Military Non-Combat Roles

"I try to be as friendly as possible, and show them that I really care and I want to be helpful.  But I am really hoping that they figure out that time is on their side, and that things are going to get better, and that their lives are going to get better.

"My role here is what my [Canadian military] mission is, but I am here 'personally' because I want to help."

Lieutenant Commander Vincent Trottier, general surgeon, critical-care doctor and intensive-care burn unit physician, Hopital de l'Enfant-Jesus, Quebec City, with the Canadian Forces since 2008

Another Canadian mission in Afghanistan.  This one at an intensive care unit at the country's Armed Forces Academy of Medical Sciences in Kabul.  Where Afghan soldiers are taken for attempted medical remediation of their war-mangled bodies.  These are men hit by shrapnel, others with cranial bullet wounds, yet others with missing limbs.

The equipment that keeps them alive, that helps them to recover is functional but out of date.  Sterile conditions are hard to come by in this hospital, despite attempts to maintaining cleanliness.  The Afghan doctors who are assigned to work there are fully academically qualified, but they have little in the way of actual experience.  This is their introduction to actual patient care.

"In medical college, you learn theory, but you are not a doctor.  You have to go through the residency program, lean how to do stuff and deal with patients, doing rotations on wards and clinics.  They have not had that chance", explained Lt.Cmdr. Trottier.  He is there to help lead the Afghan medics toward their experience, a member of the Canadian team assisting the Afghan National Army to develop a training program for medics, doctors, surgeons, and nurses.

He is there to guide.  He quietly and competently leads them to a place in their minds using their store of acquired academic knowledge and practical common sense where they are able to gain confidence in their ability to figure what they should ask of the patients and what responses to anticipate to know how to react. He is there to stimulate these people who look up to him for his years of experience, how to take effective charge of the patients' needs.

"They were not taught this way.  You can go to classes and learn what pneumonia is, but unless you do the work and try to figure out what the signs, symptoms and clues are to get you to the diagnosis, you are not going to figure it out.  But they are bright people.  They just lack the skills and experience.  And they have not been taught."

And, as Dr. Majid Mojib, a graduate of Kabul Medical University two years earlier, who had advanced straight into an ICU expanded:  "In ICU, we don't have any training program.  No one has any speciality in ICU.  We just learn from one another.  We desperately need a specialty residency program for ICU.  I hope that it is part of the Canadian plan."

Part of the Canadian plan at this juncture is also the training of nurses for the Afghan Security Forces.  Since 2008, the Canadian program will have produced over one hundred nurses at the time the next class graduates.  "Before, they used to do a lot of theory, but no hands-on, so you might have a graduating nurse who has never touched a patient", said Cmdr Collins, from Halifax.

"With this program, we actually have a skills lab, and we have clinical - so they are getting that hands-on experience.  And we are creating really amazing nurses."