It is difficult to keep a steady hand at times like that, but somehow I managed to insert the intravenous drip first time. Tony was a muscular man when healthy and had a large vein along one side of his forearm. The needle and plastic cannula slipped into it with ease.
As the first batch of Chloroquine went in I knew I had the diagnosis correct. It had been Tony’s only chance and without it he would certainly have died. Slowly I could see the colour return to his lips and fingernails, his breathing deepen. Ten minutes later his eyes opened and he managed his first effort at a smile. The relief I felt was overwhelming. Tony had probably been within minutes of dying. Once I knew control had been established, I ordered an ambulance to take him to the hospital as full recovery would naturally take several days. For months afterwards Tony would keep asking why the first thing he remembered was seeing his wife and me by his side, Jill with tears streaming down her cheeks. Relief is a powerful emotion.
Next to SAS Selection, the jungle is the end of the earth. Unfortunately, in the Regiment, you cannot escape it. My turn came unexpectedly, two days after Tony’s crisis, one foggy Hereford morning. As I staggered sleepily towards the Kremlin for my weekly operations update, I was waylaid by Major P. ‘Doc, Doc!’ he said urgently. ‘I thought I’d catch you here. We need you in Delight.’
‘Delight?’ I asked.
‘Yes, Operation Delight. You know, Central America. They’ve got problems down south and need you to set up hearts and minds on the border. When can you go?’
‘Tomorrow, I suppose,’ I replied doubtfully, praying the local practice could stand in for me at such short notice. I had all manner of things organized for the coming weeks in Hereford, including careful follow-up of Tony’s illness. Despite this, the nature of SAS service was that you had to move quickly should the need arise.
‘Good,’ Major P replied. ‘I’ll get it organized.’
So it was that I found myself seated on an RAF VC10, facing backwards as was traditional, heading across the Atlantic to Central America. It is the nature of operational codenames that they should bear no connection to the operation itself - Cloud, Prince, Bee, Rodent, Gravel. Who dreams these things up I shall never know. Putting SAS operations in Central America under the codename of Delight was typical. At that time it was a very pestilent place. If a disease featured in a medical textbook, it could be found in those fungating jungles. When you earn your living from human misery, as I do, it could be fascinating. Delighted? I think not.
The SAS has a long history of jungle warfare. Borneo and Malaya were major testing grounds for the Regiment - long periods of isolation for small SAS patrols, deep within enemy territory. This was the era of the SAS jungle specialist - the ‘jungle bunny’. The jungle brings out the best, and worst, in people. If you are claustrophobic, thrive on company or are in the least bit disorganized, it will defeat you. That is why the Regiment insists jungle training should form part of a trainee’s Continuation assessment, before he joins his Squadron. However powerfully he may walk across the Brecon Beacons, however well he resists interrogation, the jungle represents the ultimate test. Every year, a handful of individuals, and even the occasional trained SAS operative, are returned to their parent units for failing to withstand the rigours of jungle life.
Hereford Hospital loved the jungle trips. They were a mine of pathology once the operatives returned from overseas. The laboratory staff would run competitions, trying to guess which country in the world was involved, by identifying the large number of infecting organisms the men brought home. You can get a good idea where someone has been by looking at his stools, or his watery eyes, even his nasal discharge.
Gut rot, or gastroenteritis, was the commonest illness. This is a waterborne disease. A jungle animal, or more likely a local native without an understanding of hygiene, defecates into or near a jungle waterway. The excreta may be teeming with bacteria. Salmonella is particularly common. The SAS operative, in all innocence, creeps to the water’s edge to fill his waterbottle, praying that he will not be seen. High humidity has dissolved and destroyed his sterilization tablets and he cannot boil the water for fear of being detected by the enemy. He must drink it as it comes, salmonella going straight from tail end of native to stomach of operative. Florid gastroenteritis is the result. I learned to recognize salmonella by the smell. It has the most pungent, foul, penetrating odour imaginable. Routinely I would walk round the Squadron latrines once jungle trips returned home. I needed no laboratory support to diagnose the disease. The sound and smell of fifteen backsides excreting the stuff was enough. It was disgusting, though largely curable.
