This article originally appeared on VICE US
"Yogurt, parmesan, orange juice, and oatmeal," said Fay Johnson, a medical instructor, listing her favorite ingredients for simulated vomit as she mixed them together in a bucket. "We'll put a little fake blood in there to make it pink."
Johnson was preparing her smelly concoction for the final day of medical drills during the most recent "Reporters Instructed in Saving Colleagues (RISC)" training course in Turin, Italy, during the last week in July.
Conflict zones are dangerous for all journalists, but freelancers are especially at risk. Most don't have the money to take expensive hostile environment and medical training courses, and freelancers often work without comprehensive insurance, which journalists under contract with media organizations are normally provided before going to the front lines.
RISC training provides freelance journalists and photographers with a four-day crash course in battlefield medical response. The course teaches participants how to treat everything from bee stings to blast injuries, and almost 300 freelancers have taken the course in New York, London, Nairobi, Kiev, and Kosovo since it began in 2012.
RISC was founded by Sebastian Junger, a journalist and author, after the death of his colleague, photographer Tim Hetherington.
Hetherington was mortally wounded in a mortar attack in Misurata, Libya while photographing the country's uprising against Gaddafi in 2011. At a memorial for the photographer in London, Junger discovered that the wound that killed him might not have been fatal if those at the scene had medical training. In an interview with Outside magazine in 2012, Junger said that after hearing this he decided to start a medical training program "for freelancers, only freelancers" since "they're the ones who are doing most of the combat reporting. They're taking most of the risks... And they're the most underserved and under-resourced of everyone in the entire news business."
He added that while insurers insist that big corporate news organizations send their field reporters to hazardous environment courses, the fees are often too expensive to send freelancers. "I just thought we should change that and make it free, and we managed to do it."
During the training in Turin, participants listened to lectures and studied essential life-saving techniques—how to administer CPR or apply a tourniquet. They ran through drills simulating medical emergencies and learned how to provide first aid while ensuring their own safety. Trainees were taught to approach anyone needing medical aid with caution by identifying the mechanism of injury to determine if it was safe to begin treating the patient. Drills focused on different strategies for communicating with patients and evaluating their injuries. The trainees took turns role-playing as the patient and their colleagues had to diagnose and treat them appropriately based on which symptoms they appeared to have.
On the last day, the students put all they learned to the test during a mass casualty drill. The sound of gunfire and explosions blasted from a set of speakers as the instructors set off smoke bombs and firecrackers to simulate the stressful conditions of a combat zone.
"He's bleeding out! Stop the bleeding!" Sawyer Alberi, the lead instructor, yelled as she poured a jug of fake blood over a medical training dummy to simulate a sudden hemorrhage. A couple of journalists hunched over the dummy frantically applied tourniquets while the sticky red liquid pooled around their feet. After the dummies were moved to safety, an instructor dressed in a burqa ran out, screaming in grief and pushing up against the journalists who were still working to stabilize their patients. By the end of the drill, the journalists were breathing hard, covered in dirt and simulated bodily fluids.
VICE talked with some of the participants to see what the RISC course was like for them.
Sawyer Alberi, RISC Head Instructor
My mother was a nurse years ago, and I drifted in and out of EMT work for a while once I left the Coast Guard. I joined Wilderness Medical Associates (WMA) in 2002 and started doing backcountry and remote medicine for them. Since then, I've expanded my medical knowledge working with the military. I was a flight medic in Iraq in 2006, and a combat medic again in 2010 in Afghanistan. I just retired from the military in November, 2014.
When I was in Afghanistan in 2010, we noticed there were a lot of contractors in war zones and conflict areas who didn't come over with any medical knowledge, had no first aid equipment, and no training. It stayed with me as something that was problematic. In 2011, when Tim Hetherington got killed, Sebastian Junger contacted WMA to look for a course for journalists. When I heard about it, I knew we had to get it done.
We just completed our 12th RISC course—that's 288 journalists taught, over seven continents. So it's really been an extraordinary four years. Working with journalists has given me a totally different perspective on a lot of world events. I live on a farm in Vermont, so I live vicariously through all of the journalists who are my Facebook friends now, doing these extraordinary things across the world. I truly believe anyone who is in conflict deserves the right to save themselves and the people around them.
What we try to do [with RISC] is give a foundation of first aid on the first couple of days, and then we really try to press every button and distraction that we possibly can [that could happen to journalists while in a combat zone]. That includes using a lot of blood because it's very visual, it's very slippery, and it's difficult to work with. We go through gallons and gallons of fake blood on that last day. Anyone who leaves these courses needs to have the confidence that they can do what we teach them to do under extraordinary stress.
