Battleworn: The Memoir of a Combat Medic in Afghanistan

by Chantelle Taylor

Afghan commander Nazim appears, bringing my mental meanderings to a halt. His face stern and patrician below his green beret, he says a few words in Dari and then squeezes the shoulders of each of his injured men before we carry them out on makeshift stretchers to the wagons. ‘Thank you, Sergeant,’ he says to Monty. He turns, bowing his head just slightly to Abbie. ‘Thank you.’ The fleeting moment shared by the former mujahideen warrior and the young Englishwoman is oddly moving. It brings into focus the reason why we’re here.

  The moment passes, and I brief Abbie on the move. ‘Stay with him, Abs,’ I say, pointing to the least stable of the four. ‘We will sort out the rest.’ My inner thought is that the casualty will be lucky to make the journey, but that remains just a thought.

  The Jocks and Afghan soldiers cautiously place the stretchers on the wide floor space in the wagons. Battlefield wounds are hard to deal with at the best of times, and this is all the more difficult when evacuating across rough ground. We make our wounded comfortable and carry out essential drills, checking that tourniquets are secure and intravenous (IV) drips are locked in place.

  Army training teaches you that the whole is greater than the parts. Afghan men are proud of their individuality, and they mark it with the way they arrange their lungee (headwear) and shoulder their weapons. They have different methods, and we try to work around some of their less-practical drills by guiding them away from killing themselves through negligence or lack of education. We set off in a four-wagon convoy, past the hungry dogs, and out on to the pitch-black road that runs along the side of the canal next to the old school.

  I smoke a cigarette, trying to keep myself focused. An occasional smoker, I promise myself that I will quit tomorrow, remembering that I made the same promise on my last tour of Helmand when I was supporting 3rd Battalion, the Parachute Regiment (3 PARA), working long gruelling hours at the hospital in Camp Bastion. The medical facility was then one of the few permanent structures in a sprawling camp of blast blocks, T-walls, and razor wire carved out of the wilderness in what the locals call the ‘Desert of Death’. Our surgeons, nurses, and the National Health Service (NHS) volunteers were pioneering new techniques and saving more lives than ever, as the insurgency gathered pace back in the summer of 2006. Two years later, it is hard to see any progress in Afghanistan, and in some cases we are moving backwards.

  The moon is high tonight, offering a fair degree of light to outline the tall vegetation running alongside the canal. Ten minutes pass, and we’re at the HLZ. The drivers kill the engines.

  I step out of the vehicle, wondering which way the helicopter is going to land. Is the doctor going to come off? Do they want the casualties on head or feet first? Medics are always worrying and listing problems, hoping for the best and expecting the worst. My eyes are strained from looking through the NVG for so long. I should know to blink more often.

  ‘Helo inbound!’ Monty relays communications as he joins me.

  Through the shadows I can see Abbie kneeling by her casualty. I get eyes on the Chinook’s glimmering rotor blades. I hear the sound, the familiar whomph, whomph, the chug of the big engines.

  The Chinook is an essential piece of kit for any war fighting army, and I never stop being surprised that we have so few of them. Cylums (or chemical lights) illuminate the ground. The blokes grab for the stretcher handles. The helicopter hovers above as it slows before settling down, the blades whipping up a storm. Wincing as the grainy sand and grit scratches my exposed lower back, I realise an instant too late that I have forgotten to tuck my shirt in.

  The Chinook doesn’t hang around. We load up our injured, opting for head first. The team receiving nod their heads before giving a thumbs up as I hand over the paperwork. It’s all done in less than thirty seconds, and the four injured Afghan soldiers are whisked away, back to the trauma unit in Camp Bastion.

  Standing next to Monty, I put my thoughts into words. ‘I should have asked if they were carrying any spare stretchers.’

  His brow crinkles. ‘Yeah, we are going to need them.’

  I turn to face him. ‘Yeah, right. We’ll be back in Lash tomorrow.’

  He looks like he knows something that I don’t. ‘We’re going to be stuck here for a wee while yet, mate,’ he says.

  The move back to the district centre of Nad-e Ali has everyone on edge. Using the same routes in and out of any hostile area makes our call sign vulnerable to an enemy ambush.