Some operatives appeared to have greater resistance to jungle pestilence than others. The experienced jungle bunnies, those who had served many times in the tropics before, were best. I became so worried at the disease rate of returning jungle troops at one stage, I insisted each man underwent a full medical examination on his return home. I remember one Squadron medical session, fifty-five men in all, each staggering dishevelled and unkempt into my Spartan office. Fifty-three were covered from head to toe by insect bites and skin rashes. Two were entirely blemish-free. Both had served in every jungle campaign worldwide for twenty years and were as at home in the rainforests as on the main streets of Hereford. I am not surprised that one of them later produced a best-selling survival book. He cannot only write about it, he can do it too. For three months he had been isolated in the globe’s thickest jungle and yet I could not see a bite nor a bump on him. Remarkable.
The Regiment maintained a regular presence in Central America, in case of insurgence by the other side. There had been some noisy sabre rattling in the mid-1970s when the United Kingdom felt sure the opposition was about to cross the border. Immediately, the SAS was mobilized, experienced jungle troops being sent on their way to set up cross-border ambushes and observation posts. Not knowing what to expect, the operatives prepared themselves for action from the moment their Hercules landed. Fully tooled up, M16s on automatic, grenades hanging from their webbing, camouflage cream applied, they hurtled from the aircraft tailgate ready to take on all-comers. They were greeted by a sleepy, relaxed, RAF ground crew. ‘Haven’t you heard?’ a flight lieutenant asked.
‘Heard what?’ queried the gruff SAS troop sergeant.
‘The war’s off. Cancelled. Finished. Didn’t they tell you?’
It was a classic example of one hand not knowing what the other was up to. During the long flight to Central America the politicians had negotiated a settlement, though no one had thought to tell the SAS. The operatives, every muscle tensed for the action they were sure they would find, could barely believe what they had been told. In the Army one becomes accustomed to occasional inefficiencies, even in the SAS. It is to their credit that the operatives rapidly disarmed themselves and enjoyed life in the sun before returning home. Operation Delight had been born.
As my VC10 thumped to earth south of San Carlos, it was as if the same, sleepy, RAF ground crew were still there. Someone held up a large white board, the black number ‘7’ displayed for all to see from the windows as we slowed towards the end of the runway - marks out of 10 for the quality of the pilot’s landing. How bored they must be, I thought.
The main military base was at Tayola Camp, a short drive from the runway. If the airfield was sleepy, the camp was unconscious. Here the limited SAS presence mixed with the regular Army, though tried to keep separate for the sake of sanity. The place was full of soldiers bored to tears. The troops barely ventured from the camp into the jungle around it. If they did so, it was for no more than a few hours at a time. Whitewashing of the camp’s kerb stones was a regular punishment - this was the Army I wished desperately to avoid.
Despite its sleepiness and pestilence, Central America was still a region that had taken its Regimental toll. None more so than Paul J. You could not find a nicer man. Aged barely twenty-five, he was an outstanding soldier. His fiancée was a sweetheart. Following a particularly sensitive border operation, his
patrol was celebrating before returning to the UK. On his final night in the country Paul J walked back from the party, held near to Tayola Camp. I never did learn the full story. He was found, lying face down, by the side of a nearby track. He was alive, barely so, but could not move. Paralysed from the waist downwards by a forceful blow from behind, his spine had totally dislocated. The bones had flown so far apart that his spinal cord had ruptured, a situation from which recovery was impossible. Everything below the point of dislocation was paralysed - feet, knees, hips, bladder, rectum, the lot. Within seconds this capable, ambitious man had become useless to the Army.
