Page 120 - Journal of Special Operations Medicine - Spring 2016

Figure 1 A map of North and West Africa showing the key elements to the selection of the teams to support
major hubs for the MFST and ECCT in Niamey, Niger, and SOF in Africa.
N’Djamena, Chad.
The MFST and ECCT training and equipment platforms
are effective in conventional deployment locations such
as Al Udeid Air Base in Qatar, where infrastructure and
logistics from conventional US forces are robust and
where missions away from fixed facilities are shorter.
However, the mission in SOCFWD-NWA meant no
hardened facilities, a long supply chain, limited air
assets, and conduct of operations typical of ODAs in
remote locations in camps with limited life-support
systems.

In anticipation of these challenges, the MFST and
ECCT underwent training at Air Force Special Opera-
tions Command (AFSOC) headquarters, Hurlburt Field,
Florida, to prepare for operations in SOCFWD-NWA.
A unique curriculum was developed and conducted by
AFSOC to prepare the conventional medics to work
with SOF and partner nations in Africa. The permis-
sive environment in Africa prioritized cultural training
and knowledge of local customs and language. Train-
ing was tailored for the MFST and ECCT to align with
the mission and rules of engagement of SOF in Africa
and to become familiar with medical assets in the area
of responsibility (AOR). Familiarization training was
conducted to understand the mission of SOCAFRICA
advise and assist partner nations in the fight against the and, in particular, to understand the SOF team’s role to
terrorist organizations Al-Qaida in the Islamic Maghreb advise and assist partner nations in Africa. Training was
(AQIM) and Boko Haram to travel several hours or days conducted to incorporate lessons learned from battle-
from camp, which exposes soldiers to medical threats field medicine and to integrate the principles of Tactical
at a distance far outside the golden hour of trauma Combat Casualty Care and rapid evacuation systems
resuscitation. in place in the AOR. In anticipation of teaming with
2
Special Operations Combat Medics (SOCMs) while
In November 2014, the first conventional surgical and deployed to Africa, the MFST and ECCT conducted
critical care teams were deployed to support operations training to learn the capabilities of the 18D, an asset
conducted by Special Operations Command Forward- providing advanced tactical medical care to SOF, how
North and West Africa (SOCFWD-NWA). USAF Spe- 18Ds contribute to casualty care, and how to team the
cial Operations Surgical Teams were tasked in other MFST and ECCT with 18Ds to provide timely Role II
theaters, contributing to the USAF’s decision to deploy surgical care. 3
the MFST and ECCT, two conventional medical teams,
in support of SOF. Familiarization with casualty evacuation (CASEVAC)
platforms on dissimilar vehicles was conducted. Plat-
The MFST consists of five personnel: a general surgeon, forms in use in Africa, such as the Dornier C-146, the
anesthesia provider, emergency physician, operating CASA 212, and the Sikorsky S-61 helicopter, were a few
room nurse, and an orthopedic surgeon. The ECCT of the CASEVAC vehicles new to the MFST and ECCT.
consists of three personnel: a critical care physician, Principles of en route critical care and patient transport
critical care nurse, and a cardiopulmonary technician. were taught and practical considerations unique to the
The MFST was conceived to provide damage-control SOCFWD-NWA AOR were emphasized. The MFST
surgery and resuscitation to a small number of casu- and ECCT trained on unfamiliar equipment such as
alties, with the ability to deploy forward and conduct field oxygen generating systems, blood refrigeration sys-
operations with man-portable equipment. The ECCT tems, and portable devices such as the Impact EMV+
was designed to offer limited casualty holding capabil- 731 ventilator (Impact Instrumentation; http://impactii
ity and critical care support for the MFST. The small training.com). Scenarios not typically encountered by
footprint and flexibility of the MFST and ECCT were conventional medical units were rehearsed and the teams

104 Journal of Special Operations Medicine Volume 16, Edition 1/Spring 2016