ISAF Continues Improvements to Afghan Hospital, Officials Say

By Amaani Lyle

American Forces Press Service

WASHINGTON – The International Security Assistance Force has made significant improvements to save what had been a “broken” medical system for treating Afghan security forces, Defense Department officials told a congressional committee today.

David Sedney, DOD’s deputy assistant secretary for Afghanistan, Pakistan and Central Asia, and Kenneth Moorefield, DOD’s deputy inspector general for special plans and operations, testified about the Dawood National Military Hospital in Kabul before the House Armed Services Committee.

Sedney and Moorefield underscored the need for the Afghan military to maintain a capable and accountable medical system. ISAF’s NATO Training Mission-Afghanistan has strengthened Afghan health systems and will continue to do so, they said.

“Thanks to the response and effort in reforming the health care and medical systems, we are now helping to turn around what had been a broken system -- introducing accountability, standards and stewardship at all levels,” Sedney said.

Over the last several years, Sedney said, coalition medical mentors and advisors highlighted “gross deficiencies” in the system and neglect in operations and basic medical care at Dawood.

Coalition medical mentors and advisers reported these findings and elevated the concerns to NTM-A senior leaders and then- commander Lt. Gen. William Caldwell.

“Recognizing the enormity of the situation, General Caldwell took action,” Sedney said. “He requested the involvement of the DOD IG, Office of Special Plans and Operations, to assess the nationwide medical logistics system in Afghanistan.”

Moorefield testified that the gravity of the matter and complexity of the issues has spurred the DOD IG to undertake a succession of oversight initiatives. Since its February 2011 inspection of the hospital, he said, progress has been made in several areas.

The most significant changes occurred in 2010 and 2011, Moorefield said. Those changes included removing then-hospital commander Afghan Gen. Ahmad Zia Yaftali, developing clearly defined multitier standards and implementing new processes and procedures, he said.

Since executing these changes, there have been no complaints or evidence of patient maltreatment or neglect as of last August, Moorefield added.

The senior leadership of the training mission and the medical advisory group “recognized the critical importance of enabling a system that could provide adequate healthcare to the Afghan security forces,” he added.

Yemen Gets U.S. Medical Aid Following Terrorist Attacks

By Army Sgt. 1st Class Tyrone C. Marshall Jr.

American Forces Press Service

WASHINGTON, May 24, 2012 – The U.S. military has provided emergency medical aid to Yemen that’s being used to help treat Yemeni soldiers and others who’d been wounded in a May 21 terrorist suicide bombing attack in the country’s capital, Pentagon Press Secretary George Little told reporters today.

A U.S. Air Force C-130 aircraft yesterday delivered more than 13,000 pounds of emergency medical supplies to Sanaa, Yemen’s capital city, Little said. More than 300 people, he added, were killed or injured in the attack.

“U.S. Air Forces Central, part of U.S. Central Command, organized the delivery of supplies in coordination with the State Department,” Little said. “The supplies include bandages, sutures, medication, intravenous fluids and litters, and will be distributed by the Yemeni government to hospitals.”

U.S. officials have condemned the attack. Earlier this week, Little told reporters the attack in Yemen “bears all the hallmarks of having been planned and carried out by Al-Qaida in the Arabian Peninsula.”

Afghanistan: Guard members assist with large-scale inoculation project

By Army National Guard Maj. William Humes

37th Infantry Brigade Combat Team

FORWARD OPERATING BASE KUNDUZ, Afghanistan  – Soldiers from Headquarters and Headquarters Company, 1st Battalion, 125th Infantry Regiment, Task Force Viking, 37th Infantry Brigade Combat Team, provided assistance for an Afghan-led sheep inoculation project last week, north of the city of Kunduz.

The project – which saw the inoculation of more than 20,000 sheep over two days – was a collaborative effort between the Afghan Director of Agriculture, Irrigation and Livestock, the commander of the Afghan National Civil Order Police, the U.S. advisers to ANCOP, the U.S. Department of Agriculture adviser and the Kuchi Peace Ambassador.

