Iraq update #2- March 2009

Flowering tree at a mosque on Camp Victory

As Salaam Alaakum!

Rachel, did I get that right? It seems there are numerous ways to spell it, and a few ways to pronounce it.

I had Sunday morning off this week, so another one of the docs and I hopped a bus and went to another FOB, where Saddam had built a number of palaces for the Baath Party (we stayed inside the wires of US protection, of course). And Kringle will be proud to know that we went fishin'!! Of course, as usual, the other guy caught some fish and I didn't. But as they say, the worst day fishin' is better than the best day workin'. I've attached some pictures.

I've been writing this for a couple of days, and finished this morning so I can send it.

Sunday, March 22, 2009

The weather is still nice here between the Tigris and Euphrates, 50 degrees when I got up at 0450, and the high is supposed to be 75. I had thought it would have been warmer by now, but who can complain about this?

I worked in the IHA yesterday, so I thought I would explain about that. The Internee Holding Area is the transition point for new captures, detainees going from one place to another, and for release of detainees back to their “normal” life (if such a thing really
exists here). After someone is captured by the Iraqis or us (raids on suspected cells, aftermath of an IED, etc), they can be released immediately, kept for questioning, turned over to the Iraqi police if there is a warrant out for them- but a disposition must be made by 21 days after capture. By the 21st day they have either been released, turned over to the Iraqi justice system (whatever that means, I’m not sure) or they come to the IHA.
At the IHA, they get processed, their personal effects are catalogued and stored, they can let their families know where they are if that hasn’t happened yet, they get fingerprinted, retina scans, their yellow detainee clothes, and get assigned a number, their “rockma”.
(As in, “What is your Rockma?”) When they get a number/rockma, that is when they become a detainee, and become our responsibility.
That’s where the medical evaluation comes in. All the newcomers get a CXR to look for TB; we take their medical history (diabetes, high blood pressure, heart disease, epilepsy, previous surgery, etc); an exam to look for tattoos, birthmarks and bruises, and anything else a medical exam would turn up (from amputations and heart murmurs to poor
dentition and hernias). We offer tetanus shots (TdaP), flu shots (in season) and pneumonia shots for the elderly.
The outgoing evaluations are more fun for everyone. Each detainee can choose a new set of clothes to wear home. The goodbye evaluation consists of 3 questions- something like this: (1)Since the time of your capture, is your health better, the same or worse? (2) If you
take medicines, do you have a 7 day supply with you? (and if not we give them their meds), and (3) Do you have any more health problems that you want us to evaluate before your release? Then they sign the form, and a doctor signs the form. That day, the will get on the “Happy Bus” (yes, that is really what everyone calls it). The Happy
Bus takes them to various locations, where they will be picked up by the unit that originally captured them, and that unit will drop them off in the neighborhood/ town/ location where they were originally captured. Some detainees do NOT want to be taken to that spot, as the people in that area may not like them for what they did (participated
in an IED explosion that killed local people, etc). Some detainees are taken onto the Happy Bus kicking and fighting, but, as the M.P.s say, “they WILL be on the Happy Bus”.
As part of the new treaty signed January 1st, all detainees will be out US TIFs by the end of the next year- they must be charged or released. Of the 2000-3000 or so released in the last couple of months, only 100-200 have been charged and transferred to Iraqi prisons. For those detainees, the Happy Bus isn’t so happy. I understand that the most dangerous ones in our TIFs will not be released until as late as possible, so that as strong a case can be made for their continued internment in an Iraqi facility.

That’s all for now, I want to get this sent off. Thanks for the thoughts, prayers, cards, emails and packages!

Jason Roth walking to the fishing spot behind the mosque.

Me fishing at the mosque, Camp Victory.


Jason caught one- we call them bass because the way their mouths look.

Camp Cropper, Iraq- Feb-March 2009

10 March 2009
There was a big windstorm, or asifa turabia, yesterday and then it rained hard last night, making our FOB a big gravel-and-mud ball. It cooled from 91 yesterday to 57 right now, so that's good.

