Saturday, May 07, 2011

Aeromedical Evacuation Saves Lives in Afghanistan


By Donna Miles 
American Forces Press Service
BAGRAM AIRFIELD, Afghanistan, May 6, 2011 - An aeromedical evacuation capacity unrivaled anywhere in the world is saving the lives of wounded warriors in Afghanistan, said the officer here who oversees the effort at the combat theater's busiest aeromedical evacuation point.
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Air Force Lt. Col. Kathleen Flarity, commander of the 455th Expeditionary Aeromedical Evacuation Flight's operations at Bagram Airfield, Afghanistan, said better equipment and processes are improving the way the military moves wounded warriors to increasingly more advanced levels of care. DOD photo by Donna Miles
 
Equipment and procedures are being improved continually to move wounded warriors to progressively more sophisticated levels of care in Afghanistan and ultimately, in the United States, said Air Force Lt. Col. Kathleen Flarity, commander of the 455th Expeditionary Aeromedical Evacuation Flight's operations here.
During the Vietnam War, it typically took more than a month to move wounded troops to advanced treatment facilities in the United States, she said. Today, it's down to as little as three days.
"That's not the goal, to get them home," she said at her office in her unit's compound, known as "Evac-istan."
The goal is "to get them what they need, when they need it," said Flarity, an Air Force Reserve nurse practitioner deployed from Peterson Air Force Base, Colo. "That is huge, and that has changed a lot."
Flarity attributed much of that change to initiatives adopted since 9/11: the use of multiple air platforms to move wounded warriors; state-of-the-art medical equipment able to operate in demanding conditions and high altitudes; and critical care air transport teams specially qualified to transport even the most critically wounded warriors, among them.
Air Force HH-60G Pave Hawk helicopters, operated by elite Air Force expeditionary rescue squadrons, have joined Army "Dustoff" helicopter crews -- nicknamed for their motto, "Dedicated, Unhesitating Service to Our Fighting Forces" -- to evacuate wounded warriors from remote forward operating bases and combat outposts.
And gone are the days when aeromedical evacuation crews had to wait for a specific air platform to fly patients for care at Landstuhl Regional Medical Center in Germany and then on to facilities in the United States. Now, they can use a variety of aircraft: the C-17 Globemaster III, C-130 Hercules and KC-135 Stratotanker.
"We are universally qualified" on the different platforms, Flarity said. "So essentially, any time there is an aircraft available, we can take our teams and our equipment and jump onto any aircraft. ... This opens up a lot more aircraft availability."
The C-17, with its large cargo bay and ability to move the most patients, is a favorite among aeromedical evacuation crews. Specifically designed to include aeromedical evacuation in its mission set, "it's big, bright and spacious," Flarity said, with many built-in amenities such as medical-grade oxygen and buttons patients can push to call for assistance.
Although built for air-to-air refueling, KC-135s have become aeromedical evacuation workhorses in Afghanistan. They don't provide the temperature control of C-17s and require crews to carry aboard green boxes of liquid oxygen that converts to gaseous oxygen, Flarity said, but the KC-135s offer much-welcomed and much-needed capacity.
New medical equipment has improved the process. A pump introduced during the initial stages of the Iraq war enables patients to administer their own pain medication, within prescribed limits, and locally administered anesthesia is provided through strategically placed catheters.
A new liquid oxygen system is among new technologies being explored to give aeromedical evacuation crews additional capability.
In these and other improvements, Flarity said, the emphasis has been on common systems across the services that don't need to be changed as patients move through different levels of care. "That way, I can take your pump and give you back mine, instead of changing out all the tubing and pieces and parts," she explained.
The presidentially mandated electronic health record system is another development making steady progress across the aeromedical evacuation system. The transition has been relatively smooth for long missions to Ramstein Air Base in Germany and Joint Base Andrews in Maryland, Flarity said. But during 20-minute flights between forward operating bases in Afghanistan flown under low-light conditions, she acknowledged, it poses more challenges.
Challenges are nothing new to aeromedical evacuation crews, Flarity noted. Operating in conditions that include noise, vibration, air-pressure fluctuations, turbulence, and sometimes enemy fire, today's crews are the most experienced and battle-tested the Air Force has ever seen, she said.
Flarity called these "rainbow crews" -- a mix of active-duty, Air Force Reserve and Air National Guard members -- the backbone of the system committed to doing what it takes to get wounded warriors home safely.
"Ultimately, what we do is about those soldiers, sailors, airmen, Marines [and] Coast Guardsmen ... is for the warrior at the battlefront," she said. "And because we are here, it allows them to focus on their mission, ... knowing we have their backs."
Air Force Tech. Sgt. Latresia Pugh, the mission management technician on a recent aeromedical evacuation flight to Andrews, said she feels honored to be able to provide that support. "These are our brothers and sisters, and we want to take care of them," she said.
"These guys are risking their lives for us, and we have to get them back to their families safely," agreed Air Force Staff Sgt. Napolean Gifford, a critical care air transport respiratory therapist from Douglas, Ga. "That is the very least we can do for them."
Air Force Maj. Gerry Martinez, a flight nurse deployed to Ramstein from Lackland Air Force Base, Texas, said he's often touched to hear his patients express appreciation to the aeromedical evacuation crews.
"They are so grateful that we are here taking care of them," he said. "But what I say to them is, 'Thank YOU.' These guys are the ones making the ultimate sacrifices."
Air Force 1st Lt. Donna Olson, a Mississippi Air National Guardsman who served as medical crew director during a recent mission transporting 24 patients from Ramstein Air Base, acknowledged that transporting wounded warriors, many younger than her own children, can sometimes be emotionally tough.
"But I love this job, and wouldn't trade it for anything in the world," she said. "I have the gratification of helping them through all this and returning them home so they have the opportunity to live full lives."
Related Articles:
'Golden Hour' Initiative Pays Off in Afghanistan
Air Guard Assists Critical-care Evacuations
Evacuation Team Carries Wounded Warriors Home
Landstuhl Provides Advanced Care for Wounded Warriors
Registry Yields Life-Saving Medical Treatment Lessons 

