CAMP DWYER, Afghanistan — Spc. Jaime Adame carried the young girl across the airfield, her tiny, gauze-wrapped body cradled in a polyester blanket, his camouflage rippling in the winds of the waiting Blackhawk.

“What’s wrong?” shouted Staff Sgt. Christopher Meece, the crew chief, above the roar of the helicopter as Adame handed him the child.

“Another one,” he said grimly.

Amid the ruinous injuries from roadside bomb blasts and gunshot wounds typical of this war lies a hidden horror facing the air ambulance teams operating across Afghanistan. All too often they are called to pick up and treat cases of violent abuse — typically of women and children like 2-year-old Razia.

Worse, the medevac crews worry that the high number of abuse cases are more than just the consequence of a conservative society with strong patriarchal traditions — they worry the high number of cases are part of a strategy.

“It’s a tactic we see the enemy using, injuring these children or female civilians,” said Sgt. Billy Raines, an experienced medic and father of three girls. “They bring them to the local combat outpost, and at that point they gain access to a U.S. military facility. Then they get a flight on our helicopter so they understand how we fly.”

“But their vehicle to get to and fro is that injured person.”

A 2007 report written by a Provincial Reconstruction Team based out of Sharana in Afghanistan’s Pashtun-majority southeast, and published as part of the most-recent WikiLeaks cache, tells of an incident where villagers were “very upset” when local male escorts were not permitted to accompany injured women to the hospital. Their recommendation: “If at all possible, procedures must be emplaced to permit a male escort of injured females during MEDEVAC in respect of Pashtun culture and customs.”

It’s an essential concession to a deeply traditional society. But if some escorts are using this license to gather intelligence — such as details about the security on military bases, methods of flying and timing of medevac flights — then they become yet another danger facing the air ambulance teams as they criss-cross Marja to bring soldiers and civilians the care they need.

Razia’s father had appeared at a small, American compound earlier that day, his daughter’s limp body in his arms. He accidentally spilled boiling water on her, he explained to the translator. She needed help.

A quick check of the girl told the medics he was lying. Over half of her body was scalded, the tissue blistered and raw. But the injury came from grease, not water. Even more telling, she had burns between her toes, running up her thigh and into her genitals, under her arm and behind her knee. The mechanism of injury didn’t add up to the story they were given.

“As a medic, you see that there is no way for that injury to have manifested itself from the family’s description,” Adame said.

Patterns of violence also point to an intentional design behind the abuse. Raines recalled a rash of young girls coming in with gunshot wounds to the stomach earlier this year.

“It’s usually not fatal, it’s not a killing shot,” he explained. “But it’s a bloody and traumatic scene so the military doesn’t hesitate to try and save that life. And throughout that whole process their escort follows us along and gains an immense amount of intelligence.”

In a two-week period over November and December, the medevac crews from the 101st Combat Aviation Brigade at Camp Dwyer treated more burned children than soldiers hit by improvised explosive devices, the most common war-related injury here in Helmand.

For Adame, a father of two himself, Razia was one child too many that week. As the helicopter landed back at Camp Dwyer he walked away from the Blackhawk, its propellers still spinning furiously. Pulling out a pack of Marlboro reds he breathed deeply, seeking space to deal with what he described as “the anger boiling up inside of me.”

This brutal strategy is beginning to tug at the U.S. military’s medical capacity. Under NATO regulations, any Afghan civilian wounded as a result of military activity is treated in the Western military’s medical system. But Afghans seek help for many other things: motorcycle accidents and burst appendices, problems in childbirth and severe burn cases like Razia’s.

Although the medevac teams — placed at about 20 locations across the country — are not equipped to help every case that comes their way in this country of 29 million people, turning down pleas for help from the local population is hardly a recipe to win their hearts and minds.

Still, Adame acknowledged that such a tactic has turned some of his patients into Trojan horses, whose very vulnerability is their disguise.

“Do I think that they are hurting their own children as a way of turning them into a weapon?” he said. “Yeah, I think so.” 

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