THE VIRGINIAN-PILOT
Copyright (c) 1994, Landmark Communications, Inc.
DATE: Saturday, September 10, 1994 TAG: 9409130529
SECTION: SPECIAL PAGE: K1 EDITION: FINAL
SERIES: Special Report: The Navy's Mission in Zagreb
SOURCE: Story by KERRY DEROCHI
LENGTH: Long : 452 lines
The cries of Greg Kwiatek hover in the chilled hospital air, a thin, high-pitched reminder of the war outside.
The sound carries down narrow, crooked passageways and across crowded wards, past nurses who kneel to scrub padded plastic floors and by young corpsmen who struggle to lift patients off sagging gurneys.
It echoes against the canvas walls of intensive care, where a doctor pulls a yard of bloody cloth from the gaping hole in Kwiatek's body.
The cries are not soon forgotten, not in this maze of olive green tents in humid northern Croatia, where U.N. peacekeepers come to be healed.
``There are a lot of people here who are giving themselves selflessly,'' said Lt. Cmdr. Robert M. Carruthers, an emergency room doctor. ``They're getting hurt, injured and killed.
``We're here to help them.''
Two weeks ago, Carruthers and 230 members of the Navy's Fleet Hospital 5 arrived at Camp Pleso, a sprawling U.N. compound outside of Zagreb. Members of the team, 56 of them from Portsmouth, came to run a field hospital built in tents under a metal hangar, replacing a staff from San Diego.
For the next six months, they will treat thousands of U.N. peacekeepers who are injured or get sick while patrolling sectors of what once was Yugoslavia.
But the mission is not only medical.
This tiny hospital, with its sandbag bunker filled with purple and pink petunias, has come to symbolize the United States' commitment in this war-torn region, a commitment that has been criticized by other nations as too small.
Less than 12 hours after arriving in Croatia, Fleet Hospital 5 was embroiled in a controversy over whether the United States should dispatch a medical team to treat Muslim refugees 80 miles south of the camp. If approved, the mission would mark a dramatic shift in the use of U.S. forces in the region.
After eight days of on-again, off-again planning, a team was allowed to go.
``The hospital is very political,'' acknowledged Capt. Gregg Parker, its commanding officer. ``We're here because of politics. We're here to support the U.N. but not put our people in harm's way.''
Tucked in a corner of an airfield, surrounded by spiraling, jagged wire, the hospital offers refuge from the maiming and killing of the 3-year-old war.
Patients shuffle through the emergency room and wait listlessly to be seen. They sit side by side in gray cushioned chairs and stare blankly at a television program they don't understand.
For the doctors and nurses who left hospitals in Portsmouth, Orlando, Fla., and Groton, Conn., Camp Pleso is a return to the basics of military medicine, a chance to serve troops in the field instead of from an urban clinic.
They live in mustard yellow barracks and rows of tents, their belongings packed neatly in small spaces called ``hooches.'' They eat in crowded mess halls, next to troops from France, Jordan and Pakistan.
Talk is of home, and not war. Few pretend to grasp the age-old hatred that has divided this country into random pockets of violence.
It's hard to understand a war when the only signs of it you see are the mangled limbs of young men dispatched to bring about peace.
At dawn, a mist shrouds the mountains north of Camp Pleso and stretches eerily across the flat, green airfield.
A light rain falls on the jets parked on a cement runway, clouding the giant letters ``UN'' printed in black on the tails.
Inside the hospital, Gregzotz Kwiatek sleeps fitfully, his face twisted in pain as fluid seeps from the wound in his right side, staining the sheets beneath him.
For two weeks, Kwiatek has slept this way, waking only to urinate in a bucket or to be lifted gingerly onto a stretcher and taken to intensive care.
He was injured while patrolling the mountainous region of Croatia. His car went over a cliff, flipping more than 20 times. The driver was killed. Kwiatek was impaled on the gear shift.
The wound stretches half a foot inside Kwiatek's body. Each day, doctors sedate him to clean away the bandages and irrigate the hole. It's a painstaking and necessary ritual. An infection likely would kill.
Kwiatek, a tall, thin, Polish man with thick, blond hair and pale skin, speaks no English.
His name is printed on a chart behind the nurse's desk, along with a dozen others. A Jordanian who stood too close to a propane tank. A Ukranian whose car hit a mine. An Egyptian who lost most of his leg when a mortar shell exploded five yards from him.
All were treated at the hospital in the past six months, one small portion of the 9,500 U.N. troops seen by the soon-to-depart team from San Diego.
``We'll miss it,'' said Navy Capt. James A. Johnson, commanding officer of the San Diego contingent, as he strolled through the ward. ``We'll feel something when we take off. It's a mixed thing.
