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With the 7th Field Hospital in Basrah, Part 2

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With the 7th Field Hospital in Basrah, Part 2
By Tom Cooper
Nov 25, 2003, 02:39

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Note: a professional in me reminds me always to part facts from my own feelings and observations when preparing reports like this one; in the case of this article, I decided to make an exception.

Once more, a view of the OT-64 APC on the main gate...

The 7th Field Hospital of the Army of the Czech Republic was deployed to Basrah, Iraq, with the help of the USAF C-5 and C-17 transports - but also per ship - in late April and early May 2003, and started operating on 6 May. The hospital is situated adjacent to the compound of an old Iraqi military hospital, some 350x350m in size, and has currently some 265 personnel, supported and guarded by 40 military policemen.

..and the look down the "main street" of the 7th Field Hosptial: to the left is (behind a pile of bottled water) the tent city, to the left are containers with support equipment and the mess.

Tent-city with personnel quarters of the 7th Field Hospital: between 8 and 12 soldiers sleep in every single tent - several of which were equipped even with sat-TV!

The "gym" of the base was positioned between two tents and covered by camouflage net. The Czech doctors praised their young soldiers for their motivation and the care about their bodies and health.

Inside the compound a whole ?container & tent city? was built around few small concrete buildings: the containers are mainly containing support equipment (like generators), or used for storage, but also the mess and sanitary installations are built from several containers, while the tents are used by the main hospital facilities and for housing the personnel. In addition, several empty containers also act as ?watch towers? on which bunkers for guards were built out of sand-sacks and camouflage nets. The whole base is in vincinity of many private houses on the north-western outskirts of Basrah, between six and eight kilometers away from Basrah IAP.

The "watch tower" near the main gate is - like all the others in the base - improvised atop one of commercial containers.

All the sensitive installations in the base were covered by sand-sacks.

One of cour OT-64 Skot APCs that could be found in the base. Except the one on the main enterance they were apparently not heavily used.

Initially after the arrival of the Czech contingent and during the long summer months there were considerable problems with the function of the hospital in the face of the soaring heath and sand: especially the sterilization of the patients ? many of which needed complex operations (for which the 7th Field Hospital is excellently equipped) ? was an immense problem. In the course of their work, the Czech military doctors have treated over 8.000 of patients (all free of charge), of which 118 needed complex operations, including such actions like transfer of the skin.

The main operation room: 118 complex operations were undertaken here.

...and the same room from oposite direction.

The intensive care unit: the equipment is the best one can get and - except for the low ceiling - one would never think about this actually being a part of a tent, combined with a container!

Originally, the security situation surrounding the hospital was relatively simple and quite calm. With the summer and the heath, however, and due to the poor supply situation in the whole Province of Basrah, the problems came. The Czechs were only the second foreign military force to enter the city after the British. At the time, there was no water and no power in Basrah, but there were quite a few patients injured during the fighting in March and April.

Subsequently, the situation changed: an increasing number of victims of crimes started arriving at the hospital, while in turn the tensions between the Iraqis and the Coalition troops increased. Due to this the personnel of the 7th Field Hospital was forbidden from leaving the compound without military escort: most of the medical personnel haven?t put one step outside the walls surrounding the camp ever since May.

The excellently trained and motivated Czech soldiers, however, so far had to use their weapons only very sparsely. On 10 August an angry crowd blocked a convoy carrying drinking water to the hospital and started throwing stones at soldiers and vehicles. After several military policemen received minor injuries, few shots were fired into the air and the convoy was able to continue the voyage.

In a separate incident, an Iraqi man was killed when he attempted to jump on a garbage truck and fell. Also, another crowd attacked two Czech military vehicles underway back to the 7th Field Hospital compound from the British Command HQs, positioned at as-Shoibiyah AB, some 45km further to south-west. After few shots in the air, however, the crowd dispersed and nobody was injured.

Czech MP monitoring the surrounding of the base.

During the summer there were also several cases in which shots fired during different local skirmishes between the Iraqis, or even during weddings and/or other celebrations, fell into the hospital. While underway through the tent-city, we?ve seen several tents with small holes ? caliber 7.62mm ? on their roofs. In one case, a stray bullet hit one of the main tents and injured a child that was under treatment in the 7th Field Hospital. However, so far, no Czech troops have been killed or even seriously injured (except in few accidents unrelated to the situation outside the hospital) since the unit was deployed in Iraq.

Nevertheless, the CO of the 7th Field Hospital and the officer in charge of the Military Police squadron deployed to guard it, have further tightened the security of the compound, and have several times to temporarily block Iraqis from receiving treatment.

Command center of the 7th Field Hospital is linked via satellite to Prague.

