NAJAF, Iraq -- In two days of combat, U.S. Army Spc. Steve Koetting dodged bullets, overcame sleep deprivation and endured the stress of fighting grave-to-grave in a cemetery against an enemy who rarely showed his face.
In the end, however, it was Iraq's oppressive heat that put the 21-year-old soldier on his back and out of the fight.
Koetting is one of about a half a dozen soldiers who have been evacuated from the frontline in the last several days due to heat exhaustion and other heat-related problems. Several dozen more have been treated on the battlefront in this city in south-central Iraq where U.S. troops and armed followers of the radical Shiite cleric Muqtada al-Sadr are squaring off.
With temperatures approaching 130, medics fear casualties will only grow. "This could become a significant problem," said Navy Corpsman Brian Humble, senior medical officer for the Marine's emergency facility at a military camp just outside Najaf.
In the run-up to last year's invasion, military strategists voiced concern about fighting during Iraq's unforgiving summer. By sending troops into Iraq in March and reaching Baghdad in a matter of weeks, the military avoided major combat in the hottest season. By August last year, military operations consisted mostly of patrols and raids.
Even so, several soldiers died from heat stroke and heat-related problems last year, according to military officials.
Now, with the unexpected resumption of battles in Najaf, the U.S. military is facing exactly what it wanted to avoid.
In addition to increasing casualties, rising temperatures are a serious morale-buster for troops, leading to shortened tempers, aggressive behavior and battlefield mistakes, soldiers say.
"It really de-motivates you," said Koetting, who suffered from cramps and lethargy before receiving treatment for dehydration Monday. "It's by far the hardest part of all this."
In more severe cases, victims can become disorientated, lose consciousness and die. Military officials take the issue so seriously, they've ordered officers to conduct random urine checks of soldiers to look for signs of dehydration, Humble said.
Before arriving in Iraq, the 11th Marine Expeditionary Unit's 1st Battalion, 4th Marine Regiment trained in the California desert, and every Marine was forced to sit through a presentation about the risks of dehydration.
But nothing prepared the Camp Pendleton-based Marines for the Iraqi summer. During battles, soldiers can sweat away two liters of water an hour, but the body can only absorb 1.2 liters in the same time, regardless of how much is consumed.
"So when you're out there fighting, you can never get enough water," said Capt. Sudip Bose, an Army emergency physician who has been treating heat-exhaustion victims in Najaf.
Body armor and equipment weighs up to 40 pounds and can raise a soldier's body temperature by five degrees. Steel M-16 rifles can heat up so much, they become literally too hot to handle.
In the densely packed cemetery where much of the fighting has occurred, the only place for soldiers to escape the sun is inside sweltering Humvees and tanks, or in some of the hundreds of large crypts and mausoleums, where photographs of the dead stare back at them.
"It's eerie," said Capt. Patrick McFall, standing inside a mint-green cement tomb. "This is someone's sanctuary."
In the summer sun, Bradley fighting vehicles can turn into virtual ovens, with temperatures surpassing 150 degrees. Most of the serious heat-exhaustion cases so far have involved soldiers who fought on foot and then climbed back inside tanks, Humble said.
Ice, brought in coolers with supply convoys, is a precious commodity on the front lines.
"We've got nine guys in my Bradley and only room in the cooler for five bottles," said Staff Sgt. Daniel Padgelt of the 1st Cavalry's 1st Battalion, 5th Cavalry Regiment, which has been fighting in the cemetery for the last three days.
The unlucky must settle for warm, and sometimes hot, water.
"On the bright side, it's easy to make coffee in the morning," said one red-faced soldier, sitting on the top of his Bradley and holding a large water bottle filled with coffee. "Want some?"
