The Quiet Fight: Master Bombardier Bounyarattanaphon Makthepharak

November 6, 2007 by Natalie Salat



It was Canada Day Eve, a special night for the soldiers at the main Canadian Forces Base in Kandahar, Afghanistan. Master Bombardier Bounyarattanaphon Makthepharak, fresh out of the shower after one of his gruelling gym workouts, was sitting down with his buddies in the dusty tent complex to enjoy a rare steak and lobster supper. The reservist with the 30th Field Regiment (Royal Canadian Artillery) in Ottawa had only just arrived in Afghanistan two weeks earlier, in June 2006, keen to start his second tour in the war-torn country.

“We’re like, ‘Hmmm, there hasn’t been a rocket attack for about the past two weeks,'” recalls the jovial artilleryman. “We also talked about Canada Day…. ‘Oh yes! Finally we get a chance to have a couple of beers!'”

One minute, the self-described foodie was digging into his hot meal, “and next thing I know, I wake up in the hospital.”

What happened in between–although his memory of it is sketchy–was a rocket attack in which he was very nearly killed. With shrapnel flying and chaos reigning, somehow only nine others were injured, but not as critically as he was. “From what I was told by many people, I was very lucky that I was close to the hospital,” says Makthepharak. “And the fact is, when I got hit, the shrapnel went through the back. It didn’t look too bad on the outside, because all the damage was internal.” But he was spitting out blood. “A prep guy, I guess–he decided to throw me into an ultrasound…to see what happened. They noticed my rib was broken, my lung was punched right through, and the shrapnel went right through the bottom of my heart.”

Miraculously, despite being clinically dead for a couple of minutes, “Mak” survived. What’s more, he fully intends to return to duty, wherever that may be.

His road to recovery continues, 17 months and counting.

* * *

“We have not dealt with a situation like Afghanistan for quite some time. In some sense, we are going over old ground while we break new ground in dealing with modern combat casualties returning from that part of the world,” Rear-Admiral Tyrone Pile, chief of military personnel, National Defence, told the Senate Subcommittee on Veterans Affairs last November. The subcommittee has been looking into the benefits and services provided to Canadian Forces members and veterans as well as their families.

There couldn’t be a more appropriate time.

With the increasing pace and demands of operations since the 1990s–and rotations of thousands of troops going in and out of Afghanistan–the Canadian Forces, the Department of National Defence and Veterans Affairs Canada are all facing the pressures of providing care to modern-day soldiers. Since 2002, more than 70 CF members have been killed in combat, more than 220 have been injured in battle, and more than 250 have suffered non-battle injuries. These statistics are as of Sept. 11, 2007.

The Canadian Forces Health Services–5,100-strong and currently undergoing a major reform process–is at the sharp end when it comes to looking after injured or ill servicemen and women. One of the challenges is maintaining enough medical staff, given that the Canadian health-care system already has a shortage of doctors, nurses and other medical professionals. Then there is the added challenge of working in a war zone like Afghanistan.

When it comes to the most seriously wounded in Afghanistan, explains Lieutenant-Colonel Peter Rowe, the military’s head of physiotherapy, “generally, Canadian soldiers are stabilized (there)…and then they’ll be transported to Landstuhl, Germany, for a period of time until they’re stabilized enough to come back to Canada.”

Makthepharak has vague memories of his life-saving care at the Canadian-led coalition hospital in Kandahar. He recalls waking up in the hospital “kind of confused. I didn’t react very much…. Before the orderly woke me up, I was having a dream or a nightmare…some big loud bang, a lot of smoke, me pretty much yelling to say that I’m hit. I remember saying my name, rank, service number…saying how many weapons I have, how many bullets I have on me, and then, I don’t know, something silly like, ‘I’m good to go.’ Turns out I’m not ready to go. I’m pretty much strapped down.”

