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This newsletter is structured to address related topics in humanitarian assistance, using Operation PROVIDE COMFORT as its model. This newsletter is applicable to military forces, battalion and above, tasked to provide support to humanitarian assistance missions.

What was unique about Operation PROVIDE COMFORT, and the humanitarian support provided to the Southwest Asian theater following Operation DESERT STORM?

  • In the southern area, around Safwan, Iraq, the effort was required as a direct result of allied combat.

  • In Operation PROVIDE COMFORT, the effort involved contingency force intervention (had to have a forced entry, and offensive capability).

  • In both cases, units had to perform not only the humanitarian mission, but also security and internal logistical support.

  • Operation DESERT STORM logistics could easily be redirected.

  • Civil Affairs (CA) command and control elements were already mobilized, but had to be redeployed from Operation DESERT STORM.

  • Special Forces were in Turkey with JTF ELUSIVE CONCEPT during Operation DESERT STORM, and were familiar with the area.

  • Incirlik AB, Turkey (NATO), was operating at full capacity.


Although all of the above assets were in place, the first consideration for any humanitarian assistance mission is to comfort the suffering and alleviate the dying. Some of the initial considerations are somewhat different from what a tactical headquarters would do, for example:

TOPIC: Initial Assessments, Force Structure.

DISCUSSION: The rapid, initial response of coalition forces focused on the provision of food, water, shelter, and medical care. The first efforts of the senior civilian/military leadership were to conduct a coordinated assessment of the life-threatening" needs of the Iraqi citizens. The first helicopter flights made into the mountains carried military personnel who made assessments of the most pressing needs of the citizens. As frustrating as it may be, it takes time to coordinate a more detailed list of cultural needs, e.g., flour, cooking oils. After the most pressing needs were taken care of, Special Forces (SF) teams helped alter the logistics flow. This humanitarian operation showed great sensitivity and concern for ethnic needs.

LESSON(S): In future humanitarian operations, use CA personnel complimented with SF to assist in formulating the following initial assessment needs:

  • Status of hostile military/paramilitary forces in the area.
  • Identification of key civilian leaders, and their supporters.
  • Status of existing public services, such as water, electricity, communications, sewage collection and transportation systems.
  • Status of civil police, doctors, firemen, and their availability, and level of expertise, especially preventive medicine.
  • Medical condition of civilian personnel, and physical locations.
  • Any unique shelter/food needs, and host-nation support availability (e.g., capability to provide construction or transportation assets).
  • Sanitation conditions and medical supplies.
  • Facilities and host-nation resources to support humanitarian assistance forces.
  • Unique social, ethnic, or religious concerns affecting the conduct of the operation.
  • Coordination with other U.S. agencies and international organizations which can contribute to the assessment.

Note: Special Operation Forces are ideally suited to rapidly accomplish initial assessment missions.


TOPIC: C2, Ad hoc Staffs.

DISCUSSION: During Operation PROVIDE COMFORT, the JTFs (see Appendix B, Task Organizations) were not allowed to deploy complete staffs. Allowing the complete staff to deploy would have facilitated better initial assessments, and reduced the training time required of new personnel that had not previously worked together.


  • Deploy with complete staffs; if reduction is necessary, reduce The staff only after the transition to Phase 2, Sustainment. Do not piecemeal your forces.

  • Time is critical to the accomplishment of the military humanitarian assistance mission. There is simply no time to train new staffs without the risk of increasing the hardships of the personnel you are there to help.

Note: Time Is Critical! Don't Waste It. Take Time To Look at Assessments. Establish Effective C2 Channels.

TOPIC: C2, Communications.

DISCUSSION: Communication objectives must be established up-front. CTFPC grew quickly and expanded rapidly. The communications system consisted of JCS, USAREUR, and USAFE assets that required atwo-phased approach to providing service to the field commanders. During the emergency phase, communications must be established that can provide basic services and be rapidly expanded. In the second phase, a robust system increases the grade of services while preventing a simple failure from isolating a location.


