2RHPZ
11-24-2004, 05:13 PM
Exercise Balance Magic: 19th SF Group practices medicine in the heart of Asia
Special Warfare
June, 2002
While America was being rocked by the tragic events of Sept. 11, 2001, a group of Special Forces medical sergeants and other medical personnel from the 19th Special Forces Group were training in one of the most remote areas of the world, Mongolia, as part of Exercise Balance Magic. Far from the 21st-century technology that is available in the United States, the soldiers gained a unique insight into the practice of unconventional medicine.
Eight SF medical NCOs, the 19th SF Group surgeon, the 19th SF Group dentist, the former 19th SF Group surgeon and the 20th SF Group veterinarian, along with personnel from the 426th Civil Affairs Battalion, trained in Mongolia to improve their skills in obstetrics (childbirth), in dental care and in veterinary medicine -- skills that are critical in unconventional warfare, or UW The exercise was supported by a dedicated 0-130 from the U.S. Air Force's 353rd Special Operations Group. In addition, personnel from the 19th Group performed an airborne operation with the Mongolian defense forces, making the exercise truly a joint-combined event.
The medical focus of Exercise Balance Magic required SF medical NCOs to develop their skills in non-trauma subspecialties - veterinary, dental and obstetric - that are difficult for SF medics to acquire in the U.S. The goals in those skill areas are outlined in the 18D scope of practice, formulated by the surgeon's office of the U.S. Army Special Operations Command.
Because l8Ds now have to meet a paramedic requirement, more than 90 percent of the 18D refresher medical training during the last three years has been devoted to trauma. But in deployments for UW, as detachments gain and maintain ******* with the local population, many of the demands placed on SF medics will involve the non-trauma subspecialties.
Mongolia
Mongolia offers a unique training environment. Its terrain is mostly open plains or steppe, but about 10 percent of the ter rain is forest. Mongolia's average altitude is more than 5,000 feet above ground level, and its average annual temperature is below freezing. The population of 2.5 million is predominantly Mongol, but the country has many minority groups, such as Kazakhs and Uzbecks. Forty percent of Mongolians are under the age of 15. Almost half of the people of Mongolia live in the capital city of Ulaanbaatar.
Agriculture and livestock are Mongolia's economic foundation, but the growing development of the country's vast mineral resources will drive Mongolia's growth in the future. Foreign investment is encouraged, and Mongolians welcome Americans warmly. The Mongolian language is difficult to master. The U.S. Army's only Mongolian speaker, a member of the Utah National Guard's 300th Military Intelligence Battalion, accompanied the mission to provide crucial language support. Civilian-contract translators also provided valuable assistance, making it possible for the SF medics to conduct training at different locations simultaneously.
Obstetrics
The obstetrics portion of the medical mission required all eight SF medics to perform at least one hands-on delivery (most medics performed more), and several of the NCOs observed other procedures, such as Caesarean sections. The obstetrics training was conducted in Ulaanbaatar at the 1st Woman's Hospital, which averages 15 deliveries a day and accounts for 45 percent of the babies born in the city each year. By the end of the mission, the medics had performed 20 deliveries, had observed another 100, and had examined and cared for 34 newborns. The two physicians had delivered two babies under primitive conditions, and they had observed three Caesarean sections and a hysterectomy.
Dental training
The purpose of the dental training was to allow the SF medics to develop the skills needed to provide emergency dental care to team members and to provide basic dental care to the local population. Training included diagnosis and treatment of simple and complex dental problems (including oral infections and abscesses, extractions, and simple restorations). The training was conducted in Ulaanbataar, at the oral and maxillofacial clinic of the Central University Hospital, the main teaching hospital for the National Medical University of Mongolia. By mission's end, the medics had treated 122 patients and had performed 241 extractions. Their training experience in the oral clinic was unique: All the cases involved complex extractions, and the patients had been referred by other facilities. The objective was for the l8Ds to acquire as much experience as possible. Fortunately, the doctors had sufficient time to allow the NCOs to perform the extractions themselves and to work through most of the complications that they encountered.
Veterinary medicine
With the help of the School of Veterinary Science and Biotechnology at the Mongolian State University of Agriculture, medics participated in hands-on procedures with horses, cattle, sheep and goats. During the training, the medics performed physical exams, selected methods of animal restraint, made casts and administered medication (including vaccinating and deworming 250 sheep and 25 horses). The medics encountered advanced cases involving canine keratoconjuntivitis and ulceration, canine traumatic injury with multiple orthopedic injuries, and infectious respiratory diseases of sheep. Additional classes and practical exercises taught the SF medics subjects such as foodborne diseases and carcass evaluation.
While the primary mission of the SF medic is to preserve the health of the team, knowledge of veterinary care is invaluable in extended or UW operations, where animals play a key role either by transporting equipment or from their role in the economic stability of a community. Many of the medical skills that are necessary for the treatment of humans are similar to the skills needed for the treatment of animals. Veterinary training gives SF medics additional practice and experience that will strengthen their diagnostic and treatment skills for human patients as well.
Throughout the exercise, the team augmented the hands-on exercises with lectures to ensure that medics understood the theoretical basis for the treatment. Exposure to highly competent Mongolian health-care personnel, who are well-trained in Russian-style medicine, and time spent working with the group dentist and the group surgeon gave the 19th SF Group medics unique insights into the practice of low-technology medicine in a rugged and austere environment. The skills the medics acquired will be critically important to success in UW, and to establishing trust with indigenous forces. The exercise also set the stage for further training with the Mongolian military forces during 2002.