``What we've done here won't really set in until a few weeks from now.''
The proof will stay behind, in the thin, scarred left thigh of Lt. Col. Elgin Kamal.
Six metal pins pierce the skin of Kamal's leg, over a purple jagged scar. The pins are wedged into the bone, holding it in place while it heals.
It looks painful, even torturous. But Kamal doesn't seem to mind. Four months ago, he didn't think he had a leg to heal.
Kamal, 41, was on a routine patrol in Bosnia when a mortar exploded near him. The blast tore through his muscle, leaving only a thin thread of what was the bone in his thigh.
``I heard the explosion and I fell down to the ground,'' Kamal said. ``I found my leg, nearly gone. It was just attached with a piece of the bone.
``I looked at my partner. He was dying.''
Kamal crawled along the road and radioed for help. Ninety minutes later he was picked up by a helicopter. He was taken to a field hospital and then transferred to U.S. Fleet Hospital Zagreb.
There, he met Cmdr. Dana Covey, an orthopedic surgeon. Covey decided to save the leg.
He put three pins of metal into the healthy bone above the gap and three below it. He severed a piece from the healthy bone above the break and attached it to a crank.
Four times a day, Kamal had to turn the crank to move the severed piece 14 of a millimeter downward, hoping healthy bone would grow in behind it and eventually reconnect to the bone below.
The chip had to travel six inches. It took more than eight weeks.
``When I saw my leg in the beginning, I thought I would lose it,'' Kamal said from a wheelchair, his leg displayed on a pillow.
``I can't believe somebody could save my leg,'' he said, turning to Covey. ``God sent you to save my life.''
Kamal waits for the bone to strengthen before returning home to his family in Egypt. He wants to be whole, to walk without a limp before his two daughters see him.
``In the states they don't come in with their heads blown off, they don't come in with their legs blown off,'' said Lt. j.g. Angela Highberger, a nurse from San Diego.
``I don't feel there's anything we can't do here to save life. Maybe we can't do a CAT scan or do all the tests they can do in a hospital. But to keep somebody alive, to stabilize them, there's nothing we can't do.''
Across the compound, eight doctors, nurses and corpsmen gather around three white trucks parked at one edge of the parking lot.
They are preparing to go to Batnoga, a small crossroads about 80 miles south of Zagreb. A call has come in from the United Nations. Thousands of Muslim refugees are trapped there after fleeing the Bihac pocket of Bosnia-Herzegovina.
There are reports that some have been shot while fleeing. The situation is urgent.
The hospital has quickly agreed.
``This is what I came for,'' said Joe Steward, a chief hospital corpsman from Groton. ``This stuff here - I've been trained to treat people. This is my chosen profession.''
Team members load a bag of Pepsis into the front seat of the truck. They strap on protective flak jackets and tie white armbands with red crosses on their arms.
Hours later, the jackets are off, the bands untied. The mission is on hold. The approval must come from much higher than a Navy field hospital.
The white trucks are moved to the far left corner of the parking lot, where they will sit unused for more than a week.
Chris Martineau can see the trucks from where he sits on a picnic table 100 yards away.
It's a special spot. The early morning sun beats down on the grassy field, glinting off the white cement markers that line the compound. Martineau gazes at the mountains that separate Croatia from Slovenia. He picks up his pipe and flips through a book on the history of the Balkan conflict.
``Anger, when it has no place to go, goes everywhere,'' said Martineau, a corpsman who works in psychiatry. ``Wouldn't it be neat if we could start talking about why these people hate each other?''
It's a rare question - even at a compound that was built because of war.
On Camp Pleso, as in much of northern Croatia, there are few indications of the violence that has destroyed what is called the FRY - the Former Republic of Yugoslavia.
A lone Croatian sentry standing guard at the end of a winding country road. A grassy field marked with a red sign warning of land mines. A 4-foot high brick wall that circles the U.N. headquarters in Zagreb, each brick carrying the name of a Croat who has died or is missing.
``It hurts me as an individual to see people so in conflict with each other,'' Martineau. ``It really is a test for all of us.
``You can treat as many mine injuries as they throw at you, but why are the mines there in the first place? I think there's a much bigger picture we need to be aware of.''
Martineau, 27, closes his book and joins other members of Fleet Hospital 5 on the parking lot for an early morning muster.
Late-comers stream out of their tents yawning and adjusting the blue berets that still don't sit quite right.
``8:30 means 8:30,'' barks Capt. Robert L. Edmons, the hospital's executive officer, as the crew assembles before him.
``If you're not here we don't know if you're dead or unaccounted for.''
