SIRTE, Libya — Ammunition tore through Sirte's main street last week as rebel fighters emerged from behind shelter to fire machine guns and RPGs. Suddenly, Yusef Matoog Alhamaly dropped to the ground, his Kalashnikov falling beside him.
Through the smoke filled air, a sniper bullet had found its target.
As he lay fully exposed with his shattered leg twisted behind him, one man rushed in to cover him with a round of bullets and several comrades dragged him to safety. The 34-year-old winced in pain as he was thrown onto the back of a pickup truck and rushed to a waiting ambulance through a hail of incoming fire.
Every day on the Sirte frontline, young fighters risk their own lives to evacuate the injured. Ambulance drivers face incoming fire as they rush in to treat the wounded. Doctors and nurses work tirelessly with no pay and little sleep, saving lives with minimal resources.
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In recent weeks, the transportation of patients has become an even greater problem for Misrata’s medical team with a frontline that is now over 250 kilometers from the nearest hospital. A new medical airlift service has begun to ease the pressure, but many patients are still arriving by road.
Since the beginning of the conflict, Misrata’s medical services have been stretched to the breaking point with more than 10,000 injured and around 1,500 killed from this city alone. Misrata’s battalions of untrained civilians fought for two months to save their own city from Gaddafi’s army and have continued to fight from Zliten through to Tripoli. They are now leading the final and bloody battle for Sirte, the hometown of the country's former leader, Muammar Gaddafi.
On Saturday alone, Misrata’s central hospital received 121 wounded. Patients, like Alhamaly, waited on stretchers in the corridors for worn out doctors to examine them. Family members grieved in the courtyard as they awaited updates on the condition of loved ones.
Alhamaly was one of the lucky ones that arrived by medical airlift, but dozens of others were transferred by road.
Ahmed Elbira, 22, a volunteer at the Sirte field hospital, said the drive by ambulance from the frontline to Misrata can take up to three hours. This drive toward lifesaving treatment can be life threatening.
“These desert roads are very bad,” he said, referring to the pothole filled and often corrugated road from Sirte to Misrata. “The vibration can increase neuro damage, aggravate fractures — it is very painful for the patient.”
Orthopedic surgeon Doctor Ahmed Hamman, who treated Alhamaly on arrival in Misrata, said a transfer by road with his severely fractured femur or thigh bone would likely have proved fatal.
“With major fracture, especially of the femur, excessive movement can create an embolism,” he said, adding that if this had occurred while en route, Alhamaly would not have made it to surgery.
Timing was also critical.
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“An open femur fracture can result in a loss of up to 1.5 liters of blood in a very short time,” Hamman said.
The helicopter airlift service, established at the Western front field hospital, has heavily reduced the transport time for the critically injured. Two helicopters of the former Libyan regime are now averaging around five medical air evacuations per day.
The Russian made Mi-8 can carry up to eight seriously injured patients with standing room for minor cases. The smaller Mi-17 has five beds. Each has a flight team of two with a minimum of two medical staff.
At the western front field hospital Sunday, a gust of sand and debris hit those below as the Mi-17 lifted into the air.
Eighteen-year-old medical volunteer Rabea Abushaala frantically attended to patients as the deafening sound of the helicopter blades rang in his ears. Arriving in Misrata 45 minutes later on a makeshift helicopter pad three blocks from Misrata’s central hospital, a flurry of ambulances and medical staff rushed toward the landing aircraft to transfer the injured.
“This is the first time in my life I have flown,” Abushaala said. “It was a terrible journey. It was so loud and bumpy. Three of these men are in a dangerous, dangerous situation. One almost died on the way.”
Abushaala said the air lift service is saving many lives, but when the fighting is heavy, the service cannot keep up with the demand.
“Two [helicopters] is not enough,” he said. “We need at least six.”
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Abushaala has spent almost every day working in field hospitals since the outset of the revolution. He has seen hundreds die during this conflict, but the tragedy is even more frustrating when a life could have been saved with better facilities.
“Last night we had a family from Sirte — three women, two babies, and a young man,” Abushaala recalled. “With no power or water they had been making bread by fire in the garden. A grad hit the house. The injuries were terrible. The young sister died in the ambulance. There was no helicopter to take her.”
As fighters for the new Libyan government prepare yet again for another onslaught on the fiercely defended town of Sirte, medical personnel gear up for another exhausting and emotionally draining rush.
From his hospital bed in Misrata, as he waited for the next flight to Jordan for treatment, Alhamaly shook his head as he looked at photos of the men who ran through incoming fire in clear view of at least one sniper to drag him to safety.
“The men out there are good men, 100 percent,” he said, his 2-year-old son in his arms.
The grueling rescue from the frontline may not have been delicate or even medically sound, but it saved his life. Doctor Hamman said Alhamaly’s initial surgery was successful and he will now be sent to Jordon for follow up surgery. He is expected to make a full recovery.