Within a day or so, Mak was airlifted to the Landstuhl Regional Medical Centre, a world-class U.S. military hospital in western Germany. There, as Pile noted to the Senate, “the Canadian Forces health services group liaison staff (stationed in Geilenkirchen) work diligently to meet all of the (CF) member’s needs, including psychosocial and spiritual.” They work in tandem with the hospital staff.

When Mak arrived at Landstuhl, he says, “I was out. I woke up in the hospital and I was, like, ‘What a beautiful place.'”

He would only need to be there for four days. On his second day, with the encouragement of an orderly, Makthepharak mustered enough strength to get up and walk around his bed–a real achievement for someone who had just had a hole pierced through his heart. “I felt so weak…so I had to jump back into bed,” he chuckles.

He found out that a lot of people had been worried about him. Even strangers had come to visit, from an organization called Soldiers’ Angels Germany.

Meanwhile, as he convalesced, the CF Health Services liaison staff was determining what to do next for Mak’s care.

* * *

The decision as to where an injured soldier will be sent in Canada falls to the captain medical officer based in Geilenkirchen, explained Brigadier-General Hilary Jaeger, now the Commander of the Canadian Forces Health Services, in her Senate presentation. “That captain medical officer converses with the patient–assuming the patient is conscious–the patient’s family, and the receiving hospital in Canada where we think there might be a match between the patient’s clinical needs and his or her broad social support needs.”

For Makthepharak, that was back in Ottawa.

When the soldier returned home, his mother was waiting for him on the tarmac of the Ottawa airport. Asked how his Mom dealt with her son’s near-death experience, Makthepharak smiles. “She’s a strong lady.”

The two have a close relationship, bonded by love and survival through hard times. When Mak was only a baby in his native Laos during the 1970s, his father, Boutone, the commander-in-chief of the Laotian army, was imprisoned by the Communist regime. Five years later, the commander was executed. His wife and child fled the country and spent several years in refugee camps before making it to Canada when Mak was 10.

It was in the grungy refugee camps–from which he occasionally escaped to explore the outdoors–that the young boy got a lasting impression of the military. “I saw guys wearing a soldier’s uniform with a blue helmet on and helping out, giving us canned food. I thought that was a cool thing to do.”

Years later, happily ensconced in Canada, Makthepharak was intrigued when a CF recruiter approached him in a mall. He had been working at an IT company, but being an active kind of guy, “I decided why not try doing this and see how it goes? From that point on, I really liked it.”

After joining the 30th Field Regt. in 1997 as a reservist, the budding artilleryman became enthusiastic about his training, and even more so about the prospect of going on tour. His first overseas deployment was in Bosnia, in 2003. Besides patrolling, Makthepharak enjoyed building playgrounds for the schoolchildren, and putting on events such as ‘movie night.’

Almost as soon as he got back to Canada, the master bombardier asked to be sent out on tour again. His next mission–watching over the Canadian base, Camp Julien, in Kabul–was in 2004. “There were some (scary) moments,” he says, but on the whole, “it wasn’t too shabby. I’d seen this kind of environment before.”

On return to Canada, Makthepharak told friends he would do five tours back to back–“no stop in between. It was going that way–until ‘that’ happened.”

‘That’ was the rocket attack.

* * *

Despite staying only four days in Landstuhl, and then another four at the Civic campus of the Ottawa Hospital, Makthepharak’s journey back to health is not going as quickly as he would like. “Since I recovered this fast in the hospital, I was thinking I would be up and running already, but I’m still trying to get my cardio back.”

During his two months of sick leave, Mak says he “got bored of staying at home,” so he would go out for a walk or to the gym at National Defence headquarters. He got busted for that. “A lot of people know me there…. They’re like, ‘Weren’t you hit by a rocket?’ ‘Yeah, a while back. A month ago….’ They kind of kicked me out of the gym and said, ‘You have to get a doctor’s note saying you’re OK.'”

