Page 135 - Journal of Special Operations Medicine - Summer 2015

graphic depiction of the level of effort that would be for the force provider SGK as well. But, in the end, the
expected over time from the partner nation and US program was a colossal success in measures of efficiency
forces as they progress through the phases (Figure 2). and effectiveness. Described next is the phasing and
Additionally, the report details 13 metric categories that critical metrics used along the way to go from near zero
might be used during the phases to help leadership as- capacity to lives saved in a matter of 9 months.
sess the progress and/or guide them in preemptive steps
to keep the program on track (Figure 3).
Program Description
This program was originally broken into four phases.
The Mission
An additional phase was added at the request of Niger
The mission tasked to SGK: Develop a patient trans- leadership and JSOTF Commander for the purpose of
port capability in the country of Niger based on the validating skills in advance of Flintlock 2014. The final
Cessna 208 platform with the near-term objective of program design was broken into five phases:
the partner nation being able to provide a minimum
of six CASEVAC teams to provide coverage and sup- Phase 1: Operational Level Advocacy Phase and
port during Flintlock 2013 and the long-term objective Basic Skills Course
that the capacity aids the country of Niger to expand Phase 2: Casualty Evacuation Principles Course
health services to underserved populations and the ul- Phase 3: Proficiency Training (focus on train the
timate goal to save lives. The mission was funded by trainer)
$100,000 of SOCAF security cooperation, $90,000 of
JCET, and $22,000 of Flintlock funds to go through all Phase 4: Validation Drills (with expeditionary
the phases. Unfortunately, the mission requirement was employment)
for the entire program to be completed in 9 months. The Phase 5: Programmed Participation (integrated
short time frame is against the concepts and principles operation)
outlined in the RAND report and was a huge challenge
This differs from the RAND report in that it reflects
an additional phase. These phases were designed to
Figure 2 Framework for a hypothetical BPC-H training
program. Adapted with permission. incorporate a crawl-walk-run construct with some
degree of validation of the skills transfer. Each phase
was executed based on goals that led to skills develop-
ment, increasing sustainability and expanding degrees
of ownership of the capacity by the partner nation. SO-
CAF and AFSOC/SGK processes required that training
teams provide pre- and post-mission briefs and submit
concept of operations and complete after action reports
for each mission. Greater information on the plans and
methods of instruction during the phases can be found
in AFSOC/SGK reports. The phasing of BPC-H missions
is critical and serves to dramatically increase the suc-
cess of the training program and long-term sustainabil-
ity of the new capacity. The naming convention of the

Figure 3 Generic metrics for the four phases of a BPC-H effort. Reprinted with permission.
III. Conduct Full-Scale IV. Draw Down,
I. Consult, Plan, Prepare II. Launch Activities Implementation Transition, Withdraw
Metric 1: Level of need Metric 5: Adequacy of Metric 9: Effectiveness and Metric 12: Readiness for
for effort contact points and regular efficiency of processes hand-over
consultations
Metric 2: Level of broad Metric 6: Level of success Metric 10: Results of immediate Metric 13: Level of benefit
endorsement from superiors in recruiting trainees and outputs and intermediate outcomes to the partner nation and
and important audiences conducting training over time the United States
Metric 3: Development of Metric 7: Level of partner Metric 11: Impact on US military
hedging options performance training and access
Metric 4: Level of resource Metric 8: Readiness to
adequacy to execute effort scale up

MEDCANGRO Relative to RAND Conceptual Framework 125