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• W1603391477 abstract "[ILLUSTRATION OMITTED] IF AN IRAQI MAN believes that your hospital has saved the life of his child, sister, or parent, will he shoot at you? Most will not. He may even tell you where insurgents and criminals are hiding, which furthers the counterinsurgency (COIN) mission and decreases U.S. causalities. This point may seem obvious, but it bears repeating. Medical support of civilians in an area of operations can be a tool for winning support for the counterinsurgency. Unfortunately this realization is dawning much too slowly, as doctrinal changes are always slow. For instance, while one combat support hospital (CSH) could note that 60 percent of its patients at times were Iraqis, and another could note that it routinely sees civilians injured by collateral damage, it still remains the enunciated policy of Medical Command (MEDCOM) that you do not treat civilians if you can possibly avoid it. It was this way in Desert Storm and persists in the current operating environments. Instances of providing care, including the transportation of injured children by a Marine unit in Ramadi to Baghdad for treatment, are spur-of-the-moment targets of opportunity, or random acts of kindness. They are not part of the commander's visualization and design for operations. They are not part of the execution of plans. Campaign design does not include deployment of field hospitals in support of civilians. If the evacuation of the Ramadi children in September 2007 was, in fact, a proactive part of information operations employed to favorably influence the populace's perception of all coalition actions while simultaneously discrediting the insurgents, this reporter was unaware of it. Bucking Doctrine What field hospitals can contribute in COIN remains largely unexplored, and the reasons why they have not been deployed for civilian support appear merely doctrinal. The capacity of a deployed U.S. field hospital to do good (and to look good doing it) presents an awesome but underappreciated force multiplier to senior commanders. During Desert Storm, the 13th Evacuation (EVAC) Hospital from Wisconsin and another EVAC from North Carolina were colocated on Pipeline Road. In six weeks, they saw 17,000 patients, had admitted 500 patients, and performed 200 surgeries. After Desert Storm the 912th Mobile Army Surgical Hospital (MASH), Tennessee, was deployed to support Shi'ite refugees at Safwan, Iraq. The refugees were effusively grateful for routine obstetrical, medical, pediatric, and surgical attention. In Pakistan, the 212th MASH, Landstuhl, treated 20,000 causalities of the 2005 earthquake in four months. These treatments included 500 hospitalizations and 425 operations. The 212th was deployed also in Bosnia and Croatia along with the 48th Air Transportable Hospital and Navy Fleet Hospital 6. The latter two treated civilian refugees routinely to great effect; the 212th adhered to MEDCOM doctrinal limitations. A field hospital's capabilities come from a complex interaction of the clinical sections: emergency room, laboratory, pre-and post-operative care, anesthesiology, surgery, internal medicine, intensive care unit, pediatrics, obstetrics-gynecology, nurses, and corpsman. The level of nursing care in U.S. field hospitals is at least an order of magnitude better than what I have observed as a physician in six of the best hospitals in Frankfurt, Germany, and in Moscow, Russia. Most line officers have little knowledge of this scientific expertise that military hospitals bring to the field. Only one commanding general, General Frederick Franks, Jr., experienced the modern field hospital as a patient. He had to have his leg amputated in Vietnam. Twenty years later, as commander of VII Corps in 1991, when faced with a serious refugee problem in Iraq, he deployed three MASH units to provide civilian refugees with standard medical care. He ignored MEDCOM doctrine. Shortly after Desert Storm, MEDCOM told me Doctor, we're here to preserve the fighting strength, period, end of story. …" @default.
• W1603391477 created "2016-06-24" @default.
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• W1603391477 date "2009-07-01" @default.
• W1603391477 modified "2023-09-23" @default.
• W1603391477 title "FIELD HOSPITAL SUPPORT for Civilians in COUNTERINSURGENCY OPERATIONS" @default.
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