Click photo for screen-resolution imageA sign at the 455th Expeditionary Aeromedical Evacuation Flight's office at Bagram Airfield, Afghanistan, reflects its nickname: "Evac-istan." DOD photo by Donna Miles 
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Click photo for screen-resolution imageAeromedical evacuation team members and volunteers at Ramstein Air Base, Germany, prepare to carry patients being transferred from Landstuhl Regional Medical Center for a flight to Joint Base Andrews, Md., to receive advanced care in the United States. DOD photo by Donna Miles
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Click photo for screen-resolution imageAeromedical evacuation team members and volunteers at Ramstein Air Base, Germany, carry a patient being transferred from Landstuhl Regional Medical Center for a C-17 Globemaster III flight to Joint Base Andrews, Md., to receive care at Walter Reed Army Medical Center in Washington, D.C., April 29, 2011. DOD photo by Donna Miles 
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Click photo for screen-resolution imageAeromedical evacuation team members and volunteers at Ramstein Air Base, Germany, position a critically wounded warrior for a flight aboard a C-17 Globemaster III to Joint Base Andrews, Md., April 29, 2011. DOD photo by Donna Miles 
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Click photo for screen-resolution imageAir Force Capt. Jackie Richards, a critical-care nurse from Joint Base Elmendorf-Richardson, Alaska, tends to a severely wounded warrior being evacuated from Bagram Airfield, Afghanistan, April 29, 2011. DOD photo by Donna Miles 
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Sonia Gandhi urged to intervene


UPA convener Sonia Gandhi urged to intervene to stop vidarbha farmers suicide
                  ===============
VIDARBHA JAN ANDOLAN SAMITI
11, Trisaran Society, In front of Somalwar School, Khamla, Nagpur – 440 025
Mob No. 9422108846 / 9371137653 / 9822593943. Ph : 07235-227564.
========================================================
Ref No. VJAS/Cotton PULSES-NFSM/1589/2011                        Dated-05.05.2011.

MOST URGENT – MATTER PERTAINING TO FARMERS’ EXPLOITATION
From,KISHORE  TIWARI, 
B.E.(Mech. Engg.), MBA, LL.B., M.A. (Pub.Admn.),
M.I.S. (USA), Fellow – I.E.H., Fellow – CA.
(Chartered Engineer)

PRESIDENT
VIDARBHA JAN ANDOLAN SAMITI

To,
Smt.Soniaji Gandhi,
Convener, UPA,
10, JanPath.
New delhi-110001

Ref :   Exploitation of cotton and Tur- Arhar – Pulses cultivating Farmers vidarbha

Sub :   Request for thr Central Government intervention to save cotton and TUR Farmers of vidarbha

