BALAD AIR BASE, Iraq — Iraqi troops wounded as they fought alongside Americans in the recent Fallujah offensive are filling nearly half of the beds at the Air Force Theater Hospital at Balad, worrying doctors about the availability of bed space should another tidal wave of patients arrive.

“We are very nervous,” said Dr. (Col.) Greg Wickern, commander of the 332nd Expeditionary Medical Group.

Unlike the wounded Americans, Iraqi casualties are not evacuated to the Army Regional Medical Center at Landstuhl, Germany. They remain in Iraq, requiring a bed and the attention of the medical staff.

And because of both a weak health care system in Iraq and the danger faced by Iraqis who help Americans, many patients cannot be released from the hospital at Balad Air Base, known as Logistics Support Area Anaconda.

If another military action or a particularly effective mortar blast create a large number of casualties for Wickern’s hospital, he said, “We would have to swell our bed space.”

An Air Force Theater Hospital is defined as an 84-bed hospital with the capacity to expand. Specific numbers of patients are not discussed.

During the recent fighting in Fallujah, the hospital received hundreds of wounded, including American troops, Iraqi allies, enemy combatants and civilians.

Fifty-one American servicemembers and about eight Iraqi soldiers were killed during offensive to take back Fallujah, said Marine Lt. Gen. John Sattler, commander, 1st Marine Expeditionary Force, in a news conference from Fallujah on Friday. About 425 American and 43 Iraqi servicemembers were injured during the fighting.

Wickern said about 20 percent of the patients treated at the hospital during the weeklong offensive in Fallujah were Iraqis fighting alongside Americans, but those casualties now tie up between 40 and 50 percent of the beds.

The Iraqi patients require ongoing care from the hospital staff, unlike wounded Americans who are evacuated for additional care as soon as possible, sometimes within hours. American patients rarely stay longer than a day or two.

“We have to provide a much more definitive level of care for our host nationals,” said Dr. (Lt. Col.) Jim Quinn, hospital chief of staff. “The volume of total care we give them has been a surprise.”

Because of the nature of the injuries, many patients are unable to receive the care they need in the local hospitals, Wickern said.

“The Iraqi health care system is trying to build itself back up,” he said. The Ministry of Health has made that a priority.

But it still lags behind and can not offer the treatment many of these patients need.

Also, the patients could face the wrath of insurgents who want to discourage with graphic measures cooperation with America.

“You can’t take these people and put them in a facility that is not considered infiltration-proof,” Wickern said.

Some patients have been released to family members.

An Iraqi physician visits the hospital once a week to assess patients and take those he thinks can be treated safely outside the wire of the American base, Wickern said.

“Normally, he takes about two people back each trip,” he said.

Wickern would like the visits increased to two or three times weekly to possibly empty more of the beds before they are needed for new patients.

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