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Whatever the cause, detainees come to this hospital in the desert of southern Iraq, not far from the Kuwaiti border, with severe burns, colostomies, missing limbs, and spinal cord injuries. Here they receive short-term care or long-term rehabilitation in a clean, air-conditioned prefab hospital built by coalitition forces specifically for the care of detainees.
“Together with Abu Ghraib TIF Hospital, we essentially comprise the health care system for detainees,” says Lt. Col. Thomas Chapman, RN, chief nurse of the Camp Bucca TIF Hospital. “We are the Walter Reed of detainee health care.”
Nursing Spectrum interviewed Chapman by phone in February.
Detainees with traumatic injuries or other serious illnesses are initially treated and stabilized when they are taken into custody at the Abu Ghraib TIF Hospital 350 miles north, closer to Baghdad. They are later transported from Abu Ghraib to Camp Bucca to receive comprehensive medical/surgical and level IV rehabilitative care. Nurses, physicians, and medics of the 344th Task Force from Fort Totten, N.Y., staff both hospitals.
Camp Bucca is named for Ron Bucca, a New York fire fighter and an Army Reserve noncommissioned officer who died during the 9/11 terrorist attacks. The largest detention facility in Iraq, Camp Bucca holds approximately 8,000 detainees in several different camps.
“The care rendered here is quite comprehensive,” Lt. Col. Susan Peters, RN, nursing supervisor, said in an interview conducted by e-mail. “We have many disabled detainees in our hospital.”
The hospital includes an ED, an ICU, an intermediate care unit, an OR, clinics (medical, surgical, optometry, dental, and orthopedic), a laboratory, a pharmacy, physical and occupational therapy, and a nutritionist.
“Most of the patients we care for have horrible, horrible wounds,” wrote Capt. Joan Davis, RN, a Camp Bucca staff nurse, in a letter to Nursing Spectrum. “The wounds range from penetrating to superficial to burns all over the body. Quite a few of our detainees are missing one to three limbs and require total care.”
Detainees who are missing limbs or are paralyzed are given crutches, prosthetics, wheelchairs, and rehabilitation.
“An example of our population is one detainee who is missing all four limbs,” says Chapman. The detainee’s arms and legs were blown off while he was attempting to set off an IED meant to kill U.S. soldiers. Despite the circumstances that brought the detainee to Camp Bucca, hospital staff care for him with the same dignity and under the same health care standards as they would provide a coalition soldier, he says.
Caring for the enemy “makes this mission the toughest in the war zone,” Chapman says. “It takes a special group of dedicated members to accomplish this mission.”
For detainees like the quadruple amputee with special medical needs, the Camp Bucca medical staff can recommend to higher military headquarters that the detainee be given a compassionate release, he says.
Nurses and medics at Camp Bucca also care for the thousands of detainees in the camps who have chronic conditions.
“We see all the usual illnesses that any population has — diabetes, cardiac, pneumonia, TB, asthma, scorpion bites, etc.,” says Peters. “Then there is the occasional riot or fight among the detainees, so we receive trauma from these incidents, too.”
Detainees are given thorough physical assessments upon capture and are often diagnosed with renal disease, respiratory illnesses, hypertension, or diabetes that they were unaware they had.
“They have chronic health problems they have just learned to live with,” says Chapman. “We jump into the middle of the wellness fight, so to speak. Most detainees have never seen a physician, a nurse, or a dentist their entire lives.”
Cultural differences also affect the health care given to Camp Bucca’s patients. Although they generally comply with the nursing and medical care provided, sometimes they refuse to take their medications, such as during the Muslim holy month of Ramadan, which requires fasting for part of each day. When such a situation occurred, Chapman went to the camp imams, or religious leaders, to gain permission for the detainees to take their medications. The imams, says Chapman, act as the informal spokesmen for the detainees in the camps.
Although the nursing care provided at Camp Bucca is emotionally and physically trying, Davis says of the experience, “I am truly honored and privileged to be doing what I’m doing now for my country.”
Chapman, who volunteered for the detainee mission, has similar sentiments. “I’d rather be doing this than anything else [in the war]. Somebody has to take care of the detainees, too. Though we are not immune to world events, we have truly touched the hearts and minds of each and every detainee for whom we have cared.”
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