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WINGED
SCALPEL A Surgeon at the Frontline of Disaster
Richard Villar
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First published in Great Britain in 2012 by PEN & SWORD DISCOVERY an imprint of Pen & Sword Books Ltd 47 Church Street Barnsley South Yorkshire S70 2AS Copyright Š Richard Villar, 2012 ISBN 978 1 78159 168 0 The right of Richard Villar to be identified as the author of this work has been asserted by him in accordance with the Copyright, Designs and Patents Act 1988 A CIP catalogue record for this book is available from the British Library All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical including photocopying, recording or by any information storage and retrieval system, without permission from the Publisher in writing. Typeset in Ehrhardt by L S Menzies-Earl Printed and bound in England by CPI Group (UK) Ltd, Croydon, CR0 4YY
Pen & Sword Books Ltd incorporates the imprints of Pen & Sword Aviation, Pen & Sword Family History, Pen & Sword Maritime, Pen & Sword Military, Pen & Sword Discovery, Wharncliffe Local History, Wharncliffe True Crime, Wharncliffe Transport, Pen & Sword Select, Pen & Sword Military Classics, Leo Cooper, Remember When, The Praetorian Press, Seaforth Publishing and Frontline Publishing For a complete list of Pen & Sword titles please contact PEN & SWORD BOOKS LIMITED 47 Church Street, Barnsley, South Yorkshire, S70 2AS England E-mail: enquiries@pen-and-sword.co.uk Website: www.pen-and-sword.co.uk
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Contents
Foreword........................................................................................vii Maps...............................................................................................ix Chapter 1
Nightmare ................................................................1
KASHMIR 2005 Chapter 2
Shame and Upheaval.................................................4
Chapter 3
Seat 28A ...................................................................8
Chapter 4
I See Helicopters.....................................................15
Chapter 5
Meetings, More Meetings .......................................21
Chapter 6
Panjkot Valley .........................................................26
Chapter 7
Manohar .................................................................35
Chapter 8
Too Many Casualties...............................................40
Chapter 9
Missing and Unidentified........................................45
Chapter 10
Vodka is a Real Man’s Drink....................................51
Chapter 11
The Body in the Woods...........................................57
JAVA 2006 Chapter 12
Multiple Disasters...................................................65
Chapter 13
The Makeshift Hospital ..........................................70
Chapter 14
Politicians Do Not Like Me ....................................75
Chapter 15
Surgical Disasters....................................................79
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HAITI 2010 Chapter 16
The Call..................................................................87
Chapter 17
The General ...........................................................99
Chapter 18
Aftershock.............................................................113
Chapter 19
A Sleepless Night..................................................121
Chapter 20
The Psychologist ...................................................130
Chapter 21
Tents Need Poles ..................................................146
Chapter 22
I Want to Go to America .......................................152
LIBYA 2011 Chapter 23
The Arrival ...........................................................157
Chapter 24
Tataouine ..............................................................163
Chapter 25
The Mysterious American .....................................169
Chapter 26
War Changes You ..................................................180
Chapter 27
Border Crossing ....................................................185
Chapter 28
Roadblock .............................................................192
Chapter 29
Unsung Heroes .....................................................195
Afterword – Homecoming ............................................................206
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Foreword I blame the SAS. Without them I would not be writing this. I would have been someone different, enjoying a quieter life free from danger. The SAS changed me, pushed me to my limits, sometimes beyond. I used once to think I was brave, that nothing would perturb me. I was sure I had a limitless source of courage that made me stand apart from the normal male. SAS service does that to you. It makes you feel special; it makes you feel proud, privileged and fortunate. The Regiment took me to actions and opportunities throughout the world. Terrorism in London, violence in Northern Ireland, conflict in central America, the deserts of the Middle East, the mountains of Pakistan and Afghanistan, and Far Eastern jungles. It took me up Everest, and down again in an avalanche. It took me to the Falklands War, nearly killing me in the process. In many respects the SAS made me the man I am today. Yet however proud I am of my time as an SAS surgeon, however much I realise that my experiences are perhaps unique, I now know that anything the Regiment showed me was but a prelude of what was to follow. I left the SAS a changed man and then worked in England and overseas. To my patients I was an orthopaedic surgeon, one who handled problems with damaged bones and joints. Yet I did more, much more, in a world few have had the privilege to see. I worked in small hospitals in rural India and big ones in Nepal. I worked in Lebanon for the Palestinians, who taught me, surprisingly, about the futility of war. I even endured the siege of Sarajevo in a hospital so full of shrapnel holes we likened it to Swiss cheese. Today, I form part of the United Kingdom’s Emergency Response whenever there is a disaster. I work with a group called Merlin – Medical Emergency Relief International. I am often the first man in, when the buildings have collapsed or the bombs have dropped. I doubt you will have heard of me. Yet this job has taken its toll, not just on me but also on the others with whom I work. It is a difficult existence yet I hope my efforts have led to many lives being saved and much pain and psychological stress being abolished. If that is true, then my personal
