Dunedin surgeon repairing Afghanistan's wounded
3 June 2009
by Judith Martin
Dunedin maxillofacial surgeon Darryl Tong swapped the safety of the South Island for one of the busiest trauma hospitals in either Afghanistan or Iraq.
NZDF Surgeon Major Darryl Tong with a young burns victim (WN09-0002-65)
But the swap was only temporary; Mr Tong worked in his Army Territorial Force capacity as Major Tong and treated soldiers and civilians injured by bomb blasts, ballistic trauma and other combat- related events.
He worked 18-hour days in the Multinational Medical Unit (MMU) in Kandahar which is run by Canadians under the auspices of ISAF. When he was not operating on maxillofacial injuries he helped out in the trauma bays with resuscitations and stabilisations, or assisted other surgeons with operations. These including penetrating brain injuries, multiple orthopaedic injuries, and burns.
But despite that Major Tong was still smiling at the end of his deployment.. “It was frequently a high-stress environment, but there was an excellent esprit de corps and some very talented people around. Having good dining and gymnasium facilities at the base also helped. I couldn’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 were there for.”
The New Zealand Defence Force has been sending a medical team to Kandahar for the last 18 months, each rotation 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 Bamyan.
The hospital building was spartan, Major Tong says, but relatively well-equipped. “It’s perhaps better equipped than some of our smaller hospitals at home. We had a CT scanner and basic laboratory services for blood products and lab tests. It was hot and dusty, with lots of flies and constant noise from aircraft and heavy vehicles coming and going.”
The unit has two surgical teams, 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 returned to New Zealand in mid 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 was very special.”
Despite his experience Major Tong says the numbers and severity of the trauma the unit treats was sometimes “incomprehensible.”
“In civvie street you simply do not see patients with three limbs missing, plus 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.”
Highlights have included 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 device 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 were constantly reminded that our unit was in a war zone, mainly by the types of injuries we saw, as well as by the rocket attacks on the base itself.”
The other New Zealanders working alongside Major Tong included fellow Dunedin ICU nurse SSgt Fiona Thomas, Linton based ICU nurse Major Shaun Fitzell and Lt Sheree Mudford, a radiographer 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 often show others in the team new skills and 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 to be part of the NZDF.”
He says from a professional point of view “we don’t know how lucky we are in New Zealand.”
“Operating there 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”.