In a compelling story published today by the Washington Post, “Military medics combine ultramodern and time-honored methods to save lives on the battlefield” of Afghanistan.
- At 6:09 p.m., Dustoff 57 has just left this base deep in Taliban-infiltrated Kandahar province, headed for a POI, or point of injury. Somewhere ahead of the aircraft is a soldier who minutes earlier stepped on an improvised explosive device, the signature weapon of the wars in Iraq and Afghanistan. All the helicopter crew knows is that he’s “category A” – critical. The trip out takes nine minutes. Fifteen minutes have now passed since the soldier was wounded. Speed, simplicity and priority have always been the hallmarks of emergency medicine. The new battlefield care that flight medics and others on the ground practice takes those attributes to the extreme.
- Four people run to the helicopter with the stretcher holding the wounded soldier. He lies on his back partially wrapped in a foil blanket. His chest is bare. In the middle of it is an “intraosseous device,” a large-bore needle that has been punched into his breastbone by the medic on the ground. It’s used to infuse fluids and drugs directly into the circulatory system when a vein can’t be found. It’s a no-nonsense technology, used occasionally in World War II, that fell out of favor when cheap and durable plastic tubing made IV catheters ubiquitous in the postwar years. Until they were revived for the Iraq and Afghanistan wars, intraosseus devices were used almost exclusively in infants whose veins were too small to find. On each leg the soldier has a tourniquet, ratcheted down and locked to stop all bleeding below it. These ancient devices went out of military use more than half a century ago because of concern that they caused tissue damage. Now every soldier carries a tourniquet and is instructed to put one on any severely bleeding limb and not think of taking it off.
- Tourniquets have saved at least 1,000 lives, and possibly as many as 2,000, in the past eight years. This soldier is almost certainly one of them. They’re a big part of why only about 10 percent of casualties in these wars have died, compared with 16 percent in Vietnam. On the soldier’s left leg, the tourniquet is above the knee. The tourniquet on his right leg is lower, below the knee; how badly his foot is injured is hard to tell from the dressings. His left hand is splinted and bandaged, too. Whether he will need an amputation is uncertain. The hospital where he’s headed treated 16 patients in September who needed at least one limb amputated. Half were U.S. soldiers, and the monthly number has been climbing since March.
- After three minutes on the ground, the helicopter takes off. Eleven minutes after lifting off from the POI, the helicopter lands at the so-called Role 3, or fully equipped, hospital at Kandahar Airfield, about 30 miles to the east of the also well-fortified Forward Operating Base Wilson. There, surgeons will take care of the injuries before transferring the patient, probably within two days, to the huge military hospital in Landstuhl, Germany, and there, after a week or so, to the United States. It’s been 28 minutes since the helicopter left Forward Operating Base Wilson.
- Before every Grunt leaves the wire, they want to know if air or artillery support is readily available and more importantly, if required, will an aerial medevac be responsive – in Joe speak “Time on Target for Air and Arty and a quick Nine-line medevac request . . . how quick will the angels of mercy get here?”. Quick means quick, the sooner the better obviously, since every minute counts. Secretary Gates figured this out when he began his battlefield circulation tours in Afghanistan when he became Secretary of Defense and quickly realized that the “Golden Hour”, that period in time that is the standard from time of request for a medevac to arrival at the point of injury and back to medical care on a base, was not being met in Afghanistan due to lack of medevac resources and the distant out-posts that troopers were operating from. Secretary Gates made it a personal mission to close the gap and ensure that troopers were supported by the “Golden Hour” standard and personally kept the pressure on logistics planners to increase medevac resources and establish medical unit facilities in support of all forward deployed personnel. The only question SFTT raises regarding this issue is why did it take the Secretary of Defense to correct this situation?