  Rubbing my hand across my lower back now, I feel the raw open grazes that were a gift of my inability to tuck my shirt in during the casualty extraction. It’s a minor injury, but as my Osprey body armour gets to work on it, the pain is ever present. I return to the task.

  The move back goes by without incident. We roll into the old school, which by now is bathed in light only from the high moon. I catch a quick word with Monty before the remainder of us push on to the police station in the district centre.

  ‘Stay safe, mucker,’ he says. ‘I’ll catch yous lot the morra.’

  Our two vehicles press on, and my watch is telling me that I need sleep. Today feels like it is never going to end.

  The police station is in darkness, and the only sound is the noise coming from the engines of our vehicles.

  Duffy dismounts from his position on the .50 calibre. ‘I’m fucked,’ he grunts.

  I am too tired to offer any response, and my body aches from being crammed in the back of the vehicle. I feel my soaked shirt under my body armour, and lap up the smell of dried blood. Jumping down from the tailgate, I grab my kit, slinging my weapon on my back.

  Scrambling up the dusty, barely there steps and onto the roof, I make my way over to check in with Maj. Clark.

  He acknowledges my return. ‘Everything alright, Sgt T?’

  ‘All good, sir. Everything went smoothly.’

  Almost but never quite forgetting the deep grazes now covering the lumbar region of my lower back, I find a darkened corner to strip off some clothing. Being culturally aware is a lifesaver out here. Taking some gauze, I soak it with saline solution to clean the initial bloody mess. The application of an antiseptic solution gets a bit emotional; medics don’t make good patients. Dressing applied, I emerge from the shadows and look for a space to settle down for a few hours. There are bodies strewn all over the roof, it’s cold, and there is very little shelter. It’s exposed to the fresh winds coming in from the open desert a few kilometres north of Nad-e Ali.

  The town sits in the west of Helmand Province. Much of the district is unoccupied desert, with the bulk of population living in the east, near the provincial capital of Lashkar Gah. This district thrives on its opium trade, with a high percentage of the profits going directly to officials in Kabul. The local people are not overly supportive of the coalition; they know that it’s only a matter of time before we leave.

  Still searching for somewhere to sleep, I spot our interpreter sleeping soundly in his bulky army-issue sleeping bag. He has sensibly packed the ‘bouncing bomb’. It is a huge piece of kit given out back in the UK. It’s rarely used by troops because of its unmanageable size: it can easily fill a bergen (backpack).

  I left my sleeping bag behind, quite sensibly, I thought at the time. When packing my kit, I opted for my bivvy bag, which is basically a protective outer layer or shell for the proper sleeping bag. It is thin and offers little comfort, and, yes, I am now regretting my decision. Mumbling with discontent, I climb into my bivvy and try to get comfortable, but my overtired brain keeps me awake. I suffer a further hour of the cold and a series of ‘what if this happens or that happens’ before deciding to adopt the spoons position behind our interpreter. This will at least afford me some of his body heat. He’s asleep and doesn’t realise that I am there. When he wakes, he will presume that it’s one of the blokes, and for that reason alone, he won’t be too bothered. What’s left of the cold night flashes by.

  At dawn, we stand to. When first light comes, it is usually accompanied by some form of attack; the Taliban have had the night
to manoeuvre and plan what will be another day’s paid work for them. Briefs given prior to deployment cover a range of interesting facts and figures that are only put into perspective when you end up in a patrol base (PB) or forward operating base (FOB). Payment includes ten dollars a day and as much opium as you can handle while remaining marginally coherent. The going rate for local young men to join the fight against the infidels has proven too good an offer to turn down.

  As quick as the landscape is exposed by the sun, my attempts to stay warm offer the soldiers around me some much-needed laughter and a morale boost.

  Kev is the first to applaud my resourcefulness. ‘Smooth operator, mucker! Ne flies on you, eh?’ he says.

  ‘Aye, Kev, am shocked you weren’t in the bag wi’ him, ya wee fanny,’ Scotty McFadden joins in the banter.

