Hello. Fixing to go to Afghanistan.

[medic22733]

Hello all, my name is Andy. I have accepted a paramedic position with a private contracting company and will be leaving soon. Any advice or tips on dealing with enviroment or conditions. I will be working as a clinical medic on base.

Thanks.

[John5482]

The people there dont value human life. While there I saw families bring children that were obviously abused repeatedly. They brought them in for the free food and beverage. These are the kids.

The other injuries you'll see are the usual. Limbs blown off completely. Shrapnel wounds. Hot metal flying through the air then getting stuck in the flesh.

Dozens of gunshot wounds. Some dumb wounds, cuts from troops messing with them. Bring a hard drive that fits about 300 movies!!! Also while you're there you only have to worry about you, keeping yourself safe, fed, and getting into shape!!

[island emt]

Be VERY sure you want to do this, and take the risks involved, before you get on the first of many planes.

My brother in law came home from there in a box exactly one year ago. He was working as a contract employee for one of the biggest firms selling bodies to the us govt.

He was murdered by an afghan intelligence officer for getting too close to arresting important politically connected afghani's for drug trafficking.

RIP Paul Protzenko 30 Oct 1964 - 9 July 2011

Edited July 10, 2012 by island emt

[akflightmedic]

While John may have had those experiences, I assure you as an OHS medic on Kandahar you will not. Be prepared to deal with a lot of whiney people wanting the day off, sniffles, diarrhea and the occasional real medical emergency and some trauma such as lacerations or minor crushings.

You will not see any limbs missing, shrapnel or bullet wounds. You will not be dealing with locals. You will quickly become a Fobbit who hangs on the boardwalk eating at KFC or TGI Fridays then getting an ice cream after. Hard drives not needed you can buy every movie you want for 2 dollars.

Anyways, I do not have much time to expand on this right now...but email Dwayne. He can brief you in depth or if you have specific questions I can answer them when I am free. Do not overpack, you can buy what you need at the PX or order online. Easy cheesy...

[Kiwiology]

Kiwi warn watch out for the bearded one who carries lightsaber ....

[chbare]

My experiences pretty much mirror what AK has already stated. I worked primarily with the locals and expat contractors. Most of the local people were humble, gracious and valued life. Yes, there were frequent kidnappings and occasional bombings, but if you are going to be working behind the wire, you will not have all that much to worry about.

I also agree with overpacking. Go with what you need. I learned the hard way about bringing tonnes of crap. A decent company should outfit you with what you need when you arrive. However, some breathable cold weather clothing is never a bad idea if you'll be outdoors at all during the winter months. I'm not as up on Kandahar, but Kabul can be miserable during the winter.

Most of your expat patients will be typical swollen wimp node complaints; however, some of the guys have complex problem that are not well managed or become difficult to manage. I had many cases of HTN, diabetes, a couple of MI's, several subarachnoid haemorrhages, and I even diagnosed a case of haemochromotosis and blew a diagnosis of malaria. Ended up treating a suspected MI that turned out to be variant angina. Also, had numerous skin conditions and cases of cellulitis and skin abscesses. Did a fair number of I&D's with empiric anti microbial treatment. I would know common PO meds for treating MRSA.

I only saw trauma patients when I did medevac missions. However, I only saw about six real trauma cases with the majority of our medevacs being complex medical patients.

[DwayneEMTP]

(EDIT: Maybe the best advice of all....Please, please, please don't show up at the clinic in desert cammo trauma pants with a gazillion pockets, a special forces backpack loaded with lots of cool, dangly things that hang off of the outside, walking like you just watched the first few Rambo movies. You'll look like a total tool and it will take a while for anyone to take your seriously afterwards...

(And yeah, I wish someone would have told me that but I'm guessing that they'd mistakenly assumed I wasn't a complete idiot...)

(Ok, I wasn't that bad, but I did see a ton of wankers show up looking more or less like that.)

As was said above by my betters... Depending on the gig you get you may end up in a meat grinder like BAF where we saw 15-25 pts/day with full documentation, or a really slow gig where you'll see one patient every several days. What you won't be doing, regardless of what people are going to want to convince you of, is dodging bullets and sprinting across dust showered fields answering the screams of "Medic!! We need a medic!!" though many remote medics will try and convince you that 'their' gigs were like that.

