Update from the field — Afghanistan: The ‘Usual’ Day of of an Emergency Nurse

Last week a suicide truck bombing killed two civilians and wounded more than 40 in the southern province of Helmand. The causualities from the attack, all civilians, were treated at our surgical center. Roberto, a nurse working in the center recounts his day and the grim routine of his job.

“How’s it going in Lashkar-gah?”

“As usual… pretty much as usual.”

That’s more or less what I say when someone back home asks what’s happening here.

I’ve been away from Lashkar-gah, Afghanistan for three years, and now that I am back, it seems that things are as usual. It’s just that “as usual”, in Lashkar-gah, means what happened this morning.

At 9.30, while doing the rounds of the patients, there was an explosion. The earth trembles. The walls tremble. Your whole insides tremble. Just two seconds to stop still, and look at each other.

Then everyone began moving like robots, as if they’d never done anything else in their entire lives. Dimitra, the Medical Coordinator, ran to the hospital gate and then quickly announced via radio the activation of the “mass casualty plan”.

“How many?” It’s the question on everyone’s lips in those long minutes of waiting.

No-one answers. No-one knows.

A lorry-bomb was blown up just a few kilometres from here, near a police station. There’s a school next door. A never-ending time in our minds, but just a few minutes on the clock in reality.

Then movement. Organised chaos, with everyone knowing exactly what to do. The first to come in was a little girl of 9 with shrapnel in her head. Straight after that, a woman with shrapnel in her abdomen. Then it became impossible to distinguish one from the other. Bodies, wounded bodies. Bodies to be examined, to be put on the waiting list for the operating theatre, to be taken to the ward, to be stitched up, to be treated. Then I suddenly realised that most of them were children: only after a few hours did I remember the school.

You’ve been caught up in it all, my little ones. You’re one of the many “collateral damages”.

In the end, 35 people arrived. Surgery was needed for 11 of them, while the others got off with some OPD treatment. Now they’ll go home, out there, outside the white and red gate of the hospital, back to where they came from. I don’t know if they really “got off” though.

At 12.30 the mass casualty situation ended and a patient arrived from the district of Sangin with a bullet in his abdomen. He was brought in by the boys of one of our First Aid Posts. Soon after, a 12-year old body with shrapnel in his groin…

And the silent procession starts up again.

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