December 1st, 2009
09:32 PM ET

The ravages of war

By Dr. Sanjay Gupta
Chief Medical Correspondent

This week we will be talking a lot about Afghanistan and the impact of the President’s speech. Having spent a fair amount of time there, including a trip just a couple of months ago, I am always reminded of the human impact of any conflict. I am reminded there are consequences to all those booms and explosions we see on television. I am reminded of the horrific injuries I saw due to IED explosions where young men and women are robbed of their legs, and their lives. I am also reminded of the remarkable sacrifice the doctors, nurses, medics and all the medical personnel make every single day out there. They truly risk their lives to save the lives of others.

Medicine and the military are embraced in an awkward dance and no where is that more true than in Afghanistan. Because of the terrain, most of the med evac missions are carried out by chopper. They typically have 20 minutes to fly to the patients, 20 minutes to stabilize and treat, and 20 minutes to get the patients to more medical care. It is one golden hour. Right now, even as I write this, these medics are sleeping in forward operating bases just behind the front line troops - with their boots on, and eyes half open in dusty desert tents waiting to get the call. Waiting for a chance to save their fellow soldiers who got the call before them.

Truth of the matter, nearly three-fourths of the time, the call they get is to take care of an Afghan local or soldier. In fact, if you look at the breakdown of operations performed at the coalition force run Kandahar Role III, the largest trauma hospital in the country, most are performed on Afghan patients. The local medical system in Afghanistan lacks the infrastructure to take care of most of these sorts of injuries. There is only one vascular surgeon in the country, two neurosurgeons and really no ability to perform cardiac surgery. It made me wonder what will happen to patients with trauma a year from now or in five or ten years.

If you look at pure numbers, for every 10,000 troops, 127 will be wounded in action. A tenth of those wounded will have traumatic brain injuries and several others will need amputations. Still others will have serious burns. It costs close to $20,000 per soldier to provide field care, and if you add in an air evacuation, the cost is closer to $50,000. At the Kandahar hospital, doctors are performing close to 300 operations a month, and that number is expected to increase over the next few months.

Of course, these numbers are meaningless to the tens of thousands of troops in Afghanistan right now and the tens of thousands about to head there. As you watch the speech tonight and the analysis over the next few days, try and remember the medical staff there as well. They are the ones embraced in that awkward medicine and military dance – they are the ones trying to repair the ravages of war.

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soundoff (15 Responses)
  1. George

    Sad it is, War. The president does good reminding us of the brave few who are at risk at this moment. I;ve been around long enough to say this president is up in the ranks with the great leaders before him. He is aware of the living plight of this land of the brave. Easy it is to critic when no-one is aiming an AK47 at you or planting an IED in your path. Some decisions are not easy to make and the president has made one. I'm sure alone I am not feeling proud of MY country and its leader today

    December 1, 2009 at 22:36 | Report abuse | Reply
  2. John Cameron

    outstanding on the medical end and susan is correct the people really want us to teach their kids and to be there for them....the medical help enhances it...the hearts and minds enforces it

    December 2, 2009 at 00:47 | Report abuse | Reply
  3. joyce

    I would ask if Pakistan has a infrasture that could support aid in Afganistan and if Pakistan would ally in stabilizing the region. India has become significant in training medical doctors and I wonder if Pakistan is anywhere close in ability?

    December 2, 2009 at 00:48 | Report abuse | Reply
  4. Lisa B

    There is no doubt in my mind that the lingering effects of any life-threating experiences, can change the future of not just the individual, but they're familys, friends of family and strangers alike. Navigating a complex exsistance with a damaged celerbrum, can become far to difficult without consistant assitance. The family then becomes part of the experience, and so on.. Changing the dreams of so many, your bound top encounter growing resentment. Just this morning I awoke to find the new landscape plants ripped from there holes and cast about the apt complex. My first thought was, At least they did'nt set the place on fire. and was it the solider or his child who... I know the feelings of hate.. hit a critical peak last night.. even among the uninjured. Nobody wants to go to war, but It is the duty of any citizen of any country to stand. When they refuse to do so on the grounds that it's not there responsiblity, then it's not just the braindamaged that act irrationally, it's everyone who's loyal enough to pay attention to what the govt. is doing. But not disiplined enough to see past they're own prejudices. I try to tread lightly because of this, and it's like walking on eggshells . Thanks to all the ones who see the whole picture, thats a trauma in it's self. But I see a dangerous world growing more dangerous with last nights decision. Our soliders on the ground, need to go in with the right attitude, win the respect, and compassion of your enemies neighbors, share they're pain and ask them to help stop the IED attacks. Use logic not gold,.

