Balad hospital closes while redefining combat medicine Published Dec. 9, 2011 By Senior Airman Amber R. Kelly-Herard 332nd Air Expeditionary Wing Public Affairs SOUTHWEST ASIA -- It was a place of hope. A place where terrible effects of combat were sent so heroes in hospital garb could work their magic, perform lifesaving surgeries and get our brothers and sisters in arms headed home for more intensive medical care. Military members are alive today because of the warriors from Joint Base Balad's Air Force Theater Hospital. The Balad AFTH provided full-spectrum medical services for U.S. and coalition forces and Iraqis for all of Iraq. In compliance with a 2008 security agreement between the U.S. and Iraq, Joint Base Balad was transitioned to the Government of Iraq, which included the Balad AFTH. "This was definitely one of the first times we had closed down a hospital," said Col. Roy Dileo, 332nd Expeditionary Medical Group commander. "We had to maintain mission capabilities while drawing down services, so we continually revised our plans on how to provide medical care if someone got hurt, while also trying to get hospital personnel out." The Balad AFTH, formerly the biggest hospital in Iraq, was a Level-III trauma center, which is equivalent to a Level-I trauma center in the U.S. "When I got there in July, we had a population of more than 14,000 at Balad," said Dileo, who is deployed from Lackland AFB, Texas. "When I left we were at about 3,000 personnel on base. It was very interesting to see that happen." To uphold the 97-99 percent survivability rate the hospital once boasted, the AFTH was home to many medical specialties, including anesthesia, general surgery, vascular surgery, neurosurgery, nutritional medicine, ophthalmology, orthopedics, physical and occupational therapy, radiology, clinical psychology, urology, ear, nose, throat, oromaxillofacial surgery, pediatrics, emergency medicine and trauma and critical care. "The hospital was the referral hospital for any head injury in Iraq and it was also the place everyone went through prior to going to the U.S. for further treatment," said Dileo, who is a native of Medford, Mass. "The way we treat trauma, military and civilian, we learned at Balad through experience," said the colonel. Some examples of medical advancements he cited include using whole blood for traumas, using tourniquets and increasing the need for getting people up-to-date with self-aid buddy care. "We couldn't be 100 percent until the day before we left and we couldn't leave equipment behind so we really had to plan things well in advance," said the colonel. "What did we really need until the end? Safety was my biggest priority, how long do I plan on keeping people on base as it was getting more dangerous toward the end. Trauma is what we kept until the end." Dileo used X-rays an example of what the 332nd EMDG had to think about. "What about X-ray capability?," he said. "If we keep X-rays, what about a computed tomography scanner? Well we had to get the CT scanner out two weeks before we left, or it would get left behind." Dileo left Oct. 31, just a week before the AFTH closed. "The base was deserted," said Dileo. "There was not a single car on Pennsylvania Ave. Five people were left to maintain the emergency room." Pennsylvania Ave., which is the street where the hospital was located on, was the main road at JBB. "We showed that it can be done - something that big - we set the standard on how to drawdown a base in a coherent manner," Dileo said. "Were we 100 percent right? No. No one knows everything, but it was a learning experience that I went through with great folks who were very committed. "This last rotation was the most challenging rotation," he continued. "Most people went to take care of patients. We had to worry about that and get the hospital packed up. They did a phenomenal job." All patients are now forwarded to Camp Adder, Iraq, or other locations in Southwest Asia. "I feel kind of like the end of an era," he said. "I am proud to be the last commander. I'm sad, but it's also a good thing." Preceding U.S. forces' departure from JBB, the 332nd EMDG ensured the legacy of the AFTH, where more than 35,000 people passed, was upheld. "I think we paid the right tribute," said Dileo. "We had a ceremony when we took down Hero's Highway. It was an emotional time knowing how many people passed under the flag." The flag and tent were sent to a museum outside of Robbins AFB, Ga. "We wanted the heritage of the place preserved," he said. "A lot of places wanted the flag, but we felt it was very important to keep the tent with the flag." The walls to the Contingency Aeromedical Staging Facility of the only air-evacuation hospital in Iraq were also preserved and sent to National Museum of the U.S. Air Force at Wright-Patterson AFB, Ohio. "The former medical group commander, Col. John Mitchell, and former mission support group commander, Col. Mike Myers, were instrumental in moving the CASF walls," said Dileo. "The original plan was to take pictures and preserve it that way, but the Air Force Medical Service historian figured out a way to cut the walls down. Otherwise we would have had to paint over the walls, that wouldn't have been the right answer. "To read what was written there was amazing," he continued. "There are famous folks who are important, but more importantly, were the words put up as a tribute to fallen comrades." Another flag was flown at the hospital Oct. 29, which was the last U.S. flag flown at the hospital. A ceremony was held and the flag will be presented to the Air Force Surgeon General at the Medical Health System Conference Feb. 12, 2012.