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Doctors healing youngest in hostile land

Maj. Paul Klimo liked winter in Afghanistan.

The bitter cold drove the Taliban back into the mountains, across into Pakistan — less fighting, fewer casualties, more time and room at the hospital to help Afghan kids with brain and spinal conditions that are his specialty, pediatric neurosurgery.

“Relatively, they [the insurgents] quiet down … so then we could do more humanitarian things,” he said.

Klimo, 38, operated on more than a dozen children during his six-month deployment last year to Craig Joint Theater Hospital at Bagram Air Base in Afghanistan. He served from January to June 2009.

The kids who Klimo helped, though, weren’t as memorable as the ones he had to turn away because he was too busy patching up soldiers or the hospital was full.

“There were a number of kids where we could just not do anything,” he said. “Sometimes it was just because the hospital was full or we were on a bed shortage or we had a lot of trauma that was coming in.”

Klimo and his colleagues — Lt. Col. Randall McCafferty at Lackland Air Force Base, Texas; Capt. William Scott at Nellis Air Force Base, Nev.; and Dr. Brian T. Ragel of Oregon Health & Science University in Portland — write about their war-zone work in the Aug. 10 issue of the Journal of Neurosurgery: Pediatrics. From September 2007 to October 2009, the four doctors performed 296 neurological procedures — 57 of them on 43 children, ranging in age from 11 days to 18 years.

“In most countries, pretty much children are the most valuable thing for a parent — your kids are your life,” said Klimo, himself a father of three — Paul Lukas, 1; Isabella, 6; and Sofia, 8. “If you help that child, I think you really develop a bond with the parents.”

Of the children helped, 31 procedures treated traumatic injuries caused by gunshot wounds, rocket attacks and mines. The others treated conditions or birth defects — spina bifida, for example — that would have been diagnosed and treated much earlier if they had lived in the U.S. or another country with advanced medical care, Klimo said.

“Kids that are born with spina bifida in Afghanistan … I suspect the vast majority just simply die because they get infections,” he said.

Besides surgery, the doctors treated the children for malnutrition caused by intestinal roundworms. Virtually all the children who Klimo examined were malnourished, making them more susceptible to complications and slower to heal. Still, the kids healed much faster than the grown-ups.

“Kids are amazing,” said Klimo, who retired in July and now practices in Memphis.

“They suffer devastating injuries, and if you give them some time, they will make some remarkable, remarkable recoveries,” he said. “They bounce right back.”