This article was written by the medical staff of the 19th Special Forces Group.
Special Warfare
June, 2002
While America was being rocked by the tragic events of Sept. 11, 2001, a group of Special Forces medical sergeants and other medical personnel from the 19th Special Forces Group were training in one of the most remote areas of the world, Mongolia, as part of Exercise Balance Magic. Far from the 21st-century technology that is available in the United States, the soldiers gained a unique insight into the practice of unconventional medicine.
Eight SF medical NCOs, the 19th SF Group surgeon, the 19th SF Group dentist, the former 19th SF Group surgeon and the 20th SF Group veterinarian, along with personnel from the 426th Civil Affairs Battalion, trained in Mongolia to improve their skills in obstetrics (childbirth), in dental care and in veterinary medicine -- skills that are critical in unconventional warfare, or UW The exercise was supported by a dedicated 0-130 from the U.S. Air Force's 353rd Special Operations Group. In addition, personnel from the 19th Group performed an airborne operation with the Mongolian defense forces, making the exercise truly a joint-combined event.
The medical focus of Exercise Balance Magic required SF medical NCOs to develop their skills in non-trauma subspecialties - veterinary, dental and obstetric - that are difficult for SF medics to acquire in the U.S. The goals in those skill areas are outlined in the 18D scope of practice, formulated by the surgeon's office of the U.S. Army Special Operations Command.
Because l8Ds now have to meet a paramedic requirement, more than 90 percent of the 18D refresher medical training during the last three years has been devoted to trauma. But in deployments for UW, as detachments gain and maintain ******* with the local population, many of the demands placed on SF medics will involve the non-trauma subspecialties.
Mongolia
Mongolia offers a unique training environment. Its terrain is mostly open plains or steppe, but about 10 percent of the ter rain is forest. Mongolia's average altitude is more than 5,000 feet above ground level, and its average annual temperature is below freezing. The population of 2.5 million is predominantly Mongol, but the country has many minority groups, such as Kazakhs and Uzbecks. Forty percent of Mongolians are under the age of 15. Almost half of the people of Mongolia live in the capital city of Ulaanbaatar.
Agriculture and livestock are Mongolia's economic foundation, but the growing development of the country's vast mineral resources will drive Mongolia's growth in the future. Foreign investment is encouraged, and Mongolians welcome Americans warmly. The Mongolian language is difficult to master. The U.S. Army's only Mongolian speaker, a member of the Utah National Guard's 300th Military Intelligence Battalion, accompanied the mission to provide crucial language support. Civilian-contract translators also provided valuable assistance, making it possible for the SF medics to conduct training at different locations simultaneously.
Obstetrics
The obstetrics portion of the medical mission required all eight SF medics to perform at least one hands-on delivery (most medics performed more), and several of the NCOs observed other procedures, such as Caesarean sections. The obstetrics training was conducted in Ulaanbaatar at the 1st Woman's Hospital, which averages 15 deliveries a day and accounts for 45 percent of the babies born in the city each year. By the end of the mission, the medics had performed 20 deliveries, had observed another 100, and had examined and cared for 34 newborns. The two physicians had delivered two babies under primitive conditions, and they had observed three Caesarean sections and a hysterectomy.
Dental training
The purpose of the dental training was to allow the SF medics to develop the skills needed to provide emergency dental care to team members and to provide basic dental care to the local population. Training included diagnosis and treatment of simple and complex dental problems (including oral infections and abscesses, extractions, and simple restorations). The training was conducted in Ulaanbataar, at the oral and maxillofacial clinic of the Central University Hospital, the main teaching hospital for the National Medical University of Mongolia. By mission's end, the medics had treated 122 patients and had performed 241 extractions. Their training experience in the oral clinic was unique: All the cases involved complex extractions, and the patients had been referred by other facilities. The objective was for the l8Ds to acquire as much experience as possible. Fortunately, the doctors had sufficient time to allow the NCOs to perform the extractions themselves and to work through most of the complications that they encountered.
Veterinary medicine
With the help of the School of Veterinary Science and Biotechnology at the Mongolian State University of Agriculture, medics participated in hands-on procedures with horses, cattle, sheep and goats. During the training, the medics performed physical exams, selected methods of animal restraint, made casts and administered medication (including vaccinating and deworming 250 sheep and 25 horses). The medics encountered advanced cases involving canine keratoconjuntivitis and ulceration, canine traumatic injury with multiple orthopedic injuries, and infectious respiratory diseases of sheep. Additional classes and practical exercises taught the SF medics subjects such as foodborne diseases and carcass evaluation.
While the primary mission of the SF medic is to preserve the health of the team, knowledge of veterinary care is invaluable in extended or UW operations, where animals play a key role either by transporting equipment or from their role in the economic stability of a community. Many of the medical skills that are necessary for the treatment of humans are similar to the skills needed for the treatment of animals. Veterinary training gives SF medics additional practice and experience that will strengthen their diagnostic and treatment skills for human patients as well.
Throughout the exercise, the team augmented the hands-on exercises with lectures to ensure that medics understood the theoretical basis for the treatment. Exposure to highly competent Mongolian health-care personnel, who are well-trained in Russian-style medicine, and time spent working with the group dentist and the group surgeon gave the 19th SF Group medics unique insights into the practice of low-technology medicine in a rugged and austere environment. The skills the medics acquired will be critically important to success in UW, and to establishing trust with indigenous forces. The exercise also set the stage for further training with the Mongolian military forces during 2002.
This article was written by the medical staff of the 19th Special Forces Group.