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viii Winged Scalpel suffering will have been worthwhile; the nightmares, the domestic upheaval and the injuries I have sustained. This is my story, at least part of my story. It tells of my time in Kashmir and its most horrifying earthquake when tens of thousands died in seconds and I was left to decide, on the remotest Kashmiri mountainside, who should live and who should die. I write of Java and its quadruple, simultaneous catastrophes of volcanic eruption, earthquake, bird ’flu and terrorism. I write also of Haiti, that earthquake of earthquakes, where I arrived only days after the event and was immersed fully into the tragedy and violence of that desperate land. Finally, I go to Libya and Tunisia, where I worked at the peak of NATO’s bombing campaign, and where I evaded Colonel Gaddafi by crossing the border only hours ahead of his men. Before I begin, I must pay credit to the many others who accompanied me on these adventures. They are unbelievably brave and motivated people. Wherever I went, whatever I did, Merlin colleagues who have in many cases become lifelong friends accompanied me. Mostly, in this book I have changed their names, sometimes even their location. This is because to provide aid in the wake of conflict and disaster is dangerous. Not everyone makes it home. Medical staff are killed, maimed, imprisoned and tortured throughout the world for a multitude of reasons. These are brave people who do so much for the tiniest financial reward. I am but one of many and it has been my privilege to be involved. I was present at each of the events I describe and I am sure more will follow. Wars and natural disasters are an unhappy, inevitable part of mankind’s existence. However, I doubt I would have seen any of them had it not been for the SAS. They deserve my thanks, too. You see, they say you can take a man out of the Regiment but you cannot take the Regiment out of a man. They are right. Read and you may understand.
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Chapter 1
Nightmare
Different nightmares come and go but the terror, when it happens, is the same. I wake up screaming, the sweat dripping from my drenched torso, my eyes wide open, arms flaying wildly in all directions. I turn, my trembling hand struggling for the bedside light. I fumble and I grope, frequently throwing the spindly lamp unintentionally to the floor. Then I find the tiny switch. For a brief second I wait, then I push. Instantly, from darkness, there is light. I sigh, I breathe deeply, throwing myself once more onto my back. I feel that distant sensation behind my eyes as the tears slowly well. Rapidly the tiny drops become a torrent streaming down my cheeks. My body shakes, violent shakes, so forceful that the bed head thumps loudly against the wall. In the half smile, half grimace of distress, I raise my cupped hands to cover my face, as if to hide myself in shame. Always I say the same words, always my voice trembles, always I try to whisper and always I fail. ‘Oh God!’ I shout in panic. ‘Oh God, why me?’ Then it is over, almost as quickly as it began. I relax, laying my arms limply down beside me. Yet the terror remains, the terror of a next time, the realisation that everything my dreams had shown was a horror I had actually seen. The nightmare always follows the same pattern. I am walking down a rubble-strewn street in a destroyed city; somewhere primitive, somewhere poor, somewhere that tower blocks do not exist. It is early morning and the stench of death is everywhere. A shop sign dangles dangerously from a tilted post to my right, an elderly woman sits silently on an irregular boulder to my left. In the distance, at least as far as I can see through the thick, smoglike dusty haze in the immediate aftermath of an earthquake, I can see children running wildly in all directions, screaming for their parents, their friends, their brothers, their sisters. Yet whole families have disappeared, vanished without trace, and in a matter of a few seconds. The much-loved child has become an orphan in the time it takes to blink. I stop to listen, but it is not the terrified children I hear. It is the voice,
