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.
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.
The cultural gap can sometimes work against medics however, especially on board the helicopters where there is no room for the translators who are on hand in hospitals around the clock.
On a recent flight carrying two wounded Afghan soldiers to the Bagram airbase hospital, one man who was still conscious kept pointing to medic Sergeant Stephen Solum’s trousers.
After a portable urinal was rejected by the man and Solum had checked the patient’s legs for injuries, he gave up and turned back to the more delicate task of controlling the heart rate and blood pressure of a second unconscious patient.
Afterwards 18-year-old Khaysta Gulab explained from his hospital bed that he had just wanted to know what had happened to the trousers which medics cut off when he was injured.
“My wallet had four months’ salary in it, because I had not been home for a while,” said the Afghan Army soldier.
Although the medics aren’t fighting on the frontline, their jobs are still dangerous and physically demanding.
The unarmed medevac helicopters can make tempting targets for insurgents, said Captain Lukas Berg, who flies one of the “chase” protection Black Hawks that accompany every mission.
Medics carry on their body as much as 55 pounds (25 kg) of gear, and need the physical skills to extract patients from hostile places as well as the medical skills to save their lives.
The hospital at Bagram airbase is named after a medic who died when he was being winched up into a helicopter with a patient, and the cable holding them both broke.
But the biggest challenge may be seeing the physical toll of war on a daily basis. The medics are at the front line every day, picking up the pieces left behind by high-tech modern conflict.
The coincidences of duty rotas and accident times mean medic Steve Park has evacuated a disproportionate number of the children in Bagram’s hospital, many of them casualties of war. It is often unclear who fired the shots that injured them.
One girl was burned by white phosphorus, three other beds hold a family whose home was ripped apart by a rocket, and further down the ward is a young boy with a scar snaking down his abdomen after he was caught in crossfire.
Father of a toddler and a teenager, the most difficult cases have a personal resonance despite his training.”
“You see the bits and pieces left over. Emotionally it takes a toll ... (but) that’s the joy of medevac in my opinion,” he said. “We aren’t out shooting or killing, we are out helping the hurt.”
Editing by Sugita Katyal