  • Get minimum equipment on the ground to provide the basic service.
  • Employ additional equipment, and reconfigure connectivity to provide direct routing to principal destinations.
  • Add equipment to provide multiple routes to prevent site isolation.
  • Have sufficient equipment on hand for austere jump capabilities, responsive to new missions and critical outages.
  • Build in redundancy up front.

TOPIC: C2, Chief of Staff (CofS).

DISCUSSION: Not all U.S. services treat the CofS the same; for example, the U.S. Marine Corps and the U.S. Army consider the CofS the driving force in the headquarters. However, the CofS is considered just another staff officer in the Air Force and the U.S. Navy.


  • Do not assume that multinational or jointly developed staffs understand the unique relationships between staffs. Educate newly developed staffs upon their arrival.

  • Determine unique differences in joint C2 problems and their solutions.

TOPIC: C2, Joint and Combined Staffs.

DISCUSSION: As with many other operations, Operation PROVIDE COMFORT went through several stages with its staff. Phase I (Emergency) was primarily an air operation dictating that the primary staff be mostly Air Force personnel. Phase II was the assistance and resettlement of the refugees which required ground forces, and, last, the withdrawal phase which required primarily an Air Force staff with a small ground capability. The makeup of the CTFPC staff reflected these stages.


  • Transition key staff positions.
  • Assign replacements to be the deputy for a period of time.
  • Have each staff establish a continuity file, and review this weekly.

TOPIC: C2, Situation Briefings.

DISCUSSION: The standard military situation briefing does not task organization and conduct of the operation does not place enough emphasis on the supported population.


  • Review specialized organizational briefing formats to deal with civil and military situations. Exact title and briefing formats dependent on the situation - organized accordingly with top priority given to the most life-threatening aspects.

  • In the briefing, emphasize the condition and activities and especially the needs of the supported population.

TOPIC: C2, Liaison Officers (LOs)

DISCUSSION: With the number of different countries involved and he obvious language barrier, it was critical to use LOs. They were their commander's representatives and served as facilitators in overcoming doctrinal and tactical differences.


  • Language qualifications are important, but not as important as doctrinal and tactical knowledge.

  • LOs should be positioned in both higher and subordinate headquarters to ensure coordination and rapid passing of vital information.

  • UN relief agency liaison personnel must be requested up-front. In this manner, they, as well as military personnel, will have a better understanding of how each operates. The LOs might come from the UN or other major NGOs.

TOPIC: Transit Centers and Camps.

DISCUSSION: Just as important in the C2 arena was the planning and considerations that went into the development of the transit centers/camps. Camps were designed to reflect the cultural realities of the Kurds and to provide for their participation in the decisionmaking process. They were built around a five-person tent, a 66-tent neighborhood (Zozan), a 1,056-person tent village (Gund), a 21,120-person tent community (Bajeer) and in the center, the community center and administration area.


  • Refugees should participate in the design of the camp and its operation. As part of the concept of self-sufficiency, they should be used to build and, thereby, take responsibility for its success.

  • Camps should not be elaborate, but should fulfill the basic needs. If the refugees are better off in the camp than in their own towns and homes, they will not go home.

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TOPIC: C2 Security Zone.

DISCUSSION: While it was believed that expansion of the security zone south of Dahuk would have facilitated the return of over 300,000 Kurds to the Dahuk area, it was not known whether the Iraqi government could be forced to accept such a security zone expansion. After several high-level meetings, such an arrangement was achieved some six weeks into the operation.

LESSON(S): First, in any humanitarian support mission, consider the effect of expanding your zone of control before designing or building any major camp site or sites.

Note: In addition to the multinational forces sent to assisting the security mission from the world community, 12 countries provided out patient support, while six provided a medical evacuation capability. Another six sent field/portable hospitals.


BACKGROUND: The immediate objectives of Operation PROVIDE COMFORT were to ease the suffering and prevent the Kurdish refugees from dying and to stabilize the population. The medical concept for refugee support was:

  1. Assessment of needs
  2. Initial medical care
  3. Medications/medical supply support
  4. Sustainment
  5. Transition to relief agencies.

Doctrine and training relative to the interface between civilian volunteer medical organizations and U.S. military medical personnel need to be developed and implemented. This interface was a perpetual source of control problems that adversely affected treatment coverage and the optimal use of available medical assets.

