Living and working as a Paramedic in Iraq.

Saturday, July 10, 2004

Traveling to Iraq- covers multiple subjects and dates

Iraq, who would have thought a middle class guy from a basically normal American family with a basically normal life would sign up to go work in a war torn county. Certainly not me and apparently not most of my friends. Well where to begin?

It’s not a decision I just out of the blue made, I did think about it a bit first. The subject had been bounced around at work a little. I was working for the local county EMS service as a paramedic and had been for a few years now, close to ten years actually, and was quite frankly pretty bored with it. Don’t get me wrong here, I’m not a “been there, done that kind of medic”- there are plenty of things I still haven’t seen or done. Heck, I’ve still never done a decompression (I’ve asked for orders to do it and had the doctor on the other end deny them so he could show his students at the teaching hospital how to do it- Thanks you arrogant prick!) It’s just that it had never been my intention to work in EMS. Strange leap you say.

Funny thing talking about going to a war zone- lots of people start to talk about how they would like to go and try it and “Oh yeah, I applied but haven’t heard back”. Well I applied and heard back in two days so I’m calling BS on the others. I have a friend over here, Chris, who I was able to call and talk to about it before I ever agreed to go through the hiring process. So I chatted with him about it via e-mail and over the phone and figured I’d give it a go. The timing played out with the whole decision.

Cindy had decided she wanted to find another job managing a veterinary hospital, something she had always wanted to do. She had pretty much reached the zenith of her career at the pet store unless she wanted to go on the road as a district manager or move to Phoenix to the corporate office- neither of which appealed to her. So, she began looking for jobs as a veterinary hospital manager. With her qualifications, it didn’t take long for things to start rolling. She got an interview at a hospital in VA and we drove up there to check the area out and let her interview. She liked the hospital and the staff and after some negotiating, she accepted an offer.

That left us with a house to deal with. We had decided to purchase a house together about four years ago. We had been dating for about a year and a half, but have known each other since our Clemson days (I think we met our sophomore year-1987) and been friends. She was always someone who I liked and I always wanted to ask her out, but never got up the nerve. Enough about that. We had purchased a small house located on Lake Murray that was about perfect for our needs. It allowed us access to the lake, it was quiet, in a wonderful neighborhood with great neighbors, convenient to work, etc. We couldn’t have asked for much more. Anyways, we thought about renting it out, but decided that would be a big hassle so we decided to sell. We listed the house and had a contract in a week and a half- I told you it was a great house!

Around the middle of May, I loaded all of my stuff into a storage shed on one of my neighbor’s property (thanks Bill and Judy!) and all of Cindy’s stuff into a U-Haul truck. Together with her dad, we drove to VA and moved her into a rented condo. After a short week, I drove the bus (I had towed the VW behind us) down to stay with my friends Sean and Christie. I stayed there over the weekend and then headed back to stay at the folks for a week before flying to Houston.

I packed everything I thought I needed into two plastic trunks and boarded a plane to Houston, TX for the hiring process. We went through a pre-employment physical including a drug screening, a psych test (the WABI test- it measures your safety consciousness, driving, and how much of a risk taker you are), an NBC awareness class, etc. and if you made it through all of that, not that hard really, then you got to sit on your butt in a hotel room in Houston for a week or two or three while your security clearance/background check went through and you got a passport (if you didn’t already have one) and they booked you a flight to Kuwait.

I met two really great guys who were also paramedics while I was in Houston. Adrian is a forty something year old medic from San Antonio and Steve is around thirty and from Florida. Both were fun guys to hang out with and we had some good times as best we could in what has become a somewhat rough Houston neighborhood. I met two female medics also, Bernice and Brenda. Bernice was staying at the Marriott Greenspoint with us and so we all met up at the pool for beers at night.

I had flown to Houston on May 31st. I tried to fly out on the 17th of June but the KLM 747 broke down- bad fuel regulator on the number four engine. We waited around the Houston Airport for several hours, 9.5 to be exact, before heading to another hotel for the night. Bright and early we where back at the Houston Airport where we again sat until taking off around 8pm. We landed in Amsterdam on the 19th and we were supposed to catch a flight to Kuwait; unfortunately due to the delays, this was not to be. We caught another KLM flight to London Heathrow where we had to be rerouted onto a British Airways flight to Kuwait. This all having transpired rather quickly, we barely made our connections in each location before arriving in Kuwait City a little after midnight local time- temperature around 100 degrees. I spent my 36th birthday mostly in the air wondering what the hell I had gotten myself into and what awaited me.