Hon’ble  Madam,
Ours is the Peoples' Rights Group & We are fighting for protection Rights of Public at Large. We have been fighting for the cause of poor farmers in Vidarbha Region, who all are suffering due to failure of policies of Central & State Government to protect their rights & interests and in turn are forced to take extreme steps of suicides in which so far more than 8500 Farmers have killed their life due to acute depression.
We are  forced to draw attention of you to the facts that vidarbha farmers are being forced to commit suicide due wrong policies of UPA Govt. here is recent report of the cotton and pluses grower of vidarbha
 Vidarbha's Dying Fields And Farmer's Suicides
While the government of India and Maharashtra, led-by Congress, which claims itself as a party of aam aadmi and one of the world’s fastest growing economies, only images of this new prosperity have reached the impoverished rural areas where two thirds of India’s 1.1 billion people live. Left behind by India’s soaring economic boom is Vidarbha,a region of hilly forests in the middle of India. It used to be known as India’s cotton belt – but now captures headlines as its suicide belt - that’s an average one suicide every eight hours. Vidarbha farmers face a grim reality of crop failures, sinking global cotton prices and crushing debts. Farmers in default at the bank frequently resort to illegal moneylenders who charge up to 100 per cent interest. And, the government safety net – that once kept cotton prices closer to the cost of production – has all but disappeared. Under India’s new free trade policies, Vidarbha’s 3.2 million cotton farmers – most of them small landholders – must compete in a global market that includesformidable, often subsidized rivals, including American cotton farmers.
At a moment when India is enjoying record economic growth, Vidarbha’s four million cotton farmers who have been left behind, struggling to survive on less than Rs 100 a day. Kishor Tiwari, former businessman turned farmer advocate, whose tiny office in the heart of Vidarbha, the cotton-growing region, functions as the archive and watchdog for the suicide epidemic; traveling salesmen hawking genetically modified  and costly - cotton seeds that require irrigation that few Vidarbha farmers have; the last rites of a farmer who couldn’t pay his debts; a tour of the poison ward at the local hospital, where beds are always filled; and even Rahul Gandhi, the prime minister in waiting pays a visit during the election ‘season’ whom the farming widows beseech for help in convincing the government to forgive their debts.
The farmers of Vidarbha are the target of the government, politicians and bureaucrats, for the reason they don’t know. On the event of International Labour Day and Maharashtra Day on May 1, 2011, over 300 cotton farmers went on a day-long hunger strike in Vidarbha demanding the lifting of the ban on cotton exports.
the prices of cotton and pulses (tur dal) have fallen by more than 50 per cent in the last month due to what he said “anti-farmer export-import policies” of the centre.“The present ban on cotton exports is to protect the textile lobby of south India which is very close to some central ministers like Textile Minister Dayanidhi Maran. This is responsible for the crises, including falling prices, gripping cotton farmers in Vidarbha moreover it is reported that some bureaucrats were influenced by strong lobbying by the textile mill owners who wanted cheap raw material to increase their profit margins. It may be recalled that during December 2010, citing the upward trend in cotton and yarn prices, Tamil Nadu Chief Minister M Karunanidhi urged Prime Minister Dr Manmohan Singh to suspend cotton exports and cap cotton yarn exports as well as levy an export duty on it with immediate effect. In a letter to Manmohan Singh, a copy of which was released to the media, Karunanidhi - referring to the central government’s permission to export 55 lakh bales from November onwards - said: “Between last week of September 2010 and the last week of November 2010, cotton prices have increased almost by 20 percent.Further hectic buying indulged in by the exporters of cotton has resulted in arrivals to the market being woefully inadequate to meet the domestic consumption”. “Normally the period of 4-5 months after October witness a dip in cotton prices owing to fresh arrivals in the market. However, this year, the clearance given for exporting 55 lakh bales of cotton has resulted in a hand to mouth situation by which virtually no cotton is available in the market to build up cotton stocks,” competing countries like China maintain a stock touse ratio of about 33 per cent as against India’s 17 per cent.Referring to the rise in cotton yarn prices due to increase in cottonexports, Karunanidhi has said yarn exports should be moderated so thatvalue addition is possible downstream, “…so as to enable higher production of powerloom cloth, knitwear, handloom cloth, garments etc.”
“The prices have plummeted to below Rs 4,500 a quintal during the lastfortnight from a high of Rs 7,000. The situation can be salvaged by hiking the export quota to 15 million cotton bales from the existing5.5 million,” alleged Tiwari.He pointed out that the export restrictions are shocking, especially when there is good demand for cotton in the global markets which the country exploit and the farmers can made good their losses of the past one decade.
“Floods have hit cotton crops in China and Pakistan while the crop area was slashed the US. It is a rare chance for the country to export cotton at very good prices. It is a mystery why the quota is not being increased this year when last year 8.3 million cotton bales (each bale at Rs 170 per kg) were exported.
“The prices of cotton and pulses (tur dal) had fallen by more than 50 per cent in the last month due to ‘anti-farmer export-import policies’ of the UPA government at Centre. He also alleged that the agricultural ministry led-by Sharad Pawar, is have their own hidden agenda and are in hand-in-gloves with racketeers controlling the cotton and food-grain market.The government, especially Sharad Pawar, is much interested in the ‘rich man’s game’ (cricket), which is watched by the industrialists,celebrities and rich politicians. They are not interested in the enlistment of farmers in Maharashtra, who are forced to commit suicide. They are interested in pouring money in to the valets of cricketers, deliberately forgetting the poor farmers.
He also alleged that the Union Minister, who is instrumental in raining money on the players, has done little to arrest the suicide of the farmers by solving their problems.
“The money the government and industrialists spends on cricket is only benefiting the players. It is not going to stop the farmers’ suicides, it is not going to solve the fertilizer shortage in the state and it will not solve the power and water shortage in the state,”. Entire Nation & the society atlarge is shocked with these unfortunate incidence of farmers’ suicides and Govt. of India have taken many steps in this regard but no actual benefits have been reached to the needy farmers.
Pluses crisis
In order to increase the productivity of farm produce and to give ultimate advantage to the farmers, Govt. of India through Ministry of Agriculture has introduced various programme in which National Food Security Mission (NFSM) is one of the major programme formulated to increase productivity of Tur – (Arhar) Tur Dal – Pulses and in turns to give farmers advantage of new MSP.

