Preparing
for Deployment: A lecture
LTC Thomas P. Garigan, MD
September 1999
Lecture Outline:
Why we get deployed:
- Military health care providers
who are:
- physically fit to deploy;
- highly trained and proficient
in the art of military medicine;
- trained with the supplies and
equipment of their deployable platforms and units;
- ready for rapid mobilization
and deployment for any mission within the operational spectrum;
- well founded in military medical
doctrine, tactics, techniques, and procedures.
- Medical units that are:
- ready for rapid mobilization
and strategic deployment to sustain medical support for any mission;
- flexible, mobile, and adaptable
to a variety of potential missions.
Deployments vary greatly-
BE WARY OF "EXPERTS"!
- duration
- personal risk
- political popularity
- patient care
- accommodations
Types of Military Missions
- War
- Peace Enforcement
- Peacekeeping
- Peace Building (post conflict)
- Nation Assistance
- Disaster Relief
- Humanitarian Assistance
- Show of Force
- Training
Medical Programs:
- Small deployments
- Patient care projects
- HADR
- Academic, NGO, IO, WHO affiliations
- Conference Sponsorship
How We Get Notified:
- Long lead time: "stable"
operations
- Intrinsic Action- Kuwait
- SFOR- Bosnia
- Short Notice:
- Saddam Saber Rattling
- Hurricane Mitch
- No-Notice Mobilization:
- Immediate Response Units:
- Division Ready Brigade surgeons,
Aviation unit flight surgeons, etc.
- Replacement for a non-available
doc!
May 1997: The US Army announced
it had soldiers deployed to 100 countries.
- Subject Index: "Deployment"
- Prior to 1990: 0
- 1990-1997: 11
Roles of Physicians in Deployments:
- Medical Staff
- staff physician
- section chief
- Small Medical Unit Commander
- Large Medical Unit Commander
- Unit Surgeon
Deployment's Place in Your Career:
Where
to Find Information for Preparing to Deploy?
- Colleagues
- Published Literature
- DOD & Other Agencies
- Internet
- Conferences
- Historical Resources
Published Materials:
Agencies-some examples:
Internet: Army
Internet: Examples of Some
Sites
Conferences:
Historical Resources:
Lessons Learned
Sites:
Preparing
for Deployment
- Long Term Planning:
- Career Development/Personal
Study
- Family Preparation
- Physical preparation
- Short Term Planning
- Practical Aspects for You and
Your Family
- Response to Notification
to Deploy:
Organizing Your Thoughts About
Deployment:
|
Personal |
Unit |
Family |
| Personnel |
|
|
|
| Intel |
|
|
|
| Training |
|
|
|
| Medical Operations |
|
|
|
| Logistics |
|
|
|
| Research |
|
|
|
| Communications |
|
|
|
For Example: Personal Prep- Intel
- learn about:
- military operations
- military medicine
- international medicine
- disease and injury trends and
prevention
- explore key informational resources
Personal Prep- Training
Some Areas for Study:
| Medical: |
Military
Medical: |
Military: |
| Prev Med |
Med
Log |
Individual
Tasks |
NBC
|
Med Operations |
Military
Opns |
| Trauma |
Med Intel |
Staff
Procedures |
| |
Med Planning |
Leadership |
| |
|
|
Personal Prep- Physical
Training
- Toughen your feet
- Buy quality insoles
- Lifting objects
- Don't stop AFTER you're deployed!
- See also:
Personal Prep- Logistical
Preparing Your Family
Long Term Planning
FAMILY SUPPORT resources on the Internet:
Family Unpreparedness
"They did not prepare their families
or spouses [for their] going to war. People didn't know how to
do checking accounts, change tires... the military needs to learn
to teach military members to teach their families... to keep
them more involved. Many of them left their spouses hanging out
in the breeze."
That Fateful Moment:
- denial
- fear
- anger
- depression
- acceptance
When
alerted- What to work on with your spouse
- Resupply "Push Packages"
- Addresses, e-mail, and phone
numbers
- Planned calling times
- Mid-tour leave
- Know clothing sizes
- Know key dates, e.g. birthdays
- Review the worksheet
Remember your family's stresses
- spouse has to care for:
- home
- car
- children
- in-laws!
- fear for your safety
- sense of abandonment, loneliness
- uncertainty
- finances
- security
- hurricane evacuation!
