CAMP HABBANIYAH, Iraq -- "She is our future... that's why we support the Iraqi Police, so they can provide a secure future for (Iraqi children)," said Lt. Col. Bob McCarthy, a 41-year-old Police Transition Team Leader from East Bridgewater, Mass., in response to an Iraqi tribal leader's gratitude toward U.S. forces for their efforts to save an Iraqi youth named Riyam Shihan.
In the afternoon of October 13th, nine-(and-a-half)-year-old Riyam was in her aunt's house playing with her cousin.
A few hours later, many doubted she would live to play again.
Marine Corporal Justin T. Abraham spotted him first: an Iraqi man stumbling toward his position, his arms clutching a bundle of blankets.
"At first I thought he was carrying a bomb," said Abraham, a 23-year-old native of Oxford, Mich. and a Marine with PTT 6, Regimental Combat Team 5, 1st Marine Division.
Then Abraham saw the girl and all of the blood, and he knew his first instinct was wrong. He also knew he needed to find a doctor.
Navy 'Doc' Petty Officer 2nd Class Joseph Graham never expected to get out of the humvee during the coalition's routine check of the IP outposts. Then Graham heard someone calling his name. It sounded urgent.
"Everything happened so fast... I knew I didn't have time to freeze up," said Graham, 40 from Washington, D.C.
Prior to joining the military, Graham had a job in swimming pool operation and maintenance. Then he decided his life needed a change of pace. Thousands of miles displaced and a few years older, he was in the middle of a war-zone trying to stop blood from flowing out of a gash in a little Iraqi girl's head.
Graham quickly realized his best efforts wouldn't save the girl's life.
"When you're treating children that age, you don't have everything you need because you're not used to treating patients that small," said Graham.
"The best thing to do was get her to a treatment facility," said Graham. So he gave his recommendation to the man in charge.
The Commander, Prayer Time and the "Head Call"
McCarthy wanted to get his troops out of there. The Police Transition Team had just completed their mission, advising the personnel at the last of three Iraqi police stations.
Their timing was perfect. A Muslim 'call to prayer' was approaching, and a mosque stood adjacent to the police station.
"It was Friday (Muslim Sabbath), Ramadan, and a crowd was gathering," said McCarthy, "I did not want to upset the local citizenry with Marine presence outside the mosque on their day of prayer."
"It was time for the (team) to roll."
The troops had packed up, and McCarthy was about to give the order when a driver of one humvee requested to take a bathroom break or a 'head call.' The team delayed, the crowd of Iraqis grew, and tension began to mount.
"The hairs on my neck had been raised for about fifteen minutes," described McCarthy.
Word from Graham reached McCarthy, and he put his urgency on pause to take a look at the girl. She was in the casualty evacuation humvee moments later.
"I gave the order," said McCarthy, "you can't ignore a traumatic injury that falls into your path; especially to a child."
Elements of the Police Transition Team had a new mission, and renewed urgency.
"We dropped everything," said Abraham, "to save her life."
It was a fairly quiet day until the call came from Habbaniyah, said Cmdr. Theodore D. Edson, a general surgeon with Taqaddum Surgical, 1st Marine Logistics Group (Forward).
An entire team of surgeons assembled to receive and treat the girl, including Edson, 39 from Lexington, Mass. and Lt. Cmdr. Pamela C. Harvey, 39 from Muscatine, Iowa.
When the girl arrived with her father, she was delirious and disoriented, said Edson.
"She was hostile in a way that didn't make sense," said Harvey. She said the translator reported the girl was speaking gibberish.
"These are all signs of brain injury," said Edson.
The surgeons struggled to treat the girl, to stabilize her, but it soon became clear that she needed a higher level of care. A call went out for a helicopter to medically evacuate the girl to a better equipped hospital.
"As our evaluation continued, she deteriorated right in front of us, and our worst fears came true," said Harvey.
Surgeons and corpsmen "launched into action," said Harvey. They quickly medicated the girl intravenously and inserted a breathing tube. But because of the injury to her brain, she lost her ability to clot blood.
If the girl did not get blood soon, she would die.
A 'walk-in' blood bank message was sent out on Camp Taqaddum. The camp responded immediately with almost two dozen donors offering aid.
The girl got her blood. But stormy weather blocked flights from leaving Camp Taqaddum. With no specialized neurosurgeons in TQ Surgical, it appeared hope was lost.
"Back in the states, with an injury like this, the patient would be operated on within forty-five minutes," said Edson.
Two hours passed. Then three. Then four. Outside the storm raged, and inside anxiety peaked. The staff was beginning to consider opening her up here despite lack of resources and experience.
"An injury like this, left unabated, will lead to loss of speech or motor function... and then eventually death," said Edson.
One of the doctors brought the girl's father a Quran. Beside her bed he sat praying. Next to him, the doctors and corpsmen of TQ Surgical were praying as well.
God answered their prayers the only way he could: he sent in...
Through the storm they flew the C-130, landing in TQ like an angel with fixed-wings during Riyam's greatest time of need.
