Specialists lured by interesting, challenging work, as well as belief in military role

NANAIMO, B.C. | On a rainy, grey day so typical of an almost-winter morning on Vancouver Island, six specialists gather around the long, shiny table in Nanaimo Regional Hospital’s board room. The fact that they are here, craning their necks to see a presentation, would not be that unusual at some committee-type hour of a week day—but this is Saturday and these doctors are going to be here all day Sunday, too.

That’s because they have signed up to go to work in Kandahar, Afghanistan, for a month early in the new year. They are among the first civilian recruits in “Operation Tempo Relief”—a new Canadian Forces program aimed at relieving enlisted specialists who need a break.

Major Lindsay Reinelt and Warrant Officer Mark Clarke, both from Kingston, Ont., are the instructors this weekend. Their class content is basic: an introduction to the codes and behaviour Canadian peacekeepers are expected to uphold.

But there are new terms to learn, such as the cryptic lingo that distinguishes a peaceful intervention from an armed one like Afghanistan.(The latter is a “Chapter 6”). The instructors talk in new acronyms: “PSOs”(peace support operations)and “PMFs”(private military firms).

“What’s the difference between a PMF and a mercenary?” asked one of the physician recruits. The answer: PMFs are bound by certain rules of engagement.

Yes, people actually use their sidearms for shooting in Afghanistan, and there is real danger for anyone who wanders off the base. It is fairly cold in Kandahar in January, and the 19-bed hospital is a rudimentary temporary building and the sleeping accommodations might be a canvas tent. So why are busy specialists keen to go there?

“I was already in Afghanistan once, for 56 days in 2004,” said Calgary anesthesiologist Dr. Steven Wheeler, one of today’s participants.

“I found the work very interesting from a medical point of view. No, I’m not afraid for my safety. It’s not without risk, but the risk is being managed. The CF is a very professional organization.”

Internist Dr. David Forrest is part of a four-member Nanaimo delegation going. “Most of us have families so that’s why we think it is important to go and support enlisted physicians who also have families and are doing important work in Afghanistan.”

Victoria internist Dr. Peter Sherk said for him a major draw is the type of medicine he’ll be able to practise on his 30-day tour of duty. “It has to do with encountering a whole raft of things I wouldn’t see in Victoria.”

The CF hospital also treats Afghani soldiers and other locals, he pointed out—a population where diseases like TB and leishmaniasis are endemic. Dr. Sherk is looking forward to that challenge.

Working on the front lines, the physicians expect to be stabilizing patients who will then be sent to local hospitals, in the case of the Afghanis, and to Germany in the case of the Canadians. They won’t have tertiary care facilities close by to back them, but the five Vancouver Island recruits think they are ideally suited for that, because their nearest tertiary resources are generally in Vancouver, on the British Columbia mainland.

Winnipeg radiologist Dr. David Lindsay said the radiology facilities in the Kandahar hospital are limited to two Philips slice scanners, an ultrasound, and maybe a couple more little bells and whistles. One of the things he said he has already begun doing is advising the CF on ways to develop that capacity further.

“I’m in the first group going, in January,” he said. “I expect the work to be very interesting and challenging—seeing trauma victims—where in Winnipeg I might be seeing a cancer patient.”

This is not a volunteer undertaking. The pay is negotiated individually, but the formula is for doctors to get what they’d get at home, plus what Nanaimo emergency physician, Dr. Kevin Patterson(who is going to Kandahar in February), calls “a very generous additional amount.”

No one at this introductory session is talking about money, though. Perhaps money alone isn’t enough to draw well-paid specialists to a place where the number of Canadians killed is steadily rising.

“I’m interested in seeing what is happening there for myself, instead of just reading about it,” said Dr. Sherk. “It’s important.”

“I believe in what Canada is trying to accomplish over there,” said Dr. Lindsay. “I think all of us today feel that way or we wouldn’t be going.”