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David Geffen School of Medicine

Postcard from Afghanistan

MedMag-FallWinter11-Carlos Ayala, MDU.S. Air Force Lt. Col. Carlos Ayala, M.D. ’99, serves with the 455th Expeditionary Medical Group as chief of ear, nose and throat and facial plastic surgery for Craig Joint Theater Hospital at Bagram Airfield, Afghanistan. It is Dr. Ayala’s first deployment to a war zone, and his wife, Teresa, and two children, Juancarlos and Yasmin, eagerly await his return.

MY ROLE IS TO PROVIDE CARE TO LOCAL NATIONALS, Afghan National Police and our U.S. service members who have been injured in battle. I deal with their facial injuries, fractures and all types of head-and-neck trauma, using my training in aesthetics and reconstruction to allow people to go home as normal as possible.

I arrived at Bagram Airfield in early May 2011 and in that time have already seen more than 100 patients and conducted more than 200 surgeries. This by far is the busiest I’ve ever been in the military. The type of trauma we see here doesn’t exist stateside; the injuries are not in textbooks yet.

Often, patients who have been in devastating improvised explosive device (IED ) blasts arrive with multiple fragments in and soft-tissue injuries to the face. My team and I work to remove the fragments that would cause longterm scarring if they remained embedded, and we repair soft-tissue injuries to restore the facial appearance.

The injuries are so unique and devastating that there are no textbooks to show us how to fix the neck and facial trauma we see. We have to fall back on our training. After I arrived, I helped a little Afghan girl with diabetes who was intubated for a lengthy period of time. Her voice box closed up, and she would have been dependent on a breathing tube the rest of her life had I not had the necessary training and been able to save her.

Understanding the importance of training, I am also involved in the Afghan Trauma Mentorship Program. It is supported by Operation Medical Libraries, which allows me to serve as a liaison between the UCLA Medical Alumni Association and physicians here in Afghanistan.

Supporting the COIN (counter insurgency) program, we’ve worked out a relationship between UCLA and physicians here in order to provide medical textbooks. This is just one of several programs that allow me to work with other physicians, so when we leave this country, they will be able to continue providing needed care.

Carlos Ayala, M.D. ’99


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