Field hospital taking on littlest patients in Afghanistan

Arsala, 5, recovers from surgery at the tent hospital on Forward Operating Base Salerno, Afghanistan, under the watchful eye of his uncle.


Local health ministry, U.S. Army work together on tough pediatric cases

By ANITA POWELL | STARS AND STRIPES Published: March 6, 2006

FORWARD OPERATING BASE SALERNO, Afghanistan — An Army field hospital seems an unlikely place to find seriously ill children.

But a new partnership between Salerno Hospital and the local ministry of health has transformed the tiny tent hospital into something of a pediatric intensive care unit.

Through the new program, which is just weeks old and does not have a name, the hospital treats patients whose cases local doctors have determined to be too difficult or intensive. The hospital’s doctors also work with local doctors to teach them how to treat such cases in the future.

So far, in three weeks, all three cases have been children, said Lt. Col. Bruce Shonebloom, detachment commander for the 14th Combat Support Hospital at Salerno.

That was “a little unexpected,” said Shonebloom, a nurse anesthetist. “Nobody told us we’d be taking care of so many kids.”

Shonebloom said doctors have treated a range of severe and difficult ailments, including a hereditary blood disorder that causes massive engorgement of the spleen and severe burns that require skin grafts. The staff at the hospital say the unusual experience has touched them deeply.

“We get a real sense of satisfaction,” said Maj. Elizabeth Vinson, a registered nurse. “We actually get to see the benefits of our work.”

Patients and their families seem equally pleased with the care, which is provided for free.

“They treated us very well,” said 18-year-old Anwar Khan, who sat by the bedside of his nephew, Arsala, 5, who was grumpily convalescing after surgery on his enlarged bladder.

Initially, the family took Arsala to a local doctor, but later “decided to take him to the American hospital because of the better treatment,” said Khan, who is studying to be a doctor.

For local doctors, Shonebloom said, the partnership offers an opportunity to improve their medical skills.

“They’re very professional and they’re very caring and they’re very willing to learn,” Shonebloom said. “But they just do not have the specialized skills my doctors and nurses have.”

Dr. Bashir Ahmadazai, a Pakistan-trained doctor from Logar province who works at the clinic as a translator, said local doctors have learned much from the partnership.

“We are so impressed,” he said in English. “Many of the serious problems have been treated very well here.”

But the partnership has also caused some heartache.

For two weeks, 26-year-old Zainab sat by her daughter’s side, watching her tiny, frowning face and the third-degree burns that covered her arms, legs and chest.

A month ago, a pot of cooking oil toppled over 1-year-old Malala, covering almost 30 percent of her body. Her parents rushed her to the local hospital, where doctors determined that her injuries, which would require multiple skin grafts, were beyond their scope. They referred her to Salerno Hospital.

During Malala’s stay, hospital staff doted on her constantly.

“She’s our baby,” said Vinson one day last week, tenderly rearranging Malala’s bandaged limbs. “It’ll be a sad day when she leaves.”

Two days later, Malala died in her sleep of unrelated causes. Doctors believe she may have choked on the contents of her feeding tube. She was to be discharged the next day.

“We were very shocked by that,” Shonebloom said. “She was supposed to go home today. She was doing great. She was doing absolutely great. We were all very upset.”

Her parents, he said, were gracious through their grief.

“At the very last minute, as they were walking out, they were appreciative,” he said.

He said the hospital staff will work through the tragedy to help more patients.

“Part of who you are as an American is to make a difference,” he said. “This is an opportunity to make a difference.”

Maj. Elizabeth Vinson feeds 1-year-old Malala as her mother, Zainab, watches. A partnership between Salerno Hospital, an Army field hospital in Afghanistan, and the local ministry of health has transformed the tent hospital into a virtual pediatric intensive care unit. Under the program, patients whose cases are too complicated for local doctors can get care from U.S. military medics assigned to Salerno. Hospital officials were shocked when, one day before she was to be discharged, Malala died.