Stephen

Bombed, blasted and shot yet still the Taliban come

From The Sunday Times
November 15, 2009

Stephen Grey in Musa Qala

TWO years ago Corporal Alex Temple fought like a lion to capture the Afghan town of Musa Qala from the Taliban. Last week he was back, once again in a fierce battle just two miles from its centre.

Afghan soldier opens fire in Musa Qala (Photo: NIck Cornish)

“It has changed though,” he said. “It’s more dangerous. The fighting is harder.”

Amid the thunder of battle, I saw Temple lead men forward with the same raw courage I had witnessed before. The British soldiers with him seemed more composed, unperturbed by the bullets flying past their heads. The Afghan army on their flanks was better armed and vastly more competent.

Yet the enemy had learnt too. “The Taliban can shoot more accurately,” said Temple. “And they don’t give up so easily.”

In December 2007, with the photographer Nick Cornish, I was embedded with the men of B Company, 2nd Battalion, the Yorkshire Regiment, as they joined hundreds of other British, American and Afghan troops in Operation Snakebite to take what was then a Taliban stronghold.

The capture of Musa Qala was declared a model for how this war might be won. The Taliban were bribed to switch sides, the Afghan army was portrayed as the victor and a reconstruction plan prepared. “The eyes of the world will be on Musa Qala,” said Bill Wood, the former US ambassador to Afghanistan.

Now, we were back with B Company to hold a front line that, after two years of heavy fighting, has moved barely two miles north and south of the “liberated” town centre. We watched as the Taliban were pounded with bullets, grenades, shells, missiles and airstrikes — and still they came back for more.

Two years ago our journey to Musa Qala had been tinged with tragedy. We were standing close by when a B Company platoon sergeant, Lee “Jonno” Johnson, was killed in a mine blast, one of three Nato soldiers who died in the battle. A further 17 British soldiers have died here. This time we joined a B Company team led by Lieutenant Colin Lunn, who in 2007 had “Jonno” as his platoon sergeant. They cut their teeth in combat together, over at the Kajaki dam.

Continue reading Bombed, blasted and shot yet still the Taliban come

The Ghost Town littered with IEDs

From The Sunday Times, November 1, 2009

Stephen Grey in Safar Bazaar
Under the harsh sunlight, a lone grey donkey sauntered across one end of a silent street; halfway down the far end, a US marine lay in the dirt, exposed and alone — brushing the dust from a pressure plate linked to a massive bomb.