We drove to the Kalifa Tourist Resort where we spent several days wondering where our luggage was- KLM had misplaced it in the shuffle- and getting an idea of what we were in for. The temperatures were around 114 during the day, but the resort is on the Gulf so it wasn’t as bad as it sounds. The Kalifa is leased by KBR to house their incoming and outgoing people. They plan to quit using it in June.

The Kalifa was nice enough. It would have been much nicer if it wasn’t full of a bunch of transients (us) and there was still furniture in the great room. It was a lot of condos that had had a large downstairs living area, now occupied be 6-10 army cots, and several upstairs bedrooms with one full bath. The condo I was in, A3, opened up to a beautiful view of the Gulf. The sun rose every day around 4:15- 4:30. The Middle East, being a very dusty area, has spectacular sunrises and sunsets.

While in Kuwait, we got our first Anthrax vaccine and should have received our first smallpox but the PA was on R&R. Note, Anthrax hurts like hell. At first you're like "no problem" then it starts to burn for a while. The pain goes away slowly and then it swells and kind itches- for about two weeks. After some delay, we boarded a C-130 on Wednesday the 23rd for the flight into Indian country. The flight into Camp Anaconda was uneventful and we quickly debarked to get our in country briefing. This was the beginning of the mass confusion that is Camp Anaconda. After being briefed, we proceeded to get billeted (given bunks for the night) and then were told to go get on a flight list. Great, except that they had us on the wrong side of the camp, we weren’t supposed to make our own flight plans, some didn’t know what connections they had to make, some had to make other stops first, the dining hall (now called the D-Fac for dining facility, no longer the “mess hall” of old), was closed, etc. Find an MRE and a bottle of water and grab a shower if you can.

That taken care of, I climbed in my bunk, another army cot, and lay down. At night, when the sun sets and it’s not so brutally hot, the air conditioners actually work so it got a little chilly. Around 10:30 or so the sirens blared and a mortar round landed somewhere on the other side of the airstrip with a bang- Welcome to Iraq. After milling about outside of the tent for a while, the “all clear” horn was sounded and everyone went back to sleep. In the morning, confusion reigned again as it was determined that we should have been on the other side of the camp in the KBR section. No problem, we loaded onto buses and trucked on over. A loosely guarded perimeter with lots of overgrowth on the other side surrounded us on two sides. We were given new billeting and told they would schedule our flights for us. Confusion again reigned as we had to keep checking back in only to be told flights were canceled or changed or whatever.

That night the sirens again sounded and we dutifully put our 40 pounds of body armor on and reported to the bunkers. Concrete culverts turned upside down and sandbagged on the top and sides with vertical concrete slabs on either end. Supposedly a few rounds landed on the other side of the camp, but we never heard them and soon were cleared to return to bed. While in Anaconda, we were required to wear our body armor or PPE (personal protective equipment). Let me explain this piece of crap. They purchased us the cheapest body armor they could that would stop a rifle round. Sounds great until you realize that this means they have to have an insert. Kevlar, Spectra, and ceramic inserts are more top of the line and considerably lighter, but remember here that we get economy. Think steel and think about what size plate you need to stop a .308 round; thought about it yet? We have a steel plate, front and rear, in pockets on the vests. There are the usual Velcro straps on the shoulders for adjustment and straps on the sides. Now the vest weighs in around 40 pounds altogether- no lie- so it really puts a strain on the Velcro straps on the shoulders (I think I know why the wanted us to have steel toed shoes ). What makes it worse is that it’s above 110degrees during the day and you’ve got this monster strapped to your body making it harder to breathe.

