Spoken from the Front (5 page)

I was actually at the Brigade Headquarters in Lashkar Gah
when the helicopter went down. At first, we just had some
initial information coming in. We didn't know what
nationality the helicopter was. On that particular operation
Dutch, US and British helicopters were taking part, so to start
with there was some confusion as to what had happened. It
then transpired that we'd been lucky to a certain degree. I
believe that a platoon of British soldiers had just been
dropped off and it was as the helicopter was taking off again
that it went down. We were trying to identify who was on it.
The crew was US so at first we had no idea there had been a
British person on it [the helicopter went down in an isolated
area near Kajaki in Helmand province, when it was
apparently under fire].

The incident happened quite late at night and people were
up into the early hours of the morning trying to establish the
full details. It was first thing the next morning that I heard
that there was a RMP NCO [non-commissioned officer] on
board. I knew that it wasn't any of my own unit because I
would have known if they'd been there so the only other
military policeman in theatre was that young lad, Corporal
Gilyeat. Some of the guys in my unit had worked with him in
Iraq.

Every time a UK soldier is killed in theatre, there will be a
repatriation service to put that soldier on the plane to send
him back home to the UK. Our brigade – 12 Mechanized
Brigade, which we were supporting – was doing its own
thing at the same time that the repatriation service was taking
place at the airport in Kandahar. We were in Lashkar Gah, the
Brigade Headquarters, having our own little ceremony. It was
outside in an open area of ground. A warrant officer called
everyone to attention. Everybody stood in various ranks and
files and a padre said a few prayers. A member of the
soldier's unit gave a eulogy about him and then we had a
two-minute silence. Because he [Corporal Gilyeat] was RMP,
we formed the coffin-bearer party at the main repatriation [in
Kandahar]. We did as much as we could to help repatriate the
body. For our guys, the sad thing was that we were also
the ones who investigated the death: the SIB took on that
investigation too.

My greatest concern is when I am putting our people out
on the ground to support deliberate operations and to
support the infantry. I know the characters in my unit and I
probably know their wives and families too. You are putting
young people on the ground when lines of communication in
Afghanistan, for small units such as mine, are quite difficult.
Obviously the battle groups could communicate with the
brigade but trying to have communications with a particular
individual was nigh on impossible. If there was any likelihood
that they [the infantry] would take detainees, then
generally there would be an RMP presence on the op. If they
went out on an operation, we generally didn't get to speak to
them again until they got back. We also had an RMP presence
in some of the isolated detachments, such as Kajaki, because
if there was an incident up there, such as a UK death, it could
be very difficult to get to. So you had someone on the ground
who could instantly respond. We would put these guys up
there and they would embed with the infantry lads.

Including the RMP GPD [general police duties], SIB and
MPS [Military Provost Service, like prison officers] there were
seventy-three of us [Provost] all told in Afghanistan at the
time. We were lucky that we all came back safely [except
Corporal Gilyeat]. Sadly, the Royal Anglians lost nine and
had something like fifty-seven injured. The tempo of operations
during that summer was quite high so it was a
constant planning process. We were always planning the next
operation. As one unfolded, you were already into the
planning phase for the next.

Some of the Afghans found it strange dealing with a
woman. Most were OK with it, but there was one incident
which amused me: the OC of the SIB, who was male, was
reading the paper one day in Kandahar and there was an
article all about girls out-performing boys in exams in Britain.
He mentioned this to the interpreter, a young Afghan man in
his twenties, who said: 'How can that possibly happen?' And
the OC said: 'Well, it does.' And the interpreter said: 'This
would not be allowed to happen in Afghanistan. We would
manipulate the results – it would not be allowed in our
country.' That made me laugh.

