Page 129 - Journal of Special Operations Medicine - Fall 2015

Table 2 Key Personnel and Agencies for Precoordination
USG Entities HN GOV Entities Site Entities Others
Country team Ministry of Health Hotel manager Vendors
CMSE Ministry of the Environment Facility owner/manager Foreign companies/interests
Embassy Health Unit Ministry of the Interior Training officer Airlines
Unit/mission commander Ministry of Public Works Maintenance crew DHL/FEDEX or other
international shippers
RSO Tourism agencies Procurement manager
Country customs departments
Notes: CMSE, civil-military support elements; RSO; USG, US government.

from the embassy or consulate. If the embassy has a of environmental, industrial, infectious disease, and
Special Operations Forces Liaison Element (SOFLE) or zoonotic threats for a location. These provide a great
Civil Military Support Element (CMSE), this is a helpful initial starting point to identify follow-on assessment
individual who can assist in facilitating an assessment, requirements. The Defense Occupational & Environ-
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in addition to providing feedback on an assessment or mental Health Readiness System (DOEHRS) repository
engagement strategy. They may also be able to help (NIPR), Military Exposure Surveillance Library (MESL)
with site coordination, introduction of key personnel, (NIPR), and PHC MESL Query (SIPR) provide informa-
and information about logistical details pertinent to the tion on any environmental sampling that has occurred. 11
current mission. The embassy health unit can provide
the on-the-ground truth about medical issues, includ- Medical intelligence and information should be re-
ing actual costs, country-unique requirements; sources viewed via National Center for Medical Intelligence
of morbidity among the embassy population and work- (NCMI) on both nonsecure and secure media. Various
ers, and key points of contact in the medical community other sources include Joint Lessons Learned System—
in which they live. They can also help with setting up SOF and Special Operations Debriefing and Retrieval
medical facility assessments. System, which provide on-the-ground information from
various unit after-action reports. While not medical,
A thorough database, document, and literature review many identify information gaps that need to be filled.
should be part of premission activities. Develop a list of The Assault Zone Availability Report database helps to
key sites to visit to gain the most relevant information identify usable airfields. A summary of these websites
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on what has been done already, and develop situational (on the NIPR) is provided in Table 3.
awareness of the location of operations. An Internet re-
view can provide information such as medical threat, Civilian data queries can be helpful as well. Airlines con-
traveler’s health recommendations, and travel advisory. tract out a hotel for their crews and conduct sanitation
Expatriate blog sites can provide some atmospherics and force protection surveys of these hotels. Don’t be
from seasoned individuals who reside in the area. As with afraid to contact the airline and see if they will provide
any Internet source, the reliability of the source is helpful it. Major industrial operation in the area may be will-
to weigh validity of information. SOCOM conducts the ing to share any environmental reports that have been
Integrated Survey Program, which provides support to completed. A summary of common websites is provided
Joint Chiefs of Staff contingency planning in conducting in Table 4.
surveys on facilities where US interests may be at risk.
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These surveys contain valuable information about the Nonsampling equipment essentials for traveling in Af-
embassy and key points of contact. The Embassy Emer- rica include official and tourist passports; an unlocked
gency Action Plan (EAP) is an important document to phone with camera option; a minimum of 40 USD and
review. The EAP is a post-specific living document that 40 EUR emergency money; a global positioning system
provides procedures for response to foreseeable contin- for plotting sample grids; travel-friendly laptop com-
gencies at a particular post and includes facility informa- puter; travel power adapters or power transformers; a
tion and points of contact for major medical facilities in notebook with pens, mechanical pencils, and markers;
the city where the embassy is located. 9 contact information for the SOFLE and US forces de-
ployed to the area; and a sufficient amount of clothing.
DoD documents reviewed should include a Public Health
Command (PHC) Deployed Environmental Surveillance All required equipment to conduct the mission will gen-
Program Environmental Health Risk Assessment Phase erally fit in a 1600-series Pelican case. In that case, essen-
I assessment. Phase I assessments are broad overviews tial equipment includes HACH coliform paddle testers

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