By Capt. Kevin G. Tuttle
Qalat Provincial Reconstruction Team

Air Force Lt. Col. (Dr.) Christopher Scharenbrock and Army Capt. Yuri Rivera tend to a sick Afghan man May 31 during a Village Medical Outreach in the village of Sal Kalay, Afghanistan. The man had an incurable liver disease, causing his stomach to swell. During his transport back home, the vehicle he was riding in was ambushed with a rocket-propelled grenade, and he was killed. (Courtesy photo)

Editor’s Note: Capt. Tuttle is deployed from the 45th Space Wing supporting operations in Afghanistan. The events described took place May 31.

SAL KALAY, Afghanistan -- The shivering night succumbs to the dawn as more than 130 troops from the Qalat Provincial Reconstruction Team and the 2-4th Infantry Regiment at FOB Lagman rise to prepare for the last leg of their trip here for a Village Medical Outreach (VMO).

The approximately nine-mile trip from Forward Operating Base Lane to the village takes the troops roughly three hours in Humvees because of the rugged terrain and dangers posed by a ruthless enemy. The road—more like a Grand Canyon donkey trail—leads through aqueducts and the Arghandab River numerous times and lies tightly nestled into the walls of the unforgiving mountains. The tires of vehicles teeter on the very edge of the road, and one mistake can result in a devastating roll down the mountainside.

Children greet the troops with "thumbs up" as the convoy slowly rolls through a village. Some troops throw candy, and the children scramble to pick it up quickly before the next vehicle lumbers along with possibly more candy. Candy, even from strangers, is a welcome treat in this country.

The journey continues on with numerous stops for investigations of improvised explosive devices in the road. After thorough checks, the convoy resumes along its treacherous path. The driver's seat sits above the edge of the cliff while the passenger side of the vehicle barely avoids scraping the adjacent rock wall. Drivers maneuver the Humvees over boulders and trees, and through rivers in the mountains as its passengers try to absorb the bone rattling impact. The important thing is to keep moving.

Finally at Sal Kalay, preparation for the VMO begins. Two doctors, one physician's assistant and five medical technicians prepare for an onslaught of villagers needing help. As they prepare their makeshift clinic in an animal stable made of mud and straw, a couple of troops hand out toys and school supplies to the curious, barefoot children who run to the staging area hoping to get a piece of the action. They receive writing utensils, scissors, paper, balloons, necklaces, whistles—even some soccer balls and kites.

The first patients arrive a few minutes after setup is complete. The ailments are similar: muscle aches, joint pain, stomach problems and headaches. The initial 45 minutes of the operation yields about 20 patients, from toddlers to the elderly. Their "treats" from the convoy are muscle relaxants, pain medications, and vitamins or hygiene kits.

"What they need is a whole lot more than we can give, but what we can give is a whole lot better than what they have," said the lone physician's assistant Capt. Jacqueline King from Hickam Air Force Base, Hawaii,. "They have the same ailments we have, but with them it's magnified because they don't have the care. They need roads so they can have access to other means; they need a non-polluted source of water, immunizations, education on simple things like hygiene. Education is the key to everything."

In the afternoon a patient is carried in on a stretcher about an hour before dusk. The man's stomach is severely swollen.

"His liver has stopped working," said Lt. Col. (Dr.) Jon Woods, Lackland Air Force Base, Texas. "Although we probably can't cure this, I suspect that the clinic in Qalat could make him feel better. We can give him some relief by getting him drugs that we don't have with us here."

The family decides to get the man home with some of the Afghan National Army troops. They will transport him in the back of their pickup protected by two U.S. Humvees. However, at dusk, explosions and gunfire ring out from the direction of the vehicles. They have taken fire. Force Protection rushes to support them, and within 20 minutes two A-10 attack aircraft provide close air support in the form of missiles and strafing runs a couple of miles from the VMO.

Later the convoy learns the sick man in the back of the truck died when a rocket-propelled grenade sliced through the side of the pickup. Two of the civilians with him were also killed in the Taliban ambush.

Pitch darkness sets in, and the only light comes from the red glow of cigarettes and the quarter moon in the sky. The troops don their Night Optical Devices and wait for any sign of the enemy.

The Force Protection and ANA troops return around midnight after conducting a search for Taliban through the neighboring village.

The chilly night air returns and with it the chance to sleep. The lucky ones sleep on cots and others sleep on the ground, while some sleep on the hoods of the Humvees. Others pull guard duty.

At dawn, chatter centers on the night's events. Another mini-VMO takes place in the village where the fight took place in the night. Not many people come, perhaps out of fear, perhaps because they aren't sick. The troops pack up and return home through the same treacherous obstacle track. Once again, suspicion of IEDs keeps the convoy crawling along, but today no vehicles or people are lost. The children again run out to the street, holding their hands out for candy, and the troops in the convoy oblige.

Everyone returns back safely to their respective stations ready to continue operations helping the country of Afghanistan.