Page 128 - Journal of Special Operations Medicine - Fall 2015

survey the local healthcare facilities to update the medi- assessment. Once previous assessments are identified,
cal common operating picture. review them for content and gaps, and use this informa-
tion to drive the agenda for the current assessment.
Preassessment Coordination
Coordination on the ground and prior to travel are es-
All assessments follow three phases: premission, dur- sential to mission success. People with experience in
ing, and postmission. While no mission is guaranteed the Central Command AOR operate under the impres-
to go according to plan, proper execution of premission sion that Africa is a permissive environment where one
coordination and activities can go a long way toward can just show up and move freely. Think about how it
facilitating successful completion. While the most effec- would be perceived if an individual tried to do a hospital
tive way to plan an assessment is to conduct activities in assessment at Johns Hopkins in Baltimore, Maryland,
sequence, many activities may have to be conducted in by just walking through the door and saying “I’m with
parallel because of time limitations such as lead times the US Government.” Our presence in Africa is by invi-
for clearance request and visas, requirement to obligate tation and our actions should reflect and respect that.
funds, or delivery times for key pieces of equipment via
the shipping or ordering process. Precoordination with key players internal to your orga-
nization is essential prior to your assessment. Resources
The very first action that should occur prior to any as- to conduct site surveys are limited, so the ability of medi-
sessment is verifying what previous assessments have cal personnel to execute multiple missions and meet mul-
been done and by whom. In any Combatant Command tiple requirements is critical. Unit logistics planners have
area of responsibility (AOR), there are at least four vested interests in food, lodging, water, waste manage-
other components in addition to the Theater Special ment and disposal, personnel movement, and contract-
Operations Command (TSOC) conducting missions. ing issues. Engineers will have many of the same site
There were numerous incidents in Africa where teams assessment concerns, including conducting an environ-
would show up at a healthcare facility or forward loca- mental baseline survey and compliance with the overseas
tion only to be told by the locals that a unit had been environmental baseline guidance document. Precoordi-
9
there the previous week (or day) asking the same ques- nation inside the unit is summarized in Table 1.
tions. While this can be embarrassing to say the least,
8
it also represents a waste of valuable resources that can While internal coordination is taking place, communica-
be applied elsewhere. Recognizing that another units’ tion with individuals in country needs to occur to make
assessment may be insufficient or does not meet the cur- sure the mission moves with as little friction as possible
rent mission needs, collecting available reports can help (Table 2). No one, outside of combat operations, moves
narrow the scope of information required on the current in or out of a country without both a visa and permission

Table 1 Internal Unit Precoordination
Section Requirement Notes
J1 APACS, eCC, visas, passports
J2 Country brief, maps, imagery, gaps, requirements Medical personnel are not allowed to collect, but
SSO can gather information as part of normal duties
GEOINT Section
J3 Key POCs, operational concerns, expected mission ISOPREP
J3 Air set for using unit SERE-B
J3 Personnel Personnel recovery issues PLBs and other special equipment
Recovery Security Theater-specific requirements
J4 Class I and water Verify EBS requirements
Engineers Waste management Shipping requirements and concerns
Personal hygiene
Contract development
RMO Available funding
Government CC activated with appropriate limits
Country Desk/ Engagement programs Determine any outstanding information
Engagement Theater security objectives requirements
Section Previous and ongoing missions Identify locations of interest
Historical lessons
Notes: CC, credit card; GEOINT, geospatial intelligence; ISOPREP, Isolated Personnel Report; POC, point of contact.

116 Journal of Special Operations Medicine Volume 15, Edition 3/Fall 2015