Bites and bomb blasts – all in a day's work
Almost 5,000 miles away from home, Major Rose Chapman leads a team of nurses in Ward 3 of Camp Bastion hospital. Reporter Rebecca Ricks spends the day accompanying the Derriford Hospital Bank Nurse on her duties caring for the wounded and sick patients admitted to the facility.
6.15am: The alarm clock goes and Major Rose Chapman dashes from her cot bed to the showers. Simultaneously the night team of nurses and doctors at Camp Bastion Hospital's Ward 3 are coming to the end of their shift.
By 6.35am Rose is checking her rifle and picking up her body armour ready for the five-minute walk to the hospital.
I meet her in the ward at 6.45am as she prepares to take over as the officer in command. At 7am sharp a meeting starts. The day team are briefed with each patient's condition and issues that arose overnight.
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It emerges that an Afghan civilian who suffered extensive injuries on Friday, including the loss of both his legs, after stepping on an improvised explosive device (IED), did not survive the night. He had received the best care available anywhere in the world but his injuries were too severe. The other two patients admitted on Saturday with gunshot wounds are now on their way to recovery.
With about 13 patients still needing care on the ward Rose, of Eggbuckland, Plymouth, begins delegating the responsibilities to a team of eight nurses.
7.26am: Ward rounds begin. Rose oversees as her team administer medication, carry out routine tests and see to the patients' overall wellbeing.
In the ward there were a handful of Afghan patients ranging from Afghan National Police, Afghan National Army and locals. A few British and American patients were also being cared for but as the Afghans take on more responsibility for combat roles these relative numbers are what would be expected.
Non-ISAF personnel (the NATO-led International Security Assistance Force) and civilians are treated at the hospital based on risk to life, limb or eye. Three hospitals take admissions for these individuals: civilians go to Bost, the district hospital in nearby Lashkar Gah, and security forces to the National Military Hospital and the National Police Hospital in Kabul.
"Some patients wait up to two weeks to get to Bost which means we have to care for them for longer, but for our UK guys, if they have to go home, there are two flights a week so they get out pretty quick. For the very sick a special intensive care flight will come out that night," Rose added.
8.15am: Rose and the team brief the medical director, Colonel Rob Russell, and the duty doctors of the patients' overnight progress before deciding on the plan for the coming day.
9.17am: A new admission arrives. The individual requires surgery to his finger.
11.14am: Another new admission arrives with suspected gastroenteritis.
"There's a real diversity in here, you can get a real mixture of people being admitted for diseases and infections right through to really extensive blast and gunshot wounds," Rose says.
She tells me that during this short tour they have come across unexpected but often serious medical situations from individuals being diagnosed with terminal illness and tuberculosis through to a man with a bolt in his brain after an IED explosion. They have also dealt with scorpion bites, 'Helmand fever' caused by insect bites, and simpler ailments like torn ligaments.
11.44am: A transfer admission comes from the Emergency Department. The cas-ualty has a suspected torn bicep and awaits an MRI scan to reveal the extent of the damage.
12.57pm: An aero-med team arrive to collect two patients who are being discharged for evacuation to Kabul. One of the men had suffered gunshot wounds to his abdomen and pelvis, the other was severely injured by a bomb blast. Both were members of the Afghan Security Forces.
After their dispatch, Rose co-ordinates two nurses to take around the lunches while she begins a stack of paperwork and admin. Starting out her Territorial Army career as a private, the 46-year-old has worked her way up the ranks to major and as a result has a great understanding of all roles under her charge.
The patient turnaround at the hospital is faster than any you would see in the UK and it's not long before she discharges another one to the next stage in their treatment.
2.13pm: A member of British personnel is sent back to his unit after being treated for a fever and temperature. With her caring motherly smile, Rose hands the man his pain relief and says farewell as he walks out to a waiting car. I sense he is beyond grateful for the way the team have tended to him during his stay.
2.37pm: Another admission arrives. The young-looking soldier hobbles in for physiotherapy in response to an orthopaedic problem.
About 30 minutes later we hear over the public address system that a Category A casualty is being brought to the hospital. More than likely the individual will end up in the care of Rose's dedicated team after their initial emergency treatment.
By 5pm Rose returns to her desk at the head of the ward to continue her administration. The temperature inside is balmy at 25 degrees. Outside temperatures reach perhaps seven degrees, regularly dropping below zero. Rose explains they have the temperature set high for the benefit of the patients who seem to recover better with warmth.
At 6.45pm the night team arrive ready for Rose's handover. It will be 8pm by the time the married mother-of-two reaches her accommodation to relax for the evening ready to start all over again tomorrow.