Airmen advise Afghan medical mission

Published Sept. 13, 2009
By Staff Sgt. Stacia Zachary
U.S. Air Forces Central combat camera

KABUL MILITARY TRAINING CENTER, Afghanistan (AFNS) -- Between 100 and 400 Afghans are screened here daily for entrance into the Afghan national army.

The first day of screening is the medical portion - an essential process for all would-be recruits to pass before becoming an Afghan soldier.

Over a six-month timeframe, 2,500 to 3,000 Afghan recruits generated through Kabul military training center a month.

"The recruitment statistics are staggering," said Maj. Paul Valdez, a Combined Security Transition Command-Afghanistan KMTC medical administrative advisor doctor. "The (Afghan national army) has exceeded their initial goal of 90,000 recruits."

The medical screening process consists of a drug urinalysis, physical screening and eye exam. Once they receive the proper clearance to proceed, the recruits then receive five immunizations.

Early in the morning, potential recruits line up outside the medical clinic. Urinalysis kits are handed out and the Afghans are instructed on the proper procedure for administering the tests. The Afghans are tested for THC (tetrahydrocannabinol) or marijuana, opiates, amphetamines and cocaine. The later three are grounds for immediate expulsion from the (Afghan national army) medical screening and selection process.

"On average, 25 percent of the recruits we see test positive for major drugs," Major Valdez said. "That's due, in large part, to cultural acceptance of THC."

One point of contention for American advisers is adjusting their acceptance standards to the Afghan culture acceptance concerning certain drug usage.

"There is a rule zero tolerance for drug use in (our) military," the major said. "But because of the Afghan culture, THC is not frowned upon like in the United States, but the Afghan military is slowly trying to change that mindset and shift to a drug-free military."

After the recruits go through the urinalysis, providing the results are negative for drug use, they progress to the next station; physical screening. Here, doctors, with the aid of advisers, will test motor skills, strength and flexibility as well as a heart and lung check.

"Generally, we're looking for prior injuries that would make them unfit to be a soldier," said Lt. Col. Scott Caulkins, the CSTC-A METT officer in charge of medical in-processing mentor operations. Some main detractors from eligibility into the (Afghan national army) include injuries such as "missing finger tips and previous fractures that healed poorly."

Seeing doctors can be new or unique experience for the recruits as many report from rural and undeveloped areas.

"These might be the first doctors (the recruits) have ever seen," the colonel said. "Many who received some form of medical care were either seen by the village healers with limited access to modern medical care."

The next station in the in-processing line is the eye exam.

"The (Afghan) soldiers' next step is to get cleared for their vision," Major Valdez said. "They have to be within a range of vision with a minimal curative range that can be corrected through glasses."

With the introduction of state-of-the-art examination equipment, the doctors can better screen patients and more accurately prescribe the appropriate strength to correct vision.

"Compared to a year ago, we now can qualify people with vision deficiencies because we have a working eye chart designed for the country's literacy levels an eye refractor," Colonel Caulkins said. "The upgraded equipment paired with a contract with a local vendor for glasses, more recruits can qualify for service."

"The new equipment allows me to do more for the soldiers," added Dr. Sayed Zaman, a KMTC optometrist and ophthalmologist.

The final station of inprocessing is immunizations. Here the recruits will receive a shot series of hepatitis B, polio, MMR (mumps, measles and Rubella vaccine), TD (tetanus and diphtheria vaccine), typhoid and the meningococcal vaccine.

"Their arms will hurt after this, but it's the soldier's greatest chance of fighting off disease - an opportunity few have in this country," said Army Sgt. 1st Class Tom Tyler, a CSTC-A KMTC medical administrative advisor. "After that, they take their records and prepare for the next stage of inprocessing into the army."

When the recruits initially come through the medical doors, many of them are malnourished. Serving in the military not only gives the soldiers a means to earn money and support their families as well as serve their country, but also become healthier individuals.

"They look almost emaciated when they first come through," Colonel Caulkins said. "But within a few weeks, you see the vitality replace emaciation and they are putting on weight because they have good food and regular exercise. They now have the opportunity for a better life while helping secure their country."

In the span of a year, the medical advisers have seen growth in the care the Afghan medical staff is providing the Afghan national army.

"When we first came, they were operating out of a substandard, antiquated facility and were simply making do with what they were given," Major Valdez said. "After working with what they felt the facility needed to be functional, there has been a $3,500 renovation of the building that not only increased quality of life, but increases provider capabilities."

In addition to physical improvements to the structures, the KMTC medical staff has begun leaning forward and making informed decisions rather than asking for help from their American counterparts.

"There is still some discussion on how best to treat or diagnose conditions, but more and more they are beginning to own this operation," Colonel Caulkins said. "They are going to falter a little, but they are also learning to pick themselves up and learn from previous cases and apply them to other (recruits)."