  ‘Not sure if Ryan would appreciate you dating our interpreter, Channy,’ Jen joins in the banter.

  Ryan is my fiancé. He serves as part of a fire support group (FSG) within 3 PARA. We met back in 2005, in our local pub at home. He is upcountry working as part of the over watch for the Kajaki turbine move. We have no means of communication here, so I try to leave any thoughts of missing him alone. On our last tour, I wrote him a letter every day during my shift in the hospital at Camp Bastion. He was in the Sangin Valley then, during the very worst fighting of 2006.

  Our jovialities and my reminiscences come to an end as Jocks to the left of me have eyes on a group of fighting-age males fewer than two hundred yards from the base. Normally not seen as an issue in a densely populated area, the group is out of sync. Abnormal activity in a place that has been under attack for more than three weeks classifies the men as hostile; no weapons have been identified, so they aren’t engaged. They are followed, and grids are marked, along with timings and descriptions.

  Logging any type of suspected enemy activity is important; it builds a picture of what is an unknown AO, and intelligence gathering will identify how they move and the types of numbers that they move in.

  The group of males disappears into a tree line; teams on the roof will continue to monitor them, allowing the rest of the young Jocks to get busy cleaning weapons and preparing themselves for the day ahead. Boil-in-the-bag rations are eaten cold, and I tuck into my cat food and biscuits, which up until now I had managed to avoid.

  It’s not long before Monty joins us from the old school. He undertakes a vital role within B Company, and heads straight to Maj. Clark for orders. Scotty and the Sgt Maj. are also in attendance as our mission changes. Our trip back to the relative luxury of Lashkar Gah is no longer happening, so the forty-eight-hour operation has become a thing of the past. ‘We will move as a call sign complete to the old school, enabling support to what is left of the kandak. We will remain there and conduct operations to flush out the Taliban of Nad-e Ali until further notice.’ Maj. Clark breaks this news to team commanders, who in turn pass the good news to the blokes in their sections.

  I gather my medics, and we talk about the basic set-up of a company aid post (CAP); we will sort ourselves out when we get to the school.

  Looking at Kev with half a smile, I sort my equipment out and make some notes about the medical supplies we are going to need. Before leaving, Monty notices one of the junior officers, 2Lt Barclay, has placed a belt of ammunition upside down onto one of the machine guns. Barclay would later be awarded the Military Cross for bravery, but now he is verbally chastised to the delight of the junior Jocks, five or more of them making the squawking sound of a crow.

  The area housing the vehicles is a hive of activity. Wagons are squared away, and B Company is preparing to move. Young Duffy is busy checking his much-loved .50 cal., and I take time to dust off and battle clean my own weapon, checking my medical kit before mounting up with Kev and Maj. Clark. Our interpreter looks the least happy about staying out for longer than expected; not everyone on this mission has that glint in their eye.

  ‘Cpl Coyle, are we good to go?’ the boss asks.

  ‘Roger that, sir,’ Kev replies, giving his usual wry smile.

  We set off towards our new home, the sound of muffled small-arms fire in the background. This would turn out to be the least kinetic move that we would experience over the next two months.

  CHAPTER 2

  ESTABLISH ROUTINE

  B COMPANY ARRIVES AT THE AFGHAN BASE JUST BEFORE MIDDAY. THE place looks different from what I could recollect from yesterday. It was shabby and makeshift, displaying all the scars of a base under siege. Afghan soldiers sit around, some smoking, some chatting, and others sleeping. They look crushed, and we are quickly informed that they have been getting smashed by the Taliban for several weeks, constantly engaged in close-quarter firefights. They have lost several men and are low on food and ammunition. Hand-to-hand combat has left many dejected, and their battle-worn faces say it all.

  This kandak fights alone and unsupported, and they have no indirect fire weapons, such as artillery; nor are they afforded the luxury of CAS in the form of Apaches or fixed wing fighter aircraft that coalition forces can call upon.