The details of the programe are as under :
National Food Security Mission (NFSM) 
The primary focus of the NFSM is to ensure higher production and productivity of rice, wheat and pulses and to ensure enhanced incomes for farmers.  At present, NFSM covers 476 districts across 17 States.  Under a new initiative, the A3P (Accelerated Pulses Production Programme), one million hectares of potential areas for the major pulses crops – tur, urad, moong, gram and lentil – have been taken up for large scale demonstration of production and protection technologies in compact blocks. Apart from this, the Government also raised the Minimum Support Prices (MSPs) for pulses.
The MSP of Arhar (Tur) has been fixed at Rs. 3000 per quintal, of Moong at Rs. 3170 per quintal and of Urad at Rs.2900 per quintal, marking an increase of Rs. 700 per quintal, Rs. 410 per quintal and Rs. 380 per quintal, respectively over the last year’s MSPs. In addition, an additional incentive at the rate of Rs. 5 per kg for tur, urad and moong sold during the harvest/arrival period of two months to procurement agencies shall also be provided. The MSP of gram and Masur was also raised by Rs. 340 and Rs. 380 per quintal respectively.
Having seen the above scheme of Central Government to give better price for Tur – Arhar – Pulses, many farmers in the Pilot Projects’ districts in Vidarbha Region have opted for cultivation of Tur – Arhar – Pulses only with the hope that better MSP of Rs. 3000/- per quintal alongwith additional incentives of Rs. 500/- per quintal will be made available to them. Now, bumper crop & yield of Tur Dal – Arhar – Pulses have been arrived in Vidarbha region, a specially the districts covered under targeted programme of NFSM but due to failure of Central as well as State Governments no procurement centre have been opened so far and farmers are being suffered heavily as the rates of Rs. 2000/- to Rs. 2300/- per quintal is being offered to farmers for Tur – Arhar – Pulses. In rural areas, farmers are being exploitation to such an extent that the cartialization of private trader have reduced the rates to the bottom most extent @ Rs.1500/- per quintal.
This open exploitation of farmers is continued in the market where Government has declared Minimum Support Price of Rs. 3000/- per quintal plus additional incentives Rs. 500/- per quintal as assured by Govt. of India while promoting NFSM, but the farmers are being forced to sell their Tur – Arhar – Pulses produce in a throw away price of Rs. 2000/- per quintal. It is great injustice upon farmers and it is in turn causing great frustration & depression to the farmers which may again lead to more suicides if proper immediate steps are not taken in the interest of farmers at the earliest possible time.
At one stage the farmers are being exploited by not paying MSP on Tur – Arhar – Pulses on the other hand the customer atlarge across India are being forced to pay heavily for pulses. Means it double exploitation of the farmers as well as customers / consumers at large. But Governments, both Central & State, have become mute spectators unfortunately and therefore the kind intervention of Your Honor is invited in the interest of poor farmers as well as consumers at large.
In view of above, we hereby demand that :-
1-all restriction of cotton export should lifted immideitely
2. Pluses Crisis

  1. To issue suitable orders / directions to all authorities to protect Minimum Support Price of Tur – Arhar – Pulses @ Rs. 3000/- per quintal and the traders who all are exploiting the farmers may please be booked under the provisions of Essential Commodities Act read with provisions contended in various law governing Agriculture Support Price Mechanism.
  2. To issue suitable orders/ directions to start procurement centres of NAFED and/or TRIFED for procurement of  Tur – Arhar – Pulses at MSP of Rs. 3000/- per quintal plus assured bonus / incentives of Rs. 500/- per quintal in all districts of Vidarbha region to protect the interest of farmers.
  3. To take all suitable steps to seize the stock of such Tur – Arhar – Pulses purchased by private traders in the prices below MSP by exploiting the farmers and compel them to pay as per MSP and to take suitable action against such traders who have been exploiting the farmers.

  1. To issue suitable compensation to the Tur – Arhar – Pulses cultivating farmers who have been deprived from the MSP and the incentives of Rs. 500/- per quintal as admissible from the scheme of Central Government for promotion of Tur – Arhar – Pulses under NFSM programme.

HENCE PRAYED ACCORDINGLY.
Thanking you,

Yours faithfully,
  
KISHORE TIWARI
PRESIDENT - VIDARBHA JAN ANDOLAN SAMITI


CC to :       

1.     Her Highness Hon’ble President of India,
          Rashtrapati Bhavan,
         NEW DELHI.

2.    Hon’ble Shri Dr. Manmohan Singh,
         Hon’ble Prime Minister of India,
         Govt. of India, PMO, Raysina Hills, NEW DELHI.

 3.  Hon’ble His Highness Governor of Maharashtra State, 
   Rajbhavan, Malbar Hills Road,
   Walkeshwar, Mumbai. 1.       

4.        Shri Sharadchandra Govindrao Pawar,
            Hon’ble Agriculture & Food Minister,
            Govt. of India, Krishi Bhavan,
Dr. R.P.Road, NEW DELHI.

