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“It’s important as a nation that we fall silent in remembrance of those who have made the ultimate sacrifice whilst serving their country”, says Dr Ami Jones, a Lead Consultant who works on board the Wales Air Ambulance vehicles.
In addition to her civilian roles, Dr Jones is a Lieutenant Colonel in the Royal Army Medical Corps (Reserves). She has completed two tours in Afghanistan and is still operational.
She said: “It’s been one of the biggest privileges of my life to serve alongside some of the most incredible individuals, who put their lives on the line to ensure the safety of others.
“I owe a lot to all those who I have encountered through my military work. Some are not with us today, and some who came home were never the same again, but they are always in our thoughts, especially at this time of year.”
Ami is a consultant in Anaesthetics, Intensive Care Medicine and Pre-Hospital Emergency Medicine in South Wales, working for the Aneurin Bevan University Health Board.
But back in 2008, she was working in the Intensive Care Unit at Morriston Hospital in Swansea, when she encountered several reservists who had just returned from Afghanistan.
She said: “I was listening to their stories and talking to them about what was happening out there. They said if you are interested, why don’t you join our field hospital?
“Their unit featured in a TV documentary. I watched it and thought that was something I wanted to do. I wanted to use my skills to help those on the frontline.”
Ami was about three years away from becoming a consultant when she decided to join the Army Reserves in Crickhowell.
She said: “As I wasn’t a regular army officer, but a reservist, I was still carrying out my training to be a specialist consultant, alongside the additional training required to deploy as a frontline medic.
“I did my basic training, which consisted of a couple of weeks in York and then a few at Sandhurst. Then I was passed out and good to go.
Ami was told she would be going to work at Camp Bastion in Afghanistan, where there was a huge hospital that included five-theatre tables. A lot of training was required, so she had to make a big decision.
Most people would come out of their civilian job and work solely for the army. However, as Ami was already in the middle of her anaesthetic training, she decided to continue in her civilian job and fit in the extra courses needed for deployment.
She said: “At this point, one of my military bosses approached me and said that they had an opening on the military’s Medical Emergency Response Team (MERT).
“It’s basically the helicopter that flies to the front line to pick the soldiers up, and it has a doctor, a nurse and two paramedics on it.
“Of course, it sounded interesting and daunting in equal measures and would involve much more training for me before I deployed. I had a lot of additional courses to do, but I was in my late twenties, with all my specialist exams complete and at that point I had no children, so I was up for the challenge.”
Ami had never flown in a helicopter before, so the first thing she wanted to do was get some orientation training, to make sure she didn’t suffer from air sickness.
She said: “Much of my training happened in a simulated helicopter, an airframe that looks like a helicopter from the inside. They played the helicopter noise, and we wore our heavy body armour and fake casualties were sent in for us to deal with. There were actors with high-fidelity injuries as we started to get exposed to what we were going to see and to make sure we had the clinical aspect to our training nailed down.”
Nevertheless, Ami wanted to experience a real helicopter and enlisted the help of a friend to achieve this.
She said: “Fortunately, one of my friends was a search and rescue paramedic, and I got to work alongside his team for a few days. This, thankfully, reassured me that I didn’t suffer from airsickness.”
In January 2011, Ami started her first deployment. She said: “The training is great, but nothing can prepare you for the job until you experience it.
“We had to wear heavy body armour because we were flying to the frontline. So, we had heavy plates all around us and an emergency radio on our backs.
“I was lucky it was a Winter tour, so it was cold at night but not super-hot in the day.
“Sometimes we were taking incoming fire or landing in the middle of a firefight. Friends and family would say, ‘do you not think this is a dangerous job?’
“To be honest, I didn’t think about it too much. All I cared about was getting to where we were needed.”
Ami describes the experience as both ‘horrendous’ and ‘amazing’. She said: “I know that might sound strange to many, but I have never experienced anything like it.
“It’s the most amazingly privileged job; you are in the thick of it, trying to get to soldiers or civilians in need of our help. The aim was always to ensure the best outcome for those who were injured.
“Improvised Explosive Devices, or IEDs, were very common and not only our soldiers, but also many civilians were suffering horrendous injuries as a result of standing on them.”
Unknown to Ami at the time, this tour would play an instrumental part in shaping her future career. Within a few months, she was back in the UK but found it difficult to settle into civilian life.
