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US European Command (EUCOM) conducts MEDFLAG exercises at least twice a year in Africa, deploying a team of doctors, dentists, technicians and support personnel to provide joint-combined medical training and humanitarian assistance. These exercises, which are coordinated by the HQ EUCOM Surgeon's Office (ECMD), provide medical training interchange of medical information and techniques with host nation medical personnel in African nations.

MEDFLAG exercises are beneficial to both U.S. participants who are able to practice field medicine and treat health problems they may not have seen before, and to the host nation, because of the health services provided to a substantial number of patients. Of the various types of combined exercise, the kind which has stimulated the most enthusiasm in Africa by far is the MEDFLAG series-exercises sponsored by the U.S. European Command (EUCOM) which involve the military health care establishments of the United States and African hosts.

A less obvious, but much more important part of the MEDFLAG was the effort to bring together the national/local governments and health care communities in cooperative relationships that would endure long after the end of the exercise. By extension, MEDFLAGs display an ethic of public service which serves as a challenge for observers to emulate. In addition, MEDFLAG exercises enhance medical readiness by providing training and experience in establishing and executing tailored medical force missions that have joint (other U.S. services) and combined (other nations) elements. MEDFLAG exercises also provide an opportunity to emphasize numerous essential and collective wartime tasks at both the individual soldier and unit level in austere environments.

In 1987, the Joint Chiefs of Staff directed that the EUCOM initiate a series of medical exercises with African countries. These exercises were designated "MEDFLAGs." By about 1994, EUCOM had developed the MEDFLAGs into sophisticated, complex exercises involving U.S. and host-nation military medical establishments, along with private sector African medical personnel and NGO health-care organizations. The MEDFLAGs themselves had evolved into exercises of about three weeks duration that provided health care training, disaster relief training, and basic medical and dental care to local populations.

From 9 -20 May 1993, a 90-person team deployed to Niamey, Niger, for MEDFLAG 93-1, on a 37th Airlift Squadron C-130. Most of the team came from USAFE's 36th Medical Group, Bitburg AB, Germany. US Army Europe, US Navy Europe, and the German Bundeswehr were also represented. The team treated 2,225 patients, provided 3,838 immunizations, trained 256 Nigeriens in emergency medical procedures, and donated 32 463L pallets of medical supplies.

In 1994 the Germany-based 212th Mo-bile Army Surgical Hospital led a joint medical task force MEDFLAG mission to Ghana, treating locals to dental and medical care. Over a two-day period, MEDFLAG members inoculated about 3,000 people against yellow fever, a disease spreading from the north toward Ghana's densely populated coastal cities. The inoculations were part of the task force's civic action mission. Another 1,000 Ghanaians were given optometry, dental and general medical treatment at another MEDFLAG clinic nearby. During their first week in Ghana, task force members taught more than 200 Ghanaian military and civilian medical personnel combat lifesaver techniques, trauma life support and cardiopulmonary resuscitation.

Between 27 July and 18 August 1995 a 66-person team deployed to Harare, Zimbabwe, for MEDFLAG 95-3. Most of the team came from USAFE's 39th Medical Group, Incirlik AB, Turkey. US Army Europe and US Navy Europe were also represented. The team treated 2,006 patients in five medical civic action program (MEDCAP) visits.

Between 27 July and 18 August 1995 a 66-person team deployed to Harare, Zimbabwe, for MEDFLAG 95-3. Most of the team came from USAFE's 39th Medical Group, Incirlik AB, Turkey. US Army Europe and US Navy Europe were also represented. The team treated 2,006 patients in five medical civic action program (MEDCAP) visits.

Between 7-17 September 1996 a 57-member medical team deployed to Kati, Mali, for MEDFLAG 96-3. Most of the team came from USAFE's 86th Medical Group, Ramstein AB, Germany. US Army Europe, US Navy Europe, and the German Bundeswehr were also represented. The team treated 2,338 patients, provided 11,477 immunizations, and trained 139 Malians in emergency medical procedures.