The sheep owned by the Kuchi tribe, a national nomadic tribe of Afghanistan, were the target of the inoculation project.

Army Capt. Jennifer Pacurari, the civil-military operations officer for Task Force Viking, played a large part in bringing the group together.

“Meeting on [Forward Operating Base] Kunduz provided a secure location to do business,” Pacurari said. “Many of the Afghans attending the meeting had never been to our FOB so it was an opportunity to extend hospitality to our Afghan friends.”

Once all parties agreed on the specifics, the next step was to ensure security was provided for the operation. This responsibility fell to the ANCOP, and the U.S. team advising the ANCOP. In a truly combined operation, the ANCOP and their advising team went through the detailed planning process to ensure all parties remained safe while conducting the inoculations.

Army Capt. Jeremy Prince, the operations officer for the ANCOP advising team said, “I have been impressed by the operations conducted by the ANCOP since I started this advising mission. But working with the planning staff for this project really gave me a new level of respect for their professionalism.”

When inoculation day finally arrived, it was time to see if all of the preparations would work out. When the operation went as planned, it was a reflection on the thoroughness of the planning team.

"This was my first chance to witness the ANCOP in action,” Pacurari said. “At no point during the operation did I feel my safety was in jeopardy.”

ANCOP and International Security Assistance Force personnel maintained security of the location while Afghan veterinarians administered thousands of vaccinations.

The 37th IBCT is currently deployed to northern Afghanistan in support of ISAF in order to build Afghan National Police capacity.

Afghanistan: Nebraska Air Guard members hand over nursing program to local Afghans

By Erika Stetson

U.S. Forces Afghanistan

KABUL, Afghanistan  - Two Nebraska Air National Guard officers are wrapping up the U.S. role in an Afghan military nurse training program in Kabul and handing the initiative over to coalition forces.

The program, which has graduated 100 nurses, has been “one of the most successful” for NATO’s training mission at Kabul’s Armed Forces Academy of Medical Science, said Air Force Lt. Col. Shawn Zembles, chief regional adviser with the training mission and a Nebraska Air Guard member.

He and a fellow Nebraska Air National Guard officer, Air Force 1st Lt. Nicole Hansen, are the last two in a series of Nebraska Army and Air Force National Guard officers who launched and then served as advisers to the program for the last two years. Canadian Forces already serving as AFAMS mentors now will take over the guard’s role with the nursing program, which graduated its third class of students on April 3.

“The nursing program has actually been one of the most successful programs in AFAMS because for the most part they're self sufficient,” Zembles said. “We have Afghans teaching Afghans. We have Afghans directing the program.”

The program began after officials with the University of Nebraska, which has a Center for Afghan Studies and boasts a years-long interaction with the country, invited the state’s National Guard to help improve Afghanistan’s health system.

 The Guard agreed to support the effort after a series of meetings, by bringing a condensed version of an 18-month military nurse training program to Afghanistan.

The first Nebraska Guard team arrived in Kabul in January 2010 for a program assessment, and decided to phase the training into the existing, multifaceted AFAMS medical training mission at the Kabul National Military Hospital.

Since then, Nebraska’s Army and Air National Guard have deployed nursing experts in six-month rotations, bringing the training program up to its current level.

When the Guard first began working, Afghans performing many different jobs were being called nurses, Zembles said.

“Nurse ambulance driver, nurse barber – just about everyone in the hospital was being called nurse,” he said. “We discovered there was no common understanding of that term. We called that role confusion.”

Guard experts helped Afghan leaders define what professional role they wanted nurses to fill, assembled a series of skill requirements and began fine-tuning the training.

“We re-did the whole curriculum,” Hansen said. “That included streamlining it to eliminate redundant or unnecessary material and standardizing the presentation and language over the entire course, which is a 12-month, compressed version of the 18-month U.S. military program.”

The team also created a skills-lab process to give students hands-on experience.

