U.S. combat hospital saving lives of more Iraqis

updated 5:41 p.m. ET Oct. 1, 2008

BALLAD, Iraq - The U.S. military's main combat hospital in Iraq has increasingly switched to helping Iraqis. As the numbers of wounded American soldiers have fallen, the hospital is now saving the lives of a remarkable 93 percent of Iraqis who come with devastating injuries.

It's another sign of the radical improvements in health care made at combat trauma care units in war time — especially because unlike U.S. soldiers, most Iraqi patients at the Air Force Theater Hospital don't wear body armor and helmets or drive in vehicles designed to withstand roadside bombs.

"There are people with injuries that are brought here, and I say this with confidence, if they went anywhere else in the world, they would not survive," said Col. Mark Mavity, the commander of the hospital.

On one recent day, 5-year-old Sajad Lafta lay in his bed crying for his father while his older half brother, Abdul Wahid, tried to comfort him by holding up a picture of a puppy that Sajad colored while recovering at the hospital.

The boy didn't know yet that Wahid, 25, came to visit him because his father was attending the funerals for two of his other young sons. They were killed by a car bomb that blew off Sajad's lower left leg and left tiny pieces of metal scattered over his body.

"Thank God, we are positive he is going to live," said Wahid, who planned to bring the puppy picture home to their mother as proof that Sajad was alive.

Trauma victims
Over the years, the hospital on Balad Air Base has become synonymous with combat trauma care. It is best known for saving countless U.S. soldiers with catastrophic battle injuries — more than 96 percent on average over the six-month period ending in August.

But even more astonishing, during that same time, about 93 percent of Iraqis left the hospital alive — up from an average of 89.7 percent during the previous six months.

Their injuries are devastating — shredded limbs, penetrating shrapnel fragments, massive internal bleeding and gaping head wounds.

The car bomb that wounded Sajad exploded during the evening of Sept. 12 in the town of Dujail, killing at least 32 people including his 7- and 6-year-old brothers as the three walked home after buying a few pieces of candy.

When Sajad's father heard the explosion, he raced over to his sons. Sajad was the only one still breathing. After the local hospital turned the boy away because his wounds were too severe, Sajad was taken on a U.S. helicopter to the military hospital on Balad Air Base, about 50 miles north of Baghdad.

Of the 11 Iraqis wounded in the blast who were taken to the hospital, 10 survived. The 11th was declared dead on arrival, doctors said.

As soon as the Iraqis arrived at the hospital, a team of doctors and nurses began operating — up to eight patients at a time. Nine hours later at 4 a.m., they called it a night.

"The magnitude of injury is something that's unlike what we typically experience in the civilian world. ... We had a gentleman (from the blast) with an arm blown off, a leg blown off, a kidney that was destroyed, huge soft tissue injuries, a head injury and he's alive today," said trauma chief Maj. Gary Vercruysse, an Air Force reservist who is an assistant professor of surgery at Emory University and works at Grady Memorial Hospital in Atlanta.

'Head-to-toe injuries'
The injured were rolled back into operating rooms again the next day. Much of the effort was placed on cleaning wounds to prevent infection. Sajad had his leg amputation wound closed and shrapnel painstakingly picked out of his body.

Trauma surgeon Lt. Col. Debra Malone spent four hours on Day Two with one man alone, closing up his amputated finger, reconnecting pieces of his shredded bowel and washing out severe leg and groin wounds.

"This man is a poster child for what we see here — head-to-toe injuries. He would have possibly not survived if he didn't come here," said Malone, a practicing physician at the University of Maryland Medical Center and chief of the medical research branch at Air Force headquarters.

Malone predicted that the man would stay at least a week in the hospital — something unheard of just a year ago.

Fewer U.S. patients
Iraqi patients are surviving at higher rates partly because of bed space. As violence declines and fewer Americans are brought to the hospital daily, Iraqis are able to stay longer and receive more thorough care.

In August 2007, Iraqi patients stayed an average of about four days, but last month the average jumped to nearly a week, according to hospital data. The time coincides with a drop in admissions. The hospital admitted 140 trauma patients — including Americans and Iraqis — last month, less than half the number of August 2007.

"We now have the luxury of time and bed space to keep them here a little bit longer. That is a big reason why our numbers have gone up," Mavity said.

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