Nearly 80 active duty and Reserve military personnel from bases in the United States and Germany will join medical personnel from the host nation of Guinea, Africa, to take part in exercise MEDFLAG 98-1 from March 16-30, 1998. Units represented in the exercise include the U.S. Army Europe's 93rd Medical Battalion, from the 30th Medical Brigade, Heidelberg, Germany; the 96th Civil Affairs Battalion, Ft. Bragg, N.C.; and the Army Reserve's 353rd Civil Affairs Command, Bronx, N.Y. U.S. participants conducted training in preventive medicine, emergency medical technician skills, cardio-pulmonary resuscitation, and moulage application. They also conducted humanitarian and civic assistance visits and provide medical and dental treatment to the local populace in 10 villages within a 120 kilometer radius of Conakry, Guinea. There was also a mass casualty exercise held at the base camp in Sonfonia, Guinea.

Medical Personnel from U.S. Naval Forces Europe (CINCUSNAVEUR), U.S. Air Forces Europe, and U.S. Army Europe, joined with personnel from Tanzania Peoples Defense Force for exercise MEDFLAG 99-2, Sept. 13-24, 1999 in Tanzania. The EUCOM component conducting the exercise is CINCUSNAVEUR fleet medical. U.S. Naval Hospital Rota, Spain is the lead unit carrying out the exercise.

Approximately 80 U.S. military medical personnel from around Europe and the U.S. participated in the three-phase exercise, conducting training and humanitarian and civic assistance visits.

The first phase is medical training that includes preventive medicine, emergency medical technician skills, cardiopulmonary resuscitation, and moulage application. The second phase is a staged mass casualty exercise that will put the skills learned in phase one to use. The planned drill is a simulated airplane crash.

The third phase of the exercise involves Medical Civic Action Programs (MEDCAPS). MEDCAPS are visits to villages in the area. These humanitarian and civic assistance visits provide medical treatment, dental screening and treatment, and immunizations to village personnel. During MEDFLAG 99-2 seven villages were visited over eight days.

Medical Personnel from U.S. Naval Forces Europe, U.S. Air Forces Europe and U.S. Army Europe joined with personnel from Tanzania Peoples Defense Force for exercise MEDFLAG 99-2, Sept. 13-24 in Tanzania.

The 30th Medical Brigade along with U.S. Air Forces, Europe, U.S. Naval Forces, Europe and military medical personnel from the Netherlands, Germany and the United Kingdom came together Sept. 14-25 for MEDFLAG 2000-02 in Mauritania. This was the second MEDFLAG exercise in Mauritania, the first occurred in 1990. MEDFLAG 2000-02 is a joint and combined exercise intended to provide medical training, participate in cooperative medical assistance and interchange of medical information and techniques with the Mauritanian Military, civilian emergency providers and the nongovernmental and private volunteer organizations working in Mauritania. Humans were not the only species to receive care from the task force during MEDFLAG 2000-02. The veterinarians and their assistants provided care to about 250 military camels. They drew blood from both adult and infant camels to test for the parasite trypanosomiasis and treated those that were infected. Select male and new-born camels were given the antibiotic Terramycin and all were given vitamin supplementation.

The objective of the exercise was to promote regional stability by strengthening cooperation between Mauritania and NATO countries through combined exercises. This is a humanitarian operation designed to build mutual trust, confidence and friendship with the nation of Mauritania. Participating U.S. forces include the U.S. Army in Europe's 100th Medical Detachment and 30th Medical Brigade, both based in Heidelberg, Germany, who will oversee the conduct of the exercise. The 93rd Medical Battalion, also based in Heidelberg, will provide a dental team and linguists, and the 67th Combat Support Hospital from Wuerzburg, Germany, will provide a medical support personnel.

Eye care teams are coming from U.S. Air Forces in Europe and Europe Regional Medical Command, based at Ramstein AB, Germany and Heidelberg, respectively. U.S. Navy Europe's Naval Environmental and Preventative Medicine Unit, based in Sigonella, Italy, provided a four-person team to assist with public health training. NAVEUR will also provide a team of dentists from Sigonella and Naples, Italy. U.S. Army Contracting Command, Europe, based in Seckenheim, Germany, provided a contracting officer, and the 226th Medical Battalion from Miesau, Germany, provided support with communications and supply personnel. The 96th Civil Affairs Battalion, based in Fort Bragg, N.C., provided a civil affairs team to serve as a liaison with the people of the local community. Military medical teams from Germany, The Netherlands and the United Kingdom provided veterinary care, medical administration and technical support for the exercise.