As already mentioned, these original problems for the work of the hospital were mainly caused by the poor supply situation in the whole southern Iraq and the desperation of the local population. By July, the supply situation improved considerably, as the water supply was completely reconstructed, and the City of Basrah had power at least four hours a day. By the end of August the power supply was already completely reconstructed, and ever since Basrah has power the whole day and night, every day in the week. Despite the presence of a considerable number of the operatives of the Iranian Revolutionary Guards Corps (IRGC, better known as ?Pasdarans?) in the area, the situation started to slowly calm down. Namely, in late April 2003, as the Iraqi regime, military, and the security systems were crumbling, the Iranian clerical regime sent approximately 4.000 IRGC (armed) operatives into Iraq, foremost into the southern areas, to gain influence in the local population, mainly consisting of the Shi?ia. The Iranians apparently failed to gain a widespread support for their matters, but instead of them several local Mullahs became considerably powerful, most of which can be considered ?extreme? in the way they understand and practice their religion. In addition, during the US-British onslaught, the former regime has released all the criminals from the local prisons. Together with the fact that the Iraqi Shi?ia still do not directly sympathise with the foreign troops in Iraq, foremost due to being enraged for the USA leaving them without any support during the uprising against Saddam Hussein in 1991, during which dozens of thousands of Iraqi Shi?ia were massacred, executed, tortured or raped, this mix had, of course, to cause the worsening of the security situation in the Basrah area.

The local population understood the importance of the 7th Field Hospital, and was ready to use its service. In fact, the reputation of the Czech medical personnel was soon so good that it started receiving patients even from the Baghdad area ? full 500km away!

While proud of their training, knowledge and equipment, the Czech Army medical personnel would not boast with their capabilities. However, their statements do indicate that the total capabilities of the 7th Field Hospital are (far) superior to those of any hospitals inside Basrah. This is understandable given the way the former regime was treating the area: the Shi?ia were always considered citizens of 2nd or even 3rd grade by Hussein?s regime, and the situation only worsened after the uprising in 1991. Given that the former regime was in part purposely mismanaging the medical care system in whole Iraq the situation in Basrah became actually desperate, with the local hospitals lacking actually everything, including beds.

In a simulated operation the medical personnel of the 7th Field Hospital demonstrated us an operation....

...on the left foot of this "patient". The "operation" was successful, and the patient walked away - directly to the showers.

One of the tents of the main hospital complex was a room where young patients were hospitalized. The personnel of the 7th Field Hospital has obviously done everything possible to make their stay as comfortable and pleasant as possible. From the interviews with several doctors it is obvious that the sad cases of several patients that could not be recovered was a heavy blow for each of them.

The Czechs have several times tried to offer their help and support to local installations. Some of these attempts were discontinued for different reasons, foremost as the most successful method proved to ?help Iraqis be able to help themselves?. Consequently, the Czech Republic has ? as far as this was possible considering its limited capabilities ? made several significant donations to the local Iraqi authorities. Just an hour after our arrival in the compound of the 7th Field Hospital, for example, on a small ceremony organized in one of the ?back-yards? of the compound, the representatives of the local Iraqi authorities have received water-treating and different support equipment, together with a whole vehicle park, worth over USD 1 million.

A ceremony on which equipment worth $1 million was donated to the representatives of the local Iraqi authorities.

Part of the motor-park belonging to the MPs that guard the base. Note also the heavy sand-sacks in the background, reinforced by wire: walls like these surround the whole tent-city, offering a great deal of protection.

Another part of the truck-park belonging to the 7th Field Hospital consists of trucks with equipment for water treatment and carrying other specialized equipment. Several such trucks were donated to the local Iraqi authorities, and we have learned that the Czech republic is preparing an even larger donation of medical and technical equipment for the city of Basrah.

A squad of Czech MPs with anti-riot gear.

Over the time especially the economically weaker Iraqi families proved heavily dependent of cost-free medical treatment. In many cases the local hospitals, all of which charge for medical treatment, were also forced to send their patients to for further treatment to the Czechs. In the light of these facts it should actually not be strange that in October the Czechs found themselves confronted with the next problem, when one of the local Mullahs accused them of spreading anti-Koran materials. A demonstration was organized in front of the compound, causing a cancellation of all medical treatments again. The CO of the 7th Field Hospital meet the complaining Mullah and proved him that it was impossible than any of the Czech troops would be spreading such materials.

The author of this report must agree with the Czech commander: given that there are only three PCs in the whole 7th Field Hospital, one of which is for ?public? use and 24-7 used by troops to communicate with their families, one is used by the command, and one by the medical personnel, and none of which has any kind of support for Arabic language, I found it practically impossible for anybody within that compound to produce any kind of anti-Koran materials. This especially given the fact that a majority of the Czech military personnel we meet during our visit knows very little about the Muslim holly book. Also, I can?t imagine what kind of interest would there have been for any Czech military person to do something of this kind and endanger the otherwise excellent relations between the Czechs and the Iraqi authorities? Finally, contrary to the problems some US units and agencies reported about their Arabic interpreters, the Czechs experienced nothing of this sort: all of the interviewed personnel expressed only compliments for their four Arabic interpreters, all of which were also military personnel.