I was returning to Afg sitting next to a guy that was telling the guy next to him, "Yeah, I'm going to BAF. My buddy tells me that they fly us in on old Russian helicopters and most of the guys lay on the floor because you can't breath sitting up for all of the cigarette smoke!" I said, "Brother, your buddy is filling you full of shit.." He said, "You don't know! That's how our company goes in!" I said, "Man, you need to work for a different company because everyone else goes in on a commercial airliner."

The point being that you'll hear all sorts of nonsense, but most likely the job will be much less than what you're used to doing only you'll get to brag about doing it in Afghanistan, which really is cool as hell....

Warm weather clothes in the summer are a must, and layers, as Chris mentioned important for the winter, but for the most part you'll always be comfortably air conditioned cool in the summer and warm as toast in winter as a medic. You'll be given a ton of respect that you don't really deserve, and if you're like most you'll accept it, strut around enjoying it, and even come to believe that you do in fact deserve it, which should make you ashamed.

Get the time differences now and make plans to chat with your family. If you don't use a program now like the chat utility in Gmail, then learn how to use it and make sure that everyone you love knows how to use it too.

Make plans to productively fill your free time, as almost certainly that will be your biggest enemy. Learn to network with other medics. Contract medicine is fickle and I PROMISE you that you will at some point be woken up, or stopped in the middle of your day to someone saying, "Pack your gear. You're heading home tomorrow. We lost this contract. We'll call you if we need you again."

On that same note....PUT ASIDE MONEY FOR SEVERAL MONTHS OF LIVING EXPENSES! You will be making more than you're used to and though you have already made big plans to pay off all of your bills and save money to go back to school, I'VE NEVER TALKED TO ANYONE THAT FOLLOWED THOSE PLANS. Sorry for the caps, but you'll soon see why I felt them to be necessary.

Before going to Afg akflightmedic gave me the same advice and I promised to be smart and follow it, but of course didn't. If you don't, you'll end up like 99% of the medics that I know. You will spend all that you make, learn to live and expect a different standard, get the "See ya!!" talk from your company and be forced to suck the dicks of every recruiter around to find another gig so that you can "get by." Thankfully that's a habit that I've broken, but only because my friends have helped me land on my feet when I was out of work. But you don't even want to know how many figurative dicks I had to suck in the moments after being suddenly, instantly unemployed in a one income family. Yeah. Not my proudest moments.

Probably the most importat? Nothing is ever true until you see it with your own eyes. You have to learn to ignore promises, ignore rumors....they are the mainstay of the bored in the war zone and we all jump all over them at first. I wish I wouldn't have...

"Holy shit! I just heard from our boss's, boss's, boss, (Shhhhhh He and I are friends. He lay next to me on the Russian helicopter on the way in) that they are going to shut this site down at the end of this month!! No, really! They lost the contract!"

"I just heard, I just heard, I just heard!!" You truly can have an amazingly awesome time, make awesome friends, do really good expanded scope paramedic medicine there...you probably won't, but you can! I miss Afg all the time. I loved it there and would go back but they don't really enough anything any more....

Also, my experience as well is that the Afghanis are kind, generous, amazing people. They care just as much about life, and pain, and loss as you do, they've just seen so much more of it than you have that they don't always react the way that you think that they should. The Taliban is a small pimple on the ass of the giant that is the Muslim and Afghani people. Defining the entire country by them is akin to defining Americans by the relatively few three toothed rednecks that still brag about beating up 'Niggers and queers.' It makes no sense.

Good luck Brother. I'd love to hear how you get on....

Dwayne

[paramedicmike]

While I don't have any experience as a contract medic, Dwayne's post is probably applicable in some way, shape or form to *any* job that anyone could ever have. Plus one is not enough but it's all I can do.

Enjoy your experiences over there.

[John5482]

Yea my experience was in Salerno. Not KAF. I only passed through KAF. Regardless of all the other stuff, ENJOY IT.