The courses she had studied to be frontline had an expiry date, so she wanted to get another tour under her belt.
Ami said: “I only needed to do a few additional courses to be allowed to go out again, so it made sense to ask for another deployment.
“They had slots available, so I opted for a stint during the summer months this time, which wasn’t the best idea, as it was so hot.”
Her first tour counted towards her consultant training, as on her days off, she would work with the anaesthetics team in the hospital. However, for the second tour, she had to apply for three months out of her consultant training programme.
Ami said: “No one could understand why I wanted to go again, but I felt that this was the best trauma hospital in the whole world.
“That was the Summer of 2012, and I was finishing my training in the early spring of 2013. So, I only had six months to go before being signed off as a consultant.
“I had another good tour, but this time it was very different. I was based at Camp Bastion again, and by this point, we were thankfully seeing fewer IED injuries but more gunshot wounds. It was a very busy time.”
Ami completed her tour and returned to the UK, where she completed her specialist training and got her first consultant job. However, in the back of her mind, she was still thinking about all the specialist training she had had and how it could be put to good use.
She reached out to a few of her friends who were working for the doctor-led Hospital Emergency Medicine Air Ambulance in Bristol, as Wales didn’t have doctors on their aircraft at this time.
She said: “I went to meet the team and introduced myself and asked if I could start flying with them. Back then, all the consultants onboard were volunteers. I did about 3 or 4 shifts a month in my own time.”
Ami continued: “Back then Pre-Hospital Medicine training was just starting up. So, they really relied on people like us giving up our free time to do it, which we were happy to do.”
She was working alongside a then emergency medicine consultant called Dr Dinendra ‘Dindi’ Gill, who would go on to be an instrumental figure in the development of the consultant-led Wales Air Ambulance service that exists today.
Ami said: “We could see the benefits of what was happening in Bristol and wanted the same for our own population in Wales.
“So, Dindi asked me if I was going to help him set it up. Both he and another military colleague, Dr Rhys Thomas, concentrated on writing the business case for Welsh Government.
“As soon as the funding was secured, I was brought in to help with recruitment and training. So, I was part of a core team of five or six who were heavily involved at the very beginning.”
Since 2001, Wales Air Ambulance has carried out 55,000+ missions, saving thousands of lives across Wales. In 2015, the first flight carrying on board clinicians took off from the Dafen base as part of the newly formed Emergency Medical Retrieval and Transfer Service – becoming the Wales Air Ambulance Charity’s medical partners. The pan-Wales service now has four helicopters and several RRVs, and is operational after dark from Cardiff Heliport.
The evolution of Wales Air Ambulance into a service delivering advanced critical care owes much to the Armed Forces and the pioneering medical care developed and delivered on the front line. Many veterans and current military personnel are employed within the service.
Ami continues to work three to four days a month for Wales Air Ambulance. Her outstanding contributions to military and civilian pre-hospital critical care were recognised with an MBE in 2017. In March this year, she was appointed the Accreditation Lead for the Faculty of Pre-Hospital Care.
Ami says, ‘working alongside her medical colleagues in Afghanistan changed everything’. She said: “Imagine if someone hadn’t dropped out and created the MERT slot I took up on my first tour.
“I would have probably just gone to the hospital and worked there. I would have never set foot on a helicopter. It is highly likely I would not have done pre-hospital care, because you couldn’t train in it back then.
“I am so grateful to all those brave individuals I encountered in Afghanistan, and for the incredible dedication of all those who I had the privilege to work alongside.
“The medical lessons we learned in the military about pushing critical care as far forward as possible have helped transform prehospital medicine in the UK. The military was the first to carry blood products outside of a hospital setting, which is now standard at Wales Air Ambulance.
“We now have a really defined prehospital medicine pathway in the UK, which is generating a steady stream of pre-hospital consultants. It helps thousands of patients each year to have better outcomes as they are receiving hospital-level lifesaving interventions at the roadside or in their own home, or wherever they have become critically ill or injured.”
Dr Ami Jones is an Honorary Senior Lecturer at Bangor University, an Honorary Lecturer at Cardiff University Medical School, and an examiner for both the Diploma and Fellowship in Immediate Medical Care and the Diploma in Retrieval Transfer Medicine with the Royal College of Surgeons of Edinburgh.