5.        Shri Prithviraj Chavan,
Hon’ble Chief Minister,
Govt. of Maharashtra,
Mantralaya, MUMBAI-440 032.

6.        Shri Ratnakar Gaikwad, IAS
Hon’ble Chief Secretary,
Govt. of Maharashtra,
Mantralaya, MUMBAI-440 032.


Marines Prove Energy Efficiencies in Afghanistan


By Lisa Daniel 
American Forces Press Service
WASHINGTON:  There's a peculiar sight on Forward Operating Base Jackson in the Sangin district of Afghanistan's Helmand province. The base is one of several in southern Afghanistan where the Marine Corps has set up solar panels and uses solar blankets as sources of renewable energy.
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Marines and sailors of India Company, 3rd Battalion, 5th Marine Regiment, and their Afghan army counterparts pose in front of a modified ZeroBase Regenerator -- solar panels -- at Patrol Base Sparks in the Sangin district of Afghanistan's Helmand province, Jan. 12, 2011. U.S. Marine Corps photo by Gunnery Sgt. William Price 
Col. Robert "Brutus" Charette Jr., director of expeditionary energy for the Marine Corps, is working to ensure that deploying such sources of renewable energy become standard procedure. But he admits it hasn't come easy.
When 3rd Battalion, 5th Marine Regiment, received orders last year to deploy to Afghanistan, experiments in environmentalism did not come to mind.
"When we told them they'd be taking renewables to the battlefield, they were not amused," Charette told an audience at an energy, environment, defense and security conference here yesterday.
That was before they trained in renewable energy at Marine Corps Air Ground Combat Center in Twentynine Palms, Calif. -- before they'd proven the Corps' new position that resource efficiency equals combat effectiveness.
At first, the Marines grudgingly accepted the solar panels and other renewable energy sources, saying they could go on "a slow boat to Afghanistan," Charette said. After they trained with the equipment and experienced the efficiency of lighter packs and less reliance on resupplies, they said to put all of it on the planes, he said.
"That's when I knew we had something," he added.
Today, at least two forward operating bases in Afghanistan are powered entirely by solar energy, and several others get at least 90 percent of their energy from the sun. Marine Corps leaders are so pleased with the outcome that they've written renewable energy into training plans and doctrine -- something Charette said he hopes will become joint practice with other services.
"Today on the battlefield, we treat energy and water like it's air, like it will always be there," Charette said. "Logistics guys do such a tremendous job supplying warfighters that we don't pay attention."
The colonel added there still "are a lot of gaps to fill" to create an environment where the services have a steady supply of renewable resources from industry, and a system in place for fielding, training and using them.
"We need a methodical approach to doing it," he said.
The results on the battlefield, though, are good enough to be an incentive. Six solar panels at Forward Operating Base Jackson can keep at least 17 computers and 15 lighting units running throughout the night. A Marine company on a three-day foot patrol uses solar blankets in place of radio batteries, savings hundreds of pounds from packs and thousands of dollars, Charette said.
When Marines in Helmand were given a solar refrigerator that kept water at 40 degrees on a 130-degree day, he said, the unit ordered 10 of them.
As an enduring example of the Marines' energy initiatives in Helmand, they have shared their findings -- and equipment -- with local Afghans. "Without energy, they're never going to be able to stand on their own," Charette noted.
While Helmand residents "showed no interest in biofuels," he said, they like the solar panels and blankets, which are providing much-needed energy.
By 2025, the Marine Corps plans to cut in half the amount of energy each Marine consumes on the battlefield. By writing alternative energy uses into service policies and procedures, Charette said, "it ensures we truly do change the way we do business."  (Issued on May 5, 2011)
Related Sites:
Special Report: DOD Goes Green
Related Articles:
Marines Deploy 'Green' Forward Operating Base to Afghanistan 

Flournoy: Pakistan Must Strengthen Cooperation


By Jim Garamone 
American Forces Press Service
WASHINGTON, - Pakistan needs to strengthen its counterterrorism cooperation with the United States as one result of the May 1 raid that killed al-Qaida leader Osama bin Laden, the undersecretary of defense for policy said here today.
In remarks at the Aspen Institute, Michele Flournoy said U.S. government officials are talking with the Pakistanis to try to understand "what they knew and what they didn't know" with regard to Osama bin Laden hiding in plain sight at a one-acre compound about 35 miles north of the capital city of Islamabad.
"We have no definitive evidence at this point that they knew if Osama bin Laden was at this compound," she said.
The operation dealt a very severe blow against al-Qaida, she said, and the United States will use this in dealing with allies and foes alike.
"It has demonstrated U.S. resolve, it has demonstrated U.S. capability, and I think that puts us in a very strong position both to pressure the al-Qaida network further, but also to incentivize further cooperation with our counterterrorism partners -- not only Pakistan, but around the world," Flournoy said. "This is a real moment of opportunity for us in making further gains against al-Qaida."
Flournoy said she has been talking with Pakistani allies about the importance of strengthening counterterrorism cooperation "and moving forward in a way in which the cooperation is visible and concrete and undeniable."
The Navy SEAL team that conducted the raid also took materials from the compound that intelligence analysts are sifting through now, and Pakistan can help with this, Flournoy said.
"There's great opportunity for cooperation in making sense of what we learn from the materials gathered in the operation," she said, "from understanding the network as it remains and how to put further pressure on the network to hasten its demise, and more broadly to cooperate in a way that ultimately helps stabilize not only Pakistan but Afghanistan."
Flournoy described the contacts as "very candid," and stressed the need for concrete moves on the Pakistanis' part to prove their commitment.
The operation also has relevance in Afghanistan, the undersecretary said. "I would hope the Taliban are re-thinking their future," she said.
The United States supports an Afghan-led reconciliation process, Flournoy said, in which the Taliban would have to renounce al-Qaida, renounce violence and agree to abide by the Afghan constitution.
Now that bin Laden is dead, she said, the personal ties that connected senior Taliban leaders to him are broken.
"And that creates an opportunity for them to step forward and renounce al-Qaida and any affiliation with it," she added.  (Issued on May 5, 2011)
Biographies:
Michele Flournoy 
Related Sites:
Special Report: The Demise of Osama bin Laden 

Friday, May 06, 2011

Forward Surgical Team Brings Advanced Care Closer


By Karen Parrish
American Forces Press Service

FORWARD OPERATING BASE SHARANA, Afghanistan: A short gurney ride from two helicopter landing pads here, an operating room and surgical team offer the best hope of survival for many service members wounded in Afghanistan.
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The 946th Forward Surgical Team performs two operations simultaneously in its operating room at Forward Operating Base Sharana in Afghanistan's Paktika province, March 27, 2011. U.S. Army photo by Sgt. Kyle Carpenter
 