As the doctor you have to pick up the pieces. I tried hard to do so, showing him friendship and support. I helped with compensation claims, rehabilitation and appliances to make him walk again. Paul J joined an ever-increasing list of Regimental paraplegics. I admired him tremendously, feeling almost guilty at my own health. I see him now, struggling into my medical centre, on his two crutches, a huge brace around his waist and legs to hold him vertical. Every ambition he ever held had to be abandoned. It says much for his resilience and single-mindedness that he painfully dragged himself back to an independent life. When it goes well, SAS service is a great adventure. When it goes wrong, it certainly hurts.
We had received information of illegal border crossings in the south of the land. Apparently some immigrant loggers were not all they purported to be. Whether it was drugs, or an attempt slowly to establish a military presence, was not known. Whatever the reasons, it was felt a hearts and minds presence on the border would help. I would establish myself in a central location while the operatives attempted to find out what they could. The small jungle village of Joaquín was chosen as our base. Thirteen kilometres from the border, it was close enough, but not so near that an international incident would be created if an SAS presence was discovered.
Four of us went in. Tom, Roger, Jim and me. In keeping with a long SAS tradition, though I was the only officer, I was not in charge. Tom was my boss. Though only a sergeant, he had seen it all. As far as I was concerned, whatever Tom wanted was fine by me. We took with us a local twelve-year-old boy, well used to the tracks and waterways of the southern areas. He was our guide. With him came the FINCO.
The FINCO is the Field Intelligence Non-Commissioned Officer. Central America was full of them. Their task was to blend with the surroundings and pump the locals for whatever intelligence they could obtain. Information would be passed back to Headquarters at Tayola Camp and from there, if necessary, to the UK. FINCOs came in all shapes and sizes, but would often grow their hair long, wear civilian clothes and carry hidden weapons. They were largely confined to the main towns; Celoni, San Carlos, Ricos and others. Only rarely did they venture into the jungle itself. Few were jungle-trained in depth and able to withstand the days and weeks of isolation that jungle living required. It was in the deep, inner jungle the real intelligence was to be found. The result was that up to the minute information could only infrequently be obtained from FINCOs.
Our FINCO was no exception. He was a charming individual, but apparently overwhelmed by his involvement with a fully trained SAS jungle patrol. His 9mm pistol was of no use in such an environment and he remained permanently terrified of attack by wild animals or snakes. The twelve-year-old boy, meanwhile, was an invaluable asset. Not only did he speak all local dialects, but was a crack shot with a catapult. Snakes, birds, even frogs and toads, fell to his accurate shot as he guided us confidently along the unmarked tracks. We had been landed by Puma helicopter at Punta Cabello, ten kilometres to the north of Joaquín, and made our way slowly through the rainforest towards our objective.
Central America does have a number of dangerous animals. So-called immigrant loggers are not the only foe. Two, in particular, worried me. The fer-de-lance snake and the black widow spider. The fer-de-lance is a huge beast and totally illogical. Most snakes run away when they hear you coming. The fer-de-lance may not. It can attack anything and anyone on sight, including a passing Land Rover. Forcibly it will inject its venom via two retractable fangs. Death is a guaranteed result, usually from kidney failure and bleeding into the brain.
The black widow, however, is different. She has a tiny body but huge, long legs. Her favourite spot is under the overhang of a toilet seat. Her favourite target is the juicy male scrotum as it hangs downwards, its owner peacefully relaxing at stool. One bite and it is all over. Death, again, is assured. One has to sympathize with the FINCO. I never once saw him open his bowels.
It took us two days to reach Joaquín, a thriving little community on the south bank of the Dabacho River. The place was unique. Throughout the jungle could be found dozens of rundown villages. Dirty reed huts, mud-splattered paths, filthy water supplies and mangy dogs. Joaquín was different. It was immaculately clean. There was also Helen. Helen must be the most God-given creature on earth. A young nun, it was said that at the age of eighteen she had ridden by donkey into the heart of the jungle, stopping when she felt tired. It was Joaquín’s good fortune that she chose to stop there. Over the years she had struggled to educate and improve the lot of the locals. Five years later she had succeeded. Always dressed in immaculate white, however filthy the jungle nearby, her influence extended throughout the region. However trained and warlike the SAS might be, nothing was possible without Helen on side. As I shook her smooth, perfectly clean hand, I knew I was in the presence of someone very remarkable.