    December 2, 2009 at 08:18 | Report abuse | Reply
  5. brad

    We need to stop going to war, plain and simple! (If it were only that plain and simple)

    December 2, 2009 at 08:41 | Report abuse | Reply
  6. Jojy

    Yes Sanjay
    We need to improve the ratio of Medical is to Military personnel in the Afgan War Zone.We have more medical pesonnel than the military but this side of need is not much hghlighted.

    December 2, 2009 at 09:46 | Report abuse | Reply
  7. angie

    Concise and mindblowing.I knew about the lack of doctors from a neighbor who moved here in the 90's but seeing it stated that way-just ............

    December 2, 2009 at 10:20 | Report abuse | Reply
  8. Nicole Silver

    Thank you, Dr. Gupta, for your keen insight, and excellent reporting. I have great hope in our President, and his Administration, to where he has the data that you present here- data that you have risked your own safety in order to obtain, and therefore share with all of us. You too, are a hero, by keeping us informed, while in risky conditions-thank you.

    December 2, 2009 at 11:33 | Report abuse | Reply
  9. Stuart Maxson

    I am not a Genera,l nor a Company Commander. It's seems at times our troops are put into "Harms Way" in a most careless way. When 9 of our troops were killed, they were in an area where they didn't control the high ground, and the enemy did. That situation was totally uncalled for. Why would commanders even think of putting their troops in a situation such as that. Even as children and playing cowboys and indians we had better sense than to get in that position.

    December 2, 2009 at 11:40 | Report abuse | Reply
  10. Steve D

    I'm a minister and I hate war. I just can't bear the thought of taking another life or being responsible for the injury of civilians... Especially children. But I voted for this president because I believe he's smart enough and careful enough to get us out of this mess.

    May God bless us all as we try to do the right thing.

    December 2, 2009 at 12:14 | Report abuse | Reply
  11. Jill

    You raise some excellent points here Sanjay. Is anyone factoring in the longterm cost of these injuries and rehabilitation? Will there be resources for all of the injured, both US troops and Afghan citizens? War has long term consequences on all who are affected. The financial cost is much more than portrayed, not even mentioning the emotional and psychological trauma.

    It would be interesting to determine if those Afghan citizens educated in our medical system have an interest in returning to help their people.? This would be a critical network of support that may be overlooked. What about medical supplies? What efforts have been undertaken to secure the medical needs of this country? This infrastructure is critical to the long term stability of this nation.

    December 2, 2009 at 14:44 | Report abuse | Reply
  12. Bill

    Thanks Sanjay for that compelling description of life and death in Afghanistan. I have great respect for what you do and what you stand for as a caring human being. I pray for our troops in Iraq and Afghanistan everyday!

    December 2, 2009 at 18:01 | Report abuse | Reply
  13. Dr.Jimson

    Well, it is indeed shocking to know the ground reality. The Medics out there are doing a great job during the golden hour and after that also. But how is it that the government of Afghanistan going to address the problem of Medic patient ratio ? Only one Vascular Surgeon, 2 Neuro Surgeons ?? Do they get rest at all ?

    December 2, 2009 at 23:56 | Report abuse | Reply
  14. Sam Allen

    I think it is important to highlight the sacrifices of all military personnel – those who don't make it back from the war zone alive, those who are injured, the dedicated health professionals....but lets not forget the unmeasurable effect on the mental wellbeing of all those exposed to the conflict.

    We need to ensure our military personnel have access to the best medical care immediately following their injury . We need to recognise the fantastic work of medics in the field and we need to ensure all those exposed to war have access to ongoing support. An IED can leave devastating injuries that are immediately visible to the eye but the impact on mental health will not be visible immediatley or for some time...do we understand the impact this conflict will have on individuals, families, communities and society in the years to come?

    December 5, 2009 at 17:56 | Report abuse | Reply
  15. Dr. Donna Skerry

    Having watched your program and the extensive injuries in the Afghani war, I would like to say that I had the opportunity this summer to work in a proactive relationship by mentoring an Afghani medical clinic director to improve services in Kabul. I trained Frozan with whole food supplements and holistic medicine and sent her back with information and skills to improve the wellness in her clinic and family. Could we add more to the prevention in the clinics? As an anecdotal suggestion for your father and his heart there are wonderful whole food products to restore his health.

    Dr. Donna Skerry

    December 5, 2009 at 21:01 | Report abuse | Reply

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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.