Kwiatek lies in a hot sweat, his skin a splotched, chalky white.
His temperature had spiked the night before, hitting 103.8 degrees. The wound has started to smell. Doctors suspect infection.
Antibiotics have been boosted, and by morning the fever is down to 100. Kwiatek seems restless, his wound inflamed.
Most of the patients are asleep, yellow privacy curtains drawn between them.
Drew Culligan, a corpsman from the Naval Medical Center in Portsmouth, plots Kwiatek's vital signs on a metal clipboard. A large plastic water bottle sits on the plain wooden desk next to the dictionary, ``Say it in Croatian.''
A sign, ``giving care to all,'' hangs above.
``A patient is a patient, but it's different here,'' said Culligan, 19. ``You have to show a little more of yourself, to let them know you're a human too.
``They know what they see on TV about Americans. I try to tell them I'm just a kid from New Jersey stuck in Bosnia.''
It is the first tour for Culligan, who has been in the Navy nine months.
``Being over here blows my mind,'' Culligan said. ``In corps school you get to see photographs of all these combat wounds. In Portsmouth you never see anyone whose foot has been blown off by a mine.
``I said, `Wow, man. I've got a chance to make a difference'.''
Slowly, the ward begins to wake. Breakfast is served on plastic plates on a picnic table at one end of the hall. The TV is turned on, the movie ``One Flew Over The Cuckoo's Nest'' is started. There are no subtitles.
The Boston Pops orchestra plays on a portable stereo. A Scottish supply officer opens a Reader's Digest, his broken wrist hanging in a cloth sling suspended from a metal bar.
``The biggest challenge here is communication,'' said Lt. M.J. Hoban, a nurse from the Naval Medical Center Portsmouth. ``I'm getting real good at hand signals.''
On this morning, both copiers are broken and Hoban can't get a Russian patient to leave his bed.
Eleven days have passed since the patient's appendectomy and, medically, he is ready to return to the field. The doctors can't reach his battalion. The troops keep hanging up the phone.
``People are used to being in a stateside hospital where you pick up the phone and get what you want,'' Hoban said. ``You get used to it. Here, you learn to improvise, be creative.''
At 8:45 a.m., three corpsmen arrive to take Kwiatek to surgery. Doctors, worried about the fever, want a closer look at the wound. Gravel and debris may be wedged deep inside.
Kwiatek slowly lowers himself onto the stretcher, his head hanging feebly over one side.
``OK, Greggers, we'll see you when you get back,'' Hoban said.
Slowly, Kwiatek waves.
``They're sick. You know how you feel when you're sick,'' said Lt. j.g. Jody Weiss, a nurse from Beaufort, S.C. ``All you want is your mother and chicken soup. When you're in a country where you can't speak the language you want that even more.''
The nurses clean the ward, tying back curtains so all patients are in view. If they don't watch them every minute, one inevitably sneaks out to smoke by the latrine.
The nurses try to change the beds, but can't find the extra sheets.
None of it seems to bother Weiss.
``It's the basics. It's why we're here,'' Weiss said.
``In a hospital, it's so easy to get caught up in administration. When it boils down to it, serving the troops, that's our mission. What do they say? Standing by to assist.''
Two hours pass before Kwiatek returns to the ward. Doctors have found pseudomonas, a bacteria seen in combat wounds.
For Kwiatek it's a setback.
That night, Weiss, Hoban and other nurses go for a brisk two-mile walk around the compound.
The air is chilly as they circle the fields of wildflowers and abandoned hangars once used to house Soviet-made MiG fighters.
``If you imagine you're in upstate New York, this isn't Croatia, it's just a country road,'' Hoban said. ``Except you have to worry about mines in the field.''
Hoban, who was stationed in the Philippines when Mount Pinatubo erupted three years ago, is used to working in stressful conditions.
``I hope we can band together and learn something, do something good,'' Hoban said. ``I don't know how to measure that.
``I hope I can keep that sense that we're doing something worthwhile. That's why we're here.''
The nurses return to the U.S. compound, walking past the three white trucks that had been parked at the front gate since the refugee mission was put on hold.
Not three days before, a new team of volunteers had been given the go-ahead to help the desperate Muslims. They had met in the chapel, struggling to fit the flak jackets and blue helmets. They talked about carrying guns.
The situation in central Croatia had worsened. Thousands of Muslim refugees were trapped. They were fleeing other Muslims who now controlled the Bihac region.
Like most conflicts in this region, the crisis had escalated into a diplomatic mess. The refugees were in a region controlled by Krajina Serbs. But technically they were in Croatia.
The team left the chapel that night to be briefed. They were to leave in the morning.