Preventive medicine strategies should take precedence over therapeutic medicine in the initial stages of a disaster relief and/or refugee situation. All initial efforts in Phase 1 (Emergency) should be directed toward re-hydration of children. Establish a priority of care:

  • Re-hydrate
  • Furnish Potable Water
  • Provide Shelter
  • Furnish Food
  • Provide Sanitation and Health Training
  • Give High Energy Formulas to Children

TOPIC: Medical, Concepts.

DISCUSSION: The concept of vital importance in health care of refugee populations is to work through the local system (no matter how primitive) to get them back on their feet. All organizations involved (including the United Nations High Commissioner for Refugees (UNHCR), the International Red Cross (IRC), and the U.S. Army Preventive Medical civilians, and others) stated that the guiding principle in refugee operations is to get the people back on their feet, revamp, reinforce and build back the local health care system. Don't invent a new system with Western standards that the people cannot possibly maintain after we leave. Use local labor, local facilities, where possible. Sometimes U.S. standards are too far above the local people - work with them, not for them.

LESSON(S): Work through the local health care system. Revamp the existing health care system even if you start with almost nothing. Make this your guiding principle.

TOPIC: Medical, Preventive Medicine.

DISCUSSION: In a disaster relief or refugee situation, preventive black bags and try to give medicines and treat illnesses. This is a serious error. All initial efforts in Phase 1 (Emergency) should be directed toward all those in critical condition, especially dehydrated infants and children. A large tent can be directed toward re-hydration alone; special I-V solutions should be ready - directed by physicians.


  • Establish priority of care: treat all life-threatening conditions - re-hydrate; provide water, shelter, food, sanitation, health teaching; need starving children with special high-energy formulas.

  • Set up at least three separate 24-hour-a-day operations to include:

    1. Re-hydration center
    2. Intensive feeding center for acute starvation
    3. Regular normal feeding center.

TOPIC: Medical, Sanitation, Vaccination.

DISCUSSION: In any disaster or refugee scenario, the emphasis should be on sanitation rather than vaccination and treatment. Disaster medical strategy must be planned just like any other - it requires a sequenced plan for first-order business: Sanitation/re-hydration, then theraputic. The only vaccine that should be considered is measles. The other considerations are preventive strategy and sanitation, food and shelter. Re-hydration should only be done with an oral re-hydration salt (ORS) solution from the World Health Organization. In this type of a disaster scenario - soda pop and powdered milk can be lethal (these do not replenish body salts).


  • Measles vaccine is probably the only vaccination that should be given in a disaster. It requires refrigeration (cold chain).
  • Other efforts should be directed toward preventive medicine strategy and sanitation.
  • Work to educate the military medical community about ORS.

TOPIC: Medical, C2.

DISCUSSION: Medical assets should clearly delineate C2. Although medical coverage was provided successfully, the U.S. military medical force structure is not optimally configured for refugee operations, nor is it flexible enough to be altered or tailored as necessary. The medical plan was comprehensive, but medical C2 was not fully responsive to changing conditions and requirements. In this operation, medical assets were receiving orders from three or four different sources, all directing and making demands at the same time.


  • Plan for and staff a medical C2 element.
  • Deploy a surgical staff, develop a concept of operations, and get it approved at the highest echelon.
  • Integrate a medical C2 element and staff it into a CA, or Task Force.

TOPIC: Medical, MEDEVAC Requests.

DISCUSSION: Operational units, including civilian doctors on the way into the area, should be trained on how to send the nine-line MEDEVAC request. Many non-U.S. military and civilian personnel did not know or follow a standard format for MEDEVAC. Therefore, wrong coordinates were called, or call signs and frequencies were omitted.


  • Have MEDEVAC cards similar to those issued at NTC made available by the LOs.
  • MEDEVAC unit representatives, with or without their aircraft, should be stationed with, or visit, the field units.

TOPIC: Medical, Coordination of Civil Volunteer Groups.