At the start of his rehabilitation process, Makthepharak was going to physiotherapy at the Canadian Forces Health Services Centre Ottawa almost every day. Then that went down to two days of the week. “Now it’s down to once in a while,” he says. He was recently sent to the University of Ottawa Heart Institute because “now I have sporadic heart rate. Everything’s tight around the chest. Basically, I feel like a baby again. I have to learn to breathe properly because my lungs are not moving properly and my body is not aligned properly.”

Still, he is determined to get back to active duty, to be back with his “boys.” His military doctors have told him to listen to his body, “to make sure I don’t overdo it.”

His care so far has been excellent, he says. “People have been very helpful. I have assisting officers who help me out. If I have any questions or any problems I go straight to them.”

Soldiers who become so injured or ill that they are unable to return to duty are assigned an assisting officer and a CF case manager from the health services. This applies to all CF members, whether they are wounded in battle or not, emphasizes Lt.-Col. Gerry Blais, director of casualty support for the Canadian Forces. “We want to make sure there are not two classes of citizens.”

At the same time, says Blais, the Department of National Defence and the CF will involve Veterans Affairs in the care of the CF member, so that they get any benefits to which they are entitled. As of writing, Makthepharak’s claim with VAC was still being resolved. Under the New Veterans Charter, which went into effect April 1, 2006, he is immediately eligible, as a CF member, for a lump sum payment of up to $255,729.25 in recognition of his injury. Other benefits, including rehabilitation services and earnings loss support payments, would come if he has to (or chooses to) leave the military.

Over the last decade or so, DND and VAC have begun to work more closely together, notes Darragh Mogan, executive director of VAC’s service and program modernization task force. “I think we were kind of two solitudes 10 years ago, and that was unfortunate,” he observes. “I think that our Veterans Affairs is partially responsible for that, in the sense that we were focused on our traditional veterans. They’re still a priority, but we need to serve all our veteran clients.”

In 1999, the department set up a steering committee with the deputy minister of VAC and the chief of military personnel to look into the care of CF members. One of the results was the development of the new charter. Another was the establishment of The Centre for the Support of Injured Members, Injured Veterans and their Families. Based in Ottawa, the centre–with Blais as its director–has the task of helping to ensure that a CF member or veteran gets the information and support he or she needs in obtaining benefits and services from a variety of sources.

There has been progress in the DND-VAC continuum of support, but there remain kinks to be ironed out. “Obviously, there are two departments with two different cultures, but we both realize that the ultimate aim is to ensure that the clients get the services that they need,” comments Blais.

The centre’s addition of 10 two-person detachments across the country in September will help, he adds.

One of the centre’s main duties is to manage the CF return-to-work program. “We try to reintegrate people into the workplace as quickly as possible, even if it’s not full time and if it’s not in their specific area,” says the lieutenant-colonel. “Research has shown that if a person doesn’t return to work within six months of leaving the workplace, odds are they’re never going back. So we try to get them back, even if it’s for a half day a week at first.”

* * *

Makthepharak is working part time at 30th Field Regiment’s headquarters on Dow’s Lake in Ottawa. “Basically, when I come here, I do PT (physical training) in the morning, and I also try and do physical exercise when I finish work as well. I try to be as active as I can.”

Sometimes the soldier talks to a social worker, to deal with frustrations in his recovery process. “It helped quite a bit to understand my situation because, you know, sometimes, when you’re in good shape before and now you’re not, you feel like, aw, you’re crap.”

Now placed in the military’s “medical category,” Mak has three years in which to get himself in shape to return to duty, or be released. Blais notes, however, that the Chief of Defence Staff Gen. Rick Hillier has made it “very clear” that anybody who was injured in the theatre of operations “will not be released unless the CDS personally signs off on it. The aim is, when it’s at all possible, that we will retain (the CF member) to the extent where they are employable.”

Mak is raring to get back with the artillery. “(The doctors) say as long as my body’s still healing, it’s a good sign.” But the master bombardier is pragmatic. He is also working on getting his high school diploma. “Major things happened in my life that make me realize I really do need to actually get some more things under my belt.”

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