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A few days ago this town, deep in Taliban territory, was thronged with up to 800 residents and traders. This is Helmand’s biggest drugs market, but today all but a handful of Kuchi, the Afghan nomads, have vanished.
Somehow the Taliban knew the marines were coming. Rather than fight openly, they left behind a booby-trapped ghost town littered with improvised explosive devices (IEDs).
Since July, two bomb disposal technicians attached to the 2nd Light Armored Reconnaissance battalion have been killed in such circumstances.
For all the techniques they employ, this work still boils down to one man of courage making a lonely walk. The man I was watching asked not to be named. “I am just glad to be helping save lives,” he told me.
As we sheltered beneath an awning of thatched twigs, there was a sense of foreboding, broken only by black humour. “I’d be totally amazed if no one gets hurt today,” said one sergeant.
“I wish they’d get back to shooting at us, rather than this s***,” said another marine. As two Cobra attack helicopters flew over, one man joked: “Shoot the road! Shoot up the bazaar!”
After what seemed an age, the pressure plate was disarmed and a charge placed to blow the bomb apart. “Get back into cover. Watch out for secondaries!” yelled the bomb technician before the warning of “Controlled det! Two mikes! [minutes]” and then the sharp blast, throwing up a cloud of debris and leaving a 6ft crater.
A year ago, a strike like this into the Taliban’s heartland would have led to a gunfight. But by using explosives made from fertiliser, the insurgents have mastered the IED. Their next best choice is a stand-off weapon like a mortar or a rocket and we would see those, too, before too long.
Last summer the US marines brought 10,000 soldiers to join British and other Nato forces in Helmand. But the existence of Taliban strongpoints such as Safar Bazaar is testament, said marine officers, that the number deployed is still far too short of that required to control this province.
Commanding his marines from an armoured vehicle flying the Jolly Roger as they advanced through the desert, Lieutenant Colonel Tim Grattan, the battalion’s commanding officer, said the best that could be done was to disrupt Taliban havens. “They can’t be left thinking any place is safe,” he said.
Deploying to Helmand with only two companies of infantry, less than 40% of his battalion’s strength, Grattan blamed an “artificial cap” on troop numbers set in Washington.
He said his battalion, after an initial fight in July and August, was beginning to establish a 20-mile security zone along the Helmand river.
But the American drive south is still 70 miles short of Pakistan and a chain of smuggling towns that dot the border. It has also left pockets of Taliban strength, including the 30mile stretch of riverside that separates Grattan’s bases in the district of Khan Neshin from other marine units based farther north.
“There is no doubt we can interdict and deny the Taliban a route in from Pakistan, but we need the forces to do it,” Grattan said.
The most critical shortage is of Afghan forces — the centrepiece of Nato commander General Stanley McChrystal’s strategy for turning this war. Fighting alongside the 5,000 marine combat troops are just 700 Afghan soldiers. None was deployed to Grattan’s sector last week. Khan Neshin district has barely a dozen policemen and a few border guards, although others are in training.
In the ruined castle that is the Khan Neshin administrative centre, the governor said he sometimes felt abandoned by the government in Kabul.
“The government does not support me,” said Massoud Ahmad Rassouli, a 27-year-old who had trained as a pharmacist. “It’s the marines who support me. Not even my salary is paid by the government.”
The marines and civilian agencies have in four months opened a school, funded the rebuilding of long-derelict canals, held shuras [(town meetings]) with elders, opened a radio station, funded a job creation scheme and are doling out cheap loans to tradesmen. All this has helped to prove the value of evicting the Taliban.However, Grattan cautioned that until the surrounding areas were cleared the Taliban would try to return.
The raid had begun when a convoy of more than 40 vehicles forded the Helmand river from the base at Camp Payne, east of Khan Neshin.
In a ruse, the marines at first pushed west into the desert until darkness fell. Then they turned and looped north, stopping only to dig out bogged-down vehicles and staying hidden, to reach an attack position just after 2am. They swooped in at dawn on Thursday.
For all the deception tactics, the Taliban had seen them coming. “Anyone who thinks they’re not being watched in this country is being a bit foolish,” said Captain Christopher Conner, whose Charlie Company conducted the raid. In July, when they first raided this place, the marines found tons of poppy seed. This time the Taliban had removed any illicit produce and left only a nest of IEDs. Seven were found and destroyed.
As the marines pushed slowly through the bazaar, the Taliban sprung the next part of their trap. At 12.40pm two mortars nose-dived into homes beside the market.
From where I stood, the Taliban firing points were across fields to the left.
Puffs of smoke appeared as the marines began counter-fire, then came the deep belly-thumps of cannon firing from the light armoured vehicles (LAV) on the near left.
The marines could see men loading the mortar tube into a truck and speeding off, but the vehicle got away. After six hours the soldiers had barely cleared 100 yards down the streets of squat brick buildings, cutting open locked metal shutters in their search.
An order came not to bother trying to recover any more IEDS — to destroy them instead. By now helicopters were circling, jets were flying overhead and a Predator drone was high above, trying to spot the Taliban firing team.
Finally, the crew of an LAV perched on a hill to the west saw men unloading a rocket from a truck in a clump of trees.
This was the signal to unleash hell: thuds from the LAVs’ heavy cannon, orange sparks of explosive rounds detonating and grey smoke rising. Then came mortars — a pop from the launch site behind me, then the crump of the explosion. First a round to check they were on target. Then the order “Fire for effect!” and a barrage.
Artillery came, too — a screech of rounds and then sharp thuds, explosions, a flame and billowing smoke that enveloped the fields.
The artillery was off target and was told to stop shooting. More mortars and more cannon were fired instead.
It was hard to imagine anyone could have survived. The Taliban disappeared, the smoke cleared from the fields and the town returned to silence. Just before sunset the marines finished clearing the bazaar, jumped into their trucks and drove back into the desert.

US Marines at Afghanistan’s most southern combat post fight an elusive enemy.

First published in The Sunday Times, October 25, 2009
In a remote part of Helmand troops are dismayed by the ambivalence of locals and a sense that the Taliban can outlast them.

