Page 126 - Journal of Special Operations Medicine - Summer 2016

Nigerien CASEVAC program in relation to the RAND with validation and PN program sustainment. Although
corporation’s report on best practice GHE recommen- the outline recognizes a 2-year timeline, the overall pace
dations. This also included a detailed breakdown of and progression to each phase is dependent on the PN
3
the cost effectiveness of these programs. Both articles and should not be limited to a specific schedule.
provide outstanding in-depth, technical outlines of the
SOCAFR model along with best practice recommenda- Final Phase Implementation (Sustainable Model)
tions for both operational commanders and medical
personnel. (The reader is highly encouraged to reference The final phase implementation of the Niger CASEVAC
both articles to better understand the history of this program was successfully executed in 2015. This in-
program). However, neither article outlined the final cluded three separate AFSOAWC missions to assist key
key phases of the program and overall lessons learned. Nigerien CASEVAC instructors on CASEVAC course
These are discussed in this article. and curriculum development (Figure 2) in addition to
overall program validation. Important aspects focused
Over the past 2 years, the operational execution of this on instructor development and empowerment, which
ongoing mission has been led by the Air Force Spe- included “mock” courses for the instructors (Figure 3).
cial Operations Air Warfare Center (AFSOAWC) IW This provided an environment to facilitate construc-
Medical Operations Division. The division (which we tive feedback and recommendations for improvement,
fall under) remains an Air Force Special Operations which was extremely well received prior to the instruc-
Command (AFSOC) focal point for GHE/IHS and IW/ tors’ CASEVAC course.
Aviation Foreign Internal Defense (AvFID) medical sup-
port. We provide language-trained operational medi-
cal advisors to assess, train, advise, and assist foreign
aviation and medical forces in battlefield medicine and
CASEVAC principles. Our goal is to build sustainable Figure 2 CASEVAC
PN capacity through strategic GHE activities. The Ni- instructor manual (provided
gerien CASEVAC program has provided an incredible by Capt Nicole Graves).
opportunity to learn and improve our current processes
within these areas.

In review, the CASEVAC model is a phased approach
(Figure 1) grounded on PN ownership and sustainability,
a critical but sometimes absent component of military Figure 3 A Nigerien CASAEVAC instructor practices
planning. As outlined in Figure 1, initial phases focus teaching during a “mock” point-of-injury lecture (provided
on assisting the PN with developing its own governmen- by Maj Philip Flatau).
tal policies and standard operating procedures (SOPs)
officially recognizing the program. This is a key lesson
learned and is discussed further at the end of this article.
Latter phases focus on training and equipping along

Figure 1 Phased approach outline (provided by SOCAFR
Maj Stuart Fillmore).

During our last mission in December 2015, we had the
privilege of witnessing the first ever Nigerien-led CA-
SEVAC course. This course provided training to more
than 25 new students represented from each region of
Niger and was 100% Nigerien-led. This marked the
first-ever documented PN-led CASEVAC course on

112 Journal of Special Operations Medicine Volume 16, Edition 2/Summer 2016