Saturday, March 26, 2011

Face of Defense: Corpsman Boosts Afghan Forces

By Donna Miles 
American Forces Press Service
HAMPTON, Va., March 25, 2011 - Ensuring that Afghanistan's security forces are trained and equipped to assume increased security responsibility is a keystone of the U.S. and coalition strategy there.
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Navy Petty Officer 1st Class Darrell Mangham checks on a wounded sailor during exercises at a range in Southwest Asia in preparation for his deployment to Afghanistan as assistant chief of preventive medicine for the NATO-led International Security Assistance Force training mission in Afghanistan. Mangham received the 2011 Hunter-Strickland Excellence Award for Deployment Preventive Medicine for his work during that deployment. U.S. Navy photo by Petty Officer 3rd Class Jorge Saucedo
Navy Petty Officer 1st Class Darrell T. Mangham recognizes that. But as a hospital corpsman with extensive preventive medicine expertise, he also knows that the train-and-equip mission can be brought to its knees if illness or disease infiltrates the force.
Mangham spent a year in Afghanistan helping to stand up preventive medicine programs he said will have a long-term impact, not just on the Afghan National Army and Afghan National Police, but also on the country's civilian population.
For his efforts, Mangham became the first enlisted U.S. service member to receive the prestigious Hunter-Strickland Excellence Award for Deployment Preventive Medicine.
This year's award, presented yesterday at the Armed Forces Public Health Conference here, is named for Army Col. George W. Hunter III and Army Capt. G. Strickland, pioneers in advancing tropical disease prevention during the 1940s.
Mangham was singled out this year as the service member who best exemplified their work in a deployed setting -– in his case, as assistant chief of preventive medicine for the NATO-led International Security Assistance Force training mission in Afghanistan from February 2009 to February 2010.
Currently assigned to the Naval Medical Center in San Diego, Mangham knew he could serve as a corpsman supporting U.S. Marines fighting enemy forces alongside their Afghan counterparts. But instead, he volunteered to help the Afghan security forces confront a less-recognized but equally insidious enemy: illness and disease spread through poor hygiene, improper food storage and handling, and unsanitary living and sleeping arrangements.
"I volunteered for this," Mangham said of his first deployment with the Afghan army. "I wanted to go and assist at the ground level in rebuilding Afghanistan as a nation."
Once on the ground in the Afghan capital of Kabul, Mangham said, he began building on groundwork already laid as a mentor to the Afghan National Army's surgeon general's public health chief. He led teams that inspected the way the Afghans were shipping, storing, preparing and handling food for the army and police forces. Two of the big gaps he found were lack of refrigeration and specific guidelines regarding food.
So, working through the U.S. Agency for International Development and other organizations, Mangham helped to secure funding needed to buy refrigerators and food-storage units. He also initiated training for food-service personnel.
Mangham also began looking into living conditions for Afghan security forces. One problem, he said, was that Afghan troops often shared the same bunk –- an accepted cultural norm in Afghanistan, but one Mangham said makes it too easy for illness and disease to spread.
He helped to introduce a new ban on bunk-sharing, instituting a rule that bunks must be three feet apart, with troops positioned in alternating head-to-toe arrangements.
"That way, if one soldier sneezed, the germs wouldn't immediately go to the next soldier," he said. "That decreases the passing of viral diseases."
Those efforts resulted in a 40-percent decrease in disease transmission among the Afghan forces, he said.
Operating in the southern Kandahar and Helmand provinces, Mangham also served as senior noncommissioned officer of a six-person team that initiated medical screening and vaccination programs at Afghan National Police recruiting stations.
In addition to providing personal hygiene training, the team members isolated police candidates with contagious illnesses, treating them before allowing them to rejoin the ranks.
Other initiatives Mangham helped to introduce are just now starting to bear fruit. He helped in standing up an Afghan public health officer program, and its first class graduated three weeks ago.
"It was a very, very successful mission," he said of his deployment. "We got a lot accomplished in the year I was there and left a lot of initiatives in place. The mission is successful and thriving. I think we are going to see the state of public health in Afghanistan thrive in the next two to three years."
Mangham called these efforts an important contribution toward a more independent Afghanistan with a military more capable of providing security. The impact, he said, will remain long after the U.S. and coalition mission in Afghanistan ends.
"This goes way beyond the military," he said, noting that the preventive medicine lessons being learned will extend to Afghanistan's civilian population.
"I can train an Afghan doctor in public-health issues," he added, "but he's the one who is going to be most effective in getting that message across to the Afghan people."
Mangham said he is honored to receive this year's Hunter-Strickland Excellence Award for Deployment Preventive Medicine.
"But this is not something I did as an individual," he said. "There were a lot of key players in this effort. I am just one of them."
Related Sites:
NATO International Security Assistance Force 

