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pushed back and the stress of the deployment took its toll among both deployed
personnel and their families. We saw significant increase in psychological
problems, most frequently manifested by vague and non-specific physical
complaints such as chronic fatigue, insomnia, headache, back pain, etc.
Despite the increasing heat. We saw few cases of heat problems, none that were
critical.

After the 8th Army Evac closed, our nearest medical facility was the 85th
Air Evac in Daharan (a 45 min drive). The final medical draw down was
achieved in systematic and successful manner thanks to the energetic and
effective efforts of Major Richard Sachitano, flight surgeon for the New
Orleans Cajuns (A-10 squadron) who worked hard to prevent the remaining flight
surgeons and personnel from getting caught short after the 8th Evac left. A
clear dust-off plan was developed, local hospitals were visited and assessed
for possible assistance that they might provide us in the event of major
trauma, and the link with the 85th Evac as firmly established. Two Indepen-
dent Duty Medical Technicians were brought in to provide care for the residual
forces after we left.

The most common medical conditions that we saw were upper respiratory
infections, acute gastroenteritis(clinically, not food-borne), skin infections,
(dermatophytes and papilloma virus), psychological problems (primarily 
depression and some malingering). minor lacerations and orthopedic injuries,
chronic orthopedic problems such as bad knees or chronic shoulder pain, and
back pain. The most troublesome to treat are the psychological problems
which tended to be seen commonly in dysfunctional personalities who were
simply not suited to prolong deployment nor responsive to "quick fixes".
Back pain and minor orthopedic injuries were among our most commonly seen
complaints and most common cause of lost man hours. Additionally, because
people with these problems had difficulty with ambulation (their major source
of transportation), relatively minor injuries produced a disproportionate
degree of disability. When personnel with critical skills were involved, the
mission was compromised to a degree that was unnecessary. We had no physical
therapy for these common problems: bed rest was nearly impossible for the
patients since use of bathrooms, chow halls, and showers require significant
ambulation and it is difficult to allow people enough time off work to
recuperate.

OBSERVATIONS & RECOMMENDATIONS:
1. OBSERVATION: Mission planning was severely compromised by the lack of
information provided to the SME. This situation was not unique to our unit
but was cited by every flight surgeon with whom we came in contact as a
significant problem to their unit.  We never were able to communicate directly
with the medical staff at the deployed location, nor were we given clear
picture of our deployed conditions, necessary supplies, e.g. anaerobic
antibiotics that were very difficult to obtain in theater easily could have
been brought from home base had that line of communication been available.
RECOMMENDED: Mission planning must include the medical personnel and they
must be given enough information to anticipate mission medical needs and to
advise the commander about necessary supplies and personnel. If it is
anticipated that an incomplete medical package will be deployed or that the
deployment will be lengthy, the flight surgeon should be included in a site
visit prior to deployment. At minimum, the flight surgeon should have direct
communication with medical people at the deployed location and be allowed to

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