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The sign at the emergency entrance to Fallujah Surgical speaks volumes about the decreased violence in Al Anbar province. The sign was erected in 2006 due to the heavy flow of combat casualties coming into the trauma center at Camp Fallujah in need of blood. However, according to reports, May 2008 held the lowest number of coalition casualties since 2004.

Photo by Cpl. Stephen M. McGinnis

Sharp decrease in violence leaves Fallujah Surgical hallways empty

18 Mar 2008 | Cpl. Stephen M. McGinnis 1st Marine Division

The halls remain empty, the sirens are silent, the only thing collecting on the floor is dust from the staff walking in and out; boredom is consistent, and no one is complaining.

 This is the state of one of the U.S. forces most actively used hospitals in Iraq, Fallujah Surgical. Fallujah Surgical, once a frequent stop for combat casualties, is no longer treating many injured warriors in combat due to the sharp decrease in violence in al Anbar Province, but is instead a clinic treating common day-to-day injuries. The sign outside the emergency entrance, although minute, has big meaning… “No blood needed at this time.”

 According to reports, May of 2008 held the lowest number of coalition casualties since 2004. Much of that can be contributed to the combined efforts of local Sheiks, Iraqi Police, Iraqi soldiers, and Coalition Forces in quelling the violence.

Gen. David Petraeus, commanding general of the Multi-national Forces Iraq, stated during his report to congress, Sept. 10, 2007, that the most significant development in Iraq was the rejection of al-Qaeda by tribal leaders, and how it has shown dramatic changes in al-Anbar. 

“A year ago the province was assessed 'lost' politically," he said  “Today, it is a model of what happens when local leaders and citizens decide to oppose al-Qaeda and reject its Taliban-like ideology."

Tribal leaders realized that al Qaeda was lying to them about American forces wanting to occupy their land and destroy their mosques, spawning “The awakening” amongst 41 tribes.

“The awakening was not our move,” said Lt. Col. Bill McCollough, the regimental tribal engagement officer, with the Regimental Combat Team 1. “The tribal leaders and people stood up and said, ‘we cannot tolerate what al Qaeda is doing to us any more.’  We had made overtures to them, but they had to come to the final decision to join us in the fight against al Qaeda.  Once they did, we built a partnership to rid al Anbar of the murder, terror and lawlessness of al Qaeda.”

The Marines in Fallujah through recent months have been progressively pulling out of the city leaving only a small contingent of Marines mentoring and assisting the Iraqis to help take control over the city of Mosques. These changes have helped make Fallujah a much safer place for coalition forces and the citizens of Fallujah, leaving coalition hospitals a much more mundane place of employment spent waiting rather than acting.

 “The no blood sign is a dramatic change from last year, we don’t need any blood, we don’t have any patients that need it,” said Petty Officer 2nd Class Leticia Ruenas, a 30-year-old hospital corpsman at Fallujah Surgical from Pico Rivera, Calif.

Ruenas worked at Fallujah Surgical from September of 2006 to March of 2007.

 “We put that sign up last year because we were in constant need of blood. I looked at the log book from last year, for a period of time it was either everyday or every other day that we needed to tap into the blood bank. Since we got out here we haven’t had to use it once,” she added.

 In a job where boredom is looked at as a good thing, the hospital staff is stuck in a difficult spot, wanting to utilize there skills they have trained on for months prior to their deployment in Iraq, but also hoping never to have to use them.

“I was expecting a lot more before I came out here, but once I got out here I saw how slow it was,” said Hospitalman Oscar J. Castillo, a 20-year old-corpsman at Fallujah Surgical from San Francisco.

 Instead of treating mass amounts of combat casualties, the hospital staff trains constantly just incase their skills are needed by one of the many warriors patrolling the streets of Fallujah.

 “We haven’t had nearly as many chances to utilize our skills compared to those before us, but we just try and do some surprise drills to keep our guys skills up,” said Petty Officer 1st Class Alisha L. Munoz, a 30-year-old hospitalman at Fallujah Surgical from Yakima, Wash.

 Munoz deployed to Baghdad in April 2006 to October of 2007 and received weekly reports concerning the action at Fallujah surgical and can remember avoiding Fallujah and taking alternate routes around it because of the violence.

 “It has definitely slowed down a lot since the last time I was here. The young guys were expecting to come out here and be mopping up blood, because Fallujah always had action and always had casualties, but they aren’t seeing anything, ,” she added.

 Unfortunately for some, the images of a blood soaked hallway are not images they expected to see, but images they were forced to see when combat was high and Fallujah was overrun by insurgents.

 “As far as between now and the last time I was here, it is definitely more relaxed, from having a possibility of a casualty coming in compared to knowing that you were definitely going to see it,” said  Fleet Marine Force Chief Jose E. Perez, a 36-year-old hospitalman, from Rio Hando Texas, Fallujah Shock Trauma platoon.

 “It was almost every day we had a combat casualty coming through the door. We had one day when patients outnumbered the staff and we had 115 people on staff. I think we had approximately 117 casualties come in that day.”

Since the summer of 2007 and the formation of the Anbar Awakening, monthly Coalition troop casualties have been steadily declining; about two-thirds since the summer of 2007, according to Department of Defense records. An RCT-1 unclassified intelligence report revealed incidents in and around the Fallujah area have dropped drastically from around 250 reported incidents in December 2006, to less than 10 in December 2007. Iraqi Army and Police units have been working hand-in-hand with Coalition troops. Iraqi forces have even started to command and control their own operations.

Maj. Gen. John F. Kelly, commander of Multinational Force West said he’s amazed by vast improvements across Anbar province, with a sharp drop in violence and continued progress among Iraqi security forces.

“It’s stunning to me how low (violence levels) are,” Kelly told Pentagon reporters from a videoconference center in Baghdad on March 10, 2008.

“When I left here three years ago, you could not go into the cities -- Fallujah, Ramadi, places like that -- without a rifle company of Marines, and it was a gunfight going in and a gunfight going out,” Kelly said.

However, Coalition Forces still remain vigilant in their mission at hand, the number of attacks against them have decreased, but haven’t disappeared.

Just as in combat, complacency is never tolerated and one must remain ever vigilant to perform his duties if the situation calls for it.

“You could get real complacent out here; it gets boring sometimes, so we do what we can to keep us busy. It’s a good thing, it means no one is getting injured,” said Castillo.

1st Marine Division