A civilian casualty, up close

The excitement and rush of adrenaline from a firefight quickly dissipates when you see one of the innocent victims up close.

Her eyes are wide open, as I run alongside her stretcher, but even with our momentum it’s easy to see that there’s no chest rise or fall, she is silent … and motionless, except for the small nods of her head which match the racing steps of the four American soldiers who carry her.

Her purple, patterned dress is darkened on her upper torso, near where she had apparently been bleeding from her neck. Her right arm dangles slightly from the stretcher, but has been caught in the powder-blue fabric of her burqa which has been pulled back from her head to reveal her face and wounds, but lies beneath her now. Her cheeks and hands are stained in the rusty hue of her own blood.

Her husband, his white shalwar kameez tunic spotted in blood, trails behind along with their daughter — who looks to be five or six years old. I feel ghoulish trying to video tape this tragedy. Desperate to be more useful I grab a portion of the stretcher and hurry with them to the Combat Aid Station within this forward U.S. military base known as Howz-E-Madad.

As we burst through the door, the medics are caught off guard with no prior warning, but quickly jump to their feet and begin the assessment.

“What’s she got,” one asks.

“No idea sir,” one of the stretcher bearers responds.

“Doesn’t look like she’s breathing,” says another.

“I’ve got no pulse.”

Aware of the cultural sensitivities here — they make everyone leave as they cut off her clothes and begin assessing her injuries and vital signs. She’s had massive blood loss, but the only significant wounds they can find are two lacerations from the neck, caused, they believe by either shrapnel or a small caliber weapon. She also has glass in her back, they assume from the projectile smashing through the car windshield.

She has no carotid pulse and Lt. Col. David “Mack” Easty, the Battalion doctor, wants to try and establish an airway as quickly s possible so he performs a surgical procedure called a “cric” (pronounded crike) or “cricothyroidotomy,” where a slit is made just below the adam’s apple and a plastic tube is inserted directly into the trachea. They begin “bagging” her with oxygen in an attempt to resuscitate. But she’s lost so much blood already her skin color has already turned waxen and Capt. James Slone, a physician’s assistant, notices that her pupils are fixed and dilated — a possible sign of brain death. At 9:56 a.m., Easty pronounces her dead.

On this already hot, Sunday morning in the Zhari District of Kandahar Province, Dr. Anar Gul becomes another one of an estimated 12,000 civilian victims in Afghanistan’s latest war.

Only 20 minutes or so earlier — she had been very much alive, sitting in the passenger seat of a small, white Toyota wagon, her daughter Summaya on her lap, while her husband, Dr. Pad Mohammed, tried to pass a convoy of trucks carrying fuel, water and other material to U.S. military installations in the region.

Mohammed says as soon as he pulled into a clear lane to pass, the car was hit by what he thinks was machine gun fire. It’s uncertain who was doing the firing and what ultimately penetrated his wife’s neck (Mohammed said it came from the south, the direction of the Taliban ambush).

What is clear, though, is that the vehicle had gotten between the two hostile forces which had been exchanging fire for about ten minutes.

When his car emerged his wife had been fatally wounded.

Mohammed and Summaya wait in a small guard shack, drinking water given to them by Afghan National Army soldiers who live on the base next to the Combat Aid Station. Summaya is wearing a blue dress with matching tights. She has a pink hairband with a butterfly on one side. As she sits next to her father on a bare mattress in the shack, she chews nervously on the end of the candy bar someone gave her.

At moments, she looks as she may break out in tears, but somehow, because of the deep confusion of events, she reels it in and instead sets her face in hardened expression. Eventually Capt. Slone enters to give Mohammed the news — his wife is dead.

Outside the shack, I hear one powerful sob but no more, I try to imagine the incongruity of it all. You are riding in your car with your family and in one instant, by being in exactly the wrong place at the wrong time, your wife is now dead. With its endless generations of war, I wonder if most Afghans at some point just stop worrying and accept that their wrong place could come anywhere, anytime.

The Afghan interpreter asks Slone if the clothes that were cut off can be put back on her. Slone explains they will place Gul in a black, military body bag which will cover her completely and which no one can see through.

I ask the Afghan interpreters what they’ve learned about the family, but, despite my curiosity, they’ve been too polite to pry — all they say is that both were medical doctors and then shake their head at the amplified magnitude of this loss — a healer lost — in a nation that so desperately needs healers.

Mohammed comes out of the guard shack. He shakes the hands of all the medics and says, through an interpreter something like “as a doctor to doctors, I’m grateful for all you’ve done.”

They load her body into an Afghan National Army ambulance and take it back to the front gate where Mohammed’s car has been parked outside. They begin clearing boxes from the seats to make room for the body, but there’s to much blood inside and some of the local men and Afghan soldiers who’ve come to help stop an empty van and put her body in there instead.

Mohammed and Summaya climb in beside the black bag that now holds their wife and mother. The van lumbers from the embankment back up onto the highway heading West, toward home — the same direction they had all been going an hour earlier.