(Click photo for screen-resolution image);high-resolution image available.
"How fast we can get someone from that Chinook or Black Hawk to the triage area, and then to the operating room ... dramatically improves our capability of taking care of people who are very severely injured," the team's leader said.
Army Lt. Col. (Dr.) Peter D. Ray commands the Army Reserve 946th Forward Surgical Team. Since his team hit the ground here Feb. 17, he said, it has treated 73 patients and performed 50 surgical procedures on 38 of those patients.
The team consists of four surgeons including Ray, a chief nurse, a nonmedical operations and liaison officer, two registered nurse anesthetists and additional nurses, enlisted operating room technicians, practical nurses and combat medics.
"We really support the southeast region. We're what's known as a full forward surgical team, which is 20 people," Ray said, "[including] an Air Force advanced-trauma life-support augmentation of about five people."
The 946th's mission includes supporting the 10-person forward surgical team at Forward Operating Base Orgun-E, southeast of here near the Pakistan border, Ray said.
"If too many patients are coming from the border [and] Orgun-E gets maxed out on what they can do, within 11 minutes they can be in Sharana," he said. "And with the airfield here, we also can collate people together and get them moved to the next higher level of care."
The military medical system has three levels of care in Afghanistan. Aid stations are the first level. Ray's team, the first level of surgical assets, is Level 2. Level 3 is for longer-term care and staging for patients moving to Germany or back to the states.
"I primarily route my patients to the Level 3 facility at Bagram [Airfield]," he said.
The hardened surgical facility here includes a triage area, an operating room that can hold up to three surgical patients at a time, and an intensive care area, Ray explained.
The triage beds roll out to the helicopters to bring patients into the building, where the triage noncommissioned officer evaluates them. If there are more than three patients, the medical company next door steps in to help with triage, Ray said.
"Usually, a forward surgical team is located with a 'Charlie Med' company [Company C in a standard brigade support battalion], mainly because we don't intrinsically have laboratory or X-ray capability," he said. "We usually have to borrow that."
The triage area includes a "rapid infuser" machine that replaces blood quickly through a soda-straw-sized catheter inserted at the groin, shoulders or neck, Ray said. Controlling bleeding is one of the most critical aspects of level-two care for patient survival, he noted.
"When people get hit and they lose an arm or a leg, it can be a few minutes before someone can get a tourniquet on them," he explained. "And that entire time, they're losing blood volume."
The team normally has 30 to 40 units of blood on hand, Ray said, but it can put out a call if it needs more and start receiving specific types of blood from soldiers on the base within 30 minutes.
"We've had to use the 'walking blood bank' three times since we've been here," he said. "And all those [patients] survived."
The facilities at here are unusually robust for a forward surgical team, Ray said.
"We have six vehicles, four tents, our own generators, and we're considered to be mobile," he said. In both Iraq and Afghanistan, he added, many forward surgical teams have worked out of fixed locations.
"[Surgical teams'] use in Afghanistan is unique, because with the mountains and the weather, you can't actually get people to that Level 3 facility very easily sometimes," Ray said. "You need these forward surgical teams peppered around, so that they're within a helicopter flight to stop the bleeding, control the contamination and stabilize them."
The operating room equipment the team uses here is "way too heavy" to travel with, Ray said, but is the same quality as that used in the United States.
"When it comes time to do very large cases, we feel like we can get pretty close to the treatment you can get at the emergency room of a trauma center in a major city in the U.S.," he said. "So far, our data bears that out."
Ray said the team has treated a number of soldiers and returned them to their units without needing to send them elsewhere for further care.
"The soldiers do better if they stay with their battle buddies," he said. "A lot of them are very upset when we have to send them farther out."
The team sometimes gets only a few minutes' notice when patients are inbound, Ray said.
"The shortest notice we've gotten is four minutes; the longest is a day or two," he said, "just depending on what the severity of the injury is [and] what the weather is. It's a very dynamic process."
Two soldiers from the medical company manage the administrative processes for incoming patients. Army Sgt. Shay Wilson explained that when a call comes in that soldiers need treatment, he or Army Spc. Justin Maurer will make the estimated 15 or more phone calls required to coordinate and track a patient's status and location.
"We talk to the [surgical team] and make sure they can accept the patient," Wilson said. "From there, it's a matter of coordination, finding flight times and getting the patient here as soon as possible."
Army Capt. Amanda Hargrove, the team's chief surgical nurse, along with two sergeants on the team, prepares the tools and supplies required for patient care and assists in surgery.

"I'm the patient advocate," she said. "I work with the surgeon to position the patient, prep the patient for surgery, and ... provide the surgeons the tools they need."
Hargrove stays with patients until they wake up after surgery and oversees their transfer to intensive care, she said.
Most of the surgical procedures the team has performed result from rocket-propelled grenade attacks, roadside bombs or small-arms fire, Hargrove said.
Ray said the volume of surgeries here proves the value of having an operating room close to the front.
"The folks they're bringing here really do need this surgical component," he said. "It's not just a medical receiving facility. It's a place that does surgery to alter the outcomes."
Rapid evacuation is the key to patient survival, Ray said, noting that the environment and terrain in Afghanistan can make that difficult.
"There's definitely a motivation [in] all the people who work at Level 2 to get these guys to where they need to be ... as soon as we can safely do that," he said.
Ray said 43 people applied for the 15 spaces available on the surgical team before it deployed.
"Where I come from, in Mobile [Alabama], this is the kind of team that people who want to make a difference in medicine want to be in," he said. "We have really no issues with motivation or dedication."
With the location, the people, the blood bank, operating rooms and air capability his team has available, Ray said, "there's no better place to survive than to be brought here."  (Issued on May 5, 2011)
Related Sites:
NATO International Security Assistance Force 

