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July 13, 1999
Kargil Hope: Fighting death away from the battle zone
Mahesh Nair in Kargil
Major Arup Ratan Basu stood by the side of the bed and looked at the soldier lying on it. The textbooks of the Armed Forces Medical College, where he completed his masters in surgery six months ago, had not prepared him for this. What route does a splinter take once it enters a human body?
The splinter had hit the soldier while he was driving a jeep in the Kargil sector. A Pakistani shell had landed fifty feet behind the jeep sending hundreds of splinters flying. One splinter cut through the canvas flap at the rear of the jeep, ripped through the back of the drivers seat, tore the soldier's back muscles, entered his vertebra, passed through his abdomen, sliced his pancreas and lodged itself in his intestines.
For almost three hours Major Basu meticulously followed the trail of destruction the two-inch splinter had wreaked within the soldier's body. He picked up pieces of sharpnel and cleaned up ruptured organs one by one. Finally, job done, he checked the patient's blood pressure and smiled. There was a healthy chance that the patient would survive.
"Send him off tomorrow morning to Srinagar to recover," Major Basu told a male nurse, "we need the bed for other casualties."
Ever since late February when he was posted at the army medical unit in Kargil, Major Basu has operated upon about 350 men participating in Operation Vijay. Being the lone surgeon has meant sleepless nights and hectic days. And very often when he goes to sleep, he can hear a distant boom followed by a whistle like sound. He sleeps comfortably. The whistling sound is that of a Pakistani artillery shell playing overhead. You are in trouble if you don't here the whistle after the boom.
On an average, there are six to seven casualties that are brought in daily at the eight-bed emergency ward of the Kargil Army Hospital. These casualties normally come in during the afternoon. The war is at its fiercest at night. The injured are brought down from the battle zones in the morning hours.
Medical treatment consists of two stages before an injured soldier reaches the base hospital. It starts with the first-aid, administered by the injured's colleagues on the spot. All soldiers have been trained in the art of the elementary dressing. The immediate concern is to stop the bleeding and then carry the injured away from the danger zone.
Sometimes if the fighting is intense, it takes longer to bring the injured to a safe area.
Major Basu remembers an instance when a soldier who was hit at 6 am could be brought down to a safe zone only at 3 pm. By the time he reached the base hospital at Kargil, he had lost six bottles of blood. But he died of other complications. "If I had him earlier I could have easily saved him. But it was too late. I could only watch him die," says the surgeon.
The second stage of medical treatment starts once the injured is brought out from the danger zone. A medical officer and nurses who are part of every fighting unit readjust the dressing on the wounds. The injured is then administered pain-killers and put on IV fluid if the need be.
He is then rushed by medical van or airlifted by a MI-7 helicopter to the base hospital.
The Kargil Hospital is not equipped to operate upon serious head injuries. In late June, for instance, Major Basu remembers the time when an injured soldier walked into the ward. "The man had a hole in his forehead and I could see the covering of his brain. But he was conscious and was, in fact, walking and talking! I immediately asked the chaps to fly him down to Chandigarh for neuro-surgery."
The war also leaves horrendous psychological scars. A gunner in Pandrass in the Drass sector had the brains of his colleague splattered on his uniform after intense shelling from the Pakistani side.
By and large Indian forces have built a reputation for being tough cookies, remaining unshaken in the face of physical injuries. But sometimes shelling causes intense shock. The Kargil medical unit has in the past three months witnessed two such cases. One solider had lost his ability to talk and was in a permanent state of shock. The other had lost his mental balance.
For people like Major Basu, the battle of Kargil is literally an initiation into the medical world by fire. Death is teaching him all the important lessons of life. When on a quiet day, he stands on the corridors of the base hospital, listening to the soothing sounds of gurbani from the nearby gurdwara, his glance sometimes pauses at the breathtaking view of the rugged hills of Kargil. And then he realises that the beautiful rock that he sees so far could well be the splinter he has to fight in the operation room to save a soldier's life.
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