“Before they were just lecturing,” Hansen said. “We’ve helped them get assessment tools to use in the clinical area so they can assess how far the students are progressing each week.”

She said she’s seen the process move along well during her six-month deployment.

“I’ve really enjoyed working with the nursing program and the Afghans and seeing them take what we’ve given them and run with it,” she said.

Zembles estimated work on the program involved combing through about 1.2 million words, including lectures, lesson plans, skills lab checklists and other materials.

He said mentors also developed validation and internal assessment tools for the program, including a tool to evaluate the readiness of potential regional expansion sites for training.

“The validation process took a long time because we looked at every lecture,” Zembles said.

The validation and assessment tools collectively help ensure the program is sustainable as the North Atlantic Treaty Organization scales back its mentorship role for the program to an advisory one, he said.

“The nursing students that we've seen and the previous graduates are very highly praised – praised by leadership within the hospitals themselves – physicians,” Zembles said, calling the students “extremely motivated.”

Face of Defense: Dentist Plays Vital Role in Afghanistan

By Air Force Airman 1st Class Tom Brading
American Forces Press Service

JOINT BASE CHARLESTON, S.C., Jan. 12, 2012 – In a remote valley of war-torn Afghanistan, an airman home- based here is playing a vital role enhancing the country's practice of dentistry.

Air Force Maj. (Dr.) Courtney Schapira is deployed to the medical embedded training team at Forward Operating Base Lightning as the chief dental advisor at Paktia Regional Military Hospital in Gardez, Afghanistan.

"Our team is made up of 21 medical advisers from different NATO countries," Schapira said. "We each have our own areas of expertise, such as internal medicine, nursing, pharmacy, etc."

Schapira deployed to Afghanistan in November and is the first and only dental adviser assigned there.

"The Afghan dentists that I work with are excited to have a U.S. dental advisor and are eager to learn from me," she said. "They are asking questions and taking the initiative to do things on their own."

Paktia Regional Military Hospital is an Afghan army facility that treats only Afghan soldiers, police and civilians with combat-related injuries. The standard of dental care in Afghanistan is much different from that in the United States, Schapira said, noting the clinic is not current with modern preventive dentistry.

Though the Afghan dentists are skilled and adequate at their profession, Schapira said, their techniques and materials and the thought processes behind their treatments are outdated.

"The dentists here used to rarely make patients numb prior to treatment," she said. "This is both painful for the patients and can turn what may be a single appointment in the U.S. into two or three appointments here, simply because the patients can only tolerate so much pain. Since my arrival, they now numb patients prior to any surgical procedure."

During her first few weeks in Afghanistan, Schapira said, she felt overwhelmed by the challenges facing her. Her efforts were divided in multiple directions. Supplies, broken equipment, outdated techniques, infection control and patient administration all needed her attention.

"I realized I couldn't improve everything at once," she said. "So I set goals for myself and for the clinic. After most of the equipment was modernized, I turned my focus to the supply inventory."

The 6-by-10-foot supply closet was full of unlabeled boxes filled with assorted dental supplies, Schapira said. It was overflowing with supplies, she added, and it was difficult for anyone to even walk in.

In addition, she said, she found the Afghans lacked a tracking system to monitor expiration dates or maintain inventories. "The disorganization made it very difficult to find any materials they actually have," she added.

Most of the supplies on hand were donated by various hospitals before Schapira arrived, but because the Afghans never had a dental advisor in the past, she said, the staff never was taught how to stock and inventory the materials.

Once she organizes the supplies, Schapira said, she'll be able to more accurately assess the clinic's real capabilities and needs.

"Organization has been our top priority," she said. "It has created a foundation for the clinic to grow. Now that everything is in order, training will become our top priority."

With most of the equipment now working properly and with the supply closet organized, Schapira said, she can start working more on infection control procedures, new dental techniques and patient administration.

"I've set the Afghan dental clinic up for success," she said. "I'm getting the clinic to reach its fullest potential. I have complete confidence in their capabilities."