On Sunday the 27th, we flew to C1 Speiker in Tikrit aboard Chinook helicopters- although I hate flying in airplanes, I love helicopters. I hate to admit it, but I felt like a kid for the entire 40 minute flight. It was hot and cramped (we had our luggage strapped into the center of the floor), dusty and extremely loud, but I spent the flight looking though the windows and just soaking up the whole experience. We flew blacked out low to the ground. I was amazed at the amount of lights on. Houses and vehicles passed underneath us as people went about their normal business. Our crew consisted of the pilot and copilot as well as three M-60 machine gunners- one on either side behind the cockpit, and one sitting on a seat from an old office chair that was ratcheted to the tailgate with another M-60 mounted in front of it facing rearward. It looked somewhat comical but I wished I could have sat there to watch the countryside pass below us. I kept expecting the gunners to clear their weapons, but they never did.

We landed again without incident; in fact, the pilot landed the helicopter so smoothly that I didn’t realize we were on the ground until he started shutting down the engines.

Once we unloaded the helicopters, we reloaded the bags onto vehicles for the ride to the camp- this is a sprawling base. There I got to see Adrian Roberts, one of the paramedics I had met in Houston. He’s a really great guy and I was happy to see a smiling face. So many people here have their heads up their bums; they act all unhappy and bitch and moan about everything. I realized that I must often sound like that at home- pity. I’m most sick of listening to them already and watching them as they constantly battle to be the first in line, get their baggage only without helping others, etc. It must suck to be that miserable. I tried to help out where I could, I even offered a word of encouragement to one of the black guys who looked really nervous on the flight- he stuck his finger in my face and told me “I needed to worry about myself not him”. Screw ‘em, don’t come to me for help when you get shot or blown up or even just hurt yourself. You should think about how you treat the medic when you know you still have to get shots ;) .

28June04
Today I hung out at the med center and just watched and listened. The medic in charge of the C sites is a cool fellow named Mark. Mark has travelled extensively and worked overseas for quite a while now. Chris had been requesting me so Mark changed my site assignment to C2, Tikrit south, with Chris. That should make my life a little easier. I was supposed to stay here in C1 for a week or two getting some additional training, but the Physician’s Assistant is away on R&R, there are now six medics in this camp with more on the way, so I am getting shifted up there as soon as possible. They tried to get me on a flight today, but President Bush decided to hand over power to the Iraqis a few days early- that should throw a monkey wrench in the buggers plans. The helicopters are circling the camp as I type doing force protection, nobody knows what to expect, but they expect something to happen. We were told to keep our PPE close by.

This base is Saddam’s former fighter pilot school and as such is quite sprawling- you have to drive from one area to the next. The borders are a good distance apart and the mortars that have been shot at the base have landed in the open areas. There are destroyed planes including Migs and Mirages still about the base and many of the buildings are shot up and/ or bombed out. Wrecked AAA guns serve as lawn ornaments for some yards while others lie upended near one of the runways. US military vehicles are everywhere and I haven’t even seen the flight line on the other side of the base.

29June04
Well I didn’t fly to C2 yesterday and it doesn’t look like I’ll make it today. We knew that the military was going to shut down ground travel except for “mission critical” for the next few days, but air travel wasn’t restricted. Maybe because of the early handover things have changed; who knows. Back in the medical clinic and time to go for breakfast.

30June04
I got to spend time hanging out at the Combat Support Hospital (CSH) in their ER. I was there to watch and learn, but we didn’t have any patients so I just shot the breeze with the nurses. It was a change of pace anyways. They were all nice, just wanting to go home.

1July04
We treated several patients today- nothing serious. One Turk had a kidney stone which got him a trip to the military hospital for some drugs; we don’t have much pain medication anymore due to some earlier medics abusing it.

I visited the base PX today also, nothing to write home about that’s for sure. It’s in an old building with little A/C, it smells, and on top of that there’s not much there. They have some music and DVDs, very basic casual clothes, and some personal supplies. They have a small grocery section with some very abused looking cookies, cheap candy that looks stale, and the ever present “near beer”- nonalcoholic beer and wine. The Becks taste kind of like real beer, but it’s not very good- figure it travels in this heat.

06July04 (letter to a friend)
Hey Doug,

Tell them to give me or Chris a call if they want to. It's a Houston exchange so you don't have to pay long distance half way around the world (the call goes into Houston and then is relayed by satellite to us). If they call, we are eight hours ahead of you guys, there is a slight delay on the phone, and it's a recorded line. We are in and out during the day taking care of business. Dial the number then wait for the second dial tone; after the second dial tone dial the extension number.

