by Calvin Ho
August 2009, Maysan Province, Iraq: The patrol was returning with casualties. The soldier had sustained grievous leg injuries after a roadside bomb struck his vehicle. Two others were wounded. The platoon leader was overwhelmed with grief and rage watching his soldiers to suffer. In the back of my mind I knew this was an inevitable outcome of the rising tide of violence throughout our deployment. In May, June, and July, rocket and mortar attacks in the province steadily increased in frequency. We fired counter-mortar artillery. Human intelligence teams were combing the local population. We performed combat operations to find high value targets and disrupt explosive logistical networks. However all this effort did not seem to suffice and the trail of blood running from the armored vehicle towards the helicopter landing zone drove home that point. What can we do to bring stability to Maysan? I stared at the medical evacuation helicopter as it took off into the Iraqi sky, searching for an answer that would later come from a source least expected. Humbling and inspiring interactions with the local people and realization of the crucial role these interactions play in peace-building efforts.
All of our pre-deployment training had emphasized lethal means to address the instability in Iraq and Afghanistan. I had been trained as a cavalry scout and infantryman and the idea of working side by side with the population was foreign to me. But as summer 2009 wore on, it became very obvious that continuous fighting was not the answer. One day in mid-August, we received a distress call that several children had encountered unexploded ordnance from the Iran-Iraq War and suffered grievous injuries. Once again I helplessly watched as life bled out from jagged, charred cuts. Nevertheless, watching our medics conduct critical care on the children was inspiring. The jarring event became instrumental in creating solidarity between U.S. Forces, Iraqi Security, and the local population. The dialogue became more open and constructive, leading to the creation of educational programs, improvements in infrastructure, and local militia neighborhood watches. Our medical coverage came to be crucial in opening this dialogue and identifying possible ways forward.
The first time I ever saw a pelvic exam was not in a modern U.S. exam room during medical school. It was in a dirty woodshed and I was helping arrange our impromptu clinic in a way most amenable for defense against a possible attack. A middle school girl had genital-urinary symptoms. As the medics administered the Ceftriaxone shot and explained the Azithromycin course, I saw the sadness and frustration in her family at their realization of sexual abuse. Another patient was a woman with a ruptured ectopic pregnancy who we were able to save through timely diagnosis and intervention. Some women were taking expired or incorrect antibiotics, or even heartburn medication for urinary tract infections. We taught mothers how to manage common pediatric presentations of cough, fever, abdominal pain, and diarrhea. Even U.S. and Iraqi soldiers sat in on these sessions to bring the knowledge back home. Finally, we were able to introduce medical evidence into the criminal justice system for sexual abuse rather than relying on hearsay. Although we did not plan to address women’s health and gender based violence, it was a need that local infrastructure could not always adequately provide and we found ourselves to be ideally positioned to assist.
As the clinic days for locals increased in frequency something else happened. Wary eyes of became smiling faces as a soccer ball was introduced. Awkward conversations about weather transitioned into lively debates about the latest Hollywood movie. Families made and brought food to feed us. Children brought jerseys for us to wear over our uniforms during pickup soccer games. Up to that point, doctrine had focused on controlling ‘key terrain’ and engaging the, predominantly male, key leaders of towns, mosques, and tribes. After establishing relationship with locals I came to understand that the ‘key leaders’ can as well be represented by Iraqi women dealing with problems relatable to women living in troubled neighborhoods of America. They shape the next generation as much as any religious or tribal leaders do. I distinctly remember the first time I talked to a young military aged Iraqi male and he didn’t look at me with hate or fear and I didn’t see him as an adversary, we came to recognize the humanity in each other. Of course we quickly became adversaries once the soccer game broke out.
When people hear that I led an infantry platoon in Iraq, the automatic assumption is that my deployment was full of action. There is certainly a time and place for the skillset of an infantryman, but medicine proved to be our most universal and powerful tool- greater than any ambush or raid. It was an interesting role reversal with combat soldiers supporting the medics. The humanitarian aspects of our patrols allowed our soldiers to express their compassionate side and create bonds with people who previously regarded us with suspicion and mistrust. Rather than ominous soldiers with rifles and body armor, medicine allowed us to show them that we are husbands, fathers, and good-hearted young men trying to make the world a better place. In this way we came to be ideally positioned to collaborate with local men and women on some of the issues they face such as the widespread sexual violence we witnessed during our mission. I believe that we urgently need appropriate training and education for soldiers to be able to tap into the local resources and tackle the issues at hand through partnerships. Our experience illustrated that peacebuilding efforts are only really effective with support and assistance from the local communities. We cannot kill our way to victory. At the end of our mission, in May 2010, when we turned in our ammunition prior to returning home, my 23 soldiers turned in the same ammunition from December.
Calvin Ho is currently a student at the University of Colorado School of Medicine in the United States and has a special interest in Humanitarian Medicine. He is a Ranger Qualified U.S. Army Officer who led an infantry platoon and company in Iraq. Since his experiences in Iraq Calvin has undertaken a number of medical relief missions. He has deployed to Haiti several times and worked in Brazil as well as undertaking medical relief work in areas of need in urban and rural America.