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
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"The old business of deterrence and readiness has been
replaced by shape, respond and prepare, which puts us into a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
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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