Stephen Grey in Khan Neshin
Platoon360_634077a A mile from South Station, an outpost of US marines in Helmand province, the tribal chief was openly hostile. “The Americans threaten our economy and take our land for bases. They promise much and deliver nothing,” he said.

“People here regard the American troops as occupiers,” said Haji Khan, a leader of the Baluch tribe, who rules like a medieval baron. “Young people are turning against them and in time will fight them.”
Inside South Station, soldiers are proud of the progress they have made. Until they arrived, this remote part of Helmand had not had a government presence for years. But many are pessimistic about where the conflict is heading.
“I’m not much for this war. I’m not sure it’s worth all those lives lost,” said Sergeant Christian Richardson as we walked across corn fields that will soon be ploughed up to plant a spring crop of opium poppy.
A New Yorker who joined the marines after 9/11 and served two tours in Iraq, Richardson, 24, said his men had achieved much. “You can see we are making progress, slowly. But when we leave, the Taliban and Al-Qaeda will surely return.”
With enough effort, resources and time, the marines are confident the population can be won over. But, with the platoon’s influence limited to a small area around their base, many soldiers wonder if the Taliban and Al-Qaeda may simply outlast them, or if the US and Afghan governments have the resolve to send enough troops to win.
Third Platoon, Charlie Company of the 2nd Light Armoured Reconnaissance Battalion, came last July to Khan Neshin, as far south as Nato soldiers have reached in Afghanistan. It was part of a summer offensive by more than 4,500 troops of the Marine Expeditionary Brigade, which has joined British and other forces trying to turn the war in Helmand.
Although they have read the manuals on counterinsurgency and heard generals speak about how to defeat the Taliban, the reality has been bloody, painful and frustrating.
The platoon knows there are at least 20 booby-trapped bombs on the high ground around the base. More than half the men have already been caught in blasts. One marine explosive expert was killed; others suffered broken legs and amputated feet. Three have survived two explosions and come back to fight again.
General Stanley McChrystal, the US and Nato commander in Afghanistan, says the mission is to protect the population and isolate them from the Taliban, but the marines are finding it no easier to defeat the Taliban than it has been for the British, who have fought in the province for three years. Villagers are rarely willing to express a simple opinion, let alone inform soldiers where the enemy is hiding. One marine described the way the Taliban blended with the population as “unbelievably frustrating”.
In terrain crisscrossed by canals with weak and narrow bridges, the platoon has to approach villages on foot. Even when they have surrounded the Taliban, the marines have found the enemy has an uncanny ability to slip away in the ditches. All this adds to the strain of facing improvised explosive devices, which are the main threat.
“We are all brothers here,” said Lance-Corporal Corey Hopkins, 22, from Georgia. “And it hurts to see your brother hurt or put him in a bag for the last time. It pisses you off. It makes you mad. You know people out here know what’s going on, but they won’t tell you.”
Corporal Gregory Williams, 22, from North Carolina, said: “It’s going to take a lot of proving out here to make them talk to us. It’s working so slowly.” The marines are trying to implement a strategy dictated from Washington that bids them separate the population from the insurgents. But attempting that means a battle not only against the Taliban but against a feudal system that places real power in the hands of landowners such as Haji Khan.
When we talked to the grey-bearded men in the village, in the shade of one-room mosques, most appeared friendly. Asked if they wanted a school or more doctors, all said such questions were a matter for those who own the fields.
The marines hope to open a school and provide medical facilities. They are also offering to pay Khan and others to provide jobs to improve the canal system.
At a shura, or village meeting, at South Station last Friday, Khan showed up with 40 elders and heard Captain Chris Conner, commander of Charlie Company, promise development. “From the bottom of my heart, I want to say that we are here to help you,” he said.

The villagers welcomed the canal scheme and the idea of making use of a doctor at the base. But Khan and another landowner rejected the idea of a school. “Security is still too bad. We’ve seen how they are burnt down [by the Taliban] elsewhere.”
Some marines were unconvinced about paying money for the canal to a tribal leader and drug baron who gave them almost no help and would probably keep the cash.