Click photo for screen-resolution imageNavy Petty Officer 1st Class Darrell Mangham, right, administers a flu shot to Navy Command Master Chief Joseph Vulkovcan at Naval Air Station Whiting Field. Mangham shared his preventive medicine expertise with Afghan national security forces, earning the prestigious 2011 Hunter-Strickland Excellence Award for Deployment Preventive Medicine for his contributions. U.S. Navy photo by Chief Mass Communication Specialist Jay Cope 

Wars Have Been Catalyst for Army Change--Casey

By Jim Garamone
American Forces Press Service
WASHINGTON, March 24, 2011 - In a recent speech at the U.S. Military Academy in West Point, N.Y., Defense Secretary Robert M. Gates said the Army has changed the most of all the services.
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Army Gen. George W. Casey Jr. discusses the challenges he has faced as Army chief of staff with Jim Garamone of American Forces Press Service. Casey is retiring in April 2011 after four decades of service. U.S. Army photo by Myles Cullen 
"There's no catalyst for change like a war," said the architect of much of that change, Army Chief of Staff Gen. George W. Casey Jr.
Gen. Martin E. Dempsey will relieve Casey as Army chief of staff next month, when Casey ends four decades of service. During an interview in his Pentagon office, the outgoing chief of staff spoke about the changes that have happened in the Army since he became the service's highest-ranking officer in 2007.
"We will have done in seven years what normally would take us 20 years to do," the general said. "We've done it in the middle of a war, and we are a fundamentally different force and a more versatile and experienced force than we were seven years ago. I'm very pleased with the way that turned out."
In the months before Casey took over, stories about the Army and its future were common in the media, centering on concern about the pace of operations and its effect on the service.
It was the height of the U.S. surge into Iraq, and soldiers were deployed for 15-month tours and often spending less than a year at their homes before deploying again. Worries surfaced that departures of mid-level officers and noncommissioned officers would "hollow out" the service, and that families weary of the repeated deployments would get their soldiers to vote with their feet and leave the Army.
When he first took office, the general and his wife traveled all over the Army to get their own sense of what was going on. "When we got back we thought our way through it, and it was clear to us that the families were the most brittle part of the force," Casey said. "We needed to do something immediately to demonstrate to the families that we were going to take a load off."
An immediate move was to hire and pay family readiness advisers. The service put in place the Family Covenant Program, and doubled funding for family readiness programs.
Dealing with deployments was another priority, Casey said.
"The 15-month tours – on top of everything they had already done – that was choking people," Casey said. "We had to show them that there was daylight, and that daylight was going to come sooner, rather than later."
Then-President George W. Bush had authorized an increase in the size of the Army by 2012. Casey told about going into auditoriums full of troops in 2007 and telling them relief would come in 2012. "And they would look at me like, "C'mon, General, get real,'" he said.
He met with Defense Secretary Robert M. Gates and told him that the Army growth had to be sped up to 2010, "and he agreed," the general said. The Army met its growth goals in 2009.
Casey also was worried about a hollow force, and instinctively concentrated on the mid-level officers and NCOs. "They were the ones carrying the heaviest loads," he said.
Casey looked to the Army's Center of Military History for historical research, and the data showed it really was all about the midlevel leaders. "When the people it takes you a decade to grow leave, it takes you a decade to get [that capability] back," he said.
The service put in place selective retention bonuses for captains and increased the selective re-enlistment bonuses for mid-level NCOs. "I believe it gave a lot of those captains the ability to look at their spouses and say, 'We're going to be OK," he said.
But people were saying the Army already was hollow because of the readiness level of "next-to-deploy" forces. The service had to strip these forces of soldiers for units already in the combat theater. "We started thinking about generating readiness differently and enhancing the Army force-generating model that we had come up with in 2005 to make it more realistic," Casey said. Follow-on forces now are fully manned and fully trained as a unit before deploying.
Dwell time – the time troops spend at home between deployments – became an important measurement. The goal is for soldiers to spend twice as much time at home as deployed. Casey said the differences are visible in the soldiers themselves.
"I went out with a unit that was home for 18 months," he said, "and you could see the difference that time at home meant in their faces, and in the preparation they could do."
The Army also is changing to meet the demands of 21st century operations. Casey continued the process of changing to a modular brigade system. During World War II, the division was the basic unit for the Army. Today, it is the brigade combat team.
"With everything we had going on, if I had made hard turns, it would have derailed the progress," he said. "I came in and said, 'Let's finish it,' and we kept on going."
