Army dentist Captain Riaz Usmani gives a rare insight into the life of an army dentist working in a field hospital in Iraq.

Operation Telic is the name given to the on-going military operations in Iraq. During my deployment from January to May 2004, it was into its third, six-month phase. In total, four dental teams each consisting of one dentist and one dental nurse deployed together. The senior dental officer during this time was Major Tim Davies.
Pre operational training for us took place at Chilwell and Aldershot where we familiarised ourselves with the portable dental unit (PDU). Since we were all from different dental centres this proved to be a good time for us to get to know one another and to gel as a team.
Travel to Iraq was very straightforward. I was dropped off by my wife at RAF Brize Norton where we said our farewells. I met up with the rest of the team at the Gateway House Hotel (in Brize Norton) where we spent the night. The following morning, we boarded an RAF Tri-star which flew us directly into Basrah International Airport. From here, we were driven under armed escort to Shaibah Logistic Base (SLB) which was the location of the Multi-National Division South East Field Hospital where two of the dental teams would be located. In total, the journey from Brize Norton to SLB took nine hours.
The two dental teams based in SLB included Major Davies and Lance Corporal Silsby in one team, with myself and Corporal Webb in the other. The other two dental teams included my good friend, Captain Richard (Rich) Lindsay and Corporal Reid, working in Al Amarrah and Major Hudson with Private Tunabuna who would be working in the opulence of Basrah Palace.
On arrival at SLB, we were surprised by the size of the base and how good the facilities were.
SLB lies about ten miles south west of Basrah and is surrounded by a 12km perimeter fence. Within these confines are numerous smaller camps belonging to British and multinational troops as well as civilian contractors. The field hospital is based in one of these camps.
In the hospital itself, there was a NAAFI shop, bar, gym, welfare room, telephone and internet facilities. Elsewhere on camp there was the welfare village which contained another larger NAAFI shop, a bar and a restaurant and also – quite surreally – a Pizza Hut!
Before leaving for Al Amarrah the following morning, Rich told me that if his base was even half as good as SLB, he'd be happy. Sadly for him this wasn't the case (on his arrival, there was a small souvenir shop operating out the back of an ISO container selling Islamic alarm clocks).
Our primary aim on the tour was to provide emergency dental cover for coalition forces and also some routine dental treatment where appropriate. Wherever possible, we would also carry out basic emergency dental treatment on local Iraqis as part of the on-going "Hearts and Minds" campaign. This was enough to keep us busier than many of the DDS dental centres back in the UK.
Working in the field hospital was an interesting experience. The hospital was a tented structure with one long central corridor and various departments located in tents joining onto this.

There were two dental surgeries within the hospital. One was located near the entrance to the hospital. The other was in the Modular Transportable Surgical Facility (MTSF) – a high tech £4 million facility. This was supposed to be used as the operating theatre, but wasn't because it was considered too cramped to work in. It made a nice dental surgery though.
One of the challenges that faced us during this deployment was the environment. Extreme heat took its toll on the equipment and wind blown sand made it difficult to keep the surgeries clean. Both Corporal Webb and Lieutenant Corporal Silsby worked extremely hard to ensure that the surgeries were kept hygienic and well maintained.
The range of patients seen was similar to that of an emergency dental clinic back in the UK and we were required to carry out a full spectrum of treatments. One soldier presenting with acute necrotising ulcerative gingivitis was so debilitated, he had to be bedded down on the ward for four days.
One aspect of treating soldiers in Iraq was that most of them had to travel to the dental centres from outlying bases. This required a convoy of at least two vehicles each with a driver and a guard. With the potential hazards of ambushes and road side bombs putting the whole convoy at risk, we had to complete as much necessary treatment as possible within a single visit to prevent them having to return for follow up appointments.
There were many Iraqi civilians who worked in and around SLB. Wherever possible, we took time to deal with their dental problems as well. With virtually no access to dental care, most of them suffered from years of dental neglect. To prevent ourselves from becoming overwhelmed, we only carried out simple emergency procedures for the majority of them. Their gratitude made the whole experience extremely rewarding.
...I had to assist with facial traumas in A&E and in theatre.
As part of the hospital we were also required to work, on occasion, in other departments. With no maxillofacial surgeons in the hospital, both Major Davies and I had to assist with facial traumas in A&E and also in theatre. These included road traffic accidents, bricks thrown at faces and gunshot wounds to the face, the latter of which I assisted with in theatre (daunting for a young dentist fresh out of vocational training!).
One of the saddest aspects of the tour for me was when – as a Muslim – I was asked by the Padre to carry out the appropriate prayers for an Iraqi who had died in theatre. He had been shot in the head by a fellow Iraqi whilst queuing for a job to work with a foreign contractor. He was married with four children.
Outside of working hours there was plenty to keep us occupied. The gym was well equipped and we had our own physical training instructor in the form of Lieutenant Corporal Silsby who made sure that we used it. The welfare room had a large projector with satellite channels, a library, table tennis and a chess ladder. We even had a live band with the original sounding name of "Iraq and Role" who played regularly in the bar. Various sporting events were also organised throughout the tour including a 10 km run which Lieutenant Corporal Silsby and I participated in.
Midway through the tour we had our Operational Stand-Down (OSD). This involved a two day visit to Kuwait City where we could have some time off work. This was a good opportunity to check into a hotel and explore the city.
Lieutenant Corporal Silsby and I also provided cover at Al-Amarrah and Basrah Palace Dental Centres while their staff had their OSDs.
Basrah Palace, which is pleasantly situated along the banks of the Shat-Al-Arab river, was formerly Saddam Hussein's official residence in Basrah. The lavishness of the grounds and buildings were in marked contrast to the dilapidated state of the city beyond its walls. Our visit here, while very enjoyable, was uneventful.
Our trip to Al-Amarrah involved a one hour Chinook flight north from SLB. When we arrived there, we discovered that as a good will gesture, previous dentists had been involved in making a set of complete dentures for Ali Ahmed – the owner of the aforementioned souvenir shop. We became good friends with Ali who told us the story of his terrible past under Saddam's rule. He had been married with children before being imprisoned for eight years. During this time he was tortured, and he showed us the scars where this had occurred. He was only released after the fall of Saddam's regime and to this day still does not know where his wife and children are.
Lieutenant Corporal Silsby and I were therefore very lucky to fit his dentures and Ali was overjoyed with the finished product. It was a very happy and emotional experience – so much so that Lieutenant Corporal Silsby had tears in her eyes.
We finished our tour and handed over to the next dental team in May 2004. Due to the change in the threat state from surface-to-air missiles, the flight out from BIA was on board a military C130 aircraft. We changed flights at Qatar, where we boarded an RAF Tri-star back to the UK.
As a young dentist on my first operational tour, Iraq was an excellent experience. Despite the media's portrayal of the situation in the country, it was nice to see that the British troops were making a difference on the ground. From my perspective, it felt good that I could help with my own contribution.
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A tour of duty. Vital 2, 29–30 (2005). https://doi.org/10.1038/vital314
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DOI: https://doi.org/10.1038/vital314