Later, a marine intelligence officer said the drug economy and the feudal system made the strategy of winning hearts and minds extremely complex. As drug producers, men such as Khan had a “working relationship with the Taliban”.
Nobody knew of the announcement last week in Kabul of a new round of national elections. Nobody voted in the first round. “We never even heard of elections. If we had, I suppose we might have voted,” said one villager.

The Ghost Patients

More than 250,000 people languish on hidden NHS waiting lists. Some die

before even appearing in official statistics. Insight investigates.

(Published in the Sunday Times, May 5, 2002)

When Iris Bailey suffered chest pains and was diagnosed with angina, she was

told that she needed a test to show how well her blood was circulating. The

waiting list for the thallium scan was three months – a delay not included

in published government figures.

Bailey, having worked as a hospital porter, accepted it with good grace and

put her faith in the National Health Service. The grandmother from Harlow,

Essex, kept busy helping to plan her son Gary’s wedding and hoped her

condition was not serious. Three weeks before she was due to have the scan,

she again suffered chest pains. This time it was decided that she needed an

angiogram, a heart test, at St Bartholomew’s hospital in London and that the

wait would be two weeks – another delay that many hospitals do not count in

the official waiting list figures.

David, another son, was so concerned that he sought assurances that his

mother would not die waiting for the angiogram. On the day he handed a

letter to the hospital’s management his mother, 75, had a fatal cardiac

arrest. It was more than four months since she had first felt ill in October

2000 but none of her waits counted in official statistics.

“For anyone to die waiting for a test is atrocious,” said David Bailey.

Independent health groups, such as the King’s Fund, say it is an indictment

of the waiting list system – a key measure of hospitals’ performance. Bailey

was an invisible patient left to languish.

What is even more shocking is evidence that hospital trusts are discreetly

moving patients from the published waiting list to the hidden ones.

Wittingly or not, it helps the government to trumpet improvements in NHS

performance.

The truth is, however, that many thousands of patients, perhaps similar to

Bailey, will still be waiting for tests and treatment that could save their

lives. An investigation of the way hospitals and the Department of Health

count NHS waits has revealed that an estimated 250,000 patients do not

appear in published figures.

To be fair, some will be waiting for scans or tests that will reveal nothing

untoward. For them the delay will not matter clinically, despite the anxious

wait. But for others, such as those needing radiotherapy for cancer, the

wait could be lethal.

As Joseph Meirion Thomas, a consultant surgeon at the Royal Marsden

hospital, puts it: “I would want to give pre-operative radiotherapy to

between 5% and 10% of my patients with sarcoma (cancerous tumours) to give

them a surgical advantage, but none gets it because of the waiting list.

“It’s disgraceful. It’s a waiting list that is creeping up and it’s a

waiting list you don’t know about – the hidden waiting list.”

IN opposition, Labour castigated the Conservative government over its

failure to publish details of patients waiting to see a consultant after

referral from a GP. Things would be different, it promised, if Labour was

elected.

Subsequently two published waiting lists set the standard. The first is the

outpatient list which shows the waits from referral by a GP to the first

appointment with a hospital consultant. The second is the wait for treatment

in hospital as an admission or a day case.

These figures, however, still do not cover the whole pathway from “pain to

scalpel”. Missing are waits for diagnostic tests, often to see whether

surgery is required; they can be as long as 20 months. The government says

these figures are not collected centrally and are not available.

Indeed, John Hutton, the health minister, told the House of Commons in

February: “Data is not collected on the number of patients waiting for

angiograms.”

The reality is that angiogram waiting lists – and lists for other diagnostic

tests – are being compiled in hospitals across the country. They are just

not being published.

One manager at the Norfolk and Norwich University Hospital Trust said, “I’ve

got these waits on the wall in front of me”, but refused to release the

figures. Other trusts also declined to reveal the figures after seeking

guidance from the health department.

Yet some hospitals are willing to release the figures on request; some even

include these delays in their official waiting list figures. They are now

finding themselves under pressure from the NHS Executive to remove them.

“They tried to persuade us to remove angiography off the waiting list but we

refused,” said one manager at a hospital which records angiograms in its

figures. “We think it’s a proper surgical procedure.”

The second category of tests being excluded from the official lists are

endoscopies, used to help to diagnose cancer among other things. Those

hospitals that have been counting patients waiting for these tests are now

being instructed to remove them.

