Page 133 - Journal of Special Operations Medicine - Winter 2015

Figure 3 Handout for JFC-UA Servicemembers personnel were not working in direct contact with
patients suffering from Ebola virus disease (EVD). How-
ever, many of these personnel were in frequent contact
with local nationals who may have been exposed to the
disease from sick friends and family members. Elevated
concern surrounding Ebola in the United States and
throughout the world meant that a single case of EVD in
a US Servicemember would have significantly impacted
the entire mission. US personnel exposure to Ebola vi-
rus was mitigated through ongoing daily education and
command emphasis. Twice-daily temperature checks
and hand washing stations outside of every building
were also included in the prevention strategy. The JFC-
UA saw huge benefits from the regular hand washing
performed by Servicemembers and its direct effect on
lower DNBI trends. Additionally, JFC-UA worked with
contracted service providers to ensure that drivers, hotel
staff, cooks, etc. were monitored daily for signs of ill-
ness and strict sanitation standards were enforced. In
addition to the human cost, business owners recognized
the negative financial impact a case of Ebola would
have on their business and employees, which motivated
them to comply strictly with requested measures. These
precautions resulted in no case of Ebola virus infection
among US military personnel during the operation and
the continued success of the mission.
Onward Liberty (OOL). The Navy medical staff that sup-
ported the Marines had a planning factor of two gastroin- People Are More Important Than Structure
testinal illnesses per Marine, per month. This is obviously
a significant rate and would have a negative effect on mis- USARAF as an ASCC is an operational level headquar-
sion accomplishment for OUA if these rates were applied ters and doctrinally not expected to field the full com-
to a force of 3,000. Early in the establishment of JFC-UA, plement of equipment required to execute the tactical
many of the first 100 service members on the ground mission. One of the benefits of having an ASCC con-
lived and worked out of local hotels; this included eat- duct theater setting activities is, as a senior-level staff,
ing in the restaurants associated with each hotel. Drinking the amount of experience each staff section brings to
water was shipped in from an approved source and was bear in support of the mission. Also, by nature of being
the sole source of drinking water for JFC-UA. One pri- the ASCC for the theater, the staff was already prepared
mary focus for the FHP mission was to evaluate and im- and experienced in facing multiple challenges present
prove kitchen operations within the primary hotels where inherent in operating in West Africa. The ability to con-
US Servicemembers ate. The initial point of contact for duct tactical operations while understanding the opera-
these inspections was the US embassy staff including the tional and strategic implications was a key strength for
Regional Security Officer (RSO) and the Senior Defense USARAF staff throughout the mission. From an FHP
Official (SDO), in this case the Defense Attaché (DATT), standpoint, much of the baseline MIPOE was already
which provided points of contact at each facility as well as complete prior to the mission.
historical inspections on some of the hotels. Working with
the hotel kitchen staffs, health professionals were able to A significant difficulty in using an ASCC for a theater
identify and correct several of the poor hygiene and sani- opening mission is the lack of organic equipment for a
tation practices on the spot or within a short period of tactical mission. This was particularly true in the case of
time. This demonstrates a much lower gastrointestinal dis- FHP. Due to the rapid response nature of Humanitarian
ease rate (under 1%) in the Servicemembers of OUA than Assistance/Disaster Response (HA/DR) missions, there
were previously experienced by Servicemembers of OOL. is a greater requirement for those responding units ac-
cessing equipment and training in order to accomplish
the tactical mission. Lacking the ability to provide
Ebola Prevention quantifiable sampling data to support the command-
JFC-UA faced a unique force health risk in the form er’s intent has the potential to adversely affect Service-
of the Ebola virus. During the operation, US military members’ health and the success of the overall mission.

Medical Intelligence Prep of the Environment 121