By Peter Almond
Last updated at 2:29 AM on 07th March 2010
It was one of the most complex military logistical and medical operations ever undertaken – and it saved the life of a young British soldier critically injured in Afghanistan.
It involved hundreds of doctors, air and ground crews of several nations, travelling many thousands of miles, revolutionary and experimental medical equipment, several planes and helicopters and communications between three continents and cost millions of pounds.
For months, details of the massive operation to save one man’s life have been shrouded in secrecy. The injured soldier was not shot by the Taliban but was almost certainly wounded accidentally at his camp near Sangin in Helmand province in late July last year.
It is understood that Soldier X – he is not being identified at the request of his family – was not wearing body armour at the time. The Ministry of Defence has declined to offer any explanation.
The respected American journalist Michael Yon, himself a former US special forces soldier, reported on his blog that he heard the shot and saw a flurry of activity and a medical evacuation helicopter taking Soldier X away.
Then began a most incredible effort to save his life.
Soldier X had been shot in the abdomen and chest, losing his right lung and damaging his liver, according to the US military Stars And Stripes newspaper. Another American military report said his blood supply was replaced more than ten times, and that he was transfused with 75 units of blood and another 75 units of platelets.
He was alive – but only just. He needed specialist equipment to do what his lungs could not: provide oxygen to his blood and remove the carbon dioxide built up in its passage through his body. He needed an artificial lung and intensive care within hours. Such equipment was available at hospitals in Britain, nearly 4,000 miles away, but Soldier X would almost certainly die on the long flight.
He needed a portable, low-pressure artificial lung and the Americans offered to help. But the bureaucracy of moving from the British to the American military system meant that valuable time was being lost.
Contacted by a quick-thinking British doctor at Camp Bastion, Mr Yon sent an urgent email to a group of American civilian volunteers called Soldiers’ Angels near Ramstein Air Base in Germany, where most American casualties from Iraq and Afghanistan are initially sent.
The volunteers, founded by the great-niece of General George S. Patton, alerted the US Army’s nearby Landstuhl Regional Medical Center’s Acute Lung Rescue Team, which specialises in going straight to the aid of soldiers with severe lung problems.
And within an hour, the team was in touch with doctors at the nearby University of Regensberg who had access to a revolutionary portable artificial lung called a Novalung. The still experimental German-made machine takes over much of the job of circulating blood, filling it with oxygen and filtering out the carbon dioxide without the use of the mechanical pumps in the older Extra Corporeal Membrane Oxygenation (ECMO) machines, which have been known to cause damage to a patient by forcing the blood around the body.
Novalung is powered by the patient’s own heartbeat at a lower pressure, and has been used by the Landstuhl team several times, even though it has yet to be formally accepted into general use by either Germany or Britain.
It had never been used on a patient in transit, however. Soldier X would be the first to use it on his flight back to Germany.
With time running out, and Soldier X needing specialist attention immediately, a call was made from Camp Bastion to the US-led Combined Air and Space Operations Center at al Udeid Air Base in Qatar, where all military aircraft movements in and around Afghanistan are controlled.
Within minutes, the Joint Patient Movement Requirements Centre there identified a US C-130 Hercules at Kabul that could fly pulmonary specialists immediately to Camp Bastion.
At the same time, the 618th Tanker Airlift Control Centre at Scott Air Force Base in Illinois was alerted to co-ordinate the move of the Landstuhl team with the Novalung from Germany to Camp Bastion and back.
‘We received the call on our operations floor to airlift the British soldier from Afghanistan to Germany and immediately did what we could to make it happen,’ said Colonel John Martins, the 618th TACC director of operations, who led co-ordination efforts for the mission.
‘It was a complex move. Not only did we have to find a plane and aircrew to fly the patient out of Sangin, but also we had to find another plane and crew to get the right medical personnel and equipment into Afghanistan because we needed specialised medical teams to care for the patient in-flight.’
At Ramstein, a giant US C-17 Globemaster loaded with cargo for Iraq was quickly reassigned to take the Novalung team to Afghanistan and within six hours it was airborne and on its way, via a stop for more medical equipment at Bagram, Kabul.
Once on the ground at Camp Bastion, however, the aircrew found that the six hours it would take to prepare Soldier X for the flight back meant they would run out of permissible flying hours. Another aircrew would be needed while they flew back to Germany with several more wounded soldiers.
A second C-17 was urgently reassigned at Camp Bastion, while the Novalung was carefully connected to the blood vessels of Soldier X’s legs.
Eight hours later, and within 22 hours of receiving the call for help, the US Air Force had moved Soldier X from a combat zone on one continent to the medical safety of another.
At Ramstein, the Germans took over Soldier X’s care. A civilian Lifebird medevac helicopter was on hand to fly him to Regensberg for more operations.
Some time later, Soldier X was flown back to specialist care in England and is believed to be continuing his recovery.
The only official response from the MoD about the case has come in a statement from Surgeon Rear Admiral Lionel Jarvis, assistant chief of defence staff (health), which said: ‘The current Coalition operation in Afghanistan allows flexibility in the selection of the best casualty transfer system available at the time.
‘The US evacuation of a UK casualty to Germany exemplified the success of this arrangement, and the professional skills of the Coalition medical teams, resulting in a highly successful outcome.’
The only reported comment from Soldier X’s family comes from MaryAnn Phillips, of Soldiers’ Angels at Ramstein. In a message to Michael Yon on his website, she said she had met the young soldier’s mother at Regensberg Hospital, where he had regained consciousness and was improving.
‘She had no idea of the extraordinary lengths hundreds of people had gone to save him.
‘I told her about some of this,’ MaryAnn wrote to Yon. ‘She broke down and couldn’t believe “all of those people would do all that for my son”. It was a very, very moving moment.’
Michael Yon Important correction from Soldiers' Angels RE "Soldier X":
Michael Yon contacted Soldiers' Angels to improve communications about Soldier X’s status after he was moved from British to US and German medical care. Soldiers' Angels did not directly contact the Acute Lung Rescue Team. Soldiers' Angels role is to support soldiers and soldiers' families, not to initiate or intervene in medical care. 100% of the credit goes to the coalition military medical teams, who pulled together across the world to save a human life - no matter what nationality. They would have done it for anyone. That is the spirit of the original story, "The needs of the one":