In a letter to chief executives of trusts in southeast England last October,

Bob Ricketts, then an NHS regional director, advised that the removal should

be gradual to “avoid sudden lurches in figures”.

A third large category of excluded diagnostic tests are computerised

tomography (CT) scans and magnetic resonance imaging (MRI) scans, which can

be used to diagnose cancers, cardiovascular diseases and bone disorders.

Previously unpublished data from more than 30 trusts, obtained by The Sunday

Times, reveals long delays and huge regional variations for such scans.

At the Blackpool, Fylde and Wyre Hospitals NHS Trust there were 523 patients

waiting up to 14 months for a CT scan at the end of March and 1,753 patients

waiting up to 20 months for an MRI scan. But at Hillingdon Hospital NHS

Trust there were just 89 patients waiting a maximum 21 days for an MRI scan.

At South Devon Healthcare NHS Trust there were 227 patients waiting up to 18

months for angiograms on March 31. But the maximum wait at Bradford

Hospitals NHS Trust was five weeks.

Hospitals point out that urgent cases can be given priority. The health

department claims that because such scans may be for preventive purposes, or

show nothing wrong, it is not meaningful to include them in the published

waiting list figures. Try telling that to a patient who finds, via a delayed

scan, that his cancer has become inoperable.

BUT perhaps the most damning omission from the official lists is for

radiotherapy cancer treatment. Alan Milburn, the health secretary, has made

tackling cancer a priority. But hundreds of radiotherapy patients are on

hidden waiting lists of up to six months.

Some cancer centre managers complain that their “invisible” patients are

given lower priority because their treatment does not count towards official

waiting list targets. “We asked for in excess of Pounds 1m (for this

financial year). It was reduced to Pounds 650,000 and has now been reduced

again,” said Jo Yardley, general manager of Kent Oncology Centre in

Maidstone.

“The waits cause immense anxiety yet I have never reported on radiotherapy

waits for any (national) performance programme. It’s something that we have

been crying out for for years.”

Guidelines from the Royal College of Radiologists stipulate that breast

cancer patients should receive post-operative radiotherapy within a month.

But it is not uncommon for patients to suffer delays of up to three months –

a delay that appears on no published government waiting lists.

There are cases such as Joy Barthorpe, 72, of Battle, East Sussex, who was

diagnosed with breast cancer last October and had her operation on December

28. She has been told that her radiotherapy will not start until June 24.

Thomas Liston, 46, from west London, was put on a three-month wait for

radiotherapy for a brain tumour. His waiting time was reduced but he died

earlier this year before he received treatment.

These are not isolated incidents. The dangers of delay are reflected in a

report published in the British Medical Journal in January 2000. It said:

“Six weeks is the approximate volume doubling time for many tumours and

introducing an additional delay of four weeks between planning and starting

radiotherapy must prejudice outcomes.”

THEY are calling it Not The Waiting List. That is the title of a report that

the Association of Community Health Councils for England and Wales is

preparing to illustrate how many different types of waits are excluded from

government figures. Whether all of them should be part of published waiting

lists, or can be collected in practical terms, is debatable. What is clear

is that waits for certain diagnostic tests and treatment for some serious

illnesses are at present hidden from public scrutiny.

As Liam Fox, Tory health spokesman, said: “If you are interested in clinical

outcome, then one of the critical factors is access to diagnostics. The

horrendous delays in getting access may often mean that patients may die

before they get the treatment that they require.”

Hospital managers admit the disarray. Several, such as Plymouth Hospitals

NHS Trust, say they do not count angiograms, while several others, such as

the Newcastle upon Tyne Hospitals NHS Trust, say they do.

It creates a system that is both confusing and distorting, skewing managers’

attention away from life-threatening diseases to treatments for mundane

conditions that happen to reduce published waiting lists.

“When the money comes in, the chief executives want to put the money into

achieving the targets over which they will get sacked,” said Hilary Thomas,

professor of oncology at the Royal Surrey County hospital. That means

concentrating on published waiting lists.

“The public should know that one patient might be getting their varicose

veins surgery done to meet some silly target in a manifesto and another (who

does not appear on the waiting list) might not get radical treatment for

cancer and that may make a difference to whether they live to old age or

not.”

That, says Thomas, is “morally wrong”.