Service members from U.S. Air Forces in Europe (USAFE), U.S. Army, Europe (USAREUR), and U.S. Special Operations Command (USSOCOM) participated in MEDFLAG 01-2 from 23 Jul - 3 Aug 2001. The MEDFLAG was led by Headquarters, USAFE and held in Nampula and Maputo, Mozambique. MEDFLAG was a joint (multi service)-combined (multiple country) medical training and civic assistance exercise conducted annually by the U.S. European command. This exercises provided mobility training and operational experience for U.S. medical units.

Collateral benefits included interchange of medical information and techniques with host nation medical personnel, and enhanced telemedicine. Finally, the MEDFLAG team provided limited medical humanitarian civic assistance to the host nation of Mozambique.

Medical humanitarian and civic assistance visits were conducted in six health clinics within a 50-kilometer radius of Nampula, Mozambique. The U.S. team also provided training in self-aid and buddy care, trauma life support, crisis response, and universal precautions measures. A mass casualty exercise was held in Nampula City, and involved a train-wreck scenario.

As part of MEDFLAG 01-2, soldiers of the 94th Engineer Battalion deployed to Nampula to conduct vital infrastructure improvements at three health care facilities in the surrounding area. Furthermore, staff from HQ 3rd AF deployed to Maputo, Mozambique, to establish a headquarters combined joint-task force (CJTF) in support of exercise operations.

Integral to CJTF operations was the establishment of a civil military operations center, staffed by host nation personnel and members of HQ 3rd AF, as well as 96th Civil Affairs Battalion soldiers.

In late January 2002 senior Uganda army officers were already deployed in northern Uganda to assess the medical facilities and prepare for the deployment of about 250 soldiers from the US Air Force, Army and Navy. The US Army is to carry out joint military exercises with Uganda to assess the country's military readiness to handle a disaster like the volcanic eruption that took place in mid-January 2002 in the east African region. An advance team of US officers joined the Ugandans in February to set up training facilities and get acquainted with the deployment sites and interact with Ugandan counterparts. The date of the US-Ugandan Medflag 2002 operation, scheduled for about June, had not yet been released. The last US-Uganda exercise took place in 1997 at a military training academy in Mubenbe, where the Ugandan forces were trained in peacekeeping techniques.

The RSA hosted MEDFLAG originally scheduled for FY05 (agreed to at DefComm 2000) has been moved to FY 04 (between Jan-Sept 2004). Exercise focus will involve establishment of a JTF headquarters by 3rd Air Force and will focus on providing assistance during a humanitarian crisis scenario. This exercise will be regionally orientated and the SANDF will assist in encouraging participation by other SADC militaries.

Exercise (Corrdinator) Lead Component Medical Personnel Country Dates
(LTC Bryant)
USAFE 80 Cameroon 6 - 24 March 2000
(LCDR Welch)
USAREUR 35 Georgia 14 - 15 June 2000
(LTC White)
USAFE 35 Romania 9 - 13 July 2000
MEDFLAG 00-2 (LTC Jordan) USAREUR 60 Mauritania 15 - 26 Sept 2000
(LTC Jordan)
(LTC Stewart)
USAREUR 80 Nigeria 23 Apr - 6 May 2001
MEDFLAG 01-2 (Maj Jones) USAFE 80 Mozambique TBD
USAFE 80 Swaziland 1-16 Mar 2002
USAREUR 80 Rwanda 10 - 25 Aug 2002
USAREUR 80 Gabon 1 - 16 Mar 2003
USAFE 80 Morroco 1 - 16 Aug 2003
USAFE 80 Senegal TBD
(Botswana & South Africa)
TBD 80 Cape Verda TBD
TBD 80 Lesotho TBD
TBD 80 Burundi TBD
TBD 80 Malawi TBD

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