FORWARD OPERATING BASE RIPLEY, Afghanistan -- At a small village in central Afghanistan recently, a joint team of American and Jordanian medical specialists conducting a medical civil affairs project were working their way through a long line of patients when a particularly dire case caught their attention.
Jordanian army Lt. Jan Mohammed was the first to notice the seven-year-old girl laying motionless in her father's arms with shallow breathing and her skin turning an alarmingly shade of blue.
"She was in very bad shape," said Mohammed. "She was almost unconscious."
Mohammed and Navy Lt. Cmdr. Gary Martin, of Lewiston, Maine, senior medical officer for MEU Service Support Group 22, the combat service support element of the 22nd Marine Expeditionary Unit (Special Operations Capable), immediately rushed to the girl.
"She was lifeless," said Martin. "I didn't think she was going to make it. If she did make it, she'd be brain dead."
As the doctors began evaluating the girl, through a translator her father offered an explanation for her condition. Apparently, the girl, named Miraja, had wandered into an opium field near her home and ate a large poppy.
Martin and Mohammed began administering counter-narcotics to Miraja while the rest of the MEDCAP team closed up shop to focus attention on the young girl. Loading their supplies, personnel, and eventually Miraja and her father onto their vehicles, the Americans and Jordanians sped back to Forward Operating Base Ripley, the MEU's base of operations near the town of Tarin Kowt.
At FOB Ripley, corpsmen and doctors from the MEU Command Element, MSSG-22, and the MEU's Shock/Trauma Platoon (STP) received word of the inbound patient and began prepping for her arrival. The officer-in-charge of the STP, Lt. Cmdr. Alan Bautista, was among those who met the MEDCAP team.
Bautista knew that it was going to be bad. The rules governing which local nationals they could treat precluded any minor cases.
"The ones who get to us from the town are usually very sick, usually very critical," he said.
Miraja's case was this serious. The opium had all but completely block her airway and she was quickly losing her grip on life.
"It sounded like she was gargling underwater," said Petty Officer 3rd Class Andrew See, of Clearwater, Fla., a MSSG-22 corpsman, referring to Miraja's labored breathing.
Meanwhile, another corpsman, Petty Officer Third Class Eric Stanton, of Myrtle Beach, S.C., inserted an endotracheal tube into the girl's throat to force open her airway.
"I was determined to get that airway open," he said, a reservist who works as an emergency medical technician in civilian life.
Eventually, a valve mask, a device with a breathing bulb attached, was placed over Miraja's mouth and Stanton began manually pumping the bulb to mimic the girl's natural breathing.
With her airway clear and the MSSG-22 and STP docs working hard to manage the girl's rising fever, the MEU surgeon, Lt. Cmdr. George Semple, of Erie, Penn., arrived to evaluate the situation.
"It was important to me to find out what her condition was," said Semple. As the senior medical officer, he acts as the liaison between the Marines and higher headquarters in medical matters and determines if evacuation to other medical facilities is warranted.
"We aren't set up as a narcotic intervention unit," said Semple. "It was beyond the scope of our care."
Semple quickly relayed the seriousness of the girl's condition to his medical counterparts at Combined Joint Task Force 76 who authorized the girl's evacuation to advanced medical facilities at Afghanistan's Bagram Air Field.
An Air Force C-130 was dispatched to FOB Ripley to pick up Miraja, and STP member Lt. (j.g.) Brian Allen escorted the young girl on the flight to provide uninterrupted medical care. Alongside Allen was Miraja's father.
"The father in me is seeing this could be anybody's kid," said Allen. "The nurse in me is saying I'm not going to loose this child on this airplane."
During the flight, Allen continually monitored the girl's blood pressure, heart rate, respiratory rate, and oxygen saturation both by eye and by machine. Miraja's condition remained stable, and after an hour's flight, the aircraft arrived at Bagram where an Army ambulance whisked her away to the nearby 328th Army Field Hospital.
Once there, her condition was further stabilized and her journey toward wellness continued with stays at an Egyptian military hospital and at Army medical facilities at Kandahar Air Field. Eventually, Miraja and her father, who never left her side during her long ordeal, returned to their village after her recovery was complete.
Though the doctors, corpsmen and medics may have saved Miraja's life, her story has touched their lives almost as much.
"Anytime you have a positive influence on someone's health outcome it feels good," said Allen, "but having a positive influence on a child's health goes back to the father and nurse in me. We all helped give this girl a second chance at life."
In addition to its Command Element and MSSG-22, the 22nd MEU (SOC) consists of Battalion Landing Team 1st Bn., 6th Marines and Marine Medium Helicopter Squadron 266 (Reinforced). The unit is in Afghanistan conducting combat and civil military operations as Task Force Linebacker.
For more information on the 22nd MEU (SOC)'s role in Operation ENDURING FREEDOM, visit the unit's web site at www.22meu.usmc.mil.