They didn't. The mission again was off, blocked this time by the U.S. Department of Defense.
``Politics clouds everything. It's unfortunate,'' said Lt. James Webb, a family practice doctor from the Marine Corps Air Station in Cherry Point, N.C. ``It seems to have kept us from doing what would have been a very worthwhile thing.''
Capt. Parker, the commanding officer, is frustrated.
The fear has been that such a mission will overextend the hospital at a time when the medical corps worldwide has been stretched thin by the crises in Haiti and in Cuba.
U.S. Fleet Hospital Zagreb must be able to treat the troops.
``The longer they drag it out, the less likely it is that we will go,'' Parker said from his office at one end of the tent hospital.
``It's politics. Our folks are ready. It's just so slow to get us in.''
Days would pass before they had their answer.
The call came on a clear autumn night. The mission was approved. The convoy of trucks pulled out of the U.S. compound and headed south to the refugees.
For those who stay behind at Camp Pleso, the days slip into a routine.
In a war zone, that routine can mean bedlam.
At 3:30 one afternoon, the emergency room is hopping. Every bed is filled. A Kenyan with a skin rash. A Canadian who needs a vaccination.
A doctor runs through the room, searching for a prescription pad. A nurse looks for a patient who has disappeared.
There are five beds in this long, skinny room. Two are used for traumas. The equipment is similar to that in many emergency rooms. There are defibrillators, portable X-ray machines, pulse oximeters that measure blood gases.
The difference is these are in a tent. Things like sterility are a constant challenge.
Two nights before, a 29-year-old Swede was brought in with burns over 40 percent of his body. He had been shocked while standing on top of a street car outside of Camp Pleso. The jolt sent him tumbling 10 feet to the street, fracturing his skull.
He was sent to a civilian hospital in Zagreb where there is a burn-trauma unit. He returned after treatment to the field hospital on Camp Pleso to be airlifted to Sweden.
While at Pleso, he nearly died.
His lungs swelled with fluid and he had trouble breathing. Doctors worked on him for 2 1/2 hours, trying to stabilize him. They put a plastic tube into his windpipe and hooked him to a ventilator.
They put a line into his central veins. Slowly, he stabilized.
That night, he was transported to Sweden.
``I believe in what we are doing here,'' said Carruthers, a doctor from Portsmouth who is in charge of the emergency room. ``I'm here as a United States Navy officer-physician supplying the U.N. people who are trying to keep peace in Bosnia.
``This for me is a time when I really feel like what we're doing is what we were trained for. This is an opportunity of a lifetime.''
Sergei Mozjarov writhes on a stretcher, his leg wrapped in a stained white bandage. His brown eyes search the room for comfort. He tries to smile.
``Mine injury,'' someone whispers.
The room quiets.
Most know what that means. An estimated 3 million mines are laid throughout Croatia, some carrying enough power to destroy an armored car, others with just enough to permanently maim a peacekeeper.
In two years, there have been 155 mine accidents involving peacekeepers, with 156 wounded and 19 killed.
Mozjarov, 20, a Ukranian, was on a humanitarian mission in central Croatia carting provisions to the Muslim refugees. On his way back, he was forced to leave the road by thousands of destitute families who blocked his way.
That's when the car struck a mine. The explosion forced his left leg bone through the skin. His ankle was shattered into 10 pieces.
Lt. Cmdr. Barry Lurate cuts the bandage from the leg and begins to probe the wound.
Mozjarov screams.
Beneath the bandage is a swollen mass of blackened, dead tissue.
``The wound is kind of dirty,'' Lurate said. ``He has a fever. We need to get that clean as soon as possible.''
Another Ukranian patient is brought into the room to translate for Lurate. Thirty minutes later, Mozjarov is taken into surgery.
``It's a devastating injury,'' said Lurate, an orthopedic surgeon from Pensacola, Fla.
``It's tough. Only 20 years old.''
Mozjarov comes out of surgery 90 minutes later. He is taken to the ward and put on one of the iron beds.
Next to him is Greg Kwiatek.
For Kwiatek, surgery has been a success.
His temperature has stayed low. His spirits have improved. A soldier from his battalion now sits with him through the day. They play chess and read together.
At 1:50 p.m., the head nurse on the ward walks up to Kwiatek.
``Gregory, chair,'' the nurse says, pointing to the wheelchair.
Kwiatek tries to lift himself off the bed. He is helped by two corpsmen before dropping slowly into the wheelchair.
Shame and pain contort his face.
He is draped across the chair on his left side. His head flops over the metal armrest.
Wheeled into physical therapy, he has a strap buckled around his chest and parallel metal bars are lowered in front of him.
