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The first thing I saw last month when I walked into the belly of the dark grey C-17 Air Force cargo plane was a void — something missing. A missing left arm, to be exact, severed at the shoulder, temporarily patched and held together. Thick, pale flesh, flecked with bright red at the edges. It looked like meat sliced open. The face and what remained of the rest of the man were obscured by blankets, an American flag quilt, and a jumble of tubes and tape, wires, drip bags, and medical monitors.
That man and two other critically wounded soldiers — one with two stumps where legs had been, the other missing a leg below the thigh — were intubated, unconscious, and lying on stretchers hooked to the walls of the plane that had just landed at Ramstein Air Base in Germany. A tattoo on the soldier’s remaining arm read, “DEATH BEFORE DISHONOR.”
I asked a member of the Air Force medical team about the casualties they see like these. Many, as with this flight, were coming from Afghanistan, he told me. “A lot from the Horn of Africa,” he added. “You don’t really hear about that in the media.”
“Where in Africa?” I asked. He said he didn’t know exactly, but generally from the Horn, often with critical injuries. “A lot out of Djibouti,” he added, referring to Camp Lemonnier, the main U.S. military base in Africa, but from “elsewhere” in the region, too.
Since the “Black Hawk Down” deaths in Somalia almost 20 years ago, we’ve heard little, if anything, about American military casualties in Africa (other than a strange report last week about three special operations commandos killed, along with three women identified by U.S. military sources as “Moroccan prostitutes,” in a mysterious car accident in Mali). The growing number of patients arriving at Ramstein from Africa pulls back a curtain on a significant transformation in twenty-first-century U.S. military strategy.
These casualties are likely to be the vanguard of growing numbers of wounded troops coming from places far removed from Afghanistan or Iraq. They reflect the increased use of relatively small bases like Camp Lemonnier, which military planners see as a model for future U.S. bases “scattered,” as one academic explains, “across regions in which the United States has previously not maintained a military presence.”