In my travels round the world I have met many missionaries, enough to know the job is not for me. Of them all, Helen competes for top position. She did not force religion at you, but simply concentrated on being friendly, leading by example. Gradually her flock began to follow. Before long the whole area was on her side. I was not allowed to tell her we were from the SAS. In fact she never once inquired who I was, who we were, or why we were there. Unquestioning, she took us at face value, judging us by our attitude and demeanour.
At first sight we looked a frightening lot. Unwashed, unshaven, heavily armed, we formed a tight-knit, withdrawn group. Our twelve-year-old guide, passport to the area, left once we reached Joaquín. Likewise the FINCO. Whereas Tom had led us here, through the thick, slimy jungle, now it was my turn to run the show. A hearts and minds project is a complex affair. The aim is to win over the local population in as short a time as possible, offering them facilities they would not normally have. Medical care is usually top of the list. Once the word gets out, people flock in their hundreds to you, wherever you may be. Clinics can be huge. It is not unknown to see more than 200 patients in a day. So it was with Joaquín. At such times it is all hands on deck and thank God for SAS medical training. Tom, Roger, Jim and I threw ourselves into the clinics with gusto. I knew the others had little knowledge of the sometimes complex tropical diseases that faced them. However, SAS confidence is a wonderful thing. Within minutes they were making all manner of diagnoses, many I imagine invented and had created scores of delighted patients.
Naturally, every patient must leave a hearts and minds’ clinic with something in hand. There is a profoundly held belief amongst most of the world’s primitive peoples that an illness can only be cured by a tablet or injection. In the developed world we know this to be nonsense. Many are best cured by the medical manoeuvre of ‘masterly inactivity’, letting Nature take her course. Diarrhoeal conditions often respond quicker to rehydration and cleanliness than to any tablet on the market. In the jungle, many diseases are created by viruses and parasites, not by bacteria. Antibiotics, being ineffective against such beasts, are a waste of time.
In hearts and minds you have to move fast. You have a short time on site, and in that period you must win the confidence of the locals and do the best you can for their healthcare. As everyone wants a tablet or injection, you take with you a large supply of placebos. Placebos are medications that are safe to give, but without proven therapeutic effect. At least without proven physical effect. Their psychological advantage cannot be underestimated. Sugar tablets are be
st. I have used them for all manner of things, including marital disharmony, male impotence, even the common cold. Should you have to inject a patient, for whatever reason, it is sometimes worthwhile making a ceremony of the occasion, particularly if a village elder is involved. The event gives them an opportunity to demonstrate strength and confidence in front of their people. You can help by freezing the skin before you inject and using a tiny, thin needle. This makes the procedure almost painless and ensures the elder does not flinch. Excellent for his credibility and standing. Excellent, of course, for the gathering of information and intelligence by an SAS hearts and minds patrol.
Roger, in particular, was a real enthusiast. The most unlikely looking medic, he was in his element. At one point I saw a thin, tired old man dragging himself away from Roger’s clinic area, supporting himself wearily with a long bamboo walking pole. Around his forehead was swathed a large crepe bandage. ‘What’s that for?’ I shouted across to Roger. ‘Has he cut himself?’
‘No, Doc,’ came the reply, barely audible over the noise created by the gathered throng. ‘It’s what you would call bedside manner. He’s got a headache, that’s all.’
‘A headache?’
‘Yeah. I’ve bandaged an aspirin to his forehead and told him to keep it there for a week. He’s feeling better already. Look!’
I glanced across again at the elderly man. When I had last looked he had seemed distinctly the worse for wear. No longer. Already I could see life returning to his face, confidence in his stride. The bamboo pole was barely being used. Roger had effected a most thorough cure. It was not for me to interfere.
Knife Edge: Life as a Special Forces Surgeon Page 10
