An increasing number of injured soldiers are being treated at Birmingham’s Selly Oak Hospital as the conflict in Afghanistan intensifies. Phil Vinter visits the military ward to find out how medics are coping.

The wounded are the footnotes of war. Those who pay for their courage with their lives receive full military funerals. Tributes are paid in the media and by the Prime Minister.

But for those who stare death in the face yet defy the odds and live there are no tributes from Gordon Brown and no mention in the papers.

The forgotten army of permanently damaged service personnel are labelled ‘the lucky ones’, because they survived. Yet the injuries they receive are so debilitating their lives are changed forever.

Arms and legs blown off by improvised explosive devices, eyeballs shredded by flying pieces of shrapnel, colostomy bags permanently fitted because the bowel is ruptured beyond repair. Unpleasant reading isn’t it? But that’s the reality of what happens to the ‘lucky’ ones.

As I stepped into Selly Oak Military Hospital I tried to prepare myself for some shocking sights and some harrowing conversations.

I wanted to find out about the hundreds of injured military personnel who are airlifted out of Afghanistan to be treated at this incredible facility. I left with an inspiring story of humility and unshakable positivity.

This is the tale of the footnotes of war told by those who treat them.

Selly Oak hospital became the Royal Centre for Defence Medicine in April 2001. Rather than having dozens of small hospitals dotted around the country the military decided to pool medical resources. Birmingham was selected for its central location and the fact it had a network of hospitals and therefore a breadth of resources.

Within Birmingham, Selly Oak was chosen for its excellent reputation. The decision quickly began to pay off as increasing numbers of casualties from Iraq and then Afghanistan were airlifted direct from the battlefield to Birmingham Airport and on by ambulance to the hospital where they could receive excellent polytrauma help.

Last year Selly Oak and QE Hospitals treated 1,312 soldiers compared to 800 in 2008.

At their busiest, they treated 190 patients in last July alone, although the figure has slowly declined, with 111 being treated in January. Doctors and nurses at the 600-bed hospital have continued to serve the local population although the additional number of military casualties has at times strained resources to the extent that local patients have had to be transferred to other hospitals for their follow up appointments.

However, according to those that run the hospital, the disadvantages are outweighed by the new skills and experience gleaned by the medical staff who regularly treat the multi-wounded military personnel.

Wing Commander Ian Sargeant, 43, a consultant orthopaedic surgeon who has been at the hospital for 20 years, said: “Three or four years ago we were dealing with guys who had been shot, but the other side are now aware that improvised explosive devices (IEDs) work very well and lots of the injuries we are now seeing are from these explosions.

“This group with multiple injuries are the ones that are most at the edge of surviving. If you are blown up by one of these you are looking at a series of major operations with up to a dozen specialists for things like the eyes, the face, the bowels etc. It’s complex injury patterns that require all sorts of specialists to each do their bit.

“Dealing with these polytrauma injuries on a regular basis has improved of skills at dealing with traumas enormously and we are now able to use those skills to treat local patients who are involved in car accidents or other events that result in multiple trauma injuries.

“Because of the amount of time we have spent dealing with trauma injuries I would say that eight out of ten people who should not have survived we have managed to save.”

The Intensive Care Unit reveals just how many soldiers come within a hair’s breath of dying. When I was there ten beds were occupied with members of the forces. Each had been airlifted back from Afghanistan and each was receiving round-the-clock treatment to be kept alive.

The hospital treats all manner of military injuries from bad gashes, to broken limbs, to life-threatening conditions. The most seriously injured have multiple injuries. This is a result of the Taliban’s more recent tactic to use improvised explosive devises. These devastating weapons cause horrific injuries to many areas of the body.

Teams of surgical specialists are assembled to treat the injuries and once the marathon operating procedure is finished they are brought to the Intensive Care Unit to try and recover from the trauma.

Lt Colonel Phil Carter, of the Royal Army Medical Corps, served in Iraq in 2002. He said: “The more severely injured might need up to 15-20 procedures. We have people who are dedicated to looking after the welfare of families. Most of the local patients we treat at the hospital are elderly whereas most of the military personnel we treat are under 50, so there are different psychological issues for the families.”

Erika Perkins has run the Intensive Care Unit for 11 years. In that time she and her dedicated staff have helped to save the lives of hundreds of young men and women. Last year she was given the opportunity to see for herself how things work at the sharp end when the injured soldiers are plucked from the battlefield and taken to Camp Bastion.

The territorial army soldier said it was an eye-opening, but rewarding experience.

She said: “I was the most experienced when I went out to Afghanistan because of the work I had done here. It was hard work and quite stressful because I was working 12 hour days and I didn’t have a day off in the whole three months I was out there.

“My time in Afghanistan has taught me how lucky we are to be born in the western world. The difference between out there and here is that there the priority is to save lives and get them home. At Selly Oak the aim is to plan care and treatment.

“I’m glad I did it, though, and if I got the opportunity to go again I would love to. It is nice for me to understand where they go and what they do.

“The people I dealt with were all young and fit but I found their attitude inspirational. They really fought hard to get themselves fit.”

In June, Selly Oak Hospital will begin shifting its resources to a new ‘super’ hospital which will bring the resources of Selly Oak and the Queen Elizabeth Hospital together under one roof which Lt Colonel Carter said would be hugely beneficial.

He said: “The staff are really looking forward to it. The big advantage of the new hospital is bringing everything together –neuro-surgery and maximo facial surgery for example – so we will never be short of a specialist. It is going to benefit military patients, but also local patients.

“There will be more single rooms and four bedded bays which will give us much more flexibility in how we nurse military patients. A lot prefer having military patients either side of them. Military patients quickly get their banter back which is often quite earthy!”

The new hospital will improve the facilities on offer and give the talented and dedicated members of staff the chance to ensure that the footnotes of war are able to one day tell write their own incredible stories of courage.