Air Force mentors help build ANA medical capability

Published Nov. 25, 2008
By Staff Sgt. Rachel Martinez
455th Air Expeditionary Wing Public Affairs

KANDAHAR, Afghanistan -- With the help of U.S. Forces, the Afghan National Army opened a new hospital at Camp Hero in Kandahar Province, nearly one year ago. A small group of Airmen have helped transform a once empty building into a fully functional hospital staffed by ANA personnel and capable of caring for fellow ANA soldiers, Afghan National Police members, and their families.

The Kandahar Regional Military Hospital is a $10 million facility featuring 50-beds, two operating rooms and an intensive care unit. In addition, there is ongoing construction for a 50-bed expansion. Since opening its doors in January 2008, the hospital staff has treated more than 12,000 outpatients and 600 inpatients.

"This hospital is probably the most successful of the ANA hospitals," said Lt. Col. Edward Fieg, 205th Afghan Regional Security Integration Command mentor.

Much of that success is helped by the medical embedded training team. Air Force doctors, nurses, anesthesiologists, pharmacists, administrators, radiologists, medics, technicians and logisticians mentor their Afghan counterparts and teach the skills required to successfully treat and care for fellow Afghans.

The medical mentoring team is focusing on three main goals - to produce smarter Afghan healthcare workers, procure better equipment, and to improve healthcare planning and execution.

Lt. Col. Susan Bassett, a registered nurse, is responsible for mentoring the hospital's chief nurse and his team of 30 nurses. She spends a lot of time focusing on basic nursing care, such as cleanliness and sterilization.

"We've given them a lot of high-tech equipment, and now we need to show them how to use it," she said. "They see new things and they know about them, but they don't have the basic education to do it."

According to Colonel Bassett, nurses in Afghanistan attend a nine-month training program, but they learn more about tasks the doctor might ask them to do than they do about the body and disease. This is where nurses and mentors play a big role.

"My 30 years of nursing have prepared me for this," said Colonel Bassett. "I can give what they so badly need - we are helping a whole nation come up in care."

One medical area the Afghans are quickly advancing in is anesthesiology. When he first arrived almost a year ago, Maj. Elvin Cruz, anesthesiologist mentor, guessed the Afghans were about 30 years behind in the practice. Beginning with the basics of anatomy and physiology, he was worked to bring them up to speed.

"During the time I have been here, they have been able to do their first arterial line to monitor blood pressure invasively, they did some central lines, and they did their first nerve block on their own hands," he said. "They are very good with their hands, so they can do most the procedures. And they are getting good at being vigilant and monitoring.

"I am trying to get them to the point where they will be able to safely perform anesthesia and get the patient safely to the recovery area - and they are very close," he added. "I really think that by the time I leave here they will be self-sufficient."

Major Cruz does a lot of hands-on training, but also holds lectures every other day. His lectures are presented in both English and Dari. Additionally, he has built a Web site that features a variety of anesthesiology information.

"They are very happy with the Web site. It's a completely new technology for them - using the internet as a learning tool," he said. "Right now, there is only anesthesia information, but there is the capability to put any information from any of the mentors. So not only will we be able to have an impact on this hospital, but we are passing information to the other hospitals in Afghanistan."

One area outside of patient care the medical mentors are working to improve is supply and logistics. Getting supplies and maintaining a stock of needed supplies has historically been a challenge. Supplies would be pushed out to regional hospitals once a year, and whatever they received was what they had to work with for the year. Medical logistics mentors are trying to turn what was a once a year push system, to a quarterly pull system based on needs.

"We want them to be more aware of what's available to them and improve the supply chain," said Maj. Jeff Atkisson, the medical logistics mentor. "Some of our goals would be to have a full inventory at the warehouse - an automated inventory. Right now everything is on paper or in their head. We want to have a system where we know exactly what's in the warehouse at all times - and the customer also needs to know."

Although Major Atkisson just recently arrived in country, he said he has found the Afghans easy to work with and eager to learn. The other mentors have experienced the same thing.

"They really look up to the mentors," said Major Cruz. "They want information and they want to learn these skills."

The eagerness to learn and the progress the Afghans are making have helped make the year-long deployment rewarding for Major Cruz. For others, the reward is getting the chance to work with Afghans and learn from them.

"The Afghan people are absolutely wonderful," said Colonel Bassett. "They are the most gracious people. They cannot start to work until they shake your hand and ask about your family. I need to remember that when I go home.

"Not many people would say a 365-day deployment is a blessing, but I would," she added. "I've very much loved this past year."