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2 Winged Scalpel faint, remote, gasping, somewhere in the half-collapsed building behind me to my right. I turn and retrace my steps, just a few, but enough to hear the voice more clearly. Now I can make out individual words, they are more than just a mumble. ‘Help me,’ says the young female voice, ‘Please help me.’ Through the haze I see the pile of broken rubble extending outwards from the concertinaed floors of the small apartment block. The boulders are strewn across the pitted road like a reptilian tongue, the line of rubble forked at its far end as it was thrown from the collapsing building with explosive force. I come closer. Now I can see the girl. Her stained, pink, floral dress is crumpled up above her waist. She is about 16 years old, now face down in the dirt, her head forced agonisingly to the left by the large concrete boulder that is lying across her lower back and right shoulder. I can see the tiny trickle of blood coming from the side of her mouth and, through the dust, I can also see her blue, cyanosed legs now devoid of blood and crushed beyond all hope of salvage. I approach the girl, I squat down beside her, I grasp her small, cold hand in mine. I whisper gently in her ear, ‘I’m here to help you. My name is Richard. Who are you?’ For a moment I see the girl give a gentle half-smile. Her eyes flick towards me, imploringly, begging me to help. ‘Please,’ she says. ‘I’m stuck. Please get me out of here.’ I look at the boulder that has pinned her to the ground, the boulder which has ensured she will never walk again. Probably, I suspect, the girl had almost escaped from the collapsing building during the earthquake. Another few feet and she would have been free. Yet she had perhaps stumbled and then the boulder had caught her, trapped her and crushed her to the ground. I look harder at the boulder. One man, however strong, could not make it budge. It is massive, irregular, sharp-edged in parts, and has rusty and bent reinforcement wires protruding. Even if it could be moved, above us I see a large concrete slab held from its final descent by the boulder itself; one shift of the boulder and down the slab would come. Yet it is not the slab that has now drawn my attention. The terror, the horror, the realisation develops inside me like some massive, frightening tidal wave. I look closer at the boulder that has trapped the girl. I had missed it until then. There, under the boulder, and to the girl’s right, lies
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Nightmare 3 the crushed body of the child, perhaps four or five years old. The young creature is still tightly gripping the girl’s right hand. The child, I cannot tell whether it is boy or girl, is so clearly dead. I try not to show my distress as I know the girl, whose head has been forced to look away by the boulder, cannot tell what has happened. The child, I now feel certain, is the reason why the girl had not escaped. She would have stopped to rescue this tiny piece of mankind, perhaps a sibling, perhaps a stranger, but the girl’s charity has been her own demise. Then, as I look at the boulder, and the dead child, and then glance back to the girl’s imploring eyes, I realise the situation is hopeless. What can I do? What can I say? Rescue is a million miles away, certainly many days. I smile at the girl as I speak, squeezing her now clammy hand more tightly. ‘It’ll be fine,’ I say, my voice as reassuring as I can muster. ‘Just give me a few moments and I’ll have you out of there.’ I see the girl smile. She is happier now. A stranger has come to help. Gently she nods her head as acknowledgement. Slowly I rise to my feet wondering what to do. Then Nature speaks, with a violence that makes mankind seem so insignificant. The aftershock slams into the soles of my feet like a sledgehammer. I stagger awkwardly to my left almost falling to the ground. It is over almost as soon as it has started. Briefly there is silence. Then I hear the unmistakable sound of rubble shifting, of concertinaed floors subsiding, of already collapsed buildings collapsing further. I hear the shouts and screams of warning as those survivors who can run or stumble, dash to get clear. I see the concrete slab above us shifting and instantly recognise I have milliseconds to live - unless I act. My survival process takes over; every reflex and every move is aimed at keeping me alive. To my instincts I have now become the priority. I turn rapidly and half dive, half stagger into the rubble-strewn street outside once more. As I roll headlong through the debris I hear the concrete slab come crashing down and see the girl’s crushed frame disappear in a cloud of white dust. She has gone, now buried deeply beneath the debris, her pink dress already a memory. I sit in the dirt, breathing in the contaminated air, only yards away from the girl. And then I wake up, and I cry, those same tears that have plagued me for so long. Those tears are for the girl, and the many, many thousands like her. Those tears are for the ones I could not save. Such is life with disaster. * * *
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KASHMIR 2005 Chapter 2
Shame and Upheaval
Much can happen in thirteen days, especially after an earthquake. That number and that delay are writ large in my mind even now. Writ large because I am horrified and ashamed that it took me thirteen days after the Kashmir earthquake to treat my first casualty. Kashmir was a classic case of administrative chaos, and the world should take a lesson from it. Much is said at the time of a major disaster, much is promised and much may seem to be done. However, much is lacking when it comes to helping the folk who truly matter. Those are the casualties, the wounded, the diseased, the displaced. For Kashmir, the aid machine should hang its head in shame. The machine can be so willing and so well meaning, yet through sheer inertia can be so ineffective. This is my story of the Kashmir earthquake, a personal, sometimes emotional view. On the morning of Saturday 8th October 2005, with me in central London, I awoke to hear the news from Kashmir. A Richter 7.6 tremor had hit a mountainous region northeast of the city of Muzaffarabad at 8.52 am, Pakistan time. The media were in full throttle. Casualty estimates were then unknown, but the earthquake had been major. Nobody could know that the end result would be more than 75,000 dead, many more injured, and three million homeless. The tremor had been a rough, rapid, vertical shock, which at its peak had lasted no more than three seconds. Three seconds – that was all. Yet the lives of so many had been destroyed or irreversibly changed. From London, Kashmir seemed so far away. The earthquake was bad news of course, but someone else’s life, someone else’s disaster and someone else’s problem. I tried to imagine the disaster and how it might appear. I knew the area