- The Washinton Post online article provides a remarkable photo gallery, – of note is:
- the destructive nature of an IED that targeted a Mine Resistant Ambush Protected (MRAP). The simplicity of a pressure plate device loaded with hundreds of pounds of fertilizer (and other components) can defeat US “resistant” vehicles. More telling is that a device of this size takes time and local support to emplace;
- grunts not wearing all of their protective gear – no throat, deltoid, or groin protectors – obviously a commanders call, but is the decision not to wear the complete armor suite because of weight and comfort?;
- the chinstrap for the Advanced Combat Helmet is a flimsy strap of material – no chin pads are provided and the harness is simply used to hold the “brain bucket” in place. At least the trooper is being medevaced for treatment of a possible TBI.
According to an article published by the Christian Science Monitor, the Pentagon had red flags about the command climate in ‘kill team’ Stryker brigade.
- As the 5th Brigade of the 2nd Infantry Division, which Colonel Tunnell commanded for three years, was preparing to deploy to Afghanistan in June 2009, senior Army officials questioned Tunnell’s leadership focus with growing concern, and discussed the possibility of removing him from command. Now, Tunnell’s tenure is raising fresh questions in the halls of the Pentagon. Five soldiers in Tunnell’s brigade stand accused of war crimes, including creating a self-described “kill team” that allegedly targeted unarmed Afghan men and cut off their fingers as war trophies. The narrative of Tunnell’s leadership is particularly significant to the Pentagon now, however, as it endeavors to instill in troops a new ethic of fighting in its current wars – using the least force necessary rather than the maximum force permissible. Some sources suggest that Tunnell set a tone that was not only out of line with Pentagon doctrine, but was inflammatory and potentially dangerous.
- “When you feel violent intent coming down from the command and into the culture of the brigade, that’s when you end up with things like the rogue platoon,” says a senior US military official who worked with the brigade in early 2009 at the National Training Center before it deployed to Afghanistan. “He established a culture that allowed that kind of mindset to percolate. And there are second- and third-order effects that come with that. Clearly, the guys who were pulling the trigger are the proximate cause of the crime, but the culture itself is the enabler.” Others argue that Tunnell’s aggressive posture was fair enough, and even necessary, for infantry troops who must prepare to kill, and also to be killed, on behalf of their country. They point out that the brigade was, after all, equipped with Stryker vehicles designed for soldiers working in some of the most violent regions of any conflict. And Kandahar Province – the cradle of the Taliban – was precisely where the 5/2 brigade was headed for a year-long tour.
- Other officers within the battalion shared their concerns, says the senior official. “I had two staff officers [in Tunnell's brigade] separately tell me that they were afraid that the brigade was going to end up on CNN for ‘all the wrong reasons,’ ” he says. In response, trainers tried to help officers in the brigade take steps to “lead from the middle to ensure that didn’t happen,” says the senior official, who adds that some other military officials raised the possibility of removing Tunnell from command in discussions that included a two-star general.
If it is true, that senior leaders and general officers considered relieving or replacing Colonel Tunnel prior to the Brigade’s combat deployment, but chose not to, then their lack of moral courage is worse than anything the colonel may eventually be found culpable of “enabling”. Then again, the time for “relief” is over, but if anyone really believes that any Brigade senior leader will eventually be held accountable for the heinous crimes that occurred during their watch, you only need review the Army’s track record in this regard to see to see other examples of failed leadership and lack of accountability – i.e. Abu Graib, where only enlisted soldiers were charged with crimes; and Wanat, where commanders where ultimately absolved of failed leadership; it seems that the list will keep on growing.
In yet another article from Foreign Policy, it appears that there are some divergent views on the status of the Afghan War as articulated in an article entitled Petraeus Versus Obama.
- Today there are two wars taking place in Afghanistan. The first is the war confidently described by the U.S. military: a conflict that according to leading military commanders and even the secretary of defense is “headed in the right direction” and has a “good chance at success.” But virtually every day there are press reports that speak of another war. It is one defined by rising civilian and military death tolls in a growing number of once-safe regions — particularly in the north of the country — now marred by violence and insecurity; government corruption and incompetence that remains as bad as ever; and an increasing sense of fatalism among the Afghan people. The problem is that the latter conflict actually seems to be taking place — while the former seems to be a figment of the military leadership’s imagination.
