On the perimeter of Birmingham airport away from the holiday makers, businessmen and other travellers are a group of non-descript redbrick, industrial buildings normally used for cargo.
There, on most days in the last month, ambulances have been queuing – waiting for the gates to open.
As the country focuses on the planes landing at RAF Lyneham with the coffins of the fallen, it is a very different scene in Birmingham. There, soldiers who have lost limbs, been blinded or terribly burned are welcomed home – men and women who have also given up their lives for their country – at least the lives they had once known. They are the "invisible" victims of the Helmand conflict, young men or women with injuries so heart-rending that one officer privately described them as "politically explosive". This month alone it is believed that one platoon of 30 Welsh Guards suffered 19 injuries while another company of 100 men reported 40 casualties.
"I have always said that you hear, very sadly, about those who lose their lives but you are not hearing about the three or four other people who have suffered life changing injuries. I have always found that surprising," said Sergeant Major Andrew Stockton, who lost his arm after being ambushed in Helmand in 2006.
While those who are not as badly wounded are brought into RAF Brize Norton in Oxfordshire, the most terribly injured are transported to the airport closest to Selly Oak NHS Hospital in Birmingham. Outside the gates the ambulances wait for the plane to taxi to a stand before collecting their wounded. In the worst cases a helicopter is on standby. Few doubt the incredible efforts made to save the lives of the wounded. Equally, few actually hear of their existence.
"We never know how many they are bringing in," one airport worker said. "There would normally be one flight a week but you could tell there has been a push on recently because they were landing every day. They used to be discreet, only come in the dark, in the early hours of the morning but now they come at all times."
The ambulances pass swiftly into the centre of England's second largest city to the hospital, which last week conceded that it was having to reassess beds every 48 hours because of a surge in casualties. In June it took in 69 new military patients of which 30 were battle casualties. Some are in a military ward, others in critical care or the burns unit, those with brain injuries, are separated off at Edgbaston's Queen Elizabeth NHS hospital.
Unlike the dedicated American facilities, there is no official sign that in the heart of this civilian hospital is The Royal Centre of Defence Medicine, a ward full of young men, missing limbs, parts of their heads or paralysed. Their lack of self-pity is striking. They only talk of returning to their units while beside them parents bustle around, masking their own grief with encouraging words.
Frances Shine, whose 25-year-old son Stephen lost a leg in Iraq, said: "I couldn't believe what I was seeing. I was shocked. I just did not realise these kids were coming back with these kinds of injuries. There were amputees, blinded, burned. You name it they had it."
Last week Lieutenant Commander Debra Emmerson, a ward manager at Selly Oak Hospital, said: "There is a definite and noticeable change here due to the operations currently ongoing in Afghanistan. We have the surge capability and we have been planning for this peak in casualties for some time. At the moment we are planning 48 hours ahead in terms of staff and beds."
In 2006, the Ministry of Defence (MoD) was embroiled in a public furore after banning ITV from frontline visits following a programme on injured soldiers. Since then the MoD has only allowed highly-managed interviews with soldiers who have battled with stunning resilience.
Major General Mike Von Bertele, Commander of Joint Medical Command, said: "The military and NHS clinicians at Selly Oak Hospital have a duty of care to our injured personnel and their families who have a right to privacy and medical confidentiality. It would be entirely inappropriate if we compromised our responsibilities by exposing them to the media before they are well enough to handle such contact.
"Once our patients are sufficiently recovered we have frequently enabled all branches of the media to contact them."
Any frontline journalist witnesses the casualty toll. One reported in July that the Light Dragoons battle group of 700 had suffered 55 casualties in three days of fighting. Soldiers on the ground talk of an average 15 to 20 per cent casualty rate at the moment.
"The news bulletins say a soldier has been killed in Afghanistan. But you don't hear that another has been crippled, lost a limb or is in a critical condition," said Mrs Shine. Some senior officers argue that to do so would risk even further alienating a population whose support is waning for Afghanistan operations.
Colonel Richard Kemp, former commanding officer of the 1st Battalion, The Royal Anglian Regiment, which suffered nine deaths and 57 seriously wounded in the summer of 2007, disagreed: "If the Government is worried it would further undermine support, they should be putting their case more strongly. If their case is undermined by that sort of thing then it deserves to be." Colonel Kemp is rallying for a British version of the American Purple Heart medal for the wounded.
Gilly Wiggins, whose 22-year-old son Simon had a leg blown off in Afghanistan, said: "The medal is the only way we are going to get any indication of the amount of injured service personnel that are coming out... My son didn't lose his leg, the others did not lose their legs, they gave them for their country, doing their job."Reuse content