These journalist have been gassed, they've been shot at. I've been counting and I think there's 22 percent rate of kidnapped people in the course. You don't get that in the average outdoor education class, it adds a different element to it. It also inspires me to do the best work that I possibly can for these journalists because they are putting their lives on the line for this.
Federico Rios, Photographer from Colombia
I'm based in Colombia and I'm covering conflict and daily life in Latin America, freelancing for the New York Times and other magazines and newspapers. This year [the training] was far away from my home, and I had to take one plane from Colombia to Panama, another from Panama to Amsterdam, a the third one from Amsterdam to Turin. But I think the training is worth all the money you need to invest because it's about saving your life.
In my work, I have seen shootings in Colombia, riots in Venezuela, shootings in El Salvador, and the violence in Mexico. In Colombia, for example, you have landmines, crossfire, battles between the guerilla fighters and the Colombian army. Every time you're thinking, I'm going to be shot, or, I'm going to step on a landmine. I really think RISC training can save my life right now. I feel lucky that I haven't been harmed before, and I hope not to be in the future, but in these places that I'm working there's a high chance to be injured. If that happens I would like to use all the knowledge I got during RISC training.
The exercises and the training are very well planned. Maybe from the outside this can be tricky or complicated to understand but once you're there with your partner you are completely focused on what you're doing and you try to push yourself harder because you know that eventually you're going to need to use this knowledge to save a colleague. The last exercise was kind of shocking because there's smoke, simulated war noise, and people running around and screaming—plus all the fake blood. But that's good because it puts you into a real situation.
Andrew Esiebo, Photographer from Nigeria
I'm based in Nigeria and I consider myself a visual storyteller. I've been working in the North East Nigeria and bordering countries like Chad and Cameroon for different publications like the New York Times, Time Out Nigeria, CNN, and others. I've been focusing on refugees and internally displaced people from the ongoing insurgency with the terrorist group Boko Haram.
Those are hostile regions, so it was a good opportunity for me to come to the RISC training and have an understanding of how I can take more careful measures and rescue myself or other people from a dangerous attack.
I remember working in the northeast of Chad in the middle of nowhere, and I was just asking myself, If there's an attack, how can I rescue myself? What can I do? I considered myself helpless, so those experiences made me want to take the course.
And the training isn't just for hostile regions; it could be for daily life. The other day, I was in the metro in Paris and a guy who I think had a nervous problem [needed some help]. In the past, I would have not done anything, but because of the RISC training, I walked up to the guy and tried to make him sit in a good position that would help him calm down and breath well. This happened in the middle of the city, there were people all around, but no one knew what to do. I applied the experience from the program and the guy was fine. Without the kind of knowledge I gained through RISC, I wouldn't have been confident to help the guy. I hope such an initiative can be extended to other parts of the world. It offers very valuable skills for reporters all around the world whether working in conflict regions or not.
RISC was the first time I became aware of how you can deal with all sorts of problems. The training was quite rigorous, it was intense—waking up every day to the drills and simulations, all within that atmosphere of war tension. You're imagining yourself in that situation and you feel like you're in that space of war.
Gabriele Micalizzi, Photographer from Italy
I've been covering Libya since 2011, and was recently there for more than two months on assignment for Le Monde. I was covering the conflict between ISIS and the Misurata force [Libyans aligned with the government], and the fighting is not very organized, so it's very dangerous being there. You can follow the troops, but there are too many snipers. Also, they use landmines, so you can't follow the frontline. It's very risky. But I did four or five different advances with them, and during every advance there was always more than 200 to 400 injuries and 27 to 50 killed.
I applied to RISC because two years ago I lost a friend in Sloviansk, Ukraine who was part of my collective, Cesura [a photography cooperative based in Italy]. He got injured in an attack by shrapnel and died because of severe bleeding. I was there to bring the body back from Kiev to the family in Italy. It happened many times where people around me were injured and I didn't know what to do. Ten days ago, a mortar hit my car and injured my fixer. It happens often when you're working in war zones.
Before, I was a tattoo artist and knew some first aid but I never did something like RISC. So I'm very happy, especially because I just came back from the front lines. This course was amazing. They give you everything, including all the information, but it's very practical and it's very practice-based. That was the best part: You can study, but you need to practice to be ready and prepared for when something real happens.
See more photos from the RISC training course below.
Photographers Andrew Esiebo, from Nigeria, and Federico Rios, from Colombia, carry a medical dummy using an improvised harness made from a single loop of nylon webbing.