Izatullah's Story

Major Terry Ratkowski, a maxillofacial surgeon based in Edmonton, treated Izatullah's injuries. Watch the interview online.

The Role 3 trauma hospital at Kandahar air base treats civilian, as well as military, casualties of war. While the fifth estate is filming at the air base, an eight-year-old boy, named Izatullah, arrives at the hospital along with his grandfather, a farmer. An explosion had ripped through their remote village, killing Izatullah's sister, shredding his face. His wounds are life-threatening.

Izatullah and his grandfather (read an interview) are airlifted to the hospital where the boy is treated by Canadian doctors and nurses. He is in shock, unable to talk or even swallow. Major Terry Ratkowski, a maxillofacial surgeon based in Edmonton, and a team, operate twice for a total of 20 hours, to repair Izatullah's face. (read an update)

Gillian Findlay: What are the risks for him now?

Major Terry Ratkowski: Well there are many risks. There is infection. There is a risk that the hardware could fail if he's putting a lot of excess pressure, eating a hard diet. Plates can fatigue and fracture, that's supporting his lower jaw. If he does develop a respiratory infection it could be more difficult for him to receive adequate oxygenation. And the scarring itself may develop further and may disconfigure the way that his eye and mouth close.

Right now he can close his eyes which will protect his eyes from drying out, chronic problems. And right now his mouth he is able to close so those are - it's all looking in a positive direction. But there are still some things that can occur. Unfortunately he does not live in this area so he probably won't travel back here very often. However, there are other medical facilities that he can probably visit for the follow-up.

Gillian Findlay: Ultimately he's going to have to fall back upon the local medical system.

Major Terry Ratkowski: Yes. We've done what we could here from a critical acute care point of view and now it's time to step down to another resource that's closer to their home. So although it's very limited, they can manage minor complications that may occur.

Gillian Findlay: Assuming the family can pay for it, right?

Major Terry Ratkowski: There is a question about paying for things. Certainly more advanced procedures often people are selling their abilities and skills as you would in any business in a local market. But the government does provide some form of basic care, although it certainly is nothing that we would expect from a North American point of view.

Gillian Findlay: If this boy was in Canada, if he was back home with these kinds of injuries, I'm assuming down the road there would be the option of plastic surgery to repair his face.

Major Terry Ratkowski: Right.

Gillian Findlay: Those options aren't going to be available to this boy are they?

Major Terry Ratkowski: No. He's going to have a significant scar and quite likely if plastic surgery was available it would improve his facial appearance in the future. It's complex care though that would require multiple surgeries likely and multiple lengthy stays in a facility and of course with someone with experienced hands doing that type of surgery.

Gillian Findlay: What are your emotions as you send him home knowing all that?

Major Terry Ratkowski: Well, it's mixed. I mean it's sad that there's that much violence and no one is immune to it. And it's happy that we've been able to reach out to one person to help them get back on their feet. So maybe they can go on and live a live worth living here in Afghanistan.

Gillian Findlay: If you hadn't been here to intervene when you did, what would have happened with this boy do you think?

Major Terry Ratkowski: Well I think that the services we provided were absolutely essential for him and his survival. Without receiving the care he probably would not progress to the point where he could eat on his own, swallow. And ultimate-

Gillian Findlay: You saved his life.

Major Terry Ratkowski: Ultimately he probably would have - the injuries he had would have been fatal had he not gotten any medical attention.

Interview with Izatullah's grandfather

What happened to cause Izatullah's grievous injuries is, at first, unclear. Their remote village, near Tarin Kowt in Uruzgan province (see a map of Afghanistan), north of Kandahar, is in an area controlled by Dutch coalition forces. The fifth estate's Gillian Findlay spoke, through an interpreter, to Izatullah's grandfather.

Gillian Findlay: So can you explain a little bit more, the IED exploded and then what did the soldiers do?

Grandfather's Interpreter: He said the soldiers start fighting, shooting.

Gillian Findlay: Started shooting, into the village?

Grandfather's Interpreter: He said when that happened the shooting started, the youngest people I mean…

Gillian Findlay: The children?

Grandfather's Interpreter: No, the biggest they were going to their rooms and the children were still in the house on the ground.

Gillian Findlay: They were outside on the ground. And how far away were the soldiers from the house?

Grandfather's Interpreter: By walking it takes like 15 minutes from the road to their house.

Gillian Findlay: So did he see the soldiers firing?

Grandfather's Interpreter: He said yes I seen them, but the road was along the village you know between the houses. We have seen the soldiers. They were standing on the road.

Gillian Findlay: Does he know what country these soldiers were from?

Grandfather's Interpreter: He said maybe they are Dutch people, Holland. Because (unclear) there is no other base, there is just Holland people, the Dutch people. 

…

Gillian Findlay: What does Baba think of the soldiers who did this?

Grandfather's Interpreter: What should I say? There was no Taliban, there was a convoy, coalition forces. We got shot from them.