  These men are fierce and proud fighters, although many lack the basic discipline that Western soldiers learn in training. Weapons and equipment must be looked after if they are to survive the intemperate conditions of Helmand. However, the Afghans are in disarray, and their battle discipline is non-existent. Their body armour is all over the place – weapons leant up against walls in direct sunlight, rubbish strewn everywhere. They have been using the outer wall as a toilet, and the smell of human faecal matter is so strong that it overpowers the diesel fumes from our vehicles.

  Davey Robertson, B Company’s sergeant major, sets about ‘claiming’ some real estate so his men can establish a routine. He is an old-school soldier with a strong character, and by all accounts he is a bit of a ‘hard cunt’, as so delicately described by his men. I have yet to see any takers put this to the test. Just under six feet tall, Davey is covered in old tattoos. He has a glint in his eye, just like my man Duffy. Davey’s happy hardcore music would have probably been the Jam or AC/DC. That’s how it works: generations may change, but we all had our struggles somewhere along the line. It’s called ‘common ground’, and it’s how people in the military get on. You may not like the guy standing next to you, but you will find common ground with him in order to ensure that the job gets done. Beyond that, a mutual respect grows out of displayed skill and time spent together. I have only ever seen that in the military, and, more often than not, you grow to like someone’s once-annoying habits.

  Monty and Scotty get busy placing troops into defensive positions ensuring all arcs – where the Taliban might attack from – are covered. (The idea behind this is that our PB will have all-round defence should the Taliban mount an assault.)

  An ANA position on the roof of the tallest building is reinforced with a heavy machine gun. When troops are not on patrol, the big .50-calibre guns can be dismounted from vehicles and placed where they can be used most effectively. This job is left in the capable hands of young section commander Cpl Scotty Pew. Pew’s section has the back-breaking job of carrying sandbags up onto the roof to reinforce the gun position. This is both a physically demanding and time-consuming job. Sandbags are filled before Pew and his men carry them one by one up the dodgy steps and onto the roof; the steps are riddled with7.62mm holes from earlier clashes with the enemy.

  The Taliban would have eyes on the position at all times. Pew and the other young Jocks were happy that the enemy knew they were there. For them, it meant that the Taliban could see the firepower that would smash them in any future attack.

  Pte Drew Elder is another young soldier busy on the roof. Elder issued fire control orders last night to the less-experienced Jocks, acting as platoon runner for Scotty McFadden. Relaying information from one area of the roof to another, Elder took on the role of ‘link man’ for the platoon. The link man is probably the most important job in any fighting unit: if Elder gets it wrong the platoon, even the entir
e company, will become combat ineffective very quickly. Elder was raised in Falkirk, and he’s learning fast that his job is a thankless and sometimes perilous task. He puts his life on the line with every step taken in his role as link man.

  Every soldier has a job to complete before any contemplation of rest is realised. Maj. Clark’s communications (comms) are set up by Kev, who quickly turns an unused classroom into our command post (CP). Kev has the unenviable chore of keeping this company in comms with brigade HQ.

  Stopping my own job of setting up a CAP, I take a short break for a much-needed drink of water. I look around at the young soldiers going about their business, and it suddenly dawns on me that not so long ago some of them would have been bumming around Glasgow or other cities, sipping from bottles of tonic wine. They would have gone through the same decisions that I did before signing up.

  Many are from broken homes, or they crossed to and from the wrong side of the tracks. Colourful backgrounds are in abundance throughout most armies. To me, this is nothing to be ashamed of; if anything, it develops character, and that is exactly what we need if we are to stand any chance of holding Nad-e Ali.

  The young Jocks now man the corners of this isolated PB, poised to introduce the Taliban to a ‘Glasgow kiss’, in the shape of a .50-cal. machine gun. The only drink in sight is bottled water, or a few cans of Red Bull that the lads have managed to squeeze into their vehicles or bergens. When it comes to fighting, these men do it with ease; they are steeped in an infectious lust for life. Hardened beyond their years, their instinct to survive comes from a history of ferocious fighting men.

  As I make my way back into the ops room, my team are busy emptying two patrol medical packs. We operate a military medical assessment using the MARCH-P principals:

  M – Massive Haemorrhage

  A – Airway

  R – Respiratory/Chest

  C – Circulation

  H – Head Injury/Motor Function/Hypothermia