Gordon Brown hit back at claims that the Afghanistan mission was doomed to fail yesterday, as he launched a defence of a war he still insists is making Britain safer. While senior military doctors spoke of the huge challenges in treating exceptionally complex casualties wounded by improvised explosive devices, the Prime Minister acknowledged that the war had pushed alQaeda into Pakistan but insisted that the Afghanistan mission was more crucial than ever in ending the threat of terrorism from the region. The sustained pressure on al-Qaeda in Pakistan combined with military action on Afghanistan is having a suppressive effect on al-Qaedas ability to operate effectively in the region, he said. The threat comes mainly from the Pakistan side but if the insurgency succeeds in Afghanistan, al-Qaeda and other terrorist groups will once again be able to use it as a sanctuary to train, plan and launch attacks on Britain and the rest of the world. His speech bore the marks of hasty rewriting after the sudden resignation of Eric Joyce, who resigned from the Government the previously evening saying that Britons were unconvinced of the counter-terrorist rationale in the light of mounting losses. Mr Brown spoke of the resilience of spirit of British troops in Afghanistan and said that every time he heard of a casualty, he asked himself whether the fight was worth it. Each time, he concluded, it was. But those looking for details of a new strategy would have been disappointed. Mr Brown said that British troops would return home when the Afghan Army was strong enough to take its place in combat but offered no timetable for withdrawal. Instead he described the issue of troop numbers as the next stage of the exercise, adding: We have got to look in the next few weeks at the number of troops necessary for Afghanistan. Speaking as the bodies of two more servicemen were repatriated, Mr Brown said that there was nothing more heartbreaking in his job than writing to the families of the servicemen and women killed in action. Each time I have to ask myself if we are doing the right thing by being in Afghanistan, he said. Each time I have to ask myself if we can justify sending our young men and women to fight for this cause . . . and my answer has always been yes. The 50 servicemen killed and the 64 seriously injured in the past four months were not merely statistics. Mr Brown was evasive on last months Afghan election and the allegations of fraud on the side of the incumbent Hamid Karzai. He acknowledged the problem of highlevel corruption when he talked of the need for a cleaner government in Kabul, but quickly moved on to the greater relevance of local government in solving issues of security. Mr Browns speech is unlikely to satisfy critics who have questioned the sustainability of the current level of losses. The ever-increasing threat from improvised explosive devices, and their growing potency, has led to a proliferation of personnel suffering from multiple injuries that will require lifelong medical care. Surgeon Rear-Admiral Lionel Jarvis, Assistant Chief of Defence Staff (Health), said the explosions produced multiple fragments. Combined with the heat and blast impact, this caused a combination of severe injuries to the head, chest, abdomen and limbs not seen in previous conflicts. And 242 personnel had suffered traumatic brain injuries in Iraq and Afghanistan since 2003. Three years ago it was decided for the first time to recruit neurosurgeons into the Forces to cope with rising brain injuries, although it had taken time to train them. It was also disclosed that five personnel have been totally blinded, and many more have lost the sight of an eye or have had their eyesight impaired. The number who have suffered amputations is also rising, although the MoD has not updated the figures since it was disclosed some months ago that about 50 members of the Armed Forces had lost one, two, or in a few cases, three limbs. Lieutenant-General Louis Lillywhite, the Surgeon-General, said that deafness caused by explosions was also a problem but it was difficult to provide statistics because of the variations in the level of hearing loss. New efforts are being made to focus on the long-term care of the severely wounded, General Lillywhite said. The US military began a review into this issue two years ago. Britain was two years behind, he admitted, but was benefiting from the US research. The Surgeon-General said that although the complexity of the wounds was different from previous conflicts, the challenges were the same. Medical advances had also increased the chances of survival. There had been 44 cases of unexpected survival among the most seriously wounded between 2003 and July last year. The soldier killed in Afghanistan in the Babaji district of central Helmand on Thursday was named by the MoD yesterday as Private Gavin Elliott, 19, of the 2nd Battalion The Mercian Regiment. Private Elliott, from Worksop, North Derbyshire, died of gunshot wounds. Tributes were paid yesterday to Lance Corporal Richard Brandon, 24, of the Corps of Royal Electrical and Mechanical Engineers, who was killed south of Gereshk in Helmand province on Wednesday when his vehicle was hit by a roadside bomb. The US and Nato yesterday pledged a full inquiry into an air strike that killed up to 90 people in the northern Afghan province of Kunduz. The alliances war planes destroyed two of their own petrol tankers hijacked by the Taleban. David Miliband, the Foreign Secretary, said: Its important that we are very open and clear about what happened and make sure that it doesnt happen again. (The Times)