AMEDD: The dedicated men and women military, civilian, Keeping the Army Fit to Fight

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1 AMEDD: Keeping the Army Fit to Fight By LTG Eric B. Schoomaker The dedicated men and women military, civilian, volunteer and contractor of the U.S. Army Medical Department (AMEDD) personify the Army value of selfless service. Their service ensures that critical missions to protect our combatants, to deploy in support of that force, to care for wounded, ill and injured soldiers, and to protect and care for the Army family are simultaneously achieved. We are successful in these missions through a $10 billion international health promotion and health-care delivery command staffed by more than 70,000 professionals. I know firsthand that the men and women of AMEDD are experts in medical research and development, medical logistics, training and doctrine, health promotion and preventive medicine, dental care, and veterinary care in addition to delivering an industry-leading health-care benefit to 3.5 million beneficiaries around the world. These disparate missions are synchronized, resourced, measured and tracked through the Army Medicine Balanced Scorecard a tool that has seen widespread use and great advances in July 2009 ARMY 23

2 SFC Greg Deleon demonstrates the proper use of a combat action tourniquet during a combat medic class at the U.S. Army Medical Department Center and School, Fort Sam Houston, Texas. DoD/Fred W. Baker III LTG Eric B. Schoomaker is Army Surgeon General and commander, U.S. Army Medical Command. Central to everything we do is the warrior we exist as AMEDD to support the warrior. I am happy to report that we are accomplishing our missions phenomenally well. Army Medicine and the joint medical force provide top-notch medical support from the garrison to the battlefield and back, across the full continuum of care. This is an extraordinary year for Army Medicine. One hundred years ago, the first patients were admitted to a new Army medical hospital in Washington, D.C., named for a remarkable man whose scholarship, courage and reasoned approach to the communicable disease threats of his day helped change the course of history in the United States and the Western Hemisphere. That Army physician-scientist was MAJ Walter Reed, who led a team to study yellow fever in Cuba. He proved that mosquitoes transmitted yellow fever and thus contributed to the control of that disease as well as malaria, ultimately enabling the building of the Panama Canal. MAJ Reed was unaware that his discoveries would have such a transformative effect on America s future; he was driven by a thirst for knowledge and a commitment to improve the lives of his fellow human beings. His personal writings are filled with excitement and exultation when he realized he might have discovered a way to curb one of the deadliest diseases of his time (and for the 400 preceding years in the Americas). He applied knowledge, courage and clarity of thinking where passion and an almost religious belief in the cause and transmission of disease prevailed. His reasoned, dispassionate approach is being applied to the combat challenges of 2009: mild traumatic brain injury or concussion, post-traumatic stress disorder (PTSD), trauma management and infectious threats. The Army has designated 2009 as the Year of the Noncommissioned Officer. Noncommissioned officers (NCOs) are essential to military medicine and to saving lives on the battlefield. NCOs make up 18 percent of AMEDD and play critical roles in every aspect of our support for the Army family. As vital as our role is in treating and healing wounded or ill soldiers, protecting soldiers from injury and sickness is equally important. Led by dedicated NCOs like SGT Kerri Washington, who deployed from the Army Center for Health Promotion and Preventive Medicine, Aberdeen Proving Ground, Md., to Baghdad with the 61st Medical Detachment, preventive medicine specialists keep our Army fit to fight. Our medics are bringing new tools to the battlefield, helped by combat developers like MSG Christian Reid and SFC Raymond Arnold, whose work has improved the mine resistant ambush protected ambulance, Army combat helmet, combat arms ear plugs, improved outer tactical vest and fire-retardant uniforms. The survival rate of servicemembers injured in combat is greater than 90 percent. This has been accomplished despite increasingly destructive weapons wielded by an adaptive enemy and wounds unparalleled in civilian trauma medicine. We believe armored vehicles, body armor, better training of all warriors in self- and buddy-aid, better trained 24 ARMY July 2009

3 U.S. Air Force/TSgt Jeremy T. Lock SGT Catherine Olivarez, a medic with the 345th Civil Affairs Brigade, looks over a toddler during a medical civil-action program at a village school in Goubetto, Djibouti. medics, faster helicopter rescues, and rapid evacuations out of theater all contribute to lowering our killed-in-action and died-of-wounds rates. Our great health-care professionals need modern facilities and state-of-the-art equipment to continue to improve care. We have received funding for new hospitals at Fort Hood, Texas; Fort Benning, Ga.; and Fort Riley, Kan. New facilities are also being built in San Antonio, Texas, as the Army and Air Force hospitals there join to form the San Antonio Military Medical Center, and in the national capital area, where military health services will be consolidated in the new Walter Reed National Military Medical Center in Bethesda, Md., and a new hospital will be built at Fort Belvoir, Va. The quality of our facilities is tangible evidence of our commitment to our military families and our medical staffs. I also want to mention one of our research initiatives launched last year the Armed Forces Institute of Regenerative Medicine. This multi-institutional, interdisciplinary network is using bioengineering techniques to prompt the body to regenerate cells and tissue. The institute holds great promise: Ultimately, we may be able to regrow whole organs and engineer replacement fingers and limbs. We are also developing the National Interagency Biodefense Campus at Fort Detrick, Md., to fill gaps in national protection against biological weapons and epidemics and integrate agencies for a whole-of-government approach to national security. Research includes work on developing vaccines, diagnostics, forensics and therapeutics. One outstanding example of our talented researchers is Dr. Lisa Hensley. As a microbiologist at the Army Medical Research Institute of Infectious Diseases, she headed efforts to understand how deadly diseases threaten infected hosts, leading to candidate therapeutics for Severe Acute Respiratory Syndrome and Ebola. Last year, Dr. Hensley CPT Jabari White, severely burned during an explosion in Iraq, leans on a therapy table at Brooke Army Medical Center, Fort Sam Houston, while burn therapist Alicia White of the Institute of Surgical Research works on helping him flex his arm. Elaine Wilson 26 ARMY July 2009