Concluding about this topic, I would say that in this case it is relatively easy to calculate ?two and two?. By September the number of Iraqi patients in the 7th Field Hospital obviously grew such that the local Iraqi doctors started complaining about suffering economic damage due to the lack of patients (the information provided to us from several Czech doctors, by the way, was that most of their recent patients were victims of criminal acts). In my opinion, it would not be surprising if one ? or several - of the ?damaged? doctors was the actual source of these problems.

Certain is, that after this problem was solved there were no additional demonstrations against the Czech hospital.

Nevertheless, with estimated total costs of the deployment by the time reaching USD 25 million - which is a considerable burden considering the whole Czech defence budget is barely over USD 1.5 billion) ? a decision was taken to terminate the operations of the 7th Field Hospital, as originally planned, with the end of the year 2003. Already in September a part of the personnel was replaced by new officers and enlisted ranks, most of which had the task of closing down the hospital, packing its equipment and shipping it back to Czechia, starting from late November. Despite their excellent motivation and a honest wish to help the Iraqis, the Czech commanders and medical personnel also think that this decision is correct. According to them, the idea was to deploy the unit to Iraq for the problematic times immediately after the war, in order to bridge the time between the collapse and reorganization of the internal Iraqi structures. Now that the Iraqi authorities are recovering and the local hospitals can improve the quality of their service, the Czechs find that a continuation of their deployment could indeed only be damaging for the local structures. Many local Iraqis are now earning money again, either by working for local authorities, or for foreign military and agencies, or for newly-established internal Iraqi security etc., and an increasing number of them can now again support their families.

Interestingly enough ever since the news about the intention for the 7th Field Hospital to shut down its operations by the end of the year spread in the Basrah area, there were only demonstrations for the Czechs to stay in Iraq!

Understandingly, some of the Czech troops are meanwhile also tired and very much looking forward to come back home: quite some are in Iraq already since May, and were not able to leave the compound ever since. The daily routine of such a situation is never pleasant, and every little change more than welcome. Our guide and interpreter during the stay with the 7th Field Hospital was outright happy to see some ?Europeans? arriving to visit the unit.

The personnel of the 7th Field Hospital and the young Czech MPs we meet in Basrah were all professional soldiers, friendly, well motivated, and in high spirits despite the problematic conditions of work and a tense situation.

This is not to mean that the morale of the Czech contingent in Basrah is ?low? or even ?damaged?. Quite on the contrary, I found the medical personnel and the MPs to be in high spirits, excellently motivated, professional, enthusiastic, always ready and glad to help. When I only think about the endless patience of all the officers that were successively briefing us, and were patiently answering the questions from the two Austrian ?mainstream-media? reporters - who were so obviously unprepared for this trip (illustrated by them asking even about things that any ?greenhorn? could have found on the internet), while simultaneously also giving their best to ?learn? as much as possible about the Iraqi ?hate? for the foreign troops and the Czechs having ?nothing but problems? in Basrah, or find any kind of a ?hot? story ? I cannot but admire them.

My personal conclusion is that the Czechs can beyond any doubts be very proud of their troops and the splendid job the personnel of the 7th Field Hospital did in Iraq.

Given that the authorities in Prague have ascertained their comittment in Iraq even after the closing of the hospital in Basrah (most likely with a contingent of at least 40 MPs), and while hoping that all the Czech and other Allied troops will return home safely, I am certainly going to continue tracking all the reports about them.

Czech MP sorting his gear after a patrol: to the left also one of the body-guards that escorted the Commander-in-Chief of the Czech Army during his visit in the base can be seen as well.

Crew of an MP-jeep preparing for the morning patrol: the mornings in the desert can be bitter cold, despite the sun, and some protective gear is always more than wellcome.

Post Scriptum 1
Some of the readers might recall the massive reporting about the ?dying children of Basrah?, released by the former Iraqi regime in the 1990s, and accusations against the US military for ?using ammunition made of depleted uranium in urban areas?. Let me now also mention that we attempted to track down some information to this topic as well.

The doctors of the 7th Field Hospital have mentioned in their briefings that they have had a considerable number of children-patients with heart complications. In fact, two of them ? both having more than 20 years of practice as MDs - stressed that they have never experienced such cases in the Europe. They have, however, not done any studies about the possible reasons for these so far.

