In the highlands of Peru, sheep are shorn. Their fleece is milled, spun into yarn and exported to a Seattle distributor, which ships the yarn across the continent to a knitting shop on North Fayette Street in Alexandria, where it is purchased in 220-yard skeins by a Navy captain’s wife and her fellow knitters of Northern Virginia, who box the skeins into care packages and mail them 10 time zones away to a NATO hospital in Kandahar, Afghanistan.

Attn: Combat Knitters.

The Combat Knitters tote their yarn and needles in nondescript pouches, sneaking a few stitches here and there, under their desks, between shifts, after saving or losing a patient, waiting for a rocket attack to end, watching F-16s taking off from the airfield. Wrists piston and needles click as the knitters watch a Friday-night movie projected on a barracks wall under the black sky of southern Afghanistan.

The bazaar on base doesn’t sell yarn, so the Combat Knitters rely on the relay of middlemen between them and the sheep in Peru.

The Combat Knitters are women in their early 20s and mid-50s. They are Navy corpsmen, nurses and physicians. Some wear Combat Knitters patches on their uniforms: two knitting needles crossed like swords over an outline of Afghanistan colored in red, black and green. Some guard the base’s high-security wing for injured Taliban fighters while clad in Kevlar, with an M16 and a ball of yarn in their laps.

Moments of respite

Late last summer during pre-deployment training at Fort Dix, N.J., Capt. Michael McCarten noticed a physician knitting a green shawl during brief moments of respite — at the rifle range, and between grenade-throwing practice and vehicle egress training. This was Jennifer Almy, a 40-year-old lieutenant commander based at Camp Pendleton, Calif. She’d taken up knitting three years earlier to strengthen her left wrist after surgery.

“Do you belong to Ravelry?” McCarten asked Almy, referring to the online social networking site for knitters. She did, so he connected her to his wife, Kathleen Marra, a hairdresser who is part of the Ravelry group Knitting in Alexandria. The two women corresponded through the site. Female service members were asking Almy for knitting lessons, so Marra and the Alexandria knitters “adopted” Almy and her proteges, became de facto patrons and began to send wool bought at a discount from Fibre Space, a knitting shop in Old Town.

War is monochromatic. After wearing and staring at khaki all day, it was transporting to open a box and see a skein of pink or a ball of tangerine.

Almy marshaled her troops. They became the Combat Knitters: Yarn ladies at Kandahar Airfield’s NATO Role 3 Multinational Medical Unit, a 70,000-square-foot trauma center operated in concert with Canada and the Netherlands.

“It was something to keep me occupied during a deployment,” Almy says. “Some people bring a library worth of books. Some people learn a language. I brought my knitting.”

She taught at 2 a.m. if there was a lull in patient care, or on her days off on picnic tables outside the barracks. She always carried her stethoscope and her knitting pouch, which keeps out the ever-present dust. She gave one-on-one lessons because everyone was too busy to meet as a group, but for six months teacher and students worked on a joint project on their own time in their own space. They created dozens of 81 / 2-by-81 / 2-inch red, white or blue squares, and they kept in touch with their Alexandria counterparts via Ravelry’s discussion boards.

A September post on the board: The base’s director of nursing services “learned about lifelines today which I think is very important for a knitter especially a medical combat knitter. We need to save as many stitches as we can.”

A January post: “A combat war zone is no excuse not to gauge. By using gauge a combat knitter learns to be efficient with her projects.”

It’s the most domestic of activities in the direst of circumstances. Rocket attacks have killed two people on the base since Christmas. Seventy percent of patients roll in directly from the battlefield. Many trauma cases are Afghan children. The combat knitters and their brethren are the miracle workers who amputate limbs and put people’s heads back together.

“It’s a grind,” McCarten writes in an e-mail from Kandahar. “We keep a close eye on the staff for negative impact so I can say with confidence that they are resilient, even in the toughest of times, but it takes a toll on all of us to be exposed to significant trauma on a daily basis. . . . We all have — and need — our escape because there will always be the trauma.”

At NATO Role 3, troops escape by running together or by gathering in the evenings for a “cigar circle” or by knitting, square by square, an American flag afghan. An afghan in Afghanistan.

“I think it focuses you,” Almy says. “You have to concentrate on the pattern. It doesn’t leave room to dwell on other things.”

Loop by loop

Troops joke that life on the base is like the movie “Groundhog Day.” Enduring 18-hour workdays, grappling with an endless parade of patients, traveling the half-mile of unchanging terrain on the base’s main thoroughfare — every day is like yesterday, which is like tomorrow.

Which makes knitting crucial. Knitting shows progress. It proves that time moves forward, loop by loop. It demonstrates that a mission, however miniature, can be completed.

The Combat Knitters gradually submitted their red, white and blue squares to Almy, who spent January and February blocking them together. Stitching varied in tension and style and size, depending on the knitter, so unifying the afghan flag was a challenge.

Those who look closely will see that the blue squares have star patterns. Each red or white square is stitched with the outline of a U.S. state or the insignia of a military branch. Almy and the Combat Knitters presented the afghan to McCarten in February during a barbecue a week before they flew home.

The afghan will be mounted in a hospital hallway, alongside memorabilia left by other NATO forces. It will honor the fallen in the name of the Combat Knitters, McCarten says. It will be a token of globalism and voluntarism, at home and abroad. It will also be a patchwork of pain, and an allegory.

With Almy and others back in the States, the few remaining knitters will meet on Sunday nights and welcome new recruits under the stewardship of Capt. Maureen Pennington, the base’s director of nursing and Almy’s first student.

Almy, who arrived back in California 10 days ago, recalls knitting in a troop mate’s room while watching “The Hurt Locker,” an Iraq war movie about the addictive qualities of combat adrenaline in the deprivational arena of war. In her favorite scene, the main character returns home and is dumbstruck by a grocery aisle lined with shelf after shelf of refrigerated plenty.

“I think that was me in the yarn store when I got back — overwhelmed by all the different colors and choices,” Almy says.

Her local yarn shop in San Marcos welcomed her home with balloons and a giant Diet Coke. At the yarn shop, she’s back to being the student.

She landed Wednesday in Colorado to see family. She’s due for orders by the summer, and will likely be deployed to another overseas post, perhaps a forward operating base in Afghanistan, maybe Kandahar again.

She’s currently knitting a pink wool-blend sweater for her niece.