Our work week consist of seven 12 hour days, seven days a week, four weeks out of the month. We do this for four months and then get ten paid days off. The company pays for the first $860 of your plane fare anywhere you want to go. At eight months you get a second break and then at the end of your year you get time off while you decide whether to renew your contract. Contracts are good for one year and then they have to be renewed. You may decide to go home at any time (quit) and they get you out usually within four days- they don't want you being a drain on moral.

The base pay is $xxxx/month. To this you add 55% uplifts while in Iraq (Kuwait is only 40% uplift) on your first 40 hours; your overtime is straight pay at $xx. This seems like a lot of money, but remember the working hours- many people could make this in the States working the same hours. Where it really comes into play is the tax break- as long as you are out of the US for at least 330 days out of a consecutive 365 days then the first $80,000 is tax exempt.

The 55% uplifts are set by the US State Department and breaks down to a 25% hazardous duty pay, 25% theater pay, and 5% out of country pay. Kuwait receives a smaller hazardous duty as it is considered a safe country; everything is relative of course- I wouldn't wander around Kuwait alone.

When they say hazardous duty, they mean it. You've seen the news, and while they exaggerate, the hazards are real. The insurgents still have rockets and mortars and other small arms. The mortars and rockets are scary as hell because you don't know where they are going to hit and they go up and over the Hescos (the big square sand filled containers that you see surrounding every base). When I arrived in Anaconda, they had been struck by 26 rockets earlier in the day. Nothing important got hit luckily. That night, we had two mortars land on the other side of the airfield and spent about two hours in the bunker. The next night we had one mortar land on the other side of the base and spent an hour in the bunkers.

I flew to C1 a day later and it was quiet there. I am now at C2 and it's been quiet here. These bases are near to Tikrit; I can look over our berm and see the city. There was a rally of Sadam supporters there the other day. A little over a month ago this base took about a weeks worth of rocket attacks. The 1st ID (the "Big Red One") is here and they fire off their self propelled howitzers (Paladins) every now and then as a show of force and to practice.

Certain areas of the country are still getting hit pretty hard though......... I wouldn't want to be in Baghdad!

To start the hiring process, go to Halliburton.com, find the KBR link, and then go to employment. Under that heading you can type in paramedic or jobs in Iraq and find whatever they have listed. Follow the directions. I heard back from the recruiter in two days (makes you wonder about those people who say "Oh I applied but I haven't heard back yet" BS!). They were requiring you to have offshore experience or AT LEAST three to five years experience on the streets. There's a rumor that that has changed, but I don't know for sure. If you don't have the experience, I wouldn't apply- you need to be able to think for yourself and have the clinical experience to make judgments. These are not skills I learned in paramedic school, I learned them over ten years in EMS, working in an animal hospital, and just being mature. If you are a screw up, they will send you home.

I can't give numbers over the internet, but many of the camps are relatively small and have less than 100 American civilians on them- many more soldiers of course. We do not interact directly with most of the soldiers. This means that you have to be able to work well with your co-workers. You think spending 12 hours on an ambulance with someone you don't like is rough, try spending an hour in a bunker with someone you don't like while mortars fall. These people are your support system and your family while you are here, we understand that we are not only living and working together, but that we may die together. It's a sobering thought. The convoys do come in shot up sometimes, they do find IEDs (improvised explosive devices) along the highways, there is enemy counterintelligence at work, etc. Like I said, I can look over the berm and see Tikrit.

Today the temperature was 122 degrees with a wet bulb heat index around 97. It's hot and dry and dusty as hell. We are lucky in that we are not required to wear our body armor at this camp all of the time- when I was at Anaconda we had to. The body armor is level three with steel plates rated to stop rifle fire; it weighs around forty pounds. The Kevlar helmet is another pound or so on your head. The glare is intense and dust gets into everything and I do mean everything.

