By Jim Garamone

CAMP AL QAIM, Iraq, June 19, 2006 – Nestled between two giant railway buildings sits one of the most important buildings on this Marine base in western Iraq: the forward resuscitation surgical suite

Navy Dr. (Capt.) Don Elshire, officer in charge, is serving his second tour at the facility, which has provided the edge to save wounded Marines and soldiers. "I was here when we first set the area up," said Elshire, who is normally based in San Diego. "The area was receiving regular indirect fire, and this looked like the best place."

Qaim is at the end of a long supply line, right on Iraq's border with Syria. The "Golden Hour" that doctors talk about - the time from wounding to hospital - is not possible this far away from the combat support hospitals in Baghdad or Balad. The resuscitation suite allows doctors and corpsmen to stabilize patients so they can make the flight to the hospitals. "Our main thrust here is to save life, limb or eyesight," Elshire said. "That means stop bleeding, dress wounds, debride as needed and medevac out." Debridement is surgically removing dead or contaminated tissue and removing foreign matter from a wound.

Plywood buildings have since replaced the original tents. "But even there, the nylon and plastic tents are still serving," he said. "When the Seabees built the place, they used what was left of the tents as flooring." A full shock/trauma department inside the facility includes a surgical suite, a small lab, a portable X-ray machine, a portable oxygen generator, anesthesia machines, autoclaves and everything else needed to stabilize the most critical injuries. Army Black Hawk helicopters land right outside to evacuate casualties.

The facility allows the unit's 38 personnel to triage casualties as they come in and perform surgery if needed. "In roughly 20 percent of the cases, surgery is required," Elshire said. "If they have open wounds with broken bones, we take them right back into the operating room and we debride them, wash out the wounds and put on what they call external fixation devices to splint their bones. It helps stop the bleeding and also helps prevent any further infection or contamination." The operating room is clean and well-lit. The only clue that something is out of the ordinary is the fly strips hanging from the ceiling. If hard-pressed, the room could accommodate two patients at once, but it serves only one at a time. The facility does not have room to keep patients, but sometimes weather - sandstorms, in particular - forces them to.

The facility has treated Marines, sailors, soldiers and Iraqi soldiers and civilians, "anyone who requires care," Elshire said. "If we were not here and all the casualties were sent to Al Asad, I'm certain we would have lost a number of individuals. We would not have been able to intervene and save life and limb. I can think of a half a dozen alone who would have bled to death without this facility."