A few hours earlier, the crew had been planning to go on a routine refueling mission. Bad weather was the only obstacle holding them back.
At some points "you could barely see your hand in front of your face," said 31-year-old Marine Capt. Justin J. Hall, a pilot for air refueling transport squadron 352, Marine Air Group 16, 3rd Marine Air Wing (Forward).
Then they received a call from Taqaddum to do a casualty evacuation. Since helicopters usually do most "casevacs," the crew knew this had to be important.
"I knew that it was a head injury... (on a) nine-year-old Iraqi girl," said Hall, "that kind of brought it home for me." Hall has two children of his own.
The old mission was scrubbed, and feelings of urgency filled the crew. The determined Marines sat on the runway with the engines running, waiting for visibility to clear up.
"If there was any way we could get (the mission) done, we were going to get it done," said Hall.
They got it done, eventually delivering an unconscious Riyam to neurosurgeons in time for surgery.
"I just hoped she was all right," said Hall.
"Even when the Marines took off, we weren't sure if she would make it," said Cmdr. Tracy R. Bilski, a trauma surgeon with TQ Surgical.
"I couldn't believe it," said Bilski, from Bellmawr, N.J. Upon seeing the girl's outcome, Bilski burst into tears.
Doctors and corpsmen at TQ Surgical had lost a six-year-old Iraqi girl a few weeks previous to Riyam, and they weren't ready to lose another one, said Harvey.
"I definitely cried," said Seaman Tommie L. Walker, Jr. a 23-year-old corpsman with TQ surgical from Sunflower, Miss.
Inside the small, stuffy Iraqi Police office, an emotionally overwhelmed grandfather and father shed their own tears. Despite the many other men crammed into the room, these two grief-stricken individuals made no effort to hide their feelings.
Both father and grandfather repeated the same phrase over and over again in regards to what happened to Riyam.
"I don't have the words to explain how I feel..."
Patient 1267, the Iraqi Policeman, and the Sheik
"...if the surgeons were here right now, we would kiss their hands," they said, wiping tears from their eyes.
"I didn't even cry," said Riyam. Inside the office, the girl sat on a couch beside her father and across from her grandfather. All eyes were on her, and everyone in the room leaned forward when Riyam spoke her soft words.
Riyam explained how her cousin had been trying to close a heavy, metal door in front of her aunt's house when the door became unhinged and crashed down upon her body. Her skull was crushed.
Bruises on her brain caused swelling and internal bleeding, which increased the pressure in her skull, causing further damage to the brain. Surgeons were forced to remove a part of the bone to relieve the pressure.
The injury was so bad that doctors and corpsmen doubted whether she would survive the operation, much less walk and talk again. So when Riyam, patient number 1267, walked back into TQ Surgical a month later and asked for strawberry bubble gum, the staff was amazed.
"The surgeons all ran in different directions to find her some strawberry bubble gum," said her 36-year-old father, Younis Aved Shihan, a taxi-driver who became an Iraqi Policeman because he wanted to help prevent insurgents from taking over his town.
"The Iraqi people of Habbaniyah hear what the coalition forces have done to save my grand daughter, and they cry. They are very grateful and you have gained them to your side," said Riyam's grandfather, 70-year-old Aved Shihan Ghathaib. After Riyam's operation, coalition forces learned that Ghathaib was a sheik, or tribal leader, in the town of Habbaniyah.
"It's because we were there, advising the Iraqi people, that we had the opportunity to save this girl," said McCarthy.
Riyam's uncle, 41-year-old Capt. Hameed Aftat Shihan, a chief security officer said this humanitarian effort has far reaching affects in the Iraqi community. Police Transition Teams in the area are now revered by the people. They meet with smiles, waves and friendly greetings almost every where they go. Some of the team members said that saving the girl has made more progress toward stability in the region a few weeks than is usually made in a few months.
"(The sheik) is in charge of six thousand people, and all of them know this story, and soon all of their friends will know this story," said Hameed. Riyam's grandfather has also informed many other sheiks, who will probably inform their people, he added. The effects of saving this one little girl have reached far beyond just those involved. The relationship between the Iraqi Police, the Police Transition Team, and the local population has changed for the better. The citizens of Habbaniyah have a new-found respect for the work of the Americans, who strive not only to improve the quality of the Iraqi Police, but also the lives of the Iraqi people.
"Saving this girl's life," said Hameed while in Habbaniyah PTT Headquarters, "was like saving all of Iraq."
But Riyam's fight for life is far from over. With a piece of her skull incubating inside her stomach, Riyam currently lives with only soft tissue to protect that part of her brain. Riyam is forced to wear a helmet now when she plays with her friends.
Another problem is that Riyam is still growing. Without her skull intact during her growth, she could face problems associated with irregular brain growth, such as a decrease in motor function capability and speech.
Within the next six months, she will need a follow up operation to replace the missing piece of her skull. It is a delicate operation that, due to the rebuilding of Iraq's infrastructure, will be almost impossible to provide in her home nation.
The efforts of coalition forces have bought her more time, but without this operation, Riyam's future still remains stormy.