Page 119 - Journal of Special Operations Medicine - Spring 2016

An Ongoing Series

Experience of a US Air Force
Surgical and Critical Care Team Deployed in
Support of Special Operations Command Africa

Brian Delmonaco, MD; Aaron Baker, MD; Jared Clay, MD; Jeremy Kilburn, MD

ABSTRACT

An eight-person team of conventional US Air Force MFST and ECCT were the first conventional Air Force
(USAF) medical providers deployed to support US Spe- surgical and critical care teams to embed with Special
cial Operations Forces (SOF) in North and West Africa Forces Operational Detachments—Alpha (ODAs) in
for the first time in November 2014. The predeployment Africa; they deployed forward to remote areas in Af-
training, operations while deployed, and lessons learned rica, working with US Special Operations Forces (SOF),
from the challenges of performing surgery and medical partner nation forces, US contracted air crews, and the
evacuations in the remote desert environment of Chad French military (Figure 1). Medical care during Boko
and Niger on the continent of Africa are described. The Haram’s terrorist attacks in N’Djamena, Chad, in Feb-
vast area of operations and far-forward posture of these ruary, June, and August 2015 was provided when more
teams requires cooperation between partner African na- than 40 Chadian military, police, and civilian casualties
tions, the French military, and SOF to make these medi- were received. Since November 2014, the MFST and
cal teams effective providers of surgical and critical care ECCT have deployed continuously to conduct opera-
in Africa. The continuous deployment of conventional tions in Africa. The challenges of teaming conventional
USAF medical providers since 2014 in support of US medical units with SOF in Africa and the difficulties
Special Operations Command Africa is challenging and equipping and sustaining the teams to remain fully op-
will benefit from more medical teams and effective air erational are described in this article.
assets to provide casualty evacuation across the vast
area of operations. Predeployment Execution
The mission for SOF in North and West Africa is to
Keywords: US Special Operations Command North and advise and assist partner nations to counter violent ex-
West Africa; far-forward surgery; conventional US Air Force; tremist organizations that are prevalent in sub-Saharan
Mobile Field Surgical Team; Niamey, Niger; N’Djamena, Africa. Conducting operations in Mauritania, Niger,
Chad; CASEVAC; Boko Haram; al-Qaeda in the Islamic Chad, Cameroon, and six other countries, SOF teams
Maghreb; French military are deployed to remote locations across a vast area
larger than the continental United States. Consider get-
1
ting injured in Miami, Florida, flying to New York City,
New York, to the nearest Role II surgical team, then
Introduction
flying to Los Angeles, California, for definitive Role III/
In November 2014, two teams of conventional US Air IV care. This accurately approximates the medical foot-
Force (USAF) providers deployed to support Special Op- print spread across North and West Africa. The desert
erations Command Africa (SOCAFRICA). A five-person environment in sub-Saharan Africa and the large area of
Mobile Field Surgical Team (MFST) and a three-person operations contribute to medical threats from exposure,
Expeditionary Critical Care Team (ECCT) were trained disease from mosquito and animal vectors, food- and
and equipped to provide forward surgical resuscita- waterborne illnesses, and vehicle accidents, in addition
tion, critical care, and transport for injured personnel to the threat of enemy contact from terrorist organiza-
conducting operations in North and West Africa. The tions in the region. It is common during operations to

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