Picking up the pieces from Afghanistan's war

By Emma Graham-Harrison

ALAH SAY VALLEY, Afghanistan (Reuters) - U.S. gunners scanned a lush Afghan valley from their helicopter, as a small white van containing a badly burned baby inched toward another Black Hawk waiting at the army outpost far below.

Eight soldiers had flown into the heart of hostile eastern Afghanistan, in a convoy of one air ambulance and one "chase" helicopter for protection, to collect 18-month-old Amanullah who knocked a pot of scalding water over his legs, penis and scrotum.

The screaming baby is part of a mission to show Afghans that the presence of foreign troops and aircraft can bring more than Taliban attacks, at a time of mounting public anger about civilian deaths from air strikes by coalition forces.

"It's definitely part of 'hearts and minds', giving people something they don't have, letting them know by example that we care about them," said Chief Warrant Officer 2 Brandon Lynch, pilot on the helicopter that landed in the Alah Say Valley.

"If that means us flying and putting ourselves in a dangerous situation, we'll do it. To me, that's worth it."

Lynch is part of a "Dustoff" flying medical evacuation, or medevac, team of national guard troops who speed around the country in helicopters equipped with cutting-edge medical technology to pick up wounded soldiers.

They have revolutionized battlefield care, collecting the injured from the heart of hostile territory, winching them off steep mountainsides into hovering helicopters, and ensuring that all but the most severely wounded make it to hospital alive.

But the sporadic nature of fighting a guerrilla insurgency means they are not always needed by U.S. or Afghan troops. So when the fighting is quiet, they try to help ordinary civilians.

"I think that's exactly what we should be doing here, caring for local nationals," said medic Sergeant Steve Park, who treated Amanullah on his flight to hospital, just hours after airlifting a pregnant woman.

Three decades of war and unrest has left Afghanistan's infrastructure in pieces, with few and badly equipped hospitals, often at the end of bone-jarring trips down dirt roads.

After serious accidents, Afghans often turn to the only arm of the state with a presence almost everywhere -- the army. Most civilian cases are referred to hospitals from outlying bases.

CULTURAL GULF

The "Dustoff" medics do the same job back home, when they are out of their national guard uniforms and working for civilian organizations, and some have years of experience.

But the injuries in Afghanistan are different -- more violent trauma wounds from guns, shrapnel, bombs or long-forgotten landmines -- and so are the patients.

"International and Afghan forces with the same wound present totally differently. They are unbelievably tough. You'll have an Afghan soldier with a gunshot wound and you ask 'Are you in pain?' and he'll say 'No'," said medic Sergeant Reuben Higgins.