DISCUSSION: UNHCR did not have the resources or authority to definitively coordinate the civilian volunteer groups. Numerous NGOs, and PVOs showed up" from numerous entry points, deployed and set up with no coordination. The NGOs/PVOs can be difficult for the military to coordinate, but can be given priorities on the location of the most severe problem areas. Civilian agencies want to do their own thing" in an emergency situation. They should be encouraged to go where they are really needed. The U.S. Army has the transportation assets to assist them.


  • Encourage the civilian groups to step forward to coordinate their valuable expertise and assistance.
  • If you can control transport, you can control placement of civilian relief agencies. Thus they will go where they are really needed. Offer civilians transport only to a specific area where they are critically needed.

TOPIC: Medical, Medical Supply (Logistics).

DISCUSSION: Medical supply worked well from Incirlik Air Force Base (AFB) forward to Diyabakir and Silopi (see figure 1 in section II) A separate supply system was set up for medical supplies with a separate group of trucks that did not have to wait in line with other vehicles going into Iraq.

LESSON(S): Structure similar medical logistics procedures for all disaster contingency planning.


BACKGROUND: The Disaster Assistance Logistics Information System DALIS), (See Appendix C-1), should be immediately implemented at the CTF level in any humanitaran assistance operation. This system allows for the tracking of all supplies and equipment and their locations worldwide which might be necessary in a disaster situation.

As stated earlier, the initial efforts were Air Force supply drops. This occurred without much ground coordination. Following the establishment of the Combined Support Command and the insertion of Special Forces (SF) troops into the mountain camps, a more coordinated effort began, linking ground and air resupply operations.

The receipt and storage of supplies are sometimes different between services; for example, when the U. S. Air Force receives supplies at an aerial port of embarkation (APOE), it stores these items in hangers separately under the aircraft mission number, in order of arrival. It is very difficult for the Air Force to track, find, and consolidate these items upon requests from the field units. Cross-leveling supplies appears to have been generally slow because of the inability to track delivered materiel during the early weeks of the operation.

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TOPIC: Logistics, Host-Nation Transportation Support.

DISCUSSION: Large volumes of equipment and supplies have to be moved to support these types of operations. The operations are very time-sensitive; thus, it is important to use local assets. This helps reduce demands on our own systems. Local assets need to be tightly controlled to ensure that departure times are on schedule, that fuel and maintenance requirements have been met, and that rehearsals are conducted.


  • Ensure sufficient numbers of transportation support personnel are available to supervise contracted assets.
  • Ensure coordination is conducted between the transportation unit and the military police who provide security and traffic control.

TOPIC: Logistics, Recovery Support.

DISCUSSION: Vehicles that are used in the transportation of large amounts of supplies over long distances inevitably break down. Therefore, it is important to have a well-planned recovery operation that provides for a quick-responce recovery in a tactical environment. This ensures the timely delivery of supplies and provides for adequate security to remain with the main body.


  • Ensure recovery operations are well-planned and rehearsed.
  • Develop contingency plans for replacement of long haul vehicles, and recovery equipment.
  • Spot mechanics, tools and PLL along the route or on convoys.

TOPIC: Logistics, management of Critical Supply Items.

DISCUSSION: Critical supply items, especially in the health area, need to be handcarried through the transportation system. The items were procured from a UN relief company through the Secretary of State/Office of Foreign Disaster Assistance (OFDA) contracts. After the items were assigned a unit location number, and had entered the supply system, they were delivered within 24 hours to Incirlik AB, Turkey, by escort to the requesting unit.

LESSON(S): Used augmentees who work directly with the UN and OFDA to ensure the critical itens enter the military transportation and supply systems. (Recommend military guards.)

TOPIC: Logistics, Food Distribution.

DISCUSSION: Distribution of food in some camps was controlled by a ration card. This helped reduce and Black-market activities. Another benefit to issuing ration cards is the reduction of incidences concerning intimidation by stronger refugees. The benefits of using local contractors is an economic bonus to the civilian economy.


  • Use of local trucks and drivers can be a cost-effective way of providing a supply distribution.
  • A ration card system can be a way of controlling the black market activities in refugee camps.
  • Lack of control for any reson damages the credibility of the U.S. Army and its Allies.

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