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Frontline Medicine: Camp Bastion's battlefield hospital

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Michael Mosley Michael Mosley | 17:12 UK time, Tuesday, 22 November 2011

I watched a young soldier lying in the mud under a sweltering Afghan sky as his friend, with fumbling hands, desperately tried to get a tourniquet round his naked leg.

The screaming was incessant until finally the tourniquet was in place and fiercely tightened.

What I was watching was a training exercise at Camp Bastion, with most of the screaming coming from instructor, Sergeant Lee Melvin.

His job is to prepare new troops in Afghanistan for what they may encounter out on the battlefield and he makes it as realistic as possible.

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Soldiers are instructed on using a tourniquet

War has always driven innovation in medicine and science, and the reason I was out in Afghanistan was because we were filming the documentary Frontline Medicine, which I'm presenting for BBC Two, to find out what has been learnt from recent conflicts.

Jane Aldous, the series executive producer, has made numerous series with the military, including the Bafta-winning Wounded and The Bomb Squad - so I thought her excellent contacts would mean making this series would be straightforward - but I quickly learned it was far more complicated than I had realised.

There were issues to be ironed out about filming patients who were critically injured or unconscious and who weren't able to give informed consent.

An added complication was the fact that Camp Bastion Hospital, although run by the British, had medical staff and patients from a variety of other countries.

Protracted negotiations followed with the Ministry of Defence, the Pentagon and the American Navy to name just a few, before we even started filming.

There were safety briefings and hostile environment courses to be got through, but finally in May 2011 we took off on an ageing airplane from Brize Norton in Oxfordshire for Afghanistan.

We were only allocated four seats, which meant the assistant producer, Blythe, also had to cover the job of a sound recordist.

Fortunately she's experienced, because trying to record decent sound in a busy battlefield hospital is a real challenge.

We were also fortunate to have cameraman, Andrew Thompson, who as well as a great sense of humour has plenty of experience of Afghanistan, having been out there filming with Ross Kemp.

The hospital we filmed in is in Camp Bastion, where they treat injured troops of all nationalities from all over southern Afghanistan.

They deal with some of the most extreme injuries you'll see anywhere.

Despite this they manage to save the lives of up to 90% of the wounded, the highest success rate in the history of warfare.

One reason for this is that they are incredibly well set up.

I was there for a couple of weeks and in that time watched dozens and dozens of badly wounded people (and a couple of bomb sniffer dogs) being treated.

Gunshot wounds, soldiers cut to pieces by shrapnel, burns and numerous amputations caused by improvised explosive devices (IEDs) were a regular occurrence.

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Camp Bastion medics work on the US solider Chuck's injury

I saw a lot of badly injured people in Bastion, but only one that reduced me to tears.

He was a young US marine called Chuck who had had his left leg partially amputated by a bomb blast.

Although he had been treated on the helicopter, he was still in a lot of pain.

Chuck was fortunate because the anaesthetist at Bastion, Surgeon Commander Dan Connor is very skilful at pain management and he's particularly good at a technique which the military have been refining over recent years.

Instead of just giving morphine, Dan carefully inserted a fine catheter into the area near Chuck's popliteal nerve, the nerve that provides pain signals from the foot.

He then connected it to a pump that keeps a regular flow of local anesthetic to the nerve.

When I saw Chuck that evening he was completely pain free. With the apparatus in place he was flown back to the US for further surgery.

Continuous nerve blocks, like the one he had, are increasingly being used in the NHS for procedures like knee replacements.

Getting out of Afghanistan was harder than getting in. The RAF told us they could not guarantee our return date and I was a bit desperate.

Fortunately we found a plane flying to Dubai, which we boarded at dead of night.

My trip to Afghanistan was just the beginning of a long and fascinating journey to find out more about medical innovations that have emerged from recent military-funded research.

You'll see in episode two that we got access to a range of such research, including trials of new prosthetics and devices that allow blinded soldiers to "see" with their tongues.

