In Arduis Fidelis – An Anecdote of Unwavering Resolve

The Establishment of Pak Field Hospital-1 Mali, West Africa Thank you very much, doctor. We trust your abilities, as we have seen you making untiring efforts for saving the lives of our comrades today.”

Hearing this melody of gratitude on waning of a day filled with blood and sweat, stirred a feeling of pride and contentment on being able to help and heal, abating pain and sufferings, and for being steadfast amidst adversity. It was indeed a practical manifestation of lapidary phrase: In Arduis Fidelis – Faithful in Adversity. It all started on March 7, 2022, which was just another peaceful day, bright rays of a scorching sun over the red tract of Mali. The day started with knocking on the doors by fellow colleagues to hurry up for the French class. Rushing into the class, none of us had thought how this day would end. While still mired in assuaging our appetite for sweetness of the French language, suddenly, a colleague’s phone rang and Pak Field Hospital-1 (PFH-1) received a ‘Warning Order’: to be ready to receive casualties of a massive IED attack on an Egyptian convoy in Mali. The class was dismissed immediately wiph everyone rushing to their respective departments to prepare for the unseen and perhaps untoward. This Warning Order was followed by drills and procedures that medics and paramedics of PFH-1 had been rehearsing in peace time. For combat soldiers, sweat saves blood, and same goes for combat doctors; every sweaty rehearsal saves precious time and time saves lives. Everyone in line with their rehearsed drills started preparing the operation theatres (OTs), ICU and wards to receive casualties.
The OT was prepared immediately, with the surgeons rushing to change into scrubs. The triage teams organized themselves and prepared the first aid kits, blood supplies were checked, X-Ray and ultrasound machines turned on. Everyone was in a rush to get the hospital geared up to receive wounded soldiers. Air Medical Evacuation Teams (AMETs) hurried to the runway, where the helicopter carrying the casualties was about to land.
As we waited,  the distant sound of a helicopter was heard; the peculiar melody produced by the rotary wings of the helicopter piercing through the air was becoming louder as it approached the landing zone. The helicopter landed, the dust cloud created by its rotating wings had not yet settled, when amidst the dust appeared stretchers being pulled down and rushed to ambulances, so that injured men could be transferred to the hospital run by Pakistan Army. As the sound of ambulance sirens got closer, we gathered in the triage room. The stretchers bearing blood soaked patients were rushed in. A doctor in each team with the designated staff took charge of each injured soldier. Their shoes and clothing were strewn across the floor to swiftly examine them. Prompt decisions were made as we were losing the golden hours. One of the young soldiers, bleeding profusely, struggling to stay alive was urgently rushed to the operation theatre for surgical amputation of his dangling leg. Those with multiple fractures and injuries were thoroughly investigated, managed, and later shifted to the wards. Two severely injured soldiers who were brought in dead were directly shifted to the mortuary. The mourning of the injured and their fellow comrades for their lost friends was heard all over in the background. After the initial storm was over and the dust had settled, doctors and paramedics hastened to the wards to counsel the bereaving soldiers, who had lost their comrades. It was here that one of the accompanying officers of the Egyptian Army expressed those words of gratitude, that are etched in our memories as a laurel to the untiring efforts we made that day, the memories that we will carry as a reward back to our country.
PFH-1, Mali, has been pivotal in saving limbs and lives, and establishing this outfit was incontrovertibly a daunting task. Raising a hospital of this magnitude from scratch, encompassing all basic specialties called for a dedicated team with requisite professional acumen. After the selection of the team and nomination of the Commanding Officer, we were attached with the local Medical Battalion, not only to overcome the teething issues but also to instill ‘team spirit’ among us since we all hailed from different formations. Initially in Pakistan, – the team of doctors, paramedics and administrative staff had to undergo various online courses to hone our skills and enhance our understanding about the working environment at UN. To prove our mettle and prowess, Casualty Evacuation (CASEVAC) drills and demos were carried out, in which the team that was to establish PFH-1 performed to the hilt and came out with flying colors. After attaining the required professional ascendancy, finally on July 26, 2021, advance party of fifteen under the Commanding Officer left for the distant land of Mali. 

