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Trauma, Surgical Teams Act as Hospitals in Inhospitable Lands
BOANE, Mozambique - U.S. Navy medical
personnel go over broken bone procedures in
the Forward Resuscitative Surgical System
facility in Boane July 31. The team is providing
medical support to U.S. and Mozambican
service members participating in Exercise
SHARED ACCORD 2010, an annual, bi-lateral
military exercise hosted by a different
U.S. Africa Command partner nation each
year, and designed to increase partner
nation capacity for peace and stability
operations. (U.S. Marine Corps photo by
Lance Cpl. Jad Sleiman, Unit Marine Forces

Trauma, Surgical Teams Act as Hospitals in Inhospitable Lands During Shared Accord 2010

By Lance Cpl. Jad Sleiman, Marine Forces Africa

BOANE, Mozambique - The operating table and sanitation sink came, disassembled, out of a crate. So did the lights that hung from canvas walls and the portable, diesel generator-powered ventilator and X-ray machines.

A continent away from the nearest available hospital, the trauma and surgical teams of Exercise SHARED ACCORD 2010 had built a tent-borne aid station on steroids. The station, adjacent to a Boane firing range, is able to treat life and limb-threatening injuries in the field.

“We are here designed to treat anything bad,” explained Cmdr. Paul Dabrowski, a trauma surgeon with 4th Medical Battalion, 4th Marine Logistics Group, out of San Diego, Calif. “We can operate on the abdomen, chest, limbs and extremities, fractures and brain injuries - everything.”

SHARED ACCORD, an annual, bi-lateral military exercise hosted by a different U.S. Africa Command partner nation each year, has brought hundreds of U.S. Marines and Mozambican soldiers to the two Boane ranges for live fire shoots. The medical stations here, known as the Forward Resuscitative Surgical System and Shock Trauma Platoon, need to stay close to the range and the grievous injuries potentially produced in order to treat casualties as quickly as possible.

“If we can stabilize them within the first hour, we have a much better chance of saving them,” said 4th Medical Battalion FRSS-STP officer in charge Cmdr. Edward Leitz, who added that the nearest evacuation hospitals with a military presence are in Spain and Germany. “The first hour is absolutely critical.”

The “golden hour,” as Dabrowski referred to it, begins ticking down as soon as a stray round strikes or a vehicle flips. It’s during that hour the FRSS-STP’s 19-member team must be able to operate independently to save a life.

The FRSS, just larger than the average American living room, can perform 18 major operations over the course of 72 hours without being re-supplied. The STP can handle even larger numbers of less seriously wounded casualties and prepares patients for surgery.

Both aid stations are visible from the firing range.

As the Marines of Echo Company, 2nd Marine Battalion, 25th Marine Regiment, sent rounds down range today along with their Mozambican counter-parts, the sailors of the FRSS-STP were practicing sonogram techniques.

At any moment, however, a call could come through the radio indicating a casualty was en route.

The docs would then have to organize their emergency room based on whatever was coming their way: anti-venom and tourniquets for snake bite, chest tubes and suction for a gunshot wound.

“We don’t have the space of a real hospital, so we can’t fit everything in here at once,” said Petty Officer 1st Class Cory Bond, a 4th Medical Battalion field corpsman and the lead petty officer at the FRSS-STP.

By the time a casualty arrives at the FRSS-STP, a corpsman near the scene of the incident may have already stopped the bleeding. If not, that task is the FRSS-STP’s first priority. A close second is starting breathing.

Blood, then air, the docs would first treat their patients in the STP before moving them to the FRSS for serious surgery if need be – all under cramped and hectic circumstances.

“To an outsider it may look completely unorganized - like complete chaos,” said Chief Petty Officer Berry Potoker, a 4th Medical Battalion field corpsman and the senior enlisted member of the FRSS-STP. “But everyone in here knows his or her role, everyone knows what they’re doing.”

The FRSS-STP can only do so much detached from the resources of a full hospital, so it’s likely the most severely injured casualties would have to be treated out of country in Germany.

After a patient is stabilized, it won’t be more than 10 minutes before they are in a vehicle headed toward Maputo, Mozambique’s capital city, and the airfield there, said Potoker. Simultaneously, a civilian aircraft - most likely a small jet - would be called from Johannesburg, South Africa. Both take about an hour to get to Maputo.

During the final act, a FRSS-STP corpsman designated as the en-route nurse would stay with the casualty throughout the entire trip from Africa to Europe.

The intricate orchestration is designed for one purpose: saving lives in places where survival is least likely.

“There’s a range right here, and if anyone gets hurt they’re only 200 yards away,” said Sgt. Daniel Detore, a squad leader with Fox Company, 2/25. “Having (the FRSS and STP) on hand is better than just a single corpsman.”

Fighting time, space, resources and the inherently dangerous work of deployed service members, FRSS and STP docs remain on hand in Boane, as well as numerous other far-flung locales where U.S. Marines have answered the call.

From Mozambique to the battlefields of Afghanistan, they aim to act as tangible safety nets designed for the worst possible scenarios.