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More than medical care: EMEDS prescribes hope

Major poses for photo.

U.S. Air Force Maj. Diana Kofron, 48th Healthcare Operations Squadron pediatric nurse practitioner, stands at Ramstein Air Base, Germany, Aug. 27, 2021. Kofron helped a boy born with a congenital heart defect which is usually corrected in the first few years of life. (U.S. Air Force photo by Airman 1st Class Alexcia Givens)

Captain poses for photo.

U.S. Air Force Capt. Jason Lambert, 48th Healthcare Operations Squadron staff pediatrician, is one of a team of specially trained medical personnel who are giving aid to children at Ramstein Air Base, Germany, Aug. 27, 2021. Lambert diagnosed a boy born with a congenital heart defect and helped him receive the care he needed. (U.S. Air Force photo by Airman 1st Class Alexcia Givens)

Airman prepares X-Ray equipment,

U.S. Air Force Airman 1st Class Jesamarie Acosido, 86th Medical Squadron radiology technician, x-rays a patient at Ramstein Air Base, Germany, Aug. 27, 2021. Acosido provided medical care to evacuees during Operation Allies Refuge. (U.S. Air Force photo by Airman 1st Class Alexcia Givens)

Doctor speaks with patient.

U.S. Air Force Maj. Alexander Fye, 48th Healthcare Operations Squadron doctor, speaks with a patient at Ramstein Air Base, Germany, Aug. 27, 2021. Evacuees needing medical care received aid from trained medical personnel in a field hospital. (U.S. Air Force photo by Airman 1st Class Alexcia Givens)

Medical personnel provides care.

U.S. Air Force Maj. Jesse Linton, left, 48th Healthcare Operations Squadrons certified registered nurse anesthetist, and Capt. Justin Keller, 48th HCOS nurse, assists a patient during Operation Allies Refuge at Ramstein Air Base, Germany, Aug. 27, 2021. Evacuees received medical care from service members assigned to Royal Air Force Lakenheath, England. (U.S. Air Force photo by Airman 1st Class Alexcia Givens)

Doctor provides care to patient.

U.S. Air Force Airman 1st Class Tyler Barnes, 48th Healthcare Operations Squadron aerospace medical technician, helps a patient at Ramstein Air Base, Germany, during Operation Allies Refuge, Aug. 27, 2021. Service members from the 48th HCOS work with Ramstein personnel to provide medical care to evacuees during the operation. (U.S. Air Force photo by Airman 1st Class Alexcia Givens)


In less than 24 hours, medical and logistics personnel transformed Ramstein’s Southside Fitness Center Annex into an expansive Expeditionary Medical Support System during Operation Allies Refuge.
EMEDS is a mobile field hospital, complete with an emergency room, medical surgical unit, fully functioning pharmacy, and capability to conduct X-rays, run labs and perform electrocardiograms.

More than 20,000 Afghan evacuees have transferred through Ramstein Air Base in recent days. Upon arrival, medical teams do an initial health check before evacuees settle into their temporary quarters. Some conditions, like mild dehydration, can be treated on-site. EMEDS functions as an intermediary hospital for evacuees with more emergent medical needs.

EMEDS in a conflict zone are void of specialties like pediatrics or obstetrics, however, these are included during a humanitarian crisis. Air Force pediatricians from Royal Air Force Lakenheath, England, were brought in to augment 86th Medical Group personnel.

“As pediatricians, we rarely get deployed to austere environments,” said Capt. Jason Lambert, 48 MDG pediatrician. “For pediatrics in the military, they have a [medical humanitarian] course that helps us prepare for situations like this.”

Lambert says many of the arrivals are young children, most of whom haven’t received the level of medical care considered standard in the United States. Doctors have no medical records to reference and language is a constant barrier.

Despite the challenges, Lambert and his teammates are able to provide exceptional care. On Aug. 26, an 8-year-old Afghan boy suffering from dizzy spells and weakness was brought to EMEDS. Neither the boy nor his parents spoke English so Lambert and fellow 48 MDG pediatrician, Maj. Diana Kofron, used expressive gestures, translation apps and a few translated medical cards to communicate.

The boy’s father relayed that his son has a hole in his heart. He said his son is normally weak, but became increasingly worse off during the travel to Ramstein. The pediatricians took vitals and found out the boy’s oxygen saturation was well below healthy levels. They made the astute decision to call upon the expertise of nearby Landstuhl Regional Medical Center Cardiologist, Dr. Antonella Quattromanio.

Quattromanio came to the rescue to examine the patient and perform additional tests. She diagnosed the boy with Tetralogy of Fallot. This congenital heart condition is very serious and usually corrected for in infancy in the United States.

Lambert and Quattromanio say the boy isn’t their only patient with an undiagnosed congenital heart condition.

“Unfortunately due to the expense of cardiothoracic surgery in an underserved nation like Afghanistan, congenital heart disease or other conditions are common and unfortunately not treated surgically,” said Quattromanio.

Lambert said the EMEDS station has seen multiple children who have been living with serious medical conditions their entire lives.

“Children are resilient and amazing, which is why I’m a pediatrician,” he said. 

A proper diagnosis is the first step to getting the boy on a path to health. Knowing his condition meant the physicians could start the process to initiate a medical evacuation flight. 

“This intermediary diagnosis [helps us] figure out the safest way to get them to their next destination. In certain heart conditions, high altitudes can be deadly; right now an air [medical] evacuation will have more control and ability to nominate oxygen based on a patient’s need,” continued Lambert.

The medical teams celebrate each success, but the work is far from over. They will remain at Ramstein for as long as the mission requires.

“In every interaction I’m having with children and their parents, they are just so grateful and so happy,” said Lambert. “Happy not only that we removed them from a dangerous situation, but that they are finally able to get the care for their kids that they’ve always wanted. That’s why we are here, that’s why we do this.”