going home.

MasCas exercise

We've been here for 6 months now and have not had a practice "Mass Casualty" drill. The new nurse practitioner, an Air Force major, decided it would be a good idea and had several meetings with everyone medical, including medics and corpsmen. So, one evening at about 2300 (11 PM) we heard a couple of loud BOOMS and all headed to the bunkers. After the all-clear, we headed to the clinic and received the mock patients. Everyone did their jobs well. The only need for improvement was better communication. This was especially hard since our Spanish and Italian colleagues were all trying to communicate with the operations center on the single channel. We'll work it out. The photo shows one of the Spanish nurses, an Italian doc and yours truly.

Wayne State Doc/Interview

The textbook is one of the most popular texts on Emergency Medicine. It is sitting on the shelf of one of the Afghan Army docs here and is first-authored by Judith Tintinelli, MD, who spent much of her career at Wayne State University. I graduated from WSU in Detroit and taught at the med school for 15 years. Our reach is long.
The other picture is preliminary to a television interview with the Deputy Director of the hospital. The interview occured due to a visit of one of the major Ministers of the country. We provided a medical consultation with him and so the interview occurred at the hospital.

Bilingual Mass/Not Smart

We finally had a mass in English, thanks to the visit by Fr. John (Lt. Col. in the Air Force). The usual Italian mass was cancelled and combined with Fr. John's so Padre Mariano joined us and added a few words in Italiano. About 30 attended in our tiny chapel and was a great service.
The local soldiers refuse to wear seat belts or helmets, and hang on to the Ford Rangers any way they feel like it. I've even seen one sitting on top of the cab. They drive fast and there are speed bumps. No wonder our number-one cause of injury is vehicle related.

Operation Care Package/Half-way!

The nice people at Operation Care Package sent us all packages of lots of good stuff before Christmas and have done it again! Thank you to Jane, Trisha, JoAnn, Fern, Debbie S., Rose Mary, DJ, Abigail and Molly. Socks, a cap, toiletries, snacks, etc. Thanks for the nice surprise.
As of 28 February, we have been Boots On Ground for 183 days with no more than 183 to go. So, halfway home.
Also pictured is a $25 "Omega" watch bought at the local bazaar. Such a deal.

Books Without Borders

Please see the link www.medalumni.ucla.edu/bookswithoutborders/bookswithoutborders.shtml.

Books Without Borders was started April 2007 by the Medical Alumni Association of UCLA and is growing rapidly. This program provides medical education literature to the hospitals and medical schools of Middle Eastern countries that are recovering from the recent wars. I volunteered to be point-of-contact for the Herat area in Afghanistan. Great project! Check it out.

Boungiorno/Buenas Dias

Or, good day in Italian and Spanish. Italy's army (esercito) is in charge of the west region of Afghanistan for the coalition. They help run the local airport, mentor the Afghans and provide humanitarian aid. They set up a pizzeria here at Camp Stone where you can have interesting combos of toppings for around $6. One has started an Italian class twice weekly and I attended the first session on the 20th. He is teaching for free. Grazie! Shown is their logo for this mission.
Also shown is lunch with the Spanish contingent. Spain's army (eserjito) also provides mentoring and humanitarian help. They get Fridays off like we do (Muslim sabbath) and have a convivial lunch every week. We were invited and enjoyed the paella and turron (like Italian torrone, made with eggs, sugar and almonds). Gracias!

Navy missile strikes faltering spy satellite

One shot, one kill, 133 nautical miles (153 statute miles), from a cruiser shooting at a satellite traveling 17,000 MPH. Proud to be a sailor, the Force is with us.

Close Reefed Tops'l Breeze

Navy talk for a windy day. Today and yesterday were unusually warm, in the 70's which is 20 degrees above normal. Quite a change from the 20's of 2 weeks ago. The morning was quite pleasant with a nice breeze at 7 AM went I got breakfast. I walked out 20 minutes later and a gale was blowing, a Force 7 to 8. OK landlubbers, about 40 miles per hour. Shown are the flags blowing straight out and a piece of roofing blown off of one of the ANA buildings. This is a preview of the "120 Days of Wind" experienced every summer. The barometer is dropping and dark clouds forming, so rain tomorrow. That's a good thing.

Busy work

While we had the several inches of snow, earth movers shoved them into piles. Now we've had several days of 40's and 50's, but the depth of snow and weeks of intense cold prevented a complete melt. So, to provide gainful employment at a few dollars a day (per capita imcome is only $500 per year), these gentlemen are spreading out one of the surviving piles. While there was still a lot of ice around, they used pickaxes and shovels to clear paths between huts. Whatever it takes, and they are grateful.

Thank You Oak Leaf Club!

Pictured are soft warm neck gaiters paid and made by the Oak Leaf Club of Pensacola. This club includes the spouses of Navy officers in the health professions (medical service corps, dentists, nurses, doctors). They had sent generous care packages for Christmas and wanted a nice warm-up for us during the winter. They held "Wraps for Wraps" sales at the hospital, selling pita wraps to raise funds for the gaiters. Wow! They are great and much appreciated! Thanks to the club and president Teresa Beer.