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Lt Col Jody Noe And Capt Tracy Harrelson. Objectives  Understand the rationale behind counter- insurgency operations and what role the laboratory can.

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Presentation on theme: "Lt Col Jody Noe And Capt Tracy Harrelson. Objectives  Understand the rationale behind counter- insurgency operations and what role the laboratory can."— Presentation transcript:

1 Lt Col Jody Noe And Capt Tracy Harrelson

2 Objectives  Understand the rationale behind counter- insurgency operations and what role the laboratory can play  Appreciate the current capabilities of one Iraqi medical clinic and the efforts that the 332d EMDG is making toward addressing its needs  Comprehend the challenges/ consequences of “helping” host country laboratories

3 Counter-insurgency Operations (COIN)  COIN, by definition is military, para-military, political, economic, psychological, and civic actions taken by a government to defeat insurgency.  In this instance the 332d EMDG sought to capitalize on the good will generated in the local community from medical care previously provided to local wounded Iraqi civilians.

4 History  Efforts were already underway to provide training and equipment to doctors and nurses  Recently, there has been a push to include ancillary medical services with the laboratory being the first service to be assessed  Came out of coincidental meeting with the mother of an Iraqi lab tech

5 Preparation  Mine Resistant Ambush Protected ( MRAP) basic training Rollover Rollover in water Rollover under fire

6 Assessment - Initial Assumptions  Intermittent power issues  Staff retainability/training – 4 lab staff  Reagent storage problems/refrigeration Lack of reagents to perform spectrophotometric assays for Glucose, Bilirubin, Uric Acid, BUN, Cholesterol

7 Assessment Goal  Find areas for improvement where the Air Force could provide laboratory assistance which could in turn be sustained by the Iraqis.

8 Concerns  Cultural  Power and water supplies  Future sustainment capabilities  Security of donated equipment Previous endeavors have resulted in equipment being sold on the black market.

9 Mission Brief

10 Convoy!

11 Clinic Findings

12

13 Findings - Laboratory  Basic laboratory requirements such as reliable power and clean water for reagents were woefully inadequate

14 Findings - Laboratory  Reagent supply issues were problematic

15

16 Findings - Laboratory  Equipment was antiquated and in disrepair

17 Findings- Laboratory

18 Findings  Operating instructions and reference material were non-existent.

19 Findings

20 Initial Response  Preliminary efforts to get the local Iraqi clinic laboratory staff to come to the 332 d EMDG laboratory failed for cultural reasons.  Efforts are on-going to develop training aids and operating instructions in Arabic for use at local facilities and future visits to other clinics and hospitals are being considered.

21 Initial Training Aids

22 Initial Training Aids

23 Initial Supplies  Provided shovel, rake, trash bags and gloves so that the Iraqis could get the grounds cleaned up  Plan was to next bring painting supplies once outside was cleaned up

24 Challenges  Training Initial training received, unable to assess adequacy No evidence of ongoing training Specifically concerned about microscopic urinalysis  Chemistry Testing Manual methods require dangerous chemicals Piccolo -pilferable, supply issues and cold storage issues

25 Challenges  Personal hygiene inadequate Access to clean water Education  No Microbiology testing capability Only fecal wet preps  Cultural issues, all tests MUST have a result “No stool pathogens” statement not seen in log

26 The Road Forward  Appealing to the female doctors to try to get an invite to their clinics and training for their techs.  Gathering intelligence on the Iraqi Health Care System and the Ministry of Health  Crossing our fingers!!!


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