I've been working in Iraq for about 2 weeks now, and have enough perspective to write a few things. A friend suggested I start a blog, but I'm not disciplined enough for that! One thing that you'll notice as I write, is that the Army has a language all its own- not just all the abbreviations, but the names, and little catch-phrases that I'll sprinkle in from time to time.

I arrived at BIAP (formerly Saddam Hussein Int'l Airport) early in the morning of 19 Feb 2009, did some quick in-processing by 0400 and slept for 6 or 7 hours. Welcome to Iraq.

The Place. Because of OpSec (operational security), I can't tell you exactly where I am, but I am in Baghdad, more or less. Because I work at the TIF (Theater Internment Facility, = prison), everyone is EXTRA paranoid of letting people know the exact location. So those of you with Google Earth, sorry. As you can tell from my address,

COL Martin Weisse
TF 115 MED
Camp Cropper
APO AE 09342

I am at a FOB (forward operating base) called Camp Cropper. It is a fairly small place; I can walk from one end to another in about 10 minutes. It only includes the TIF, the Military Police HQs, an Iraqi Special Forces training post, a small chapel, our small hospital, housing for most of the people who work here, the DFAC (mess hall), a gym (the most popular place on the FOB), a semi trailer that is our shoppette, a "Green Bean Coffee" kiosk, and the local MWR (Morale, Welfare, Recreation) building, where I watched the WVU-Louisville game this morning at 0500, and where I make phone calls. Most of the buildings are temporary, or trailers, like the one where I will live for 6 months.

The Work. I work almost exclusively inside the walls and wires of the TIF. So I am practicing 'Wire Medicine". I work in 3 locations within the TIF- the DMC, IHA, and the SHU.

I'll talk about the Detainee Medical Clinic (DMC) first. Mornings start at 0730 with various clinics- wound clinic, TB clinic, type 1 Diabetes clinic, type 2 Diabetes clinic, Hypertension clinic, coumadin clinic. While we are doing this, the medics go out to the "wire" (which in this context means to the compounds where the detainees are) twice a day, and any of the detainees can come up to them with any medical complaint. The medics do what they can with OTC meds, then come and check out any questions with one of us doctors, arrange for a sick call appt, etc.

At 12:30, Sick Call starts, and the 2-4 providers will see anywhere from 20 to 40 patients (the high has been 33 since I've been here). It is extra challenging because of
(1) the difficulties with obtaining a medical history through a translator who isn't necessarily medical;
(2) patients who many times want attention more than have a medical problem so the medical history doesn't make sense (since I think they're making it up);
(3) an imprecise idea of time (in answer to "how long has this been going on?" the story changes every moment);
(4) the unfamiliarity that a pediatrician has with adult male problems that are mostly focused above the knees and below the waist; and
(5) other issues that I'm sure I'm skipping.

After sick call, we talk to the medics about the detainee-visits they have made in the afternoon, and any insulin questions that came up on Finger-stick and insulin rounds they make in the compounds. There also may be urgent visits to the DMC, usually chest pain, which we'll take care of until about 7 pm when it reverts to the ER. From 5-7 p.m. nightly we do physicals on detainees, screening them for communicable diseases (TB, scabies, etc). Every patient visit- by the medics or by us- has to be documented in the military's electronic medical record, which in Iraq cannot be read by anyone anywhere else, is unbelievably slow due to all the security on the computers, and is archaic in its "usefulness". It can take literally twice as long to document a visit as it does to see the patient.

In the mornings, one of the docs will make a visit to the SHU, or Segregated Housing Unit. These are solitary cells approximately 8x8 ft, that detainees are put in for medical isolation (24 hours while their scabies get treated, or 3 days to rule out TB), or more commonly, for violating rules out in the compound (fighting, throwing body waste at guards or medics, etc). I was the SHU doc yesterday- before I go, a medic & translator stop at every cell and ask if there are medical problems. I (and a translator) will only stop at the cells where there are issues, and otherwise will co-sign the medics note.
There had been a "rumble" in one of the compounds the night before so about half of the 70 SHU rooms were occupied.

That's enough for now. For those that didn't receive it already, here is an internet article I found about where I work. The commentary is from a certain perspective, but the information seems accurate to me.