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Force Protection Covers All Aspects of Troop Health 
12 June 1998
By Douglas J. Gillert
American Forces Press Service
        WASHINGTON -- Health care for family members and 
retirees is just as important as field hospitals to deployed 
soldiers' ability to perform their mission, said a senior 
Joint Staff medical planner.
        "We've got to stop thinking of [service members] as 
being automatons who just take orders, go off over the 
horizon and forget about the world until such time as they 
may come back," said Dr. (Rear Adm.) Michael Cowan, deputy 
director of logistics for medical readiness. Deployed 
service members, he said, need to know their families are 
being taken care of and that they, too, will get the health 
care treatment they need before and after they retire. 
        "Whenever we put an American pair of boots in the 
field, we need to fill those boots with somebody who is 
healthy and fit to do that particular job," Cowan said. 
"That means a combination of the right kind of training, 
good health surveillance, vaccinations and good health 
habits. And that guy has to be socially and psychologically 
fit as well."
        Cowan wields much influence as director of the 
Pentagon's force health protection plan. Today, his 
concerns, and those of other medical and line planners 
throughout DoD, are on the verge of changing medical 
doctrine. The changes, however, aren't revolutionary but 
rather reflect the evolution of medical care, Cowan said. 
        The admiral said he and his medical colleagues changed 
their way of thinking: U.S. medicine in the past focused on 
cure, while doctors today take more interest in prevention. 
For the military, he said, this trend means deploying 
healthy, fit soldiers and protecting them from environmental 
factors that could return them home ill or suffering from 
noncombat injuries. 
        Although military medicine in many ways follows the 
same paths of progress as medicine in general, service 
medics face unique challenges, Cowan noted. As warfighting 
changes, so must military medics change the way they treat 
battlefield casualties, he said.
        "The old business of deterrence and readiness has been 
replaced by shape, respond and prepare, which puts us into a 
full spectrum of military activities throughout the globe," 
he said. "The way we will go to war in the future will be on 
a sparse battlefield -- very few people controlling the 
battle with high technology and high lethality."
        Cowan and his colleagues from DoD and the services 
settled on more than a dozen priorities for improving force 
health protection. They include enhancing en route "care in 
the air" during medical evacuations, mobile surgical units, 
and environmental surveillance and protection against 
chemical and biological hazards. Another priority, 
leveraging new technologies, includes research and 
development of new products like lightweight packets of 
artificial blood and bandages that stop bleeding. 
        The services also must better document events affecting 
deployed service members' health, a lesson learned from the 
Gulf War, Cowan said. "One of the most acrimonious things 
about the Gulf War has been our inability to reconstruct 
events -- where people were, what was done to them and why. 
In the future when events occur that make us suspicious, we 
need to be on top rather that try to figure it out later 
on."
        Even as the new rules are being written, the services 
are developing and implementing the initiatives, Cowan said. 
"For example, we now know more about the soil, air and water 
of Bosnia than we know about Fort McNair [an Army 
installation in Washington, D.C.]. We're doing constant 
surveillance, constant environmental probing, including 
looking for biological and chemical hazards including, but 
not limited to, warfare."
        Another Gulf War lesson is the need to involve people 
in their own health management, he said. "In the anthrax 
vaccination program, we're spending a great deal of time 
explaining to people why we're doing this. Anthrax is a kind 
of poster child for force health protection. We have a 
terrible, dangerous risk of mass destruction and a safe 
vaccine that can essentially eliminate that risk.
        "All these things are coming together, and we are now 
experiencing record low levels of disease and nonbattle 
injuries in all of our deployments," Cowan said. "In Bosnia 
and Southwest Asia, those levels are below what you see in 
folks stationed back home."
        Cowan's office plans to publish a capstone document 
this summer that outlines force health protection measures 
for the next 10 years. The staff also has begun rewriting 
the joint medical doctrine. Both documents will reflect the 
initiatives DoD is taking to better protect forces and take 
care of their families, Cowan said.
        "The force health protection plan acknowledges that 
we've been doing the right things -- but in bits and pieces 
and frequently reactively," Cowan said. "We can do better if 
we get in front."
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