Ensure your jacket is checked regularly; they do not last forever, and the plates can fracture if dropped or mistreated. The same goes for your helmet and goggles, which again should meet certain specified standards.
When it comes to IEDs, car bombs, random shootings and mortar attacks, I believe that everyone should take every precaution they can to stay alive, even if that means staying at home for years on end or getting the hell out of the country like I did. I want to die for a good reason if I can’t die from natural causes.
6/ First aid and Emergency Medicine
It is difficult to keep a reality check, to stay sane in a place with so many uncertainties. You get a headache in London and it’s just a headache. But get one in Africa and you start to think it’s dengue fever or malaria. You have to learn to manage that fear. The fear and worry is often far worse than the headache itself.
Readers of this book have probably been through some sort of basic medical training, but might not realize it. Whether it was putting a bandage on a teddy bear’s broken arm or watching hours of Grey’s Anatomy because you fancied one of the doctors, some sense of first aid has rubbed off. The problem is working out which bits are fact and which are fiction.
The good news is that common sense almost always prevails. It’s just a little more complicated in a war zone or during a disaster. Time and limited resources mean that you will be forced to prioritize. Say, for example, you don’t have a stretcher or neck brace – do you move the person with a potentially broken back out of the line of fire or not? Or say you’re in open ground when snipers start firing – do you run and save your life, leaving someone bleeding to death behind you? Who do you help when you have to choose between one starving child and another? Often the choices have to be made in seconds. There is almost never a correct answer.
I was in the British Army for a year before I went to university, and during that time I was given about a week’s worth of Red Cross training. In the army they limit your choices. There is a strict battlefield order of who gets attention and who doesn’t. It’s brutal. If an injured person isn’t breathing, you leave them and move onto the next one. You don’t even try to help. You are issued with one giant bandage – though people carry as many as possible – and it should be used carefully. When in battle, you’ll get morphine too. And that should be guarded for the most acute moments of pain.
Soldiers are prepared for the worst – in fact, taught to expect it. And if you are working anywhere near them, you should be too.
Journalist Tim Albone took this advice and told me all about it:
‘Before I left England for Afghanistan I went on a “Surviving Hostile Environments” course run by ex-special forces operatives near Hereford. It turned out to be one of the smartest things I did.
‘On 13 December 2005 I was travelling with Canadian troops on the border of Kandahar and Helmand province when the armoured jeep I was in was hit by a roadside bomb. When the dust settled, it turned out that I was the only one who could move. The driver and the front-seat passenger were both trapped and had broken legs. The gunner, who had been standing half out of the top with an armoured turret for protection, had simply disappeared.
‘I remembered my security training: they had told me on the course that it is always safer to stay in an armoured car, but I soon had to reassess this idea. The guys in front started cursing at me and telling me to hurry up and get them out – they were in a lot of pain. I remember the moment I pushed open the armoured door: I was convinced I was going to get shot. Luckily, there was no follow-up ambush, but what I saw was shocking enough. The gunner had been flung out of the vehicle and was lying a few feet away with the armoured gun turret on top of his chest. I was convinced he was dead. Then he started shouting. I pulled the turret off him and was amazed to find he was totally unharmed.
‘We both set about getting the two men out of the front of the jeep. It was a complete mess; the engine block had been thrown a few feet away, one tyre had been completely destroyed, and the other lay some distance away. I was surprised that no one was coming to help us. I later found out that they were sweeping the area for mines, but as we were in a dip by a dry riverbed, we couldn’t see them working their way slowly towards us, their mine detectors at the ready. I felt we were completely alone.
‘Once we had got the driver and passenger out of the front seat, I remembered some of my first-aid training and set about putting it into practice. I cut off the soldiers’ boots and, using the medical kit I had been given, splinted their legs. They were a bit of a mess: the bones were sticking out and I’m pretty sure without the training I would have had no idea what to do. When the medic finally got to us, about 20 minutes later, he was pretty quick to undo one of my splints and redo it. I hadn’t done it up tightly enough. It was clear that a one-week course was no replacement for years of training, but what it meant was that while we had the wait, I didn’t panic and I set about doing something. Without the training, I’m pretty sure I would have been more nervous and less certain of what to do. The incident taught me the importance of preparing for the worst and not going into a war zone without some kind of training.’
BBC correspondent Caroline Hawley agrees in principle, but warns that doing a course is no guarantee of doing the right thing in a medical emergency: ‘When violence strikes unexpectedly you’re caught off guard. In November 2005 I was in Amman, on a break from Baghdad, enjoying the kind of meal out that you could only fantasize about in Iraq, where many of the city’s restaurants had shut down. When the suicide bomber blew himself up in the lobby of the Hyatt Hotel, we had just ordered a beer in the Asian restaurant on the lower ground floor. The sound, of course, was deafening. I snapped my head around to see a column of fire and smoke on the stairway in the middle of the hotel. Then I saw the bloodied bodies – or were they still just about alive? I’ll never know. One man had vomited and defecated. I ran to get the ambulances to come round to our part of the hotel. It was a relief to get away from all the blood. But why didn’t I think to put the injured in the recovery position first? In the shock of it all, I seemed to have forgotten the elementary rules of first aid.’
This same thing might happen to you, so the first lesson is to trust your instincts. So many people I know are nervous of using the medical knowledge they learn. Nervous they will get it wrong. Nervous they won’t remember how to do anything.
Inside hot classrooms after long cold runs in the rain I nodded sleepily through most of my Red Cross training. I had regular updates throughout the year, and thought little had gone in. But two months later, when I was in a car accident in Botswana, I managed to whimper Red Cross instructions to my 12 injured friends while passing in and out of consciousness myself. They hopped into the next car that would take them, and I was left with two friends to wait for an ambulance. I couldn’t move my legs, so we refused several offers of a lift from passing farmers. Dehydrated, concussed and sick with pain from my crushed back, I wanted a doctor with a proper stretcher. It was like holding out for a London ambulance on the edge of the Okavango Delta. Silly. The ambulance did come eventually and four nurses each grabbed one of my limbs and threw me into the back of their dirty van. I thought I would never walk again, but I did…the next day.