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4- The Oakville Beaver Weekend, Saturday November 17, 2007 www.oakvillebeaver.com Combat nurse treated military personnel and civilians Continued from page 1 Smith and the other new arrivals did not sit on the sidelines long, jumping in as more patients arrived. Although stationed on a NATO base Smith says around 90 per cent of the people her hospital received were Afghans, who would be either flown in by helicopter or driven in from outside the base. Of these Afghans the vast majority were made up of Afghan National Police and army as they are often on the front lines in the country's battle with the Taliban. Smith says Afghan civilians made up a smaller percentage of the people she saw during her time in Kandahar and of these, she's quick to point out, only a small fraction received their injuries in clashes between coalition and Taliban forces. "We treat any civilian that is injured in a crossfire, which is a very limited amount, and if it does happen you hear about it on the news," said Smith. "Lots of children that we've seen in the hospital would be there because they picked up a landmine from years ago, which exploded and caused a traumatic amputation." Captain Stephanie Smith The scourge of landmines, which plagues Afghanistan, was also pointed to by Smith as another factor that often brought Afghan civilians to her operating table. "Lots of children that we've seen in the hospital would be there because they picked up a landmine from years ago, which exploded and caused a traumatic amputation," she said. "Seeing children injured was something I found very difficult to internalize emo- tionally. It was difficult to deal with the fact that they were suffering, but at the same time that made us want to be there more." The stoic way in which many Afghans took the pain of such horrific injuries was another memory that stuck in Smith's mind. "You would look at them and their expression and the way they would respond made you think that they had very minor injuries, but then you'd remove a blanket and see that their arm had been traumatically amputated above the elbow," she said. "It seemed to us like they were all like that. All very stoic, very strong, almost like they were trying to internalize and control their pain in a very odd way. I think maybe because they've seen so much in their lifetime they just think this is no different than it happening to someone else, so they need to be strong through it." Smith says seeing injured Canadian and coalition soldiers was also difficult as they were injured on far rarer occasions than Afghan civilians, police and army. "I had one British soldier who had had a traumatic amputation of his leg and I found that very hard because he was a young 20-year-old guy who had come into this country to help out," said Smith. "You can talk to them and tell them how proud you are of them, that they're greatly appreciated and that they're going to go back home and get great rehabilitation, but it's very sad to see them like that." Smith, herself, was not completely safe from danger despite the fact that exceptionally tight security manned the entrances and exits to the NATO base. At least 10 times during her deployment the base fell prey to sporadic Taliban rocket attacks, which while largely inaccurate could still be lethal. During these attacks, Smith and the other nurses were required to get all the patients who could be moved to nearby bunkers while one nurse would put on a helmet and flak jacket and stay behind to look after the patients who could not be moved. As time passed and the conflict continued, so to did Smith's work, with severely injured coalition patients being stabilized on site and flown to other countries for further treatment while Afghan patients were treated and then transferred to Afghan Captain Stephanie Smith hospitals or into the care of family members. However, not everyone who came to Smith could be saved. In one such incident a sixyear-old girl was brought to the hospital after a suicide bomber blew himself up to punish local villagers for not supporting the Taliban. " We tried to save her, but there was absolutely no hope," said Smith. "Normally I'm pretty good about holding it together, but I bawled. I was so upset that she had died. Her mother wasn't with her at the time. Her father had brought her in, so her mother didn't get to see her when she died and that to me was awful that she wouldn't get that closure. The father was devastated. I've seen a lot of devastated fathers, so caring and loving and you see them there with their head in their hands crying." While not bothered by the bloodied legless appearance of landmine victims or the severe burns of the victim of a suicide bomber, Smith was bothered by the troubling experience of losing a patient. "I've seen a Canadian soldier die and it was odd for me because you just don't internalize. If you had known the person, it's very different. If you work on them and they die, like we did with that little girl, it's very hard to take," said Smith. "If they come in and they're almost dead when they get there, it's not as hard. It's awful that it happened, but you don't question yourself, `Did I do something wrong? Did I not work fast enough? Should I have done this?' That's what happens with medical personnel, we're very hard on ourselves when someone does die. Even if there's nothing else you could have done, you still feel that guilt. `Could I have done something more?'" Despite the pain Smith felt, day after day she and the other See Second page 7