On setting their feet in Mali, an uphill task awaited them in a time constraint environment. They had to prepare the living area well before the arrival of the main body, in parallel with supervising the erection of the hospital building, emptying of containers and equipping the modules. Incontrovertibly, time was short and the task gigantic but out of sheer resolve, this indomitable team of fifteen rose up to this tough grind. The residential complex comprising of officers and troops accommodation, Mess, kitchen and ablution units were also put in place before the arrival of the Main Body.  
We, the Main Body comprising the remaining members of the team in Pakistan, were anxiously waiting for our turn to contribute in this noble cause. Finally, on August 15, the Main Body flew for Mali, fully cognizant of the fact that a whole new world of unexpected challenges awaited us. After a long flight, we felt the friction of the opposing winds being casted against the gigantic wings of our Boeing 747 as the aircraft started descending. After a few minutes, we could see the land beneath. The first areal glimpse of the barren and beautiful red tract made us wonder if there can be life in this vast sterile desert. Not long after landing we discovered that the red land embraced us with arms wide open, inviting us to explore its sequestered jewels of rich culture and hospitality. After the landing gear of the aircraft embraced the improvised runway, we found our comrades already standing there to receive us. Finally, all apprehensions abated and here we were, standing in the barren and desolate desert under the scorching sun to sow the seeds of hope, to raise a strong foundation that will host wounded warriors and ailing souls, and vanquish their sufferings. 
We had to raise the complete hospital building along with the rest of the residential complex in two months’ time. A few days after landing, we got busy with the task at hand with full zeal to make the hospital functional. Miraculously, with the help of the Almighty, we were successful in raising the complete infrastructure of the hospital including modules of clinics, OTs, ICU, wards, diagnostic departments and Medical Store in a bleak bracket of time. Proving our mettle in a short span of weeks with limited experience and resources against unlimited impediments is an achievement that we will cherish for a long time to come. Containers were opened and required machinery assembled, and subsequently installed to make diagnostic departments functional, including X-Rays, ultra sounds and basic laboratory facilities. The pharmacy was established, medicines stacked and made fully functional. Minor refurbishments of the hospital including flooring, alignment of beds, trolleys, medical equipment, tables and cupboards were carried out. Hospital waste management was thought out with a designated Environmental Officer to ensure containment and proper disposal of waste. Tree plantation was also carried out which was later highly appreciated by the visitors. The most important landmark was working on the concept of TeleMedicine by proffering valuable input through arduous research. This concept after materialization would enhance the capabilities of PFH-1 manifold by provision of prompt medical services to its remote dependent outfits.
Serving here in Mali is a unique experience because previously we had been accustomed to working in hospitals already equipped with requisite infrastructure as deemed incumbent for any given hospital. Before coming here, none of us ever contemplated the idea of raising a hospital amidst the tempest of odds in a foreign land, mired in insurgency — a hospital that would act as a harbinger of hope and would pull out many drowned souls from desperate straits. This is a foundation that has been laid with the sweat and blood in the hope that it would bring comfort and cure to many in the years to come. Today, PFH-1 is effectively providing service to thousands of dependents, bringing goodwill to Pakistan and its adept, proficient Army. This was acknowledged by various visiting delegations including European Union, UN New York team and other high ranking UN officials. The Force Commander, on his visit, also applauded the role of PFH-1 and acknowledged the professional competency in aptly handling eventualities.
Compassion knows no boundaries. Throughout the world, medics and paramedics of the Pakistan Army have reached wherever and whenever needed, be it the horrific war zones, barbaric genocidal attacks, disastrous natural calamities, chaotic disease epidemics of a pandemic. Humanitarian responsibility has been the foremost priority for us, irrespective of race, ethnicity, religion, profession, political affinity or social status. Now that we look back at this staunch building along with its paraphernalia standing tall and firm on its grounds, which proved its worth through tests of time with bundle full of challenges, we as the pioneers of PFH-1 in Mali, feel proud enough to share our experiences with those looking for an inspiration. HH


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