The in processing in Houston is a pain and getting into the country and to your assigned site is worse. It's also dangerous. Now, would I do it again? So far, I can unequivocally say YES! I have met some really great people both here and in Houston. Most of the medics I have met are great people with good clinical skills. The HCNs (home country nationals- otherwise known as Iraqis) I have met are very happy to have us here and seem like great guys. There is a language barrier of course, but they smile a lot, shake hands enthusiastically and try very hard to please us. They love having their picture taken and ask questions about American life. They are mostly very poor and are envious of what they see on TV- most are like everybody else, just trying to make a better living for themselves and their families. They have been repressed for a long time and it shows.

I am now living in a hooch, some places are still in tents. We are still waiting for our clinic to be built; we are in a makeshift trailer at this point. Much of our work involves papertrails (actually we're paperless here). We do paperwork to get here, we do paperwork when we get here, we do paperwork on new people when they come to the base, we do paperwork when they come in with a complaint, etc.

Much of what we see is the everyday problems of a population- we really do act on the PA level almost. We treat everything that comes in the door from heat rash to sniffles to heart attack (we had one when I was still in Kuwait). Much of what we see is environment related- rashes, blisters, fungus, and respiratory (the dust causes lots of coughs). We are fortunate to have a military medical group on this base with a PA. Chris has worked hard to develop a good working relationship with them and their PA is a really nice guy who doesn't mind helping whenever he can; not all sites are so lucky.

We still don't have a monitor (we have electrodes, defib gel, etc.) but we do have lots of other stuff (not all clinics are quite as well stocked). I may still have to order some stuff. Our monitor is "on order" supposedly. We carry a lot of antibiotics, antifungals, and respiratory drugs. We also have the usual cardiac drugs (including Amioderon). Trauma supplies are in abundance.

Well I need to get back to work, the address is listed below along with the phone number. Take care.

10Jul04
I've been slack about writing; I imagine I will get more slack as I get further into this. I've decided to publish this on a blog so that anyone who wants to can follow along. I'm also lazy and this allows me to write once instead of a bunch and I don't have to worry about forgeting who I told what.

I sent Sean a note the other day and recieved one of his Ambien inspired rambles in reply- crazy stuff. I still love you Bro but you are liberal. Speaking of, I keep thinking about how I am going to miss Sean and Christie's wedding and I feel bad about it. I feel like I let them down to go support "The Man" instead of rebeling. Not much I can do about it now but send my best congrats when they tie the knot.

On to other subjects... I am now a millionaire! I have over 1,000,000 Iraqi Dinars. Like many of the Expats in Iraq, I have started a collection of Iraqi money. Everything I've read says that it is a good investment opportunity. Once the Iraqi government stabilizes, the economy should follow. When oil production can be increased, profits should go up and with it the value of the Dinar. The Kuwaiti Dinar is worht over three US dollars and Iraq has more oil. I figure even if goes up to fifty cents on the dollar it's a great deal. I also realize it's probabaly a long term investment.

12Jul04 19:00hrs
It's been a long day. We've got a patient who is exibiting some of the signs of malaria. We've been taking turns sitting with him and monitoring his vital signs. Fever spikes to 103, run more fluid, night sweats, then feeling cold and temp drops to 98.0. We have no laboratory facilities here so we can't do a CBC or anything. We are going to be sending him out on the next convoy to get checked by the base hospital at larger camp.

It's funny, we sat around with no patients for a few days and then got several over two days. Typical I suppose.

I was really wanting a beer last night. The closest thing we have is Budweiser nonalcoholic.... as if Budweiser wasn't bad enough with the alcohol.

I need to clean the truck tommorrow. That's a never ending chore. You rinse it off and it dries with streaks because of the sulfer content of the wash water. You spray wax on it and wipe it off and then the dust doesn't stick quite as bad. Within a few hours it's dusty again. In a few days it's tannish gray. Speaking of the truck though, we have a pimp daddy Ford Excursion. It's got every option except leather (Eee gads, as if it wasn't hot enough in the States) and the trip computer. Trip computer? I know it drinks fuel, I don't need a computer to tell me that. We run JP8 in the truck since that what the military specs. Mmmm, think about what that's doing for the engine- those of you who are mehanical geeks will recognize JP8 as helicopter fuel- it has very little lubricating properties.





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