DoD raises status of medical care in war zone - Military News | News From Afghanistan, Iraq And Around The World - Military Times

DoD raises status of medical care in war zone

In yet another step toward crafting a military that can tackle humanitarian relief to counterterrorism and everything in between, the Pentagon now wants planners and commanders to give medical support missions as much consideration as combat operations during the planning and execution of stability operations.

The new policy, effective May 11, falls in line with the military’s goals of preventing and deterring conflict, a desire to improve capabilities in counterinsurgency and stability operations, and in enhancing newfound coordination with other U.S. and foreign government agencies, nongovernmental groups, and, now, private-sector groups.

Military Health System personnel, the Pentagon says, must be able to operate in every phase of conflict and perform “any tasks assigned” in order to set up, rebuild and maintain local health sector capability when others cannot do so.

“The new policy recognizes what we’ve been learning with our medical missions,” said Cmdr. William Hughes, program director for contingency planning for the Pentagon’s International Health Division. “It hasn’t just been combat casualty care. ... It reflects health’s unique ability to be a beneficial and/or impartial player in the field.

“The line commander’s objectives may not be health, per se, but the strategic end goal is regional stability,” he said. “We need to be able to respond quickly and proficiently throughout the world and have a positive impact on different cultures.”

To create that sort of impact, future medical support missions increasingly will focus on training local providers in an effort to leave behind more capable indigent medical capabilities. The Pentagon says the training of host-country medical caregivers might have “as much or more value as the number of patients treated or medications dispensed in humanitarian outreach missions.”

“We have to do it smart and talk to the local health department and NGOs in the area,” said Warner Anderson, a physician and director with the International Health Division. “We’re here to make [them] look good.”

In terms of direct care, the new policy places restrictions on military medical caregivers, saying they “shall not practice outside their scope of privileges and their profession’s scope of practice.” Personnel providing care in short-term medical assistance missions, the Pentagon says, need to consider the availability of appropriate follow-up care and to try to ensure that a care regimen is in place before leaving the area.

To some extent, the Pentagon will be feeling its way along as it adopts this broader mission set. Hughes said training is being launched for medical personnel on “general competency” in medical stability operations, or MSOs, but follow-on specialized training with a focus on “long-term measures of effectiveness” at levels from the tactical to the strategic remains to be developed.

The training and performance measures will draw from a wide variety of sources, including lessons learned from operations such as this spring’s post-earthquake response in Haiti, Hughes said. Those measures will allow officials to analyze whether the MSO practices are effective and whether policy changes will be required.

“For example, a hospital ship treats a number of patients in a given country, and we can examine how that helps the population long-term and if it trains enough local personnel to sustain care,” Hughes said. “We have to work with host-country health advisors and our interagency civilian counterparts during humanitarian missions to create a lasting benefit and then sustain that. We need to ensure what we are doing is what they need.”

In his May 17 instruction on the new policy, Undersecretary of Defense for Personnel and Readiness Clifford Stanley said MSOs are a “core military mission” and that doctrinal planning, training, education, materiel, leadership, personnel, facilities and planning for such missions must be “explicitly addressed and integrated” across all Military Health System activities.

According to the instruction, the assistant secretary of defense for health affairs:

• Is responsible for identifying MSO capabilities and gaps and recommending priorities that the Pentagon should address.

• Must ensure that research and development programs address MSO capabilities and are integrated into acquisition planning.

• Must establish health standards of care and technical supervision.

The new policy also calls on each service to appoint a senior medical department officer to advocate MSO initiatives and develop MSO capabilities by properly equipping and training medical personnel in their respective services.

DISCUSS: Medical care in war zone