Stacy Pearsall: A Real Warrior

By Elaine Sanchez 
American Forces Press Service
WASHINGTON: Black-and-white photos of Vietnam-era veterans line the wall at a Veterans Affairs center. Some are smiling and others are gazing at a distant point, but in all, an unseen light catches the emotion in their eyes.
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Then-Air Force Staff Sgt. Stacy Pearsall, a combat photographer, serves a tour of duty in IraqCourtesy photo 
The photographer, Stacy Pearsall, a veteran of the more recent wars, strove to capture the character and the experience etched in their faces while listening to their recollections of war.
"Their stories are amazing," she said.
This line of photos on a wall in a VA center in Charleston, S.C., serves not only as Pearsall's veteran tribute, but also a milestone in her recovery from physical and emotional wounds of war.
Just a few months earlier, Pearsall had nearly given up hope of working as a photographer again or of taking photos that didn't serve as a haunting reminder of a painful past.
Pearsall's photography career took off while she was in the Air Force. As a combat photographer, she took thousands of pictures over the course of her Air Force career, earning her accolades and awards from leaders at all levels of her chain of command.
She traveled extensively for her job, so she felt prepared when she was tasked to deploy to Baghdad in September 2003.
As part of her duties, Pearsall documented a school rebuilding process, and when the school marked its opening with a ceremony in February 2004, she attended. After the ceremony, as the unit prepared to head out, the Humvee she was riding in was making a tight turn on a dead-end street when a roadside bomb detonated.
Pearsall was sitting behind the driver's seat. The impact threw her forward, and her head hit the back of the seat. But more concerned about her ears, which were bleeding from the concussive sound, she didn't feel the neck pain until hours later. She was seen by a doctor who chalked it up to whiplash, and she was back out on a mission the next day.
Months later, the headaches and vertigo lingered, as did the severe neck pain. But concerned about her Air Force career, Pearsall didn't seek treatment. Her deployment ended in March, and she became a student at Syracuse University for a year to hone her photography skills.
She had become accustomed to hiding her pain and the emotional after-effects of combat from others, but was unable to keep them from a friend -- a fellow photographer and Vietnam veteran -- who recognized the signs of post-traumatic stress. He connected her with a Vet Center, where she began counseling.
"It definitely helped me work through a lot of emotions and stress," she said. "I knew whatever I said to [my therapist] wouldn't go back to my active-duty command. There was no threat of losing my career."
After school, Pearsall went on back-to-back deployments, first to Africa, then to Lebanon and finally, back to Iraq. The difference between her first and second Iraq deployments was like night and day, she said. In 2003, she never fired her weapon, but in 2007, she fired it constantly.
Her unit experienced heavy casualties in Diyala province. Pearsall saw bodies of Iraqis who had been executed and mutilated, and comrades shot just a few feet away, which she later had to photograph. People getting wounded or killed was a daily occurrence, she said.
A series of back-to-back events took their toll. Pearsall lost three teammates, and a day later, her video partner was wounded and evacuated. Another friend had been shot in the head right in front of her. "Nothing prepares you for the death of your friends," she said.
Her photos from that time are haunting.
In one photo, three soldiers are gathered in a dimly lit room, faces downward as if in reflection, a single light shining through a window. Two days before, their teammate had been shot in the head just 10 feet away from where they were standing. In another photo, two soldiers are comforting each other, one close to tears, after the loss of a friend the day before.
"I'm eternally tied to the photographs that I made and those soldiers who were in those photographs," she said.
The photographer said she had to keep her emotions in check, for her teammates and for the troops who served under her. "I think I handled things pretty well by just not addressing the emotions at the time," she said.
Pearsall was injured again -- further damaging her neck -- when a roadside bomb detonated during a mission. A few months later, her unit was ambushed. She was running out to help a wounded soldier in the street when a cord attached to her helmet snapped her back. Her head slammed on a Stryker vehicle, again injuring her neck.
The next morning, she felt neck pain unlike anything she had felt before, and she knew it was time to get help. The doctors did an X-ray and she was on a helicopter that day. Her neck injury had grown so severe, the doctors told her, that if she had jolted her head one more time, it would have severed her spinal cord.
Pearsall's greatest fear -- losing her career -- was now at hand, she said. And her husband, a strong source of support, was deployed at the time. "It was a really ugly time in my life," she said.
The years of wearing 85 pounds of gear had wreaked havoc on her neck. The doctors told her she wouldn't be able to work as a photographer or pursue another passion, riding horses, again.
But Dr. Patrick Lovegrove, an Air Force flight surgeon at the time, offered her hope through prolotherapy treatment -- which involves insertion of a 4-inch needle down to the bone -- that lasted for more than two years. Pearsall was able to get off of the pain killers and finally on the road to physical recovery.
Invested in her recovery, her doctor separated from the Air Force, but continued to donate his services to her until the therapy ended in 2009 and she switched over to the VA system.
"I'll always owe him a debt of gratitude," she said. The therapy enabled her to ride horses and take photos again, but she knew she'd always have some degree of pain from her degenerative condition.
"It was either adapt to life or shrivel up and die," she said. Pearsall chose to adapt.
But the loss of her Air Force career affected her, as did the emotional wounds of war that she had pushed aside to focus on her physical recovery. She started seeing a mental health therapist about a year after her deployment.
"The military told me I couldn't be a photographer for them anymore," she said. "Mentally, that put me on a roller coaster. What am I good for?"
Pearsall found an answer at the VA medical center in Charleston. While she sat for hours in waiting rooms, she began to notice the men and women around her. Most of the veterans there were from the Vietnam era, and she reached out to hear their stories. She felt inspired to bring her camera and take their portraits, leading to the project that now fills a wall there.
"Just because I was disabled, didn't make me unable," she said. "Once I wrapped my own mind around that, I could do more."
Pearsall plans to keep up her veteran portrait work at VA hospitals in Georgia and North Carolina, then here, and to Maryland and Virginia as well. In another effort aimed at helping veterans, Pearsall provides horse therapy to veterans through a nonprofit group.
Most recently, Pearsall offered to have her story documented for the Defense Department's "Real Warriors" campaign in hopes of encouraging other veterans and servicemembers to seek help. The campaign in sponsored by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, and it features stories of service members who sought psychological treatment and continued successful military or civilian careers. Her profile is now posted on the Real Warriors website, http://realwarriors.net/.
"My hope is that if they watch my story, they'll find a way to offload their burden," she said. "Everyone wears a different amount, but it's not necessary to carry it around with you all the time."
Pearsall said the stigma that kept her from getting help has been greatly reduced through projects such as the Real Warrior campaign and through efforts by the Defense and Veterans Affairs departments.
For servicemembers still leery about getting care, Pearsall recommended online support networks, blogs and forums where people can go and shed their burdens. "You'll see you're not alone," she said. "The loss of sleep, nightmares, anxiety, road rage -- they're products of war."
Pearsall also hopes leaders will gain a greater understanding of mental health issues and, above all, avoid judgment.
"Be positive and supportive," she said. "You're the first in line for that service member."
While it's been difficult to discuss, Pearsall said, she believes it's important to share her story.
"If I get one person to get help if they're having issues, then I feel like I've been successful," she said.  (Issued on May 4, 2011)

