Bastion transplanted to Yorkshire for hospital exercise

The growing sound of approaching helicopters can only mean one thing. A disembodied voice on the crackling tannoy confirms it. There are more casualties on the way. They will be arriving in five minutes.

In the field hospital the medical staff carry on dealing with the injured that came in less than ten minutes ago and brace themselves for more.

The doors burst open. First come the stretchers carrying the shredded bodies of soldiers; some have legs missing, some have gunshot wounds and burns. They are carefully lifted on to the hospital beds while patrol medics - in loud, urgent, but controlled voices shout out what has happened and what treatment the casualty has had so far.

Next come the walking wounded, some look shocked, some are demanding to know if their mates are all right.

This is life at Camp Bastion's field hospital. Or at least, for the next three months, it might easily be like this for the 90 reserve medics from 256 (City of London) Field Hospital (Volunteers) engaged in today's hospital exercise.

The action is happening at the Royal Army Medical Services' training centre near York. In a converted warehouse, a detailed mock-up of the Helmand hospital has been created to prepare medical staff for the clinical pressures they will face in theatre.

Outside, casualties 'arrive' in a static model of a Chinook. They are then driven by ambulance to the field hospital where they are carried inside on stretchers:

"This is the second training exercise, the first was six months ago and tested the teams in a relatively controlled clinical environment," said Colonel Ian Hicks, Clinical Director.

"They get a critique highlighting problems that need addressing, such as casualty tracking. It's easy to lose command and control in a complex environment."

Behind him the pace of activities shows just how easy it would be to end up in chaos.

Today's exercise happens one month before deployment, and it really piles on the pressure:

"Everything gets ramped up until the hospital is at its maximum capacity. Then we throw in some extra challenges such as, 'OK, now your blood bank is low', or we give them problems of security with Taliban detainees being treated in the hospital," said Col Hicks.

This is the team's chance to get to know each other before arriving in Bastion. And, because the team is tri-service, and a mix of regular and reservist personnel from several coalition countries, it helps to sort out different ways of working and problems with terminology.

It is the first time that the Americans have been through the exercise. There are 47 taking part. What do they make of it?

"This is fantastic training, we've been amazed by how detailed it is, all the equipment and processes are exactly how the real thing will be," said Lieutenant Commander Gregg Gellman of the US Navy.

"We don't have anything this big or this detailed for hospital training in the US."

High praise indeed. In fact the Americans are hoping to push a second group through in six months time:

"The only issue is, we'd prefer to do this for two weeks instead of just one."

Estonian Lieutenant Laurie Lemming, a paediatrician, has also been impressed:

"This is the best military training exercise I've seen. I'm really excited to be here. It gives me a really good idea of the team's skills and a chance to get to know the people I'll be going out with," he said.

It's not just the equipment that is convincing. So are the casualties.

Most amputees are Armed Forces veterans who have been through this for real, play the wounded. With the aid of special effects make-up, the injuries look believable and help to prepare the medics for what they could soon be facing:

"It can be a shock for the regulars, let alone reservists," said Col Hicks.

"Reservists working in the NHS will have dealt with trauma, but the pace of it in theatre means they will see more in a month than they probably would in a life time in the NHS."

Captain Raj Nathwari, an NHS anaesthetist has been with the TA for ten years. This is his first tour, and he is apprehensive:

"I know I won't have seen anything like it, it's difficult to know how I will be affected. But this exercise really helps us come together as a team, build trust and learn from others experiences," he said.

NHS radiographer, Captain Karen Dear has been in the TA for five years and has a tour of Iraq under her belt. She has some idea of what to expect:

"There will be plenty of times when we won't get much time to eat or sleep. But in the grand scheme of things that doesn't matter," she said.

This article is taken from the December 2009 edition of Defence Focus - the magazine for everyone in Defence.