Activation and Deployment of
Reservists-
- Family support systems: Problems:
- lack of knowledge of resources
- often geographically distant
- lack of info for families
- lack of family education during
mobilization
- not enough trained people
- these are similar to what
a PROFIS doc might encounter
Family support systems: Problems:
"...relationships within the family
support network needed to form prior to activation, mobilization,
and deployment of military personnel."
The Other Side of Technology
- compulsion for instantaneous
news:
- impatience with official channels
- family members know things before
you do,
- and before official notification
"No matter how
well you think you prepare children, you are never sure how much
they understand."
Children's
concerns:
- fear of death of parent
- disciplinary problems if source
of discipline deployed
- teasing and harassment by peers
- loneliness
- enhanced by lack of a parent
to confide in
- or fear of upsetting the parent
at home
- acting out
Children
- Write regularly to each one
- Tell them stories about the
area
- Tell them what you are doing
- Audiotape stories
- Join in a long term game or
project
- Send photos
The
PROFIS Physician: Integrating With Your Unit
- Establish Relationships:
- Meet the commander & key
personnel
- Expect skepticism-
- Expect that it will take time
to be accepted
- Know you are needed; don't wait
to be told
- Attend meetings
- Learn unit history & traditions
- Spend time, share hardships
- Involve yourself with:
- training
- Field exercises
- look, listen, ask questions
- give lectures
- help with medic and PA training
- work with the other medical
personnel as a team
- planning
- medical intel
- medical logistics
- Just because you can't figure
out where you can help, doesn't mean there isn't a way!
- The Physician and the Medical Unit
"This survey and Army lessons learned
indicate that effective communication may be the single
most important factor related to mobilization of reserve soldiers"
Mangelsdorff AD, Moses GR: A
survey of Army Medical Department reserve personnel mobilized
in support of Operation Desert Storm, Military Medicine,
Vol. 158, pp 254-8, April 1993
Preparing Your
Unit: Medical Intel
- Identify intelligence resources
- Create a health threat assessment
- Identify host nation medical
resources
- Plan & execute preventive
and treatment operations
- Prepare for medical surveillance
- SEE: Well Digger's Workstation
Preparing Your Unit- Training
- individual medical skills
- medical team training
- Medic Treatment and Evac teams
- Combat Lifesavers
- Field Sanitation Teams
- health threat briefings
Preparing Your Unit- Logistics
- medical supplies and equipment
- know your mission
- know your MES's
- Medical Equipment Sets
- Try to use what'sin the supply
system
- Inventory, organize, label,
be compulsive, prepare for the NEXT guy's deployment
- Train on your stuff!
- Sustainment:
- Water/Washing/Waste Management
- Learn how to get resupplied
- train your soldiers on supply
methods
- Maintenance of vehicles, equipment,
weapons
Preparing Your Unit Medically:
- Medical Screening
- Immunizations
- Personal Medications
- Health Threat Brief
- Prepare yourself- knowledge
alone is not immunity
Psychological
Issues During DeploymentPsychological
Issues in Peacekeeping Operations
- In Peacekeeping Operations:
- Early maladjustment
- 5 weeks
- higher risk in those with Axis
I disorders
- e.g. depression, conversion
disorder, adjustment disorder
- Late maladjustment
- breakdown of interpersonal support
systems
Top stressors at mid-deployment:
- missing spouse
- boredom
- drawdown
- lack of access to transportation
- uncertainty about future
Loneliness and Frustration Disorders:
Presentations
- Substance Abuse
- Sexual Problems
- STD
- Pregnancy
- Fraternization
- Indiscipline
- Dehumanization of local nationals
- Depression
- Conflict with other groups/forces
- Withdrawal
Prevention
- Unit Cohesion
- Realistic Training
- Unit Cohesion
- Realistic Training
- Rest and Nutrition
- Professional development
- Variety of experiences
- Critical incident stress debriefing
(CISD)
- COMMUNICATION!
Keeping the Right Attitude
- Honor and Dignity
- Use foresight to see how you'll
look back
- Set the Example
- whether you feel like it or
not
- Help Others
- Never EVER Quit
- Don't expect perfection
- Don't try to impress
- Seek opportunities to learn
- You need few amenities
- what you can carry
- food, water
- mail
- sleep
- fellow team members
- Mission First, Troops Always
- Semper Gumby
- There a NO "inappropriate
consults"
- You'll be a better person
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