By the end of the year, the Army will have converted all but a handful of the 300-plus brigades to these modular organizations, "and we will have rebalanced 300,000-plus soldiers out of Cold War skills to those more necessary today," Casey said. "Together, it's the largest transformation of the Army since World War II."
The personal costs and effects of combat also pushed Casey.
"I'd been in Iraq," he said. "I'd seen the effects of combat on folks and what it did to folks, and I recognized that no matter who you are, everyone is affected by combat in one way or another. I set out to try to reduce the stigma associated with getting treatment for behavioral health issues."
Post-traumatic stress and traumatic brain injuries are the signature wounds of the conflicts in Iraq and Afghanistan, but there may be no outwardly visible signs of the injuries.
"I started getting the word out then to everyone we could that combat is hard, everyone is affected by it -- we're human beings," Casey said. "If you've got a problem, get some help."
The general said he wanted to encourage openness, and knew it was going to be a hard slog.
"We went from where 90 percent of the people wouldn't get help to now, where about half of the people won't get help," he said. "That's still a lot of people, but it's a start. We still have to crack the company and platoon levels. It's gradually getting more traction."
Concurrently, the Army's suicide rate began rising.
"It struck me how futile it is to be sitting around a company orderly room – like we've all done – with the first sergeant saying, 'Gosh, Smith was a wonderful guy. I should have seen something, I should have known something, I should have done something.' And you never can," Casey said. "It occurred to me that maybe we ought to come up with something that gives them skills on the front end before they get to that dark place that would lead them to suicide to begin with."
The Army introduced Comprehensive Soldier Fitness to unit operations to avoid some of the stigma that some people associate with a medical program.
"The whole idea was to bring mental fitness up to the same plane as physical fitness," the general said. "The thrust behind it is [that] part of being a good soldier is knowing when you need a break and when you need to get some help. That doesn't mean you're a wimp."
All this is having results. Army surveys show that family satisfaction with the service has increased steadily since 2007, and this continues to trend upward.
But the Army is not out of the woods yet, Casey said. For the next several years, the United States will continue to send 50,000 to 100,000 soldiers to combat. They are going to have to maintain their edge, but so will the thousands of soldiers who won't be going to combat. At the same time, the Army has to reconstitute after a decade at war.
"What I worry about is you get these guys back in garrison and you go back to the same bull I went through in the 1970s, and these young guys are going to say, 'I'm outta here,'" Casey said.
The service also has to concentrate on building resilience in soldiers and their families, Casey said. "We've just got to keep at it," he added.
The Army has learned from Iraq and Afghanistan that the next conflict probably won't look like anything it is fighting today. "We changed our doctrine in 2008 and said that full-spectrum operations are offense, defense and stability operations," Casey said. "It's done simultaneously and in different proportions, depending where you are in the spectrum of conflict."
He said that when he commanded the 1st Armored Division in 2000 and 2001, he believed that if a unit could do conventional war, it could do anything.
"But after 32 months in Iraq, I don't believe that any more," he said. "What we realized was its not going to be either conventional or counterinsurgency. The wars in the 21st century are going to be different than the wars I grew up trying to fight. We're not going to be fighting corps-on-corps operations, except maybe [in] Korea.
"So we're working scenarios where we have hybrid threats that are a mix of conventional, irregular, criminal [and] terrorist, and we've set up the training centers with these types of [opposing forces]. The 2nd Brigade, 82nd Airborne Division, went through such a hybrid threat scenario.
"We're training them for full-spectrum operations, and that includes having to deal with uniformed militaries," he said.
More work needs to be done, Casey said.
"While we've talked about this and thought about it," he added, "until we start putting brigades out there on the ground and have them do it, we're not going to crack it."
Casey said he is worried about the Army's budget. He wants a balanced force in which the manning, training and equipping is in the right proportion. "The kicker is the wheels are falling off the budget," he said. The Army will remain its current size through at least 2015.
"People are motivated and focused and trying to do the right thing," the general said.
Casey commanded his first platoon in April 1971 in Mainz, West Germany. He had nine soldiers in a 36-man mortar platoon, and five of them were pending discharge from the Army. Each company had a duty officer, he said, and that officer had to be armed.
"Drugs were pretty bad, and there were tensions," he said. "I remember ... the first time we went to the field it struck me like a ton of bricks that these guys depended on me, and I resolved at that point to never let my subordinates down. I always tried to make the unit I was in as good as it could be."
It was just the scale that changed.
Army Gen. George W. Casey Jr. 

Click photo for screen-resolution imageArmy Gen. George W. Casey Jr. discusses the challenges he has faced as Army chief of staff with Jim Garamone of American Forces Press Service. Casey is retiring in April 2011 after four decades of service. U.S. Army photo by Myles Cullen