Page 125 - Journal of Special Operations Medicine - Summer 2016

An Ongoing Series

Searching for Sustainability

How Niger’s CASEVAC Success Is Leading the African Continent
and Educating the GHE/IHS Community

Philip Flatau, MD, FS, FAWM

ABSTRACT
Against all odds and despite significant challenges and troop confidence fighting violent extremist organiza-
scarce resources, Niger’s Armed Forces (FAN) continues tions (VEOs), including one story of a Chadian soldier
to lead a successful casualty evacuation (CASEVAC) pro- benefiting from their CASEVAC capability. I wondered
gram. This program and the Special Operations Com- when a US Servicemember may benefit. Given the tyr-
mand Africa (SOCAFR) model that influenced it has anny of distance across the desolate Saharan landscape,
become a template for the Global Health Engagement it is likely only a matter of time. The next day, we found
(GHE)/International Health Specialist (IHS) community. ourselves in front of the US Ambassador outlining the
This article provides a summary of the overall CASEVAC details of the program.
mission, outlines the final phase sustainable execution of
this program, and provides the reader with critical les- Operating within the human domain in an effort to in-
sons learned for best practice GHE approaches. fluence and support the resolve and capacity of relevant
populations will only continue to grow within Special
Keywords: Niger; casualty evacuation; Special Operations Operations Forces (SOF) Irregular Warfare (IW) and
Command Africa Grey Zone operations. Whole of government and inter-
agency coordination of efforts remain essential to ac-
complish strategic objectives. The story of the Nigerien
CASEVAC program provides an example of a PN-led
Introduction
program that has remained successful in these areas.
“You do understand that Niger is one of the poorest Yet, by all accounts, it should not have. The embassy
countries on Earth? I’m not sure this type of program team was right and their hesitation appropriate. Niger
can be successful here.” The conversation echoed across ranks dead last in the most recent Global United Nations
the embassy courtyard where we were sitting for cof- (UN) Human Development Index score. Resources are
1
fee. It was another hot and extremely humid sub- extremely limited. Despite this reality, Niger, the under-
Saharan Africa morning. At 0800, sweat was already dog, succeeded. How did they do it and what lessons
pouring down my shirt and forehead. Sitting within the can we learn to improve sustainable Global Health En-
small Niamey compound, our conversation had even- gagements (GHEs)?
tually centered on the main emphasis of our mission:
continue to empower the Nigerien casualty evacuation History
( CASEVAC) program. However, the questions were fair.
Could it truly succeed? How could the program survive The history of Niger’s CASEVAC program is not new
within this extremely resource poor country? to the Journal of Special Operations Medicine or SOF
and it has been highlighted in two previous articles high-
Later that day, the questions and speculation by the lighting SOF PN capacity building. The first outlined
embassy team would be laid to rest as the partner na- the SOCAFR Medical Capacity for African Nations-
tion (PN) outlined its praise for this capability and its Growing Regional Operability model and highlighted
growing ownership and sustainability of this process. the CASEVAC program within Niger as a case example
Stories were told of how this program boosted PN of a sustainable GHE. The second article outlined the
2

111