Morgantown, West Virginia, USA
Kuwaiti – U.S. military medical cooperation.
“We appreciate what you Americans have done for us in the past. But we will not allow you to come into our hospital uniformed and armed.”
It was their country, their hospital, and their rules. She was the hospital administrator, a woman in a Muslim country but clearly the unchallenged boss. Her father and his brother owned this hospital, but she dictated its operation. Educated in the United States, where she had lived for several years, she spoke English extremely well and understood all the nuances of American-speak.
I assured her that we will strictly comply with that restriction. We were dressed in civilian casual attire and our weapons were in civilian SUVs in the hospital parking lot with uniformed and armed military drivers.
This hospital was one of the largest, best-equipped and staffed hospitals in Kuwait City, most of its specialists and surgeons trained in the United States and Britain. No such local medical access was available to the combat support hospitals located in Iraq, which had little choice but to evacuate their sick and injured to U.S. Army Landstuhl Regional Medical Center in Germany. In 2005, that facility was so busy dealing with the seriously ill and injured cases that minor cases were sent back to the States and few ever returned to duty. This presented my combat support hospital with a huge opportunity, but we needed Kuwaiti assistance.
Although we received battle injuries directly from southern Iraq, our numbers of serious patients were comparably small. However, if we could get the less serious injured and ill patients from all of Iraq, and ensure that they were safe to return to duty, we could mitigate a large drain on U.S. forces. Normally our combat support hospital would keep patients for up to seventy-two hours before evacuating them to Germany, but if we could return them to duty in Iraq, I would be allowed to keep them for up to three weeks, if they were not occupying one of my hospital beds. Hence the need for access to the sophisticated outpatient medical resources and services available in Kuwait City. Moreover, it was cheaper and more efficient to contract for these goods and services in Kuwait City than to send them back to the States, from where they might never return.
This was an important introductory meeting by the senior officers, physicians, and officials from my combat support hospital with their counterparts from this Kuwait City Hospital. The Kuwait hospital administrator and her father listened intently as the civilian U.S. Army contracting agent detailed the goods and services we were hoping to procure from the hospital. We had previously discussed these desired items at length with the contracting agent. During this meeting, I openly expressed concern for emergency services not expressly covered by contract. The army-contracting agent assured everyone present that any emergency goods and services obtained would be paid for.
All the Kuwaitis present spoke excellent English, except for one of the brothers who owned the hospital. The Kuwaitis would translate and explain to him in Arabic everything said during the meeting. After about two hours the Kuwaitis left the room to discuss matters amongst themselves, except for the brother-owner who did not speak English. During their absence, I again emphasized that I was serious that the army must promptly pay for unspecified emergency goods and services; otherwise, this agreement will fall apart.
“Captain Riggs, we will pay for all unspecified goods and services that you certify as emergent necessities,” she assured me. I was satisfied. At that point, we began to banter back and forth the usual Army/Navy rivalries and jokes. After the Kuwaitis returned, they announced that they were interested in working out an agreement with us. As the meeting broke up, the brother who seemingly did not speak or understand English began speaking perfect English.
When we got out to parking lot, we all began laughing. The Kuwaitis hoodwinked and tested us. We had passed the test.
We usually had one or two U.S. military personnel hospitalized in this Kuwaiti hospital. I had informed the hospital administrator that under no circumstance would I leave a sick or injured American soldier alone in her hospital. A Navy corpsman with a cellphone had to be in the hospital 24/7 anytime that a U.S. military member was in the hospital. She agreed to that demand, and even provided a hospital room and meals without charge for that duty corpsman.
After several months, the hospital administrator expressed a desire for her two young sons to meet American soldiers and visit our hospital. That request was easier asked than accomplished. There were only two ways onto our camp. The gate that she and her two children would have to use was the non-military gate, which required exiting the vehicle, undergoing a physical pat down, and going through a metal detector while the vehicle was swept. This process can be intimidating and humiliating, particularly for young children, and while under the watch of serious looking and armed American soldiers standing by at the ready. I did not want this to be her two young son’s initial memory of meeting American soldiers. After explaining how crucial this civilian Kuwaiti hospital was to our mission, I was able to get permission from the colonel in charge of camp security to escort the hospital administrator and her two young sons through the military entrance gate.
The contract worked flawlessly during my rotation. On a half-dozen occasions, we emergently needed goods and services not specified in the contract. The Kuwaitis always immediately provided them, and the U.S. Army always promptly paid for them. The primary mission of military medicine is to “conserve the fighting force.” Because of Kuwaiti assistance and cooperation, we were able to see hundreds of extra soldiers from all of Iraq and safely return them to duty.
JACK RIGGS, MD, is Professor of Neurology at West Virginia University. He spent twenty-nine years in the Navy Reserve before retiring as a Navy captain. He served almost one year as commanding officer of a combat support hospital in the Middle East.