Aerospace Medicine Consolidated After-Action Report

File: doc08_09.txt
Page: 09
Total Pages: 38
technicians     felt inadequate in performing the       neces8ary environmental
assessments.

                            EM PLOYM EN T

               The early deploying units found heavy patient loads -- tip to 80
patients a day at King Fahd. This demand typically decreased and leveled after
the first month or two. Reported patient visit workload is contained in Appendix
A. The perception was that even after the ATH's arrived, ATC's saw 2 to 3 times
more sick call patients because of better accessibility.  Traveller's diarrhea was
common but self limited.    Diarrheas refractory to conservative therapy usually
responded to Cipro.    Heat stress visits were minimal in units with good pre-
deployment briefs. Several SME's treated significant numbers of heat casualties
from other units such as security police or collocated Army units.
      Some units deployed with inadequate amounts of personal hygiene
supplies.
      MRE's were the only source of food at some locations while others had host
nation food services in place.  Line commanders were reluctant to close down
marginal host nation food services because of the adverse impact on morale.  A
combination of reluctance to be inspected on the part of the Saudi1s, inability to
enforce recommendations, low level of experience in food inspection among the
SME's, and early demands for dinical vs. preventive medical services resulted in
several food-borne outbreaks of gastroenteritis. In all, 16 separate outbreaks at 10
different locations were identified involving 2,500 cases. Of these, 4 occurred in
the month of August at 4 separate locations. Appendix B contains a summary of
these outbreaks extracted from information presented by Col. Butts to the After-
Action Conference.   The SME's concurred with the Environmental Health after-
action assessment that an organic food service could have prevented nearly all of
these outbreaks.    Additionally, SME's wanted more environmentaI/sanitation
experience in the SME package. First preference was to substitute an rDMT for a
9OlXO, second to substitute a military public health technician, third to leave the
SME as is and construct an environmental UTO with 907X0, 9O8xO, and a suitable
equipment package that may be deployed on reques~
      One location reported that colocated Canadian forces had a "model
installation~'. Three hot meals a day were provided by their own food service.
Their medical staff was twice that of the SME and supported fewer personnel.
Their  supply    pipeline was responsive  within 48       hours.  Their mobile
decontamination system was simpler and more flexible than the American
equivalent.
      Many flight surgeons1 especially the fighter SME's, had difficulty meeting
flying hour requirements.      All currency requirements in AFR 60-1 were
eventually waived by HQ USAF/SGPA, but the requirement for 4 hours per month
to qualifY for flight pay is set by Congress. CENTAF(rear)ISGPA coordinated with
HQ MAC/SGPA to allow all flight surgeons in theater to log time on MAC
aircraft.  CENTAF/CC also authorized the combat-related time extension
specified in DOD regulations.  Physiologic training and flight physical currency
was also waived by HQ USAF/SGPA.
      At some locations, medical intelligence became more difficult to get with
time.
      A few SME's relocated within theater.  One relocated three times.    This
underscored the need for the logistics and command and control aspects of the
ATC's to remain substantially independent of the ATH.