Perfection looks simple: AFCENT provides critical airlift capability to ground commander

Published Oct. 26, 2010
By Capt. Heather E. Ward
AFCENT Public Affairs

SOUTHWEST ASIA -- There are about five people in Brig. Gen. Mark Kyle's office. He is the director of mobility forces for United States Air Forces Central Command. He is preparing to make a call to Camp Bastion, Bagram Airfield and Kandahar Airfield in Afghanistan. The parties are sitting around talking while the executive officer, Maj. Gary Durst, makes the connection down range. The conversation in the room is sporting at the expense of each other. For living in a combat zone, the mood is light, as is the reason for the call.

The Event
The theater's geographic footprint is equivalent to the distance from Florida to Alaska. The most efficient manner of movement is through the air. To keep the warfighter supplied, the people of air mobility move food, water, mail, various types of equipment -- large, small, electronic, and mechanical -- and people.

The day started out as routine, but in theater, it is rarely routine. On Oct. 17, AFCENT Aeromedical Evacuation Operations Teams, Aeromedical Evacuation crews and Critical Care Air Transport Teams moved five critical care patients prioritized as Urgent. The average number of Urgent patients moved in theater during a week is 12. In one day, the teams moved half the weekly average.

Coordination and Planning
The coordination to move anything on airlift involves many touch-points. For this particular patient movement, Tech. Sgt. Aldwin Donaldo, an Aeromedical Evacuation Control Team duty controller, talked with the Joint Patient Movement Requirements Center, 618th Air and Space Operations Center (Tanker Airlift Control Center) in the U.S., BAF Operations Team, KAF Operations Team, Al Udeid Air Base and various medical care facilities downrange. By the time Sergeant Donaldo accomplished his shift change, a C-17 was scheduled to fly from BAF to Ramstein AB, Germany, for a routine AE flight with one critical care patient.

The plan was handed off to Tech. Sgt. Stephen Thackery, AECT NCO in charge.

"My part was pretty small ... the ones who made is happen were the ones who executed," said Sergeant Thackery.

The starting point of coordination for the patient movement resides with Sergeants Donaldo and Thackery. The planner and coordinator make the phone calls; they are the hub of information; the collection point and the push point.

The C-17 mission to Germany was cancelled after Sergeant Donaldo completed the shift change with Sergeant Thackery. Sergeant Thackery worked to re-coordinate the routine AE flight.

Around the Office
The Air Mobility Division shares space with the AECT and it is packed full of people and stuff. Very little desk space exists. The few inches of desk space that are exposed hold on for a short period of time before being covered with a coffee cup, a bottle of water or an energy drink. In an office without windows, just inside the door on top of a filing cabinet, sits a curious occupant -- a plant.

The people in the room are involved in the coordination of moving cargo around theater. In one corner sits AECT, at the opposite end of the room people communicate directly with aircrews around theater, in-flight and on the ground. There are about 40 people at any given time working different areas of AMD coordination, including AECT who is unique in many ways. For example, the medical teams speak the language of airlift and planning to coordinate their missions.

The coordinators and planners are experienced AE flight crews. Their previous work is still on their mind, as they task the movement of patients.

"It's not that far from my time in the Army," said Sergeant Donaldo. "When I look at the patients that are moved, that's me. That could have been me. I see those guys and I can relate to them."

Forward and Flexible
Down range at BAF, AEOTs worked to configure a C-130 flight for the routine mission.

Charge medical technician, Tech. Sgt. Tiffany Brown was responsible for the aircraft configuration. The teams set up the aircraft to the specifics of the Patient Movement Requirement and a little extra, for equipment and unexpected changes.

The "C-130 is a chameleon. It can go from moving cargo to moving in upwards of 50 some odd patients. All it takes is the crew to reconfigure the aircraft," said Sergeant Thackery.

The routine flight was headed to Camp Bastion to pick up four patients for transport back to BAF. According to Lt. Col. Bobbie Stemen, medical crew director, 15 minutes prior to their arrival at Camp Bastion, their mission changed. Sergeant Thackery had re-tasked the crew based on new patient requirements.

The routine flight had just gained some urgency. The new tasking: pick up four critical care patients who were on ventilators. The aircraft was currently configured to handle two critical care patients. Sergeant Brown had 15 minutes to reconfigure the aircraft. Like acrobatic medical mechanics, the crew began climbing ladders, hanging straps, breaking down seats, and setting up more litter stanchions.

"We expect there to be changes -- everything that could change and not go according to plan happened." said Sergeant Brown.

Once on the ground at Camp Bastion, Colonel Stemen received the latest change on a blue sticky note, an indicator that Sergeant Thackery was staying busy at AECT.

Dedication
On the flight with Colonel Stemen's crew was Maj. Judith Mate, also a medical crew director.
Her role is to take care of the patients.

She was born in Hungary, moved to the U.S., became a nurse and a U.S. citizen and joined the U.S. Air Force. She had a noticeable accent during the phone interview, she pronounced we -"vee."

When asked why she joined the military she replies quite simply, "I like to fly. I like to take care of my patients."

The men and women that make up the AEOTs, AE Crews and CCATTs are dedicated and humble.

Interview after interview I receive humble and dedicated answers:

"We love what we do, it is unfortunate that we do what we do because they (patients) are hurt, but we will do whatever it takes regardless of the challenges ... the end result is getting these patients where they need to be." -- Colonel Stemen

"Our first and foremost priority is the warfighter. We love to work but we would rather not be doing it." -- Sergeant Thackery

"Taking care of the guys because those people are fighting for freedom." -- Major Mate talking about her mission

After the interviews it is easy to understand how life can live in the desert. That plant -- absent exposure to sunlight, just inside the door on top of a filing cabinet -- symbolizes their dedication to life.

Moved with a Sticky Note
The plan changed two additional times while on the ground at Camp Bastion. Because the plans changed so quickly, there was not enough time to print them out. The blue sticky note held the final true patient count. The teams were heading back to BAF. Once the patients were delivered they would fly to KAF to pick up the remaining patients that included the four ventilated patients. By the end of the day, the coordination tally was: three aircraft, a change from inter-theater to intra-theater, aircraft configured four times, and four Routine patients became five Urgent ventilated plus routine patients.

At the end of that week, the AECTs coordinated even larger numbers. In one day they moved nine Urgent critical care patients. Sticking with previous averages, the nine patients in one day is 75 percent for an entire week.

The Call
Monday morning, following the patient movement effort, General Kyle turns his attention away from the ribbing in the office to the people downrange that are joining him on the call. He asks who is on the line, he starts to rib the people a little, then he turns his attention to the matter at hand and says, "You guys pull this off every day with very little fanfare, outside intervention and little turbulence to the system."

After the call he turns to me with conviction and says, "If a tanker's not there to pass the fuel it's called a divert to base, if an air drop can't be done because of cross winds it's called a reschedule. A guy only gets one chance to have his life saved ..."

General Kyle's gratitude for the effort of the teams was simply stated, "You guys rock. You absolutely rock ... now get back to work."