- This growing divide is increasingly bringing into question the very credibility of U.S. military statements about military progress in Afghanistan. And the Obama administration faces the possibility that its planned July 2011 deadline for the commencement of troop withdrawals may be undermined by the very individuals that are tasked with carrying out the war effort.
- From a security standpoint the situation in Afghanistan is worse than at any point in the past nine years. Already 406 U.S. troops have been killed this year — if the trend continues, the highest annual death toll since the conflict began. A recent report by the Afghan NGO Safety Office (ANSO), paints a very different picture than the one described by U.S. officials. The authors conclude that the insurgency is in its ascendancy and describe it as “increasingly mature, complex and effective.” The White House got into the pessimism game with an assessment that said “progress across the country was uneven,” Afghan governance remained “unsatisfactory,” and “district-by-district data show that only minor positive change had occurred with respect to security.” What seems most backwards about the military’s congenital optimism is that even by the key metrics of their own counterinsurgency (COIN) strategy there has been almost no change for the better in Afghanistan.
- Governance in Afghanistan remains as hopeless as ever. September’s parliamentary elections now appear to have been so fraud-ridden that the entire vote is in question. U.S. efforts to curb incessant government corruption have not led to any real crackdown on graft; instead it has heightened tensions with the Karzai government, and reports that Afghan government officials receive bags of cash from the Iranian government have been met with official shrugs in Kabul.
- While the Pentagon talks optimistically of progress being made in training the Afghan Army, the force is still years away from being able to operate effectively on its own. Attrition rates remain high, drug use is rampant, and soldiers lack competence in basic military skills. During recent offensives in the town of Marjah in Helmand province and ongoing efforts in Kandahar, the Pentagon claimed that the efforts were Afghan-led. So long as Taliban insurgents can melt over the border into Pakistan and so long as the Afghan government is incapable of taking control of areas that have been cleared — either administratively or militarily — these gains are likely to be ephemeral.
- If the military’s public performance is any indication, it seems likely that Obama’s generals will regale him with signs of halting progress divorced from Afghanistan’s bleak reality. The simple fact is that ever since the president announced a July 2011 deadline for commencing withdrawals the military has chafed against what its views as an arbitrary deadline for pulling the plug on the operation. Rather than following Obama’s admonition to not send troops into areas that could not be realistically handed over to the Afghan security forces by 2011, NATO and U.S. forces have engaged in a “clear, hold, and build strategy” in places where there is limited chance of turnover any time soon. It’s hard to square that approach with a White House that seems desperate to embrace political reality and find the Afghan exit ramp. But by spinning an optimistic tale of progress — and pushing stories to journalists that suggest success is just around the corner — the military could see only a nominal decrease of troops in July 2011. At the very least, it will put more public pressure on the White House to stay the course and fudge the troop withdrawal deadline. To be fair, military leaders appear to believe they are doing what it is necessary for the United States to “win” in Afghanistan. But that doesn’t mean anyone — least of all the White House or the American people — should confuse the military’s assessment of the situation in Afghanistan with the truth.
This cogent portrayal of the situation in Afghanistan confirms SFTT’s recent reporting that ISAF/NATO commander’s strategic communications efforts revolve around spinning success out of continued failure. At some point the debate will fracture around this premise that there is in fact a behind-the-scenes sophisticated campaign to sustain the current operational footprint in Afghanistan beyond that ordered by the President in December 2009. Given the likelihood that Congressional majorities may change in tomorrow’s election, the political price will only grow that much steeper. At the other end of the debate are the thousands of deployed troopers that have no choice but to remain tactically engaged in a no-win situation. However, now it has become increasingly obvious that these troopers are not only under-resourced and ill-equipped, but are also being mislead.