In co-operation with Helmand’s Director of Health and the Provincial Reconstruction Team, the Joint Force Medical Group in Helmand province is laying the foundations for an Afghan ambulance service in Lashkar Gah by training Afghan nurses in specialist transit care, an initiative that began early in 2009.
Injured local nationals are brought to the medical centre in Lashkar Gah, where their conditions are stabilised, before being moved to one of the locally-run hospitals in Lashkar Gah.
But the nearest hospital is 15 minutes away and there is currently no way of continuing the care during transit.
Major Tamsin Clark,Â Royal Army Medical Corps, explained:
Lashkar Gah primary healthcare centre receives nearly all local national trauma cases brought in by ISAF in Helmand province.
They travel from point of injury to here, where we stabilise their condition before passing them on to one of the two locally-run hospitals in Lashkar Gah.
A problem we currently face is that the nearest hospital is 15 minutes away - after we have stabilised the casualty here, there is no continuity of care in transit between here and the hospital.
Major Clark and her team at the primary healthcare centre have created a syllabus that covers all of the basic areas that the Afghan nurses need to be trained in to look after patients during transit. She said:
We don’t have the time or resources to turn them into fully qualified paramedics, that is a university course in itself. But what we have done is created a three-week course that will cover the most frequently seen injuries.
Our students are already nurses at the local hospital so we are providing additional training for skills to deal with patients in transit, which allows them to be ambulance transfer specialists.
Over an intensive three-week course, the key areas covered are catastrophic haemorrhage, airway assessment and management, breathing assessment, common injuries and intervention, packing the patient for transport, dealing with disability and the prioritisation of casualties.
At the end of the course, the students have a full day of practical assessments, using realistic simulated casualties.
Rafe Ullah, the head of nurse training at Bost Hospital, watched the students receive their certificates of achievement and said:
The course has been very good. It is very important for the progress of medicine in Helmand and we are happy with the course.
We see a lot of trauma patients and the training is very relevant. I’m going to recommend as many of my nurses as possible to come on this course.
Corporal Andrew Taylor, 4th Regiment Royal Artillery, said:
Working with the Afghan nurses has been fun because they are so keen to learn the new skills we are teaching.
It was a valuable and rewarding experience - I’m happy to have helped create something that will outlive my six months tour.
Ahmad Ahmadi, one of the students, added:
I wish to get more training like this, so that I can pass on the skills.
We were told this course was being planned three months ago and we were happy. Now we have got to do it and the promise made by ISAF was kept.
The project and syllabus will also be handed over to the incoming 16 Air Assault Brigade and the next stage in forming a credible and effective ambulance service will be equipping the vehicles with the kit and equipment that the students have been trained on.