Face of Defense: Doctor Employs Skills in Afghanistan

By Air Force Capt. Korry Leverett

455th Air Expeditionary Wing

BAGRAM AIRFIELD, Afghanistan, Aug. 4, 2011 – Many wounded airmen, soldiers, sailors and Marines in Afghanistan have suffered injuries that have changed their lives forever, but one doctor at the Craig Joint Theater Hospital here has made it his mission to support those who need it most.

Air Force Lt. Col. (Dr.) Carlos Ayala, chief of ear, nose and throat facial plastic surgery with the 455th Expeditionary Medical Group here, is the only ENT surgeon who specializes as a facial plastic surgeon in Afghanistan.

"My role here is to provide care to local nationals, Afghan National Police and our U.S. service members who have been injured in battle," he said. "I deal with their facial injuries, fractures, and all types of head and neck trauma using my training in aesthetics and reconstruction to allow people to go home as normal as possible."

Ayala, who is deployed from Nellis Air Force Base, Nev., arrived here in mid-May. He has seen more than 100 patients and performed more than 200 surgeries.

"This is by far the busiest I've ever been in the military. … There's nothing like this," Ayala said. "The type of trauma we see here doesn't exist stateside."

Often, bomb blast survivors arrive with multiple fragment and soft-tissue injuries to the face, he said. Ayala and his team work to remove the fragments that would cause long-term scarring if they remained embedded in the patient's tissue, and they repair soft-tissue injuries to restore their facial appearance.

Being the only facial plastic surgeon in Afghanistan, Ayala has seen a multitude of injuries in a relatively short period of time. Some, he added, are so unusual and devastating that no textbooks can show him how to fix them. The only thing to do then, he said, is to fall back on his training.

"After I arrived, I helped a little Afghan girl with diabetes [who] was intubated for a lengthy period of time," Ayala said. "Her voice box closed up, and she would have been dependent on a breathing tube the rest of her life had I not had the necessary training and been able to save her."

This is just one surgery of many the doctor says has been successful because of the training he received at the David Geffen School of Medicine at the University of California in Los Angeles; the Harvard Otolaryngology Residency Program at the Massachusetts Eye and Ear Infirmary; and the Lasky Clinic in Beverly Hills, Calif.

"The training I've received at these fine institutions has allowed me to be here to help our service members most of all," he said. "It was my professors and teachers that brought me to this point.” Ayala said he’s grateful and thankful to be able to use his skills to help the nation’s wounded warriors.

“This is what it's all about," he added.

Ayala is involved in the Afghan Trauma Mentorship Program. The program is supported by Operation Medical Libraries, which allows Ayala to serve as a liaison between the UCLA Medical School Alumni Association and physicians in Afghanistan.

"We've worked out a relationship between UCLA and physicians here in order to provide medical textbooks," Ayala said. "This is just one of several programs [that] allow me to work with other physicians, so when we leave this country they will be able to continue providing needed care."

When the time does come for Ayala to redeploy, he said, he will take with him a wealth of knowledge and experience to continue supporting those who have sacrificed so much.

"My hope is to continue to work with the Las Vegas Veterans Hospital, collocated at Nellis Air Force Base, to take care of these soldiers," he added. "I want to be able to see their care through to the end, until they're home. I truly believe that this will always be a part of my life."