Gillian Findlay: And how does he feel about the coalition forces? Is he angry at them?

Grandfather's Interpreter: He said of course I am sad from them, because there was nobody like no Taliban, nobody just houses, just people.

Gillian Findlay: How many other children, how many other people were injured?

Grandfather's Interpreter: Five of them got injured, and two of them passed away.

Gillian Findlay: Two of them died?

Grandfather's Interpreter: Died.

Gillian Findlay: And one of those was your granddaughter?

Grandfather's Interpreter: Yes. One was his granddaughter.

Gillian Findlay: I'm sorry. How did he get Izatullah to medical help?

Grandfather's Interpreter: He said I didn’t take him to the clinic or the hospital. On that time the soldiers spent all the night on the road, close to the village. In the morning time they came to the houses and they have seen the causalities and they took him to the hospital.

Gillian Findlay: Did the soliders say anything to you? Did they understand that they had been responsible for this?

Grandfather's Interpreter: He said the soldier told us there was the Taliban in the village and that’s why we start firing and they also told us why you didn’t call inform us at the night time, because of the causalities.

Gillian Findlay: What did you say to the soldiers?

Grandfather's Interpreter: He said we were scared at the time, because it was (unclear) you know. And there was convoy vehicles like helicopters in the sky.

Gillian Findlay: When you saw how badly injured Izatullah was, what did you think was going to happen to him?

Grandfather's Interpreter: He said we were thinking about him, he will die.

Gillian Findlay: And when you came to the hospital here, what did the doctors tell you?

Grandfather's Interpreter: He said the doctors told us he would be alright, he will be fine, he will get better.

Gillian Findlay: And what do they tell you now about the future for him?

Grandfather's Interpreter: He said the doctor told me he will get better in the future.

Gillian Findlay: But he will still have problems with the way he looks? Is that right? You have scars?

Grandfather's Interpreter: He said yes.

 …

Gillian Findlay: What does he think about the care that Izatullah has received here? What does he think about this place?

Grandfather's Interpreter: He said it’s a good place, that they treated him well. In other place they couldn’t treat him well.

Gillian Findlay: But coalition forces hurt him in the first place. They were responsible for this, and now the coalition doctors have made him well. What do you think of that? Is that they way it should be?

Grandfather's Interpreter: They said that was misunderstanding you know. They told him that wasn’t our fault.

Gillian Findlay: Does he accept that? Even though it killed your grandfather and injured Izatullah?

Grandfather's Interpreter: He said that was like, they told him that wasn’t our fault.

Gillian Findlay: Baba, you've seen many things in your life. You've seen much happen to this country. Is it good that they coalition soldiers are here? Do you agree with this?

Grandfather's Interpreter: He said whenever they bring security and stability in Afghanistan, I agree for the coalition. This is the same thing as fighting.

Gillian Findlay: Do you think, will they bring peace to Afghanistan?

Grandfather's Interpreter: He said of course they will bring security, because the Taliban is very weak you know.

Gillian Findlay: You think that the coalition is winning?

Grandfather's Interpreter: He said because of the power yeah they will win.

…

Gillian Findlay: If you could speak to people in Canada, what would you say to them?

Grandfather's Interpreter: He said if there was no Canadian how can he get better there was no doctor here and they have treated him.

Gillian Findlay: So is he happy that Canada is here?

Grandfather's Interpreter: He said yes, of course, they are helping.

Gillian Findlay: Izatullah will need more help in the future and that is going to cost money. Do you have the money to get him more help if he needs it?

Grandfather's Interpreter: He said, no I don’t.

Gillian Findlay: What will you do if he has infection or he has to get more treatment?

Grandfather's Interpreter: He said, I will find I will borrow some money from someone.

Gillian Findlay: Do you worry?

Grandfather's Interpreter: He said if there is no money, everyone worries.

 Gillian Findlay: And just one last question; obviously Izatullah is going to have many scars on his face because of this, but he's alive. Will this make life difficult for him, do you think?

Grandfather's Interpreter: He said it’s okay, but he will his face will not be like before.

Gillian Findlay: Wwill that make it difficult for him in his life?

Grandfather's Interpreter: He said, I don’t know the future, only god knows.

Just a normal boy

Watch the video online.

Despite Izatullah's pain and discomfort he is, after all, an eight-year-old boy with a small boy's curiosity for all things. One day, while being examined by Dr. Ratkowski, he becomes curious about the medical flashlight being used. Like any boy, he has to know how it works.

 

Update

Izatullah did manage to return to Role 3 hospital for a follow-up examination after the fifth estate cameras left Afghanistan. Major Terry Ratkowski reports that Izatullah's "wounds were healing well except for one area about 1.5 cm on his left cheek and close to his left eye, the wound margins had separated." Izatullah was given an antibiotic and the wound was cleaned.

He did not show up for a subsequent check-up, not surprising considering the distance to his village and the difficult terrain. But, Izatullah's grandfather did pass along, through an interpreter, that the wound was doing better and that the medications were working.