Page 67 - Journal of Special Operations Medicine - Fall 2015

this reason, US Army Africa ( USARAF) has moved away respectively. In 1996, the weakened military was un-
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from the traditional MEDCAP model and toward Medi- able to defend against an invasion of Rwandan forces
cal Readiness Training Exercises, or MEDRETEs. These and militant dissidents, which led to the overthrow of
are presumed mutually beneficial events that foster rela- President Mobutu in the First Congo War. Immediately
tions and build capacity. In a MEDRETE, the focus is after, the Second Congo War, or Great African War, be-
on working with the host nation military medical assets gan, which officially ended in 2003, although hostilities
directly, to provide education and training on skills. Pre- continue to this day. This history of conflict prompted
vious MEDRETEs in countries throughout Africa have the government to put an emphasis on security sector
focused on surgical techniques, women’s health, public reform and professionalization of the DRC military. 11
health, and infectious diseases.
Opportunities for security and medical cooperation
With a population of more than 65 million, the Demo- abound in the DRC, especially in Kitona. The Kitona
cratic Republic of the Congo (DRC) is the fourth most Air Base, near the town of Muanda, is a strategically
populous nation in Africa and 19th most populous na- positioned training center that occupies a high plateau
tion in the world. It is also the second largest country at the intersection of the Congo River and the Atlan-
in Africa and the 11th largest in the world. However, tic Ocean (Figure 1, circle). There are numerous loca-
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a lack of infrastructure, including roads, makes travel tions within the DRC that make good candidates for US
throughout the country difficult. The DRC’s geographic engagement, but Kitona Air Base stands out for many
position in Africa is presented in Figure 1. reasons. It is the home of the Forces Armées de la Ré-
publique Démocratique du Congo (FARDC; Armed
Figure 1 The Democratic Republic of the Congo, in relation Forces of the Democratic Republic of the Congo) Basic
to neighboring countries. Training, Infantry School, Non-Commissioned Officer
(NCO) School, Infantry Officer Course, Military Train-
ing Hospital, FARDC Nursing School, and a significant
airfield. Additionally, the European Security Council
(EUSEC) in the DRC has invested significant funding
toward building refurbishment, including renovations
to the nursing school. Furthermore, other nations work-
ing with the FARDC have limited or no presence on the
base. These factors make Kitona a unique military-to-
military engagement site within Central Africa.

Methods

The Exercise
At the invitation of the DRC, USARAF conducted
MEDRETE 13-3, focused on public health and infec-
tious disease, at the Military Referral Hospital of Kitona
in June 2013. The location and resources of Kitona Air
Base allow the United States to assist the DRC in meet-
Notes: The square denotes Kisangani (formerly Stanleyville), the site ing these goals while taking advantage of the numerous
of Operation Dragon Rouge. The star is the capital city of Kinshasa. training venues and audiences, benefiting from EUSEC
The circle is the location of Kitona Base, the site of MEDRETE 13-3. infrastructure investments while not interfering with
Map modified from the The World Factbook. 9
other donor-country programs. The location lends it-
The DRC has a long history of conflict since indepen- self to the full array of US engagement, because of the
dence, marked by events such as the Simba hostage rescue presence of Kitona’s military schools, proximity to the
from Stanleyville (now Kisangani; Figure 1, square) by Naval Academy at Banana, and a large, albeit dormant,
Belgian and US troops during Operation Dragon Rouge in airfield. In addition to the political considerations, the
1964. During President Mobutu Sese Seko’s rule, the mili- DRC and the health zone of Kitona present a broad
tary was weakened and made ineffective, in large part to range of infectious diseases not usually found in the
remove it as a threat to his regime. In 1991, after decades United States or Europe, such as malaria, measles, yel-
of being underpaid and underequipped, paratroopers low fever, and a recent outbreak of cholera. 12
looted Kinshasa (Figure 1, star), until they were stopped
by Belgian and French forces in interventions known The objectives of the MEDRETE were to provide US Army
as Operation Blue Beam and Operations Baumier, personnel an opportunity to practice in resource-limited

Medical Readiness in the Democratic Republic of the Congo 55