Lieutenant Colonel Duncan Parkhouse, 16 Medical
Regiment

Lieutenant Colonel Duncan Parkhouse, of 16 Medical Regiment
(part of 16 Air Assault Brigade), is a senior member of a medical
emergency response team (MERT). Aged forty-two, he was born
and brought up in Exeter, Devon. His father was a civil servant,
his mother a teacher, and he has an elder sister. After attending
Exeter School, he went to University College Hospital as a
medical student. At twenty-one, he signed on as a military cadet
because he wanted to combine medicine with a career in the
Army. Married to a former nursing officer, he is based at
Colchester, Essex. His tours of Afghanistan last, on average,
two months, and he is a veteran of no less than six between
2006 and 2008, which means he has spent an entire twelve
months there during just three years.

After a major trauma, a certain percentage of victims will die
within the first ten to fifteen minutes. There is another peak
at around the hour mark. Then there is a third peak at the
two-to-three-day mark that is due to complications. With the
best will in the world, we [the MERT team] are not going to
be able to do a huge amount about the ones that are going
to die within the first ten to fifteen minutes, particularly in a
military environment.

So instead what we are doing is looking to keep people
alive during what we call the 'golden hour'. We have always
had in place a medical evacuation system from the point of
view of the wounded. But when we first came out [in early
2006], we looked at the med plan and we knew it was going
to be difficult to evacuate soldiers who were wounded on the
ground back to us within the golden hour. We estimated that
it would probably take – with the problems of extraction and
the hostile environment – up to two hours to get them back to
surgery. So we wanted to mitigate that by pushing out on our
evacuation teams – senior doctors who have specialist
skills in resuscitation. We are basically your emergency-department
doctors, your intensive-care doctors and
anaesthetic doctors. The aim is to help the small number of
soldiers who may succumb – who may die in transit –
because of the potential delay. And that's what the concept of
the MERT is all about. It is bolting a small, specialist
medical team on to an RAF evacuation team to produce
a link from the medic or young doctor on the ground, and
the all-singing-and-dancing hospital where a patient will
eventually end up.

MERT dates back to the Balkans conflict, if not before. At
that stage we had an incident response team [IRT]. An IRT
was a way of getting specialist agencies to the site of an
incident. That was not only medical, also engineers, bomb
disposal, Military Police. That was when we were first
putting medical teams on helicopters to go forward and pick
casualties up. That was very much a local organizational
structure: it was not doctrine. That was when people first had
the idea of putting medics or any specialty on a helicopter
and maybe leapfrogging other medical nodes along the way
to speed up the casualty evacuation. In Iraq this was
continued in the early days of 2003–4. We would have
specialist RAF teams usually involving a paramedic and a
nurse, sometimes backed up by a doctor, depending on the
nature of the incident. The thing is those doctors were not
necessarily pre-hospital-care-trained to the standard of what
we have now in Afghanistan. It was a different war, different
situation. It worked reasonably well and they worked very
hard.

Coming back to 2006, when we – 16 Medical Regiment –
deployed with 16 Air Assault Brigade, we had a lot of
experienced critical-care doctors including anaesthetists and
emergency medical care practitioners, A-and-E docs. Also,
they had the ethos that they really wanted to support 16 Air
Assault Brigade as much as possible in-field. 16 Medical
Regiment took this idea of a medical IRT and formalized it in
to a medical emergency response team [MERT]. It was
actually breaking new ground and, like all things when you
break new ground, there was a certain amount of resistance
to it. I would suggest that the one person who had the most
input in starting it was a chap called Lieutenant Colonel
Andy Griffiths – in the early spring of 2006. As well as Andy,
the other man who really pushed it was the commanding
officer of 16 Medical Regiment, Lieutenant Colonel Martin
Nadin – now a full colonel. They simply wanted to support
the troops on the ground as much as possible.