Lt. Cmdr. Joe Halter, the physical therapist, wants Kwiatek to stand. It's been weeks since the injury.
It's time for Kwiatek to walk.
Halter holds one end of the strap to brace him. Petty officer Tim Rice holds him from behind.
Slowly, Kwiatek shuffles down the platform, his right foot barely touching the floor.
He reaches the end and turns haltingly. He repeats it seconds later before collapsing exhausted back into the chair.
In two minutes, he's gone 12 feet.
Rice bends down to give Kwiatek a thumbs-up.
``Good job, buddy,'' he bellows, his face beaming.
Kwiatek raises his fist, opens his palm and shakes Rice's hand. He tries to lift his head above his pillow. He opens his mouth, hesitantly.
``Thank - you.'' ILLUSTRATION: Color photos by BILL TIERNAN
Physical therapy begins for Gregzotz Kwiatek, a 22-year-old Polish
soldier who was impaled in a car accident while on U.N. patrol in
Croatia. Kwiatek has been undergoing treatment for weeks at U.S.
Fleet Hospital Zagreb, where doctors have struggled to fight the
infection common in a wound as large as his. Helping Kwiatek are
hospital workers Michael Disimone, left, from Maryland, and Chad
Wise, a medical corpsman from Portsmouth.
Lt. Cmdr. Karen Page bids farewell to son Brandon, 8, as she leaves
Norfolk Naval Air Station on Aug. 23 for six months in Zagreb. Page
is assistant director of nursing with Portsmouth-based Fleet
Hospital 5.
A layover in Frankfurt, Germany, means a chance to rest for Eric
Geter, left, and Doris Earley, from the Philadelphia naval clinic.
For many, the Zagreb assignment is the first chance to use their
training in military medicine.
In ceremonies at the U.N. compound in Zagreb, Capt. Gregg Parker of
Portsmouth takes over the medical center serving sick and injured
members of the peacekeeping force. Parker is commander of Fleet
Hospital 5.
Photos by BILL TIERNAN
RIGHT: A nurse prepares mine-blast victim Sergei Mozjarov for
surgery in the tent hospital's crowded emergency room. The explosion
occurred when the 20-year-old Ukrainian soldier drove his car off
the road to get around refugee families blocking the way. With as
many 3 million mines planted throughout the former Yugoslavia, cases
like Mozjarov's account for most of the battle-related injuries
treated at the hospital.
BELOW: At the morning muster, nurses listen to the hospital's plan
of the day.
Lt. Cmdr. James Rooks, a surgeon from Portsmouth, cleanses Gregzotz
Kwiatek's side wound. Helping in the daily ritual is Lt. Betsy
Smith, a nurse from North Carolina.
Zagreb, Croatia's capital and location of the field hospital, also
serves as headquarters for the peacekeeping effort throughout the
six republics of the former Yugoslavia.
ABOVE LEFT: Capt. Bill Little of Portsmouth waits for word on a
special mission: treating refugees in Croatia. Approval of the
politically charged assignment was granted and withdrawn repeatedly
before a team finally set out from the hospital.
LEFT: The emergency room swings into action with the arrival of a
burn victim, a Swedish soldier who received an electric shock from a
streetcar. Inside the emergency room are five beds and equipment
similar to that in many U.S. hospitals - defibrillators, portable
X-ray machines, pulse oximeters that measure blood gases. The
difference is these are in a tent.
TOP: Nickie Enos, an operating room technician, helps with an X-ray
of Sergei Mozjarov. The Ukrainian soldier's left leg was shattered
by a mine.
ABOVE: Lt. Terry Snow of Portsmouth, left, and Petty Officer 2nd
Class Doris Earley scrub the padded plastic floor in intensive care.
Keeping the tent hospital sterile is a constant challenge.
ABOVE LEFT: In downtown Zagreb, the only sign of civil war is ``The
Wall of Shame'' around the U.N. compound - a shrine built from
bricks bearing the names of Croats killed or missing.
LEFT: An exhausted Gregzotz Kwiatek finishes his first walk since he
was injured on a peacekeeping patrol. In an emotional moment for
both Kwiatek and Tim Rice, his physical therapist, the Polish
soldier shuffled 12 feet across the floor in about two minutes.
In a quiet alcove off the emergency room, Lt. Chris Beck studies
triage - a skill he may find more use for in Zagreb than in military
clinics back home.
Graphic and map by Staff
Keeping the Peace: Location of U.N. forces; top 5 contributing
nations; participants in fighting
KEYWORDS: PORTSMOUTH NAVAL HOSPITAL CROATIA by CNB