19 May 2009
By Judith Martin
Dunedin maxillofacial surgeon Darryl Tong has swapped the safety of the South Island for one of the busiest trauma hospitals in Afghanistan and Iraq.
But the swap is only temporary; Mr Tong is working in his Army Territorial Force capacity as Major Tong and is treating soldiers and civilians injured by bomb blasts, ballistic trauma and other combat related events.
He is working 18-hour days in the Multinational Medical Unit (MMU) in Kandahar which is run by Canadians under the auspices of ISAF. When he is not operating on maxillofacial injuries he helps out in the trauma bays with resuscitations and stabilisations, or helps other surgeons with their operations. These have recently including penetrating brain injuries, multiple orthopaedic injuries and burns.
But despite that, Major Tong is still smiling. “It is frequently a high-stress environment, but there is an excellent esprit de corps and some very talented people around. Having good dining and gymnasium facilities at the base also helps. I can’t complain at all compared to those soldiers out in the field. They are the ones who deserve all the credit and who we in the medical services are here for.”
The New Zealand Defence Force has been sending a medical team to Kandahar for the last 18 months, each of them doing a six-month stint at the MNMU. The unit is several hundred kilometres away from where the 120-strong New Zealand Provincial Reconstruction team is based in Bamian.
The hospital building is spartan, he says, but is relatively well-equipped. “It’s perhaps better equipped than some of our smaller hospitals at home. We have a CT scanner and basic laboratory services for blood products and lab tests. It’s hot and dusty here, with lots of flies and constant noise from aircraft and heavy vehicles coming and going.”
The unit has two surgical teams currently, one Canadian and one Danish, and each team has an anaesthetist, general surgeon, orthopaedic surgeon and operating theatre staff. The unit’s nursing and technical staff are from New Zealand, the Netherlands, Canada and the USA. An Australian primary care doctor acts as a liaison officer for the air evacuation of patients and is the senior trauma team leader.
Major Tong, who at home is part of the New Zealand Army’s 2nd Health Support Battalion has, as well as doing his civilian medical work, had ballistic trauma experience in the USA. He arrived in Kandahar in late March, and is expected to return to New Zealand in May.
Most soldiers and civilians injured by bomb blasts in Afghanistan are taken to the MMU, which is the main referral base for southern Afghanistan. The unit has the only neurosurgeon and maxillofacial surgeon in southern Afghanistan so receives referrals or transfers of patients requiring those services. “Being the only maxillofacial surgeon for Southern Afghanistan was quite daunting at first but you just get on with the work and do the best for the patient. Being the first Kiwi to assume this role is very special.”
Despite his experience Major Tong says the numbers and severity of the trauma the unit treats is sometimes “incomprehensible.”
“In civvie street you simply do not see patients with three limbs missing, face and head injuries all in one individual. Everyone gets the best treatment possible and for local nationals that treatment is a universe away from what they could ever hope to receive in a country whose infrastructure has been decimated by the Taliban. Sometimes resources at the MMU cannot sustain the patient and hard decisions have to be made about their survival.”
The highlights for him so far have been being able to save the eyes of three coalition soldiers, and treating an 18-month old boy who fell into an open fire sustaining second and third degree burns to his face and scalp.
“Battle related injuries or improvised explosive devise blast injuries are challenging in surgical repair. There are often bits missing, and as a surgeon you must be meticulous in cleaning out the wound be it face, arm or leg. We are constantly reminded that our unit is in a war zone, mainly by the types of injuries we see as well as by the rocket attacks on the base itself.”
The other New Zealanders working alongside Major Tong include fellow Dunedin based ICU nurse SSgt Fiona Thomas, Linton based ICU nurse Major Shaun Fitzell and Lt Sheree Mudford, a radiographer also from Linton. Laboratory diagnostic technician Captain Kevin Drysdale from Nelson has recently finished his six month deployment to the unit and has returned to New Zealand.
Major Tong says he is extremely proud of how the Kiwi contingent of nursing and technical staff in Kandahar has and is performing. “They are well-liked, and have that typical Kiwi way about them. They are respected for their skill base and are often showing others in the team new skills or knowledge. They have a can-do attitude, and are not afraid of hard work and pitching in to help others. It makes me proud to be a New Zealander and part of the NZDF.”
He says from a professional point of view “we don’t know how lucky we are back home.”
“Operating here puts the world in perspective and many of the problems we face at home seem all of a sudden very small and insignificant. It makes you appreciate what is truly important in life which for me is my wife and children and the friends that share my life.”