The MERT is a concept. It is purely about getting the care
that the soldier requires to him or her as early as possible.
And that is really making sure that these critical interventions,
which can be life-saving, are done as quickly as
possible by having a team on the helicopter that mitigates the
extra length of time it takes. You can carry on doing the treatments
while evacuating them and see how they should be
treated when they get to the base hospital. The [MERT] team
make-up will vary depending on your resources and what is
going on on the ground. In the spring of 2006 in Afghanistan,
we had a four-person team and that was based around an RAF
paramedic, an RAF flight nurse, a senior clinician with critical-care
experience – probably an anaesthetist or emergency
medicine doctor – and the fourth member of the team was an
Operating Department practitioner [ODP]. In 2006, we were
averaging three shouts [medical call-outs] a day, but sometimes
we would do as many as five.

One of the reasons why I do this job, and one of the reasons
other people do this job, is that in the military medical system
there is a huge duty of care for the soldiers on the ground.
Personally I think the NHS has lost that. The NHS does not
have that link with the general public any more and there are
lots of reasons for that. But we certainly still have that very
strong ethos of supporting the guys on the ground.

Colour Sergeant Richie Whitehead, Royal Marines

We had a couple of attacks on the camp [Lashkar Gah] as they
[the Taliban] started to get a little bit braver. Or we were
perhaps setting one too many patterns – they started to learn
what our routine was. The first ever RPG attack was in the
early hours of the morning – one or two a.m. It was pitch dark
and I was doing my rounds, walking around the base. And a
guy with an RPG had literally just walked up to the fence and
fired it at a sangar. It missed the sangar and the RPG just went
on, like a rocket, straight over the camp and outside again. He
had completely missed us from twenty-five metres. How that
happened I don't know. I rushed into the sangar, where there
was one of my lads, a young Scot named Ted. He had only
just come out of training and he was just sat there in amazement
saying: 'Did you just see that?'

I said: 'Yes, but are you all right?'

He said: 'Yes, but did you just see that?'

I said: 'Yes, I did. It's OK. It's fine. There's no point dwelling
on it.' It was just like a bang and a rocket, like a firework, going
off. The RPG just hit some derelict ground on the outside and
that was that. But from that point we realized we needed better
torches – dragon lights in the sangars – because what we were
issued with was not good enough. You could not see out, which
meant this guy had just walked up to the fence and fired at us.

McNab:
A British soldier was killed and two were seriously
wounded in a fire-fight. Captain James Philippson, aged twenty-nine,
of 7 Parachute Regiment Royal Horse Artillery, was the first British
serviceman to die after the deployment to Helmand province: his patrol
was ambushed by Taliban fighters outside Sangin. The servicemen
were in Land Rovers when the attack happened. Anthony Philippson,
the victim's father, said his only consolation was that his son had died
in 'the job he lived for'. Apache attack helicopters were called in to
support the troops following the ambush. Several Taliban fighters
were killed.

Flight Sergeant Paul 'Gunny' Phillips, RAF

Flight Sergeant Paul 'Gunny' Phillips, RAF, is forty. He was born
and brought up in Dundee, Scotland, and is the eldest of three
siblings. He left school at sixteen and began on a Youth Training
Scheme (YTS), rebuilding car engines. He joined the Royal
Marines in 1985, but left in 1990 and worked in various jobs on
'Civvy Street'. In 1993, he joined the RAF and spent seven years
as a storeman, serving three years at RAF Lossiemouth and four
years on Tactical Supply Wing at RAF Stafford. In 2000, he began
retraining to become a member of the air crew and joined 27
Squadron in 2003. He did tours of Northern Ireland and Bosnia
as ground crew and later, as air crew, two tours of Iraq and four
two-month tours of Afghanistan. He is based at RAF Odiham in
Hampshire.

I hate to use the term but I am a jack-of-all-trades, really. My
role is probably the most multi-skilled job in the air-crew
world. To run down my duties: I am responsible for the on-and
unloading of passengers and cargo, responsible for
voice-marshalling the aircraft by day and night in confined
spaces, voice-marshalling the aircraft for underslung pick-up
and drop-off, air navigation assistance, radio work, limited
search and rescue capability, and air-to-ground gunnery. I can
field service the aircraft but not in nearly as much detail as
engineers.