MANAMA, Bahrain - The crew of the USNS Comfort, the Navy hospital ship sent to the Persian Gulf to treat injured coalition troops, finds itself unexpectedly treating more Iraqis than Americans or British.
By dawn yesterday, the ship, which is based in Baltimore, had taken on 80 casualties, about three-fifths of whom were Iraqi soldiers or civilians, said Cmdr. Ralph C. Jones, director of surgical services. After patients are stabilized in the emergency room, they are divided into three groups. Coalition patients are treated in their own wards, with Iraqi soldiers and civilians in separate quarters.
One problem, however, has been deciding whether Iraqis not in uniform are civilians. Some soldiers may have dressed in civilian clothes to disguise themselves, or they could be partisans who took up arms against invading forces.
"It's a difficult part of the world to figure out who is who," said Lt. Byron Adams, a Navy lawyer on the Comfort.
Where there is a question, the plainclothes Iraqis are housed with Iraqi soldiers. Eventually, a tribunal provided under the Geneva Convention will decide the question. Anyone judged to be a combatant would be confined to a prison camp, while civilians would be repatriated to their homes if it is safe to do so.
"Once the conflict ends, everyone is free to go," Adams said.
No Iraqis have been discharged from the Comfort, so the difficult business of sorting out their fate has been put off. Jones and others say the Iraqis receive the same level of care as coalition personnel, but some medical staffers were surprised to find that they were mostly treating Iraqi prisoners.
"Some of the people have mixed feelings, and a lot are wrestling with all sorts of issues, but they are professionals," Jones said of the nurses, doctors and corpsmen caring for POWs.
"They're being treated with the best medical care the world can provide, even though they technically are bad guys," said Charity Ann Grable, 24, an emergency room corpsman from San Diego.
Psychiatrists and psychologists aboard the Comfort have briefed the servicemen and servicewomen about treating prisoners of war. They've cautioned the medical staff to care for them well, but not to form personal attachments.
"The advice we give them is not to cross boundaries and discuss personal issues," said Capt. Ralph Bally, a clinical psychologist from Gaithersburg. "They can be very friendly people. ... Attachments can cause people to drop their guard." He warned that prisoners could attack their caretakers or run off.
Bally also said that some on the Comfort have been distressed after seeing injured civilians, especially children. He counseled a young woman who was upset about a wounded boy.
Jones said the ship's patients, whether Iraqi or coalition, suffered similar injuries: mostly orthopedic trauma to extremities caused by high-velocity bullets or shrapnel that shatters bones and leaves gaping wounds.
Though some injured Americans on the Comfort have spoken to reporters, the Navy has been careful to keep the press from seeing - much less speaking with - wounded Iraqis. Officers said this is to protect their privacy and avoid the appearance of exposing them to humiliation, as U.S. officials complain Iraq did by broadcasting images of captured Americans.
It's easy to keep the Iraqis segregated. The huge ship has an endless network of corridors, and its many medical services are spread out. Because most of the 1,000 beds are empty, some wounded coalition personnel find themselves alone or with one companion in a 40-bed ward.
An Iraqi man and a boy, appearing no older than 8, were in the emergency room Friday. The boy had a sutured wound on one side of his head and was said to have lost his parents in the war. The man, according to some staff, was the boy's uncle.
Doctors were making an effort yesterday to relieve swelling around an American soldier's injured spinal cord and prevent permanent paralysis. Jones said the man lost feeling in his legs, but might recover because he arrived on the Comfort, which is cruising near the Kuwait coast, within hours of his injury.
If he had been flown to a military hospital in Germany, where many serious injuries are treated, he would have arrived too late to have any chance of recovery. "Hopefully, we'll restore this young man's spine," Jones said.
The soldier had been brought in Friday night with another young man who had a severe head injury and was on a respirator. Army respiratory therapists who accompanied the pair on a helicopter said they were hurt when a vehicle rolled over.
Jones declined to give details of the second man's wounds, except to say he had penetrating and blunt injuries and was under the care of neurosurgeons.
"He's obviously going to take some time if all the things we do work out," Jones said.