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Shame and Upheaval 5 well, having spent time in the North-West Frontier Province when Russia had been knocking on Afghanistan’s door. Moscow had been one of many to believe it could tame the untameable. There is something almost romantic about the North-West Frontier. These are real mountains, rugged and hard, populated by a resilient and welcoming people. A wimp would not last long in the North-West Frontier. The mountains are more than huge - Nanga Parbat in the Great Himalaya, sometimes called the Naked Mountain; or K2 to the north and part of the Karakoram range. I may be a medical man but I am also a mountaineer. To a true mountaineer the mere mention of Kashmir stirs the belly. This was a busy professional time for me. I was relocating my practice from Cambridge to London and was right in the middle of the move. I had little time to spare for Kashmir and its tortured human load. The 8th October came and went, the stories fed by the media became more horrifying and yet more distant, while I was certain I would not be involved in the slowly awakening humanitarian aid machine. The television would show an occasional rescue team, each worker dressed in flashy uniform and carrying a spotless holdall, heading towards the earthquake zone. Often, their interviews were held on airport runways, in hotels, or on well-swept pavements. Rarely were they given in areas with damaged buildings, or in the mountainous region where the earthquake had occurred. Meanwhile Government spokesmen would announce generous offerings to Kashmir’s victims, yet offer no detail of how the funds would be transferred, or when they would reach their intended destination. There was certainly no detail of how they would be used. Anyway, for me, why did it matter, I thought? I had repeatedly offered my services in previous years to a succession of disaster charities. Few had replied and for those who had responded, none had given me a job to do. However much experience I might have gained as a Special Forces surgeon, the world of disaster relief appeared a closed shop. There was no way in, it seemed, without some major organisation supporting you. It was on the 16th October, eight days after the Kashmir tremor, that my life irreversibly changed. I had taken a weekend off to escape London and walk in the soft and soggy hills of England’s White Peak District, near to the village of Hartington. My mind was filled with the trivia of life. Kashmir to me then was a million miles away. That was until my mobile rang, a piercing trill that brought me back
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6 Winged Scalpel instantly to the here and now. I moved to one side of the footpath, allowing a small group of walkers behind to pass and answered my telephone. I did not recognise the caller. ‘Is that Villar the surgeon?’ came an authoritative tone. I suppressed a chuckle. ‘Yes, this is Villar the surgeon,’ I replied, half smiling. The use of my surname carried images of time spent with Her Majesty’s Armed Services, so it was no surprise when the caller introduced himself as a Major General. The questioning then continued. ‘The same Villar who was with the SAS?’ Here we go I thought. I had spent a considerable time with the SAS, I had even written a book about my time with the Regiment, but it was still not something I freely discussed with strangers on the telephone. ‘Many years ago, yes.’ The Major General clearly understood my concern. ‘Just checking you are the right chap. What do you know about mountaineering?’ he asked. I looked around me at the smooth contours of the White Peak’s hills and smiled further. The Major General would of course have no idea from where I was speaking. ‘A fair amount,’ I replied. ‘I have spent much of my life in the mountains.’ ‘And field hospitals?’ ‘Them too.’ ‘Then you are just the man for the job,’ said the Major General. ‘What is this about?’ I queried, suspicion evident in my voice. ‘Kashmir, man. It’s all over the news. You must surely have heard?’ My mind instantly switched into overdrive. So this was how these things began. This was the first approach and how it was done. My name was registered with at least a dozen charities, each made aware that I would be happy to help in a disaster, that I could move fast, and that I had the relevant experience. It was now so long after the earthquake that I was sure I would not be required. Surely no aid machine could be this slow? Yet it was. Briefly the Major General explained. Merlin, one of the UK aid organisations wished to position a field hospital near to the epicentre of the Kashmir earthquake. They needed someone with experience to help run the show in the field. Was I interested? For an ex-SAS surgeon that was an unnecessary question. Of course I was interested and of course I wanted to go. Suddenly my worries about
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Shame and Upheaval 7 the trivia of a practice move disappeared. It was as if they had never existed. My focus instantly changed. Whether it was a search for adventure, whether it was a desire to help others, or a mixture of the two, the Kashmir call struck home. Irrespective of the upheaval it would create in my life, if Kashmir summoned I would go. * * *