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Army Spc. Chris Jankowski, Army Spc. Joshua Philbeck and Army Staff Sgt. Lawrence Washington take time to reflect on their departed friends during some down time in Buhriz, Iraq, Jan. 27, 2007. U.S. Air Force photo by Stacy Pearsall 

Supply Specialist Takes Charge


By Army Spc. Terence Ewings
U.S. Division North

CONTINGENCY OPERATING SITE MAREZ, Iraq: Delivering, receiving, storing and maintaining accountability for equipment and documents are primary tasks for all Army unit logisticians.
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Army Spc. Diana Ortiz signs a hand receipt after accounting for equipment at Contingency Operating Site Marez, Iraq, April 26, 2011. U.S. Army photo by Spc. Terence Ewings 
Army Spc. Diana Ortiz, a 1st Cavalry Division supply specialist assigned to Company A, 27th Brigade Support Battalion, 4th Advise and Assist Brigade, is doing her part here in support of U.S. Division North's task to transition security missions to Iraqi-led operations.
"Ortiz has done a great job not only fulfilling her duties as a supply specialist, but going above and beyond to ensure all company logistics operations are taken care of," said Army Staff Sgt. Sabrina Taylor, Company A's supply sergeant.
During the deployment, Ortiz has overseen the turn-in of wheeled vehicles, military corrugated metal packing crates, and a palletized load system trailer -- equipment with a combined value of more than $3 million. Ortiz played an integral part of all turn-in processes and change-of-command inventories, where 4th Brigade soldiers inventoried more than $35 million worth of equipment with no losses, Taylor said.
In addition to her duties as a supply specialist, Ortiz is a company armorer, responsible for maintaining accountability of weapons, optical devices and other supplies within the company's arms room.
"We are here to support the company by ensuring all their supplies and equipment are mission-ready and capable," said Taylor, a native of Sumter, S.C.
Logistics specialists work long hours to ensure their fellow soldiers have the equipment they need to conduct the company's support missions.
"Ortiz has experience in managing supplies, maintaining property and [facilitating] transactions that happen within the company," Taylor said. "She's a great asset to have, because she is that good at doing her job."
Born and raised in Ecuador, Ortiz moved in with family members in Miami before joining the military in 2007. In 2008, after completing basic and advanced individual training, Ortiz was assigned to Company A, 27th Brigade Support Battalion, and deployed later that year with the brigade to Tallil, Iraq.
"My first deployment taught me a lot," Ortiz said. "I got to my unit and learned how to do my job there. It was a good experience for me."
Now on her second deployment with the unit, Ortiz supports her section sergeant in sustaining the company's supply operations.
"I enjoy doing my job, because it allows me to support other soldiers here," she said. "The soldiers here appreciate what we do."
When Ortiz is not filing hand receipts and maintaining accountability of the unit's tactical vehicles, weapons and equipment, you can find her taking online classes and continuing her undergraduate studies in business administration.
After returning to Fort Hood, Texas, Ortiz said, she plans to finish her studies and earn her bachelor's degree. She eventually wants to attend Officer Candidate School.
"The Army has done great things for me so far, and I'm sure I have a lot to look forward to as I continue to do great things for the Army," she said. (Issued on May 4, 2011)
Related Sites:
U.S. Forces Iraq