On Sept. 3, 2004, at about 1 p.m. the first bomb exploded inside Middle School No. 1 in Beslan, Russia, ending all hope for a peaceful resolution to a school siege by a heavily armed gang.
As gunfire erupted from inside the school, children and adults poured out in a desperate attempt to escape the school's gymnasium where more than 1,200 people had been held for three days without food or water. The scene was chaotic, but 800 meters away in an emergency medical mobile unit an elite team of Russian doctors, nurses and medical professionals were ready and waiting to take in the hundreds of people that would need care, primarily pediatric care.
Dr. Andrei Prodeus, head of pediatrics at Moscow Children's Hospital No. 9 told ABC News the kinds of injuries they were prepared to treat. "There were head injuries, burns of course and bullet wounds, and some fractures as well as people were jumping out the windows, and people were injured by the falling roof and the flames," he said.
One of the cases to arrive was 18-month-old Azam Mukagov. When he was brought into the mobile unit, he had no heartbeat and the shrapnel wound in his abdomen was so severe that it severed his liver and one of his intestines was outside of his body. Doctors performed three hours of intensive surgery.
"He was in an extremely bad condition. He was in shock," said Dr. Yandiev Suleyman, the doctor who performed Azam's surgery. "We didn't even prepare him for the operation as we normally would. That is we applied anti-shock therapy during the operation."
When Azam's condition was stabilized he was driven by ambulance to the hospital in Vladikavkaz where he received further care. In the early morning of Sept. 4, Azam and five other severely wounded were driven in ambulances equipped with life support systems onto a transport plane and flown to Moscow. Azam was then admitted to Moscow Children's Hospital No. 9, where doctors performed two more surgeries. Six weeks after the siege Azam is still in the hospital undergoing treatment, but doctors think that he will have a full recovery.
The Beslan medical team is part of a larger government organization. Ten years ago the Russian Federation founded the Ministry of Medical and Catastrophic Aid with the objective of saving lives and preserving health in the event of catastrophes.
This mobile ability has allowed the team's physicians to save lives throughout the Russian federation and former Soviet Republics as well as in a number of foreign countries, such as Iran, Iraq, Afghanistan and Turkey and many of the doctors brought in to Beslan had gained their field experience during the first and second Chechen wars. "Within 15 minutes our brigades are ready to go and extend assistance to any place in the world ... this is how we went to Colombia and Turkey to help after big earthquakes occurred," Sergey Guncharov, the director of the ministry, told ABC News.
The Success in Beslan
Although the ministry has been integral in saving the lives of many people all over the world, the work done by the unit with the victims of the terrorist attack on Beslan School No. 1 might be its greatest success yet.
Guncharov arrived in Beslan on Sept. 2 with a team of 20 medical professionals from Moscow. Nine of the pediatric specialists were from Moscow Children's Hospital No. 9, which specializes in burn treatment. The group from Moscow met up with 200 other emergency services professionals from hospitals and field units in neighboring regions and began setting up the mobile unit in the parking lot of the local hospital in Beslan.
By the morning of Sept. 3, the team had set up a sophisticated field unit made of inflatable tents that was ready to accept patients. The unit was equipped with 70 ambulances, a tent for triage, numerous surgical stations and areas designated for victims with specific health concerns, such as diabetes and heart conditions. The unit even had oxygen-producing machines and mobile CAT scan stations.
When the bombs in the gym began to explode the injured and wounded flooded into the tents. Because of the large numbers needing treatment within the first few hours, one of the most important and difficult tasks the doctors faced was prioritizing the arriving patients. Guncharov told his people that they should only take one minute to determine what treatment an arriving patient needed. "Because if they took two, three, four or five minutes there would have been a backup of patients. ... You have to consider that while you assist one patient another may perish."
Incredibly, within the first four hours after the siege, 47 life-saving surgeries were performed and not one patient was lost. Altogether, 527 victims passed through the mobile unit, were given treatment and then sent to nearby facilities if further care was needed.
Over the next week, 94 children were flown to Moscow. More than 130 people from Beslan have now received treatment in Moscow hospitals.
Even the most experienced of the group was touched by the tragedy before them. "We've been working with children for years and I saw one veteran specialist who'd seen lots of terrible things in their life, working with tears in their eyes," said Suleyman. But standing outside of Azam, the "miracle baby's" hospital room in Moscow, Suleyman said that he and his colleagues do feel that they performed their duties well. "It's been a very successful mission from the medical point of view, but let's pray that such things will never happen again."