Dr Mark de Rond from the Judge Institute of Management Studies, Cambridge University visited the Foundation to reflect on his experience of Field hospitals in Afghanistan.
Mark de Rond's research interests involve studying people by living with them under the same conditions - trying to understand how and why their world makes sense. This powerful talk, including a video that followed the experience of a badly wounded soldier arriving at Camp Bastion, looked at issues far beyond the medical challenges. It placed the work of the field hospital in the context of the people and politics of the wider conflict whilst examining the pressures that affect different groups as they make split-second, life and death decisions.
The students attending this talk were deeply affected by what they heard and the reflections by two L6th below perfectly capture the mood of the audience.
An account by L6th student, Freya
It’s said that a picture speaks a thousand words, but in the case of the pictures shown at Mark de Rond’s talk last Thursday, it was more like millions. Most of these words became questions; why is this happening? What is being done to prevent it? When will it end?
Many of us attended the talk with only a basic grasp of the politics behind the war in Afghanistan, not a great deal of awareness of the events occurring there and next to no knowledge of the movement against it. But Dr. de Rond’s talk was not about any of these things. It was about people. The soldiers who are loosing their limbs and lives; the civilians who are getting caught up in the warfare; and, above all, the surgeons dealing with the myriad of injuries of both from the frontline, and of those living in the cross-fire.
Following the medical staff at Camp Bastion, Dr. de Rond’s talk focused on the responsibility of having to make potentially fatal choices in seconds, and the effect this has on the decision-makers. It doesn’t help that those the medical staff are fighting to save are often civilians who will only be referred afterwards to a local hospital, where chances of survival are slim. This complicates decisions hugely, as the doctors have to take into account not only the cost of resources required to save a life, but standard of living a patient could be expected to have if they do pull through. Futility and guilt at the callousness of these criteria must pervade every conversation about every patient. Despite the insight we gained from watching a video of a wounded soldier arriving for surgery, the pressure of frontline care is still unimaginable.
This video, a hundred times more emotive than any headline or statistic could ever be, bluntly delivered the reality of war zone hospitals. Combined with Dr. de Rond’s perfectly candid reflection on his experiences, the true nature of the war in Afghanistan and its implications for civilians was revealed. It provided an uncomfortable but very valuable context for our knowledge of historical warfare, and our understanding of ‘just warfare.’ As well as our comprehension of the Afghanistan war itself, gleaned from parents’ rants over the kitchen table and media snippets heralding heroes and lamenting losses. Rarely does reporting deal with the supposedly invisible damage: the psychological impacts on the unsung – and sung – heroes and heroines who deal with the war’s brutality, or the suffering of civilians. This can be seen time and time again, with war after war.
Dr. de Rond didn’t even mention the hope that we, the audience, would oppose the war that tears apart Afghanistan, or the hope that what he had said would be contemplated and would inspire. At the time, I thought it was strange that he did not encourage us to dispute the conflict, but now I see that he did not need to.
An account by Clarissa, a L6th student
How people behave under pressure is something I’ve never considered before. We all experience a certain amount of pressure in our lives as students but relative to the field doctors in Afghanistan that stress now seems entirely negligible. Discussing the talk with friends afterwards, we had all found ourselves comparing our everyday lunchtime lamentations over workload to the life or death, split-second decisions made by the field doctors on a daily basis: our concerns struck us as inane and self-indulgent. On my way home, my friend and I began talking about how engrossed and fixated we are with our lives, always concentrating on the trivialities of our own limited microcosm and disregarding too much the bigger picture.
During the talk, what struck me was the order and certainty of our own lives in comparison with the chaos of day-to-day life for the field doctors or the soldiers. In our lives, the division between good and bad seems much clearer whereas in Afghanistan sometimes decisions which seem to be bad are necessary: a normal 7 year old child found digging around an IED is deemed an insurgent and shot at. There is the sense that everything is skewed in war; the atmosphere is so rarefied. An immensely interesting part of the talk came when Dr de Rond talked about the reactions of different people to conflict; those who were repulsed and those who were hooked on it. I found it thought- provoking to consider whether these reactions were determined by the nature of a person; are some people hard-wired to become addicted to the adrenaline rush of war and some more likely to be immune to it? Further to this, is one of these reactions a “better” reaction than the other? I’m yet to make up my mind.
At the start Dr de Rond warned those seated that this talk was to be a ‘candid’ one; exposing both the good and the dark-side of field hospital work. Although comparing our own lives with the lives of soldiers and field doctors is perhaps futile, this kind of sobering honesty is what we all needed to reaffirm our perspective and place ourselves in a broader world view.