An Ounce of Prevention
March 4, 2013
PARWAN PROVINCE, Afghanistan -- Two days of seminars and shared lessons concluded Feb. 26 as preventive medicine experts from coalition forces convened on Bagram Air Field to discuss solutions to challenges they face in Afghanistan.
As US forces perform retrograde and redeployment operations, the mission of force health protection becomes increasingly important. The annual conference assembled preventive medicine (PM), veterinarian, environmental science, and public health personnel to address issues ranging from burn pits to bottled water.
Tie in with the base closure plan, the engineers, and the commanders, said Joe Schroeder, a Department of Defense civilian environmental engineer. "You're there to advise and protect the Soldiers' health."
Schroeder's point is that prevention is in large part a matter of risk communication. One warning repeated at the conference was to continually remind and educate all service members to take their anti-malaria medicine, especially post-deployment for the recommended time. Also, the risk of rabies is higher in Afghanistan than in the United States. Therefore, good discipline and working with vector control are key steps to ensuring the safety of each service member.
"The communication I've seen from starting in Iraq to now is ten-fold better" said Christopher Quesada, a contractor in charge of managing pest control in many parts of the country. Quesada has more than a decade of experience in pest control, and his team of more than 50 personnel work on multiple bases to assist the preventive health system by eliminating mosquitoes, rats, snakes, and other unwanted pests.
Working together, communication, with the chain of command is the only way to truly solve pest control and minimize the risks associated, he said.
"It is interesting that every coalition force is fighting the same fight as regards to preventive medicine," said British Army Captain Christopher Taylor, a force health protection officer in Regional Command South-West. Although different regions might see a variety of specific health issues, such as leishmaniasis in areas with more sand flies, the fundamental issues remain consistent. Taylor echoed many of the presenters saying risk mitigation communication to the service members in a way that makes sense is vital to their protection.
Army Maj. Claudia Luna, the Task Force Medical-Afghanistan environmental science and engineering officer, who helped organize the conference, explained how streamlining the Occupational and Environmental Health Site Assessments also contributes to a responsible withdrawal in theater.
In short, OEHSAs are mandatory comprehensive environmental and health assessments performed by trained preventive medicine teams analyzing factors such as soil, air, and water on coalition bases in Afghanistan. The data collected becomes a "living document" at the Department of Defense level to be shared with the Veterans Administration for future use should the health of a population or individual from a specific location be assessed, said Luna. This data is also monitored for preventive purposes as well, to help warn of potential health hazards in an area.
The time spent on a base for a PM team averages only a few days, but Luna's team found that the whole process took 20 steps, averaging 16 days from start to finish. When each PM detachment has nearly a hundred OEHSA's to complete across the country during their mission, time becomes the enemy. And when PM reduced from three detachments to two last year, a method to do the same amount of work with two-thirds the force became essential. Working with the detachment commanders, Luna utilized a process known as value stream mapping to identify how to cut the 16 day process down to less than a week while ensuring the same level of quality in each assessment. The refined process also saved $400,000 per OEHSA, according to Luna's team.
Her team, along with others, shared similar experiences and knowledge at the conference.
"The goal of the conference," said Army Lt. Col. Alden Weg, Task Force Med-A chief of public health, and conference director, was "to provide a forum for individuals from across [Afghanistan] to share ideas, knowledge, and expertise in order to further enhance the delivery of these services across the theater."