Page 134 - Journal of Special Operations Medicine - Winter 2015

Having operational floats of FHP equipment to support SOTF-E personnel with a significant number of Afghan
HA/DR and theater opening missions, which are not partners embarked on what was planned as a 72-hour
tied to funding for release, would greatly aid missions operation in a hotly contested area in northeastern Af-
like this in the future. Equipment should include, but ghanistan. The limited duration of the operation and a
not be limited to; raw and treated drinking water, air, perceived sense of familiarity with the area resulted in
soil, and entomological sampling and control. Preidenti- significant challenges in the realm of entomology and
fied equipment sets, training, and dedicated reach-back waste management. The most crucial information that
laboratory support creates the ability to timely identify would have been gathered by the MIPOE was: what
and stratify risk in support of the commander’s decision were the likely risks in the area and how could they be
cycle. If a solution to this is ignored, the potential for mitigated should the mission extend beyond 72 hours, a
increased exposure for service members and an overall frequent occurrence in much of AFG due to the impact
lack of force health protection will exist. of weather and geography on transportation.

The FHP lessons learned from this mission were a direct
Conclusion
result of a lack of experience of the team medic and a
The early phases of this operation serve as clear and widespread complacency related to years of operating in
striking examples of the required level of command in- a particular area and expecting things to always work
volvement in FHP and the subsequent achievable suc- out the same way. The FHP issues identified from this
cesses. The use of experienced officers and NCOs early mission also highlighted shortcomings in an 18D cur-
in theater opening operations facilitated a detailed and riculum lacking in preventive medicine training.
effective MIPOE that decreased Soldiers’ risk of DNBI,
increased operational effectiveness, and garnered popu- The village stability concept was in its early stages and
lar support for the mission. It also set the conditions for the preventive medicine (PM) challenges of operating
smooth transition with the 101st Division Headquar- and living in remote areas without the benefit of con-
ters. This high level of command influence must be sus- ventionally provided infrastructure were becoming ap-
tained throughout all operations, clearly prioritizing the parent. FHP personnel (ESEOs and 68S’) were faced
importance to the Servicemembers and therefore con- with challenges comparable to pre-GWOT missions in
serving the strength of the force. The initial response remote regions elsewhere in the world. Unfortunately,
was not without challenges; the rapid establishment of the fairly well established infrastructure many had come
living areas without the ability to sample or provide any to rely on in much of Afghanistan resulted in the deci-
quantitative feedback is still an issue in Liberia today. sion to frequently deploy without FHP assets or to dis-
The rapid planning and response timelines for any mis- regard their input to mission planning. The impact of
sion of this type will often not allow ideal FHP condi- these decisions became abundantly clear for a small ele-
tions. However, the difference was the people, the US ment of SOF personnel in the summer of 2010.
Servicemembers as part of JFC-UA working together to
ensure a safe and successful mission.
The Crafty Flea
It is widely known that the disease risk is significant and
References
varied in Afghanistan. What is less known is that the risk
1. Department of the Army. TRADOC Pamphlet 525-3-1, Army can be geographically unique due to the isolation caused
Operating Concept, Winning in a Complex World. Training by high elevations. This can be beneficial when the
and Doctrine Command, 2014.
2. Whitman TJ, Coyne PE, Magill AJ, et al. An outbreak of Plas- unique circumstances are known, as they were in parts
modium falciparum malaria in U.S. Marines deployed to Libe- of NE Afghanistan, but that information is only useful
ria. Am J Trop Med Hygiene. 2010:258–265. when it is sought. Flea and tick issues are widespread in
Afghanistan but information related to increased preva-
lence of these vectors and their associated diseases was
Fleas and Waste: Unforeseen Challenges to a fairly well known by PM personnel in the SOF com-
Special Forces Mission in Afghanistan munity by 2010, especially after the 2009 death of a US
Jennifer B. Caci, COL, MS Soldier from Crimean-Congo hemorrhagic fever con-
1
tracted in southeastern Afghanistan. In the case of our
ven in areas occupied by the US military for years, team heading into a remote region of northeastern AFG
EMedical Intelligence Prep of the Environment/ for a short mission, the readily accessible knowledge of
MIPOE is critical to effective mission planning. Failure vector activity available from the SOTF or CJSOTF-A
to conduct MIPOE can at most result in catastrophic PM team would have helped the medic to better prepare
consequences and at least delay or disrupt mission ac- should the mission either intentionally or unintention-
complishment. In the summer of 2010 a small element of ally be extended. The sheer volume of missions being

122 Journal of Special Operations Medicine Volume 15, Edition 4/Winter 2015