The cost of this war, for civilians and military, has been exceptionally high.

But I do believe some good will come out of so much suffering and because of what we've learnt, future lives will be saved.

Michael Mosley is the presenter of Frontline Medicine.

Frontline Medicine continues on BBC Two on Sunday, 27 November at 9pm.

For further programme times, please visit the upcoming episodes page.

Comments made by writers on the BBC TV blog are their own opinions and not necessarily those of the BBC.


  • Comment number 1.

    Just watched episode one on iPlayer and it had me on the edge of tears most of the way through. The amazing teamwork, the matter-of-fact attitude of the surgeons, doctors and nurses volunteered out of the NHS, and the technical advances they have made were just mind boggling.

  • Comment number 2.

    Very much enlightened by this program. Michael's emotions help to highlight the real cost here. As dukeofearl mentioned, the matter of fact way that these soldiers are treated must take its toll on the doctors and nurses.

  • Comment number 3.

    Fantastic programme. The doctors and nurses working at the hospital were outstanding in their efficient and matter of fact way they deal with the injured soldiers. I had to smile when the soldier who brought in, I think it was Chuck, described the "mechanism was IED versus foot soldier" in the true army "do not mince words" way. All our men and women out there are a real credit to our country. During the programme I felt so proud, and protective at the thought of the MERT team helicopter being fired at, of them all.

  • Comment number 4.

    Dear Michael

    Fantastic program I was impressed by the professionalism by all concerned it is just a shame that we need to fight wars to get the funding put into this sort of groundbreaking research into reconstructive surgery. But why oh why did you not go on to examine the psychological trauma suffered by many servicemen and women who have seen active service?

    I am a psychiatric nurse and we are seeing an increasing number of soldiers, sailors and airmen discharged from the services who are struggling to cope with the emotional aftermath of what they have seen and done. I believe more lives have been lost following the conflict in the Falklands by suicide than were lost in the conflict itself. Add to that the number of lives lost or ruined through alcoholism and drug addiction, the damage to relationships and the true cost of fighting even a limited conflict like the Falklands war is truely staggering.

    I think we are only just seeing the tip of a very large iceberg, symptoms of PTSD (post traumatic stress syndrome) or battle stress often only become apparent ten or 15 years after the event. Come on Michael I think you need to get back out there and finish the job by making another program about this important and often overlooked aspect of modern (and not so modern) warfare.

  • Comment number 5.

    I watched both episodes of Frontline Medicine and it gave me hope for so many young men and women who have suffered (and still are suffering) from these conflicts. The advances in medical treatments is staggering and as the father of a son who lost both legs earlier this year in Afghanistan i can only hope they they continue to make such rapid progress. Over the last 10 months my family and I have met many young men and women with very serious debilitating injuries who have shown tremendous courage and determination to get back the life they previously had. Sadly some of them are struggling and probably will continue to struggle for a long time to come. We can only hope that all of these injured young people recieve the help and support they deserve for as long as they need it. Thank you for sharing this experience with us Michael

  • Comment number 6.

    as a retired a+e nurse-I know the danger we all fall into is feeling that because we can do something -we must .But unfortunately,the long term effects of trauma are rarely catered for in the real world that our patients return to-just like the rehabilitated drug user,all may be ok in the protected environment of supportive units,but external pressures are outside our control

  • Comment number 7.

    Michael, ONE of the stories in your Rebuilding Lives programme would have been inspirational enough - but you gave us at least FIVE amazing tales of incredible souls PLUS the medical teams who are doing great work to help people survive their daily lives with a bit of dignity. Thanks go to all the people you connected with for letting you tell their stories. This is the sort of excellent journalism that doesn't attract enough attention. Moving and inspirational!

  • Comment number 8.

    I have a question:
    In the case of the soldier Marine Isaias Hernandez. I understood the muscle growth but what about the nervous which is also part of the muscle, do they grow as well? Was not consider that muscle growth was impossible to happen?


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