Nelson nurse saving lives on the front line in war-torn Mosul
Nelson nurse Renee Barrett has just returned from an extended stint in a Mosul field hospital where she dealt with victims of war, including children. Bonnie Strawbridge reports.
The reality of what she had signed up for became clear for Renee Barrett as her armoured vehicle approached Iraq's war-torn city of Mosul.
"When we came close to Mosul, we went past another checkpoint and there were 10 to 12 bodies lined up on the side of the road," the Nelson nurse said.
"They were ISIS soldiers, placed there as a warning. They had been there for days – heads covered, face down.
"The Government military were making a statement."
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Barrett has just returned to Nelson after spending 25 days straight in the Emergency Room (ER) of a Field Hospital close to the frontline.
The victims she tended were innocent civilians suffering gunshot wounds; injuries from bomb blasts, explosions, burns, and injuries suffered trapped in the rubble of collapsed buildings following air strikes.
The injuries described were horrific and innocent children were frequently targeted. She has images of children as young as five with gunshot wounds through their shoulders, chests and limbs.
Barrett said the resilience of the Iraq people, in particular the children was clear. Witnessing the horror of war had desensitised most people.
"The children could handle pain very well-the kids hardly ever cried," she said. "They lay there and let you do what was needed. Also, some of the children had just seen their parents killed. Your heart went out to them."
Barrett recounts heartbreaking attempts for survival – stories of families resorting to eating cardboard, grass and cats in desperation for food.
Despite media reports, she said there were an estimated 100,000 civilians still trapped.
"There is no food and little water and families are still trapped in the Old City."
Frequently, extreme desperation forced families to attempt a bid for freedom and Barrett was told of an area where a 300 metre dash would get civilians from the Old City to rescue workers waiting and relative safety.
There, children were frequently targeted by snipers.
"The children who ran out into the open would be shot by snipers and used as bait as the snipers knew their parents and adults would come out to rescue them," she said. "The snipers would then shoot the adults. They also shot at rescue workers who attempted to assist them."
Barrett looked after an eight-year-old boy who had survived a sniper. The bullet had gone through his neck, out the other side and missed his vital blood vessels and spinal cord. His outlook was good.
A less fortunate victim was a 20-year-old woman she nursed among a group of mass casualties.
"She was trapped in the Old City and was running out for freedom and was shot in the head. The bullet lodged in her brain. The decision was made to make her comfortable and nurse her in the ward but the next day she was still alive so they were trying to transfer her out to a base hospital for on-going management."
Despite the constant threat of danger, there was only one time when Barrett felt uneasy. It was the middle of the night and she was in the sleeping quarters when the bombing sounded particularly close.
"The fighting had intensified during the day and we had been told we could get up to 250 mass casualties," she said.
They were on high alert. She could feel the fighting in her bed and got nervous thinking: "Is this it?"
"I got up and got dressed and went over to the ER and sat in there the rest of the night."
Her colleagues did not flinch and slept on in the room the five of them shared. They were local Iraqis.
The Field Hospital set up in February was made up of several make-shift containers and pre-fabricated buildings.
Barrett and her team assessed all patients and speed at triaging them was essential. It was not unusual for 100 people to arrive at once following a raid.
Victims were assessed, sorted, and prioritised from those needing urgent care through to those who could not be helped. Essential treatment was initiated before they were transferred to the Intensive Care Unit, Operating Theatre or one of the two 20 bed wards.
A Refugee Camp nearby was home to 30,000 people who also came to the hospital.
Other services included a basic laboratory and radiology. Supplies and resources were limited with frequent delivery delays giving rise to creativity.
"We ran out of dots for doing ECGs and had to use old fashioned suction things," she said. "There were no towels. We had to cut up gauzes to use for washing."
International teams of nurses and doctors rotated in and out for one month terms while Iraqi nurses and doctors worked five days rotations and went home to their families.
There were no days off. Language was sometimes a problem and assessing patients and collaborating with colleagues speaking differing languages provided it's challenges.
"The civilians had very little English," she said. "You had to work closely with the Iraqi staff who spoke English."
The hospital compound itself was circular and it's perimeter was made up of two fortress-like walls, the outer a four metre solid blast wall, the inner a four metre wire fence, both with coils of barbed wire along the tops. Between the walls was a three metre strip.
"We used to walk or run around the perimeter between the two walls in the late evening for exercise," she said. "It was 400 metres around one complete circuit and sometimes we ran. Just when you went past the gate, you had to go a bit faster."
The one entry gate was manned 24/7 by five security guards who ran metal detectors over people and vehicles that turned up and searched people thoroughly before they radioed through to the ER to say who was coming through. Ambulances were lined up outside the gate ready to retrieve the injured from the front line.
Despite the War, the Maternity Unit was very busy and Barrett said an average of 20 to 30 babies were delivered each day. "There were lots of babies - a lot of women have 10 children."
She said ISIS had no qualms about shooting pregnant women.
"Often ISIS would shoot someone who was pregnant in the head and the stomach so that they took out the mother and the baby as well."
Barrett had a debrief with a psychologist who also did a spot visit to Mosul during Barrett's assignment to ensure she was coping.
It takes a special kind of person to work in Emergency Response and Barrett's account of her deployment in Iraq began with a gruelling journey and little sleep.
Confirmation of her deployment came three days before departure and papers and tickets were emailed 24 hours prior. She flew the 18 hour Auckland to Qatar flight and had a three hour stop-over before flying to the northern Iraq city of Erbil. There, she was briefed on what to expect and given some survival strategies including what to do in the event of kidnapping.
At 3-30am two well-armed Iraq security guards collected her and all three set out on the road for the last leg of her journey.
"After we had passed through the safer Kurdistan area, they pulled over and I had to get out and they helped me put on my bullet-proof vest and helmet. I was told the safest place now was in the car."
"If anything happens, stay in the car," they said.
They arrived in Mosul at 6-30am and she was on the job by 9am. Her Australian predecessor left two days later.
Mrs Barrett says she would return to another Emergency Response situation when the need arose and the timing was right.
"It puts things in perspective," she said. "I've always wanted to help with International emergencies, disasters and in conflict zones. It enlarges your heart – you care more."
She also feels more confident and equipped to cope with any mass casualty situation that could arise in her current workplace and is thankful the security her current job offers.
"It has also reminded me just what good resources we have and our safe environment."
In typical fashion Barrett was back working in Nelson's Emergency Department (ED) the day after her return home.
Next on the agenda is a trip to the Greek Islands in September where she will present at a conference on her Emergency Response work in Sierra Leone, West Africa where she worked with Ebola victims in 2015.
She is thankful for the support of her work colleagues in Nelson Hospital's ED, her church family, and her husband Sam.
"Sam's always believed in me and I wouldn't be able to do what I do without his support."