4 U.S Army/PFC Eric J. Martinez Heike Hasenauer Above, PFC Leanna M. Goodrum, a mental health counselor for the 62nd Medical Brigade, conducts a counseling session in Iraq. Below, SPC Nicholas Williams, wounded in Iraq in July 2007, works out his prosthetic leg at Walter Reed Army Medical Center. was named one of the Ten Outstanding Young Persons of the World by the Junior Chamber International worldwide federation of young leaders and entrepreneurs. As the Secretary of Defense has stated, aside from winning the war we have no higher priority than the care of our wounded. To that end we have had several successes. This year I, along with all my hospital commanders, signed the Army Warrior Health-Care Covenant in which we express our gratitude for what our warriors have given and promise them the highest quality of care possible as well as the assistance needed during their healing. That covenant is more than a piece of paper; indeed, it is a solemn commitment by which we live. This year, the U.S. Army Medical Command (MEDCOM) stood up the provisional Warrior Transition Command (WTC), a new one-star command within MEDCOM that serves as the organizational focal point for the Army s Warrior Care and Transition Program. The WTC is responsible for execution and oversight of the Warrior Care and Army Wounded Warrior programs for the MEDCOM commander. In our first year of Warrior Care and Transition, we heavily invested in the structure of our units and support systems. Now in our second year, we recognize that our focus needs to be on optimizing the transition for our soldiers. In March 2008, MEDCOM launched the Comprehensive Transition Plan initiative for warriors in transition. Instead of focusing solely on injury or illness, the Comprehensive Transition Plan fosters a holistic approach to a warrior s rehabilitation and transition. This is accomplished through the collaboration of a multidisciplinary team of physicians, case managers, specialty care providers and occupational therapists. Together with the soldier, they develop individually tailored goals that emphasize the transition phase to civilian life or return to duty. MEDCOM employs ombudsmen who operate independently, answering to MEDCOM and the Army for service to wounded warriors and their families, cutting through red tape. These ombudsmen, most of them former medical noncommissioned officers, know the system. For example, an ombudsman contacted a soldier s commander and told him the soldier s medication needed to be stabilized before he could deploy. The ombudsman s negotiations resulted in the soldier being allowed to remain with a rear detachment and receive the medical care he needed prior to deploying. The Medical Evaluation Board and Physical Evaluation Board processes 28 ARMY July 2009

5 U.S. Army/PFC Jasmine N. Walthall COL Lionel M. Nelson, USA Ret. (left), assists soldiers during a mass-casualty training exercise in Baghdad, Iraq. Nelson, retired since 2004, was on a 90-day boots-on-the-ground volunteer assignment as brigade surgeon for the 449th Theater Aviation Brigade. are being reformed and streamlined so that the disability of a warrior in transition can be evaluated more efficiently and promptly. Warriors should be able to concentrate on regaining their health without worrying about paperwork and bureaucracy. PFC Rachelle Halaska, a combat medic with the 1st Squadron, 9th Cavalry Regiment, inspects a child's ear during a medical-assistance mission at a clinic near Forward Operating Base Hunter in Iraq. 30 ARMY July 2009 Army leaders at all levels recognize that combat and repeated deployments are difficult for soldiers and put stress on our families. We are making bold, sustained efforts to improve the resilience of the entire Army family, to reduce the stigma associated with seeking mental health care, and to provide multidisciplinary care addressing specific behavioral health needs promptly and expertly. For example, across the Army over the last two years we increased the number of behavioral health-care providers by almost 40 percent; we are completing the sixth iteration of the intheater Mental Health Advisory Team; we held an Armywide stand-down to train soldiers on suicide prevention; and we launched the Army Campaign Plan for Health Promotion, Risk Reduction and Suicide Prevention. We are resolved to prevent adverse social outcomes associated with military service and combat, such as driving while intoxicated and family violence. Suicides are unacceptable losses of our soldiers. Realizing that the loss of one soldier to suicide is one too many, we are looking closely at factors involved. Rather than primarily PTSD as one might expect, we continue to see fractured relationships and workrelated stress as the major factors in soldier suicides. The Army Chief of Staff has established a vision of an Army composed of balanced, healthy and self-confident soldiers and families whose resilience and total fitness enable them to thrive in an era of high operational tempo and persistent conflict. To achieve this ambitious vision, he is instituting the Comprehensive Soldier Fitness program, the intent of which is to increase the resiliency of soldiers and families by developing the five dimensions of strength: physical, emotional, social, spiritual and familial. Under the leadership of BG Rhonda Cornum and through the commitment of NCOs like MSG Richard Gonzales, I expect this program to have a profound effect on soldiers and their families. Belonging to the Army medical family means having the opportunity to serve America and the global community. We are motivated by the desire to do the very best we can for each wounded person we treat and to work tirelessly to improve our ability to save as many as possible. The nation expects us to save lives on the battlefield using the finest techniques, best research and highest professional values I am proud to affirm that the men and women of Army Medicine live up to this expectation every day. Army Medicine: Army Strong, NCO Strong. U.S. Army/SPC Creighton Holub