Medics Prepared for GI Casualties Now Treat Young Victims of Iraq’s Civil War : Refugees: A U.S. military hospital in Saudi Arabia takes in scores of critically wounded.

The beds at an elaborate U.S. Army tent hospital deep in the rutted desert of northern Saudi Arabia are filled with the young victims of Iraq’s civil warfare.

A 6-year-old girl whose lung was partially shot away by gunfire lay wide-eyed in one ward Wednesday, her father at her side, while nearby a 16-year-old smiled and tried to talk despite the four-inch gash left in her head by a grenade. A 12-year-old returned from surgery on her small leg, wrecked by shrapnel. A 2-year-old, allegedly shot in the back by the Iraqi Republican Guard as punishment for his father’s refusal to join the army, was released to another hospital.

The fallout from the turmoil inside Iraq has now reached Saudi Arabia. U.S. Army medical teams at this remote, state-of-the-art evacuation hospital are treating scores of critically wounded Iraqi refugees, including many women and children.

In American helicopters and ambulances, the wounded civilians and their families have been arriving steadily for the last two weeks at the 803rd Medical Group, one of the primary hospitals set up for Gulf War casualties, U.S. military officials said.

It is the plight of the children that most disturbs the doctors and nurses at this field hospital. Concealing their pain, the young boys and girls smiled faintly at strangers Wednesday while lying swaddled in bandages and attached to tubes, bottles and machines.

“We did not expect children,” said Capt. Rosemary Ramos, a staff nurse. “It’s very heartbreaking to see children here.”

The presence of Iraqi civilians at King Khalid Military City, site of the 803rd, indicates that the American military is much more involved in rescuing Iraqi refugees than was previously thought.

It has been reported that fleeing Iraqis were receiving emergency first aid in U.S.-occupied southern Iraq, as well as tons of rice and other food. But by evacuating the refugees to King Khalid, the Americans place the Iraqis into the U.S. military medical system and guarantee their treatment at the best facilities available here for combat wounds.

“This is the new wave of work for us,” said Col. Richard H. Kennedy, commander of the 803rd Medical Group. “The care of Iraqi civilians.”

Treating women and children was not supposed to be part of the job at this facility, one of three hospitals in a complex known as Medical Base America, 50 miles south of Saudi Arabia’s border with Iraq.

The new task posed an unexpected dilemma for both Saudi and American officials, forcing them to rethink their mission here and to improvise at a hospital created to provide care to thousands of GIs.

The anticipated American military casualties--this hospital alone planned for 600 to 700 in four days’ time--never materialized. Instead, the 803rd Medical Group received hundreds of Iraqi prisoners of war. Next came civilians.

When the first baby victims arrived, surgical drapes were hastily used for diapers, and mattresses were spread on the floor because there were no cribs. Nurses scrambled to find blood-pressure cuffs and intravenous needles small enough for the new patients.

On Wednesday, 167 wounded civilians and 45 prisoners of war were being treated at Medical Base America, Kennedy said.

Many of the civilians are children. Some have lost arms and legs, blown off after they stepped on land mines or unexploded bombs. Some were shot in the chest or back. Several were hit by shrapnel.

It was not clear how many were wounded in the fighting between the army loyalists of Iraqi President Saddam Hussein and their enemies, Shiite Muslim and Kurdish rebel forces, and how many simply stumbled upon arsenals left over from the Gulf War.

“It’s very sad to see,” said Maj. Susanne Mihalek, chief operating room nurse. “We’ve had mothers in here crying. It’s hard to explain to them what was happening. We’d try to touch them, give them a hug and hold their hands. It seemed to work.

“Our mission has changed, and we’ve had to change with it.”

The children rarely cry, even at painful moments, such as when the dressing on their wounds is changed.

“It is amazing how they can tolerate some of the pain,” said staff nurse Ramos, who is from San Antonio.

In her ward, a bearded father dressed in a gray thobe and red-and-white-checkered headdress sat, legs folded, on a cot beside his son. He proudly pointed to the boy, then to his heart, and clasped his hands.

The 12-year-old had been sprayed with shrapnel, his legs and chest taking the brunt.

“I get very attached to them,” Ramos said of the children.

Stitches crisscross the shaved side of a 16-year-old girl’s head. She underwent brain surgery after she was hit in the head by a grenade during what her father described as fighting between the Republican Guard and rebels in the family’s town of Nasiriyah.

“I feel good now, very good,” she said through an interpreter. “I am not afraid anymore.”

Smiling with her eyes, the girl seemed to be a favorite among nurses, who gave her underwear and helped arrange what was left of her brown curls.

The girl’s father, a 39-year-old office worker, said he turned to seek American medical help because there was nothing else available.

“There is no hospital or clinic there,” he said of his battered hometown. “Everybody preferred to go American.”

Hospital officials remain “greatly confused” about the fate of the wounded civilians and where they should go once released from treatment, Kennedy said. Some are being placed in Saudi hospitals.

Saudi officials, the commander added, grappled with the question of whether they should be treating Iraqi civilians. After internal debate, they decided to accept the desperate patients--a contrast to the policy of neighboring Kuwait, which has blocked the entry of Iraqi refugees.

Doctors and nurses said the families and POWs alike are grateful for the treatment they received. The patients clearly were receiving attentive medical care. But at least one man--the father of the 16-year-old girl--complained that he felt overly restricted by the armed guards.

“We feel like prisoners,” the man said. “The guards follow me. . . . Everybody wants to go home . . . to the desert of Iraq.”

Lt. Col. Hal Schade, executive officer of the 114th Evacuation Hospital, said security was necessary for the protection of staff members and patients, especially the POWs. Everyone entering the hospital for treatment is searched, he said, and military police are permanently on duty.

A mother who apparently did not understand that her daughter was being operated on, or why, followed the girl into the operating room Wednesday, wailing and crying, her small son in tow.

As a sergeant tried to usher the woman out of the operating room, the young boy began hitting the man for touching his mother, something that is not allowed in many Muslim nations.

Finally, Mihalek, the chief operating room nurse, intervened and tried to console the woman. “I drew her close and hugged her,” Mihalek said in recounting the incident.

She guided the woman back to her daughter’s bedside and motioned for her to ready the bed for her daughter’s return. That seemed to calm the distraught mother, Mihalek said.

“You have to understand what they’ve gone through even before they ever get here,” she said.