We have asked them if ? according to the best of their knowledge ? such heart complications could have been caused by the depleted uranium ammunition, spent by US forces, as frequently claimed by the former Iraqi regime and the Western media. Their answer was negative: both stressed that the DU is producing only very minimal radiation, and nothing of the sort that could cause complications of this type. (Besides, let me remind that during the 1990s the US forces were not using any kind of DU in the Basrah area, simply because there was no combat of the type for which such ammunition is used there).

Then, we have explained to our briefers that during the Iran-Iraq War the Iraqis have used dozens ? if not hundreds ? of thousands of tons of chemical weapons against Iranian troops, frequently very close to the city of Basrah (in several cases only between two and five kilometres from the outskirts), and asked if these could have ? in the long term ? caused any similar complications. One of the asked doctors answered positive, stressing that nerve agents do damage a specific chromosome, which in turn can cause heart complications for children.

Post Scriptum 2
I have been asked several times about my personal observations and opinons regarding the security situation in Basrah, and especially that of the Czech contingent there.

Let me first say that I never felt threatened by anybody while underway in Iraq: before the trip we were warned by some colleagues to follow carefully the instructions from the military personnel to which we are assigned, as it could ?get dangerous?. So, I would say, this at least heightened the adrenaline levels at least a little bit. We have acted accordingly and listened carefully to our guides, doing exactly what was said to us, regardless of ? most of the time ? not knowing why had specific things to be done (with ?we? I mean foremost us three reporters with specific interest in aeronautics: the two Austrian ?mainstream-media? reporters were frequently simply ignoring safety instructions from the Czech troops).

As second, on the basis of this trip but also my own contacts inside Iraq, my conclusion is that currently there is no direct threat for the Czech contingent in Basrah. The "normal" people in Basrah are actually apprehensive towards them, and a little bit disappointed they don't get more of the foreign troops to see, but because of the few exceptions the security situation is such that the local commanders of the Coalition units try to avoid any unnecessary risks.

From discussions with different contacts inside Iraq, and also interviews with members of the 7th Field Hospital, it appears that the ?worse? that can happen to the Czechs is that somebody mixes them with the US troops: apparently, these are not especially wellcome in the area. The story goes taht the US troops are, namely, reported as having been increasingly present in the area, because of a large US military base and airfield being built somewhere in south-west Iraqi desert, in turn negatively influencing the security situation in southern Iraq.

Nevertheless, elements of the former regime, foreign terrorists, and operatives of several foreign ? anti-Coalition positioned ? countries are present in the area, and consequently moving of the military personnel around the city without proper security measures must ? and clearly is - be considered as risky, if not even outright dangerous. This not because of any kind of a ?general? anti-Coalition feelings, but foremost because of a plethora of possible ?private? matters of different Iraqis.

Major problems should not be expected for the following months, however. The elements of the former regime still present do not have an easy time finding any kind of support for their matter within the local Shi?ia population. Quite on the contrary. The foreign terrorists or foreign operatives can also not expect too much support from the local population, which repeatedly proved resistant to non-Iraqi propaganda in the last 20 years. Of course, some minor exceptions are definitely possible, but these are mainly depending on the personal abilities of the terrorists and/or operatives in question.

The major role in the relations between the Coalition military authorities and the local population will therefore in the future play the local Mullahs, as well as representatives of different Iraqi authorities. The Shi?ia Mullahs are a factor that is immensely problematic to assess for any Westerners: left alone, they should not be causing any problems. Without any kind of a direct intervention from the foreign military into the everyday life the Mullahs are left without any reasons to turn the population against the British, Czech, Italian, Norwegian and other troops based in the area. The local civilian authorities, on the other side, must be supported in their development ? albeit in a very careful manner. The foreign troops should not and can not intervene in the development of the new political life in Iraq: they can and should support this development by offering equipment and training, but not influence it by any other means.

The multi-national troops deployed in the southern Iraq have so far proven their ability to act carefully and appropriately, and the results of their work can only be described as a success. Regardless how ?unlikely? this appears - especially in the light of the reports from the "mainstream" media, and despite the presence of many uncertain factors - the local Iraqis know to make a difference: they should also never be mixed with the Ba?ath Party-associated Sunnis, especially not with those living in north-western Iraq, most of which are about to lose all of their remaining influence due to the presence of foreign troops in Iraq, and the general reorganization of the Iraqi society and state currently underway.

While it is a fact that ? for a number of very different reasons ? the Allied troops were unable to start a proper ?Hearts and Minds offensive? in Iraq so far, the suppression of the remaining elements of the former regime, suppression of the foreign terrorists on the Iraqi soil, building of a new Iraqi society based on democratic organizations and functioning authorities, establishing of a functioning supply system, fighting the crime and anarchy, combined with as little of mixing into internal - every-day - Iraqi matters as possible, should be a good receipt for the success of the current operations in Iraq.