Page 152 - Journal of Special Operations Medicine - Fall 2017

An Ongoing Series

Remote Dental Surgery as a
Medical Civilian Assistance Program (MEDCAP)

Helping Iraqi, Kurdish, and U.S. Forces Win
Hearts and Minds in the Fight Against Daesh

Bryan Ferreira, DDS, EMT-P*

ABSTRACT
Dr Ferreira discusses the work of the Humanitarian Aid and while it was not safe for local medical personnel to return to
Security Forces (HASF) in providing volunteer dental services the local clinics and hospitals, they had been destroyed and
to a local Christian militia in Mosul, Iraq. were no longer available. HASF had a request for dental as-
sistance, and with the U.S. SOF operating in the vicinity, this
Keywords: Iraq; dentistry; Humanitarian Aid and Security was a perfect opportunity to exploit that doctrine that turns
Forces conventional medical assets into counterinsurgency force mul-
tipliers. For a commander in the field, the short-term effects
of medical relief can be significant, particularly if the team is
combating a dangerous terrorist group and depends on the
Introduction
good will and support of the local population.
At the outskirts of Mosul, in northern Iraq, a team from a
501(c)(3) nonprofit organization called HASF (http://dvm Even though HASF provided only the Dental Civic Action
hasf.org/) is providing assistance to a local Christian militia. Program (DENTCAP) of the MEDCAP, it probably is one of
Since daesh, or the so-called Islamic State of Iraq and the Le- the most crucial parts of it. Not only are dental pain and oral
vant, took over part of northern Iraq, these men are the only infections very crippling to any fighting force, after the team
people left in the Christian cities of the Nineveh Plains. As leaves, the only long-term effects are perhaps more healthy
the fight focuses in retaking Mosul, the Iraqi Army and Occi- mouths with less teeth.
dental Special Forces have insufficient resources to be present
everywhere, so these militias are the only thing that stops the To this mission, the team deployed in civilian vehicles to go as
terrorist organization from overwhelming these cities again. low profile as possible. The main objective would be to pull
Unfortunately, they have no medical resources, except for rotten carious teeth and teaching dental hygiene; most soldiers
what is provided by organizations like HASF. and villagers could not obtain toothbrushes or toothpaste, so
the team had some donations to distribute as needed.
With a mix of volunteers with diverse experiences that range
from private military contracting to personal security detail, Instrumentation
mechanical and process engineering, paramedics, combat
camera, and dental surgery and a vast experience in some of Storage space in the vehicle was tight, and the places to mount
the most austere environments in the world, HASF, in con- the mobile clinics had to be improvised according to the lo-
junction with local government, managed to coordinate some cation and security available. The dental kit had to be very
deployments to the frontlines and accomplish this dangerous simple and effective. Some of instruments were:
mission.
1. General Tools
MEDCAP is something that Special Operations Forces (SOF) a. Suction (improvised with a large-bore syringe with a sa-
often use to win the hearts and minds of the country in which liva aspirator)
they are operating. In this case, all local medical personnel had b. Mirror
been dislocated and had fled to other cities or even outside the c. Explorer No. 23
country. The soldiers on the field and some of the population d. Periodontal probe
assisting them had serious medical issues with tooth decay; e. Tweezers (also called dressing pliers)

*Correspondence to bryanferreira@gmail.com
Dr Ferreira is a doctor of dental surgery and a paramedic (EMT-P) with extensive experience in remote medicine around the world. He is an
American citizen and has lived in Portugal for several years. Photographs by Bryan Ferreira.

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