Friday, February 08, 2008

America Supports You: Group Facilitates Valentine's Day Greetings

By Samantha L. Quigley
American Forces Press Service

Feb. 7, 2008 - Letting servicemembers know they're not forgotten this Valentine's Day couldn't be easier, thanks to a national troop-support group's online care package program. Operation Homefront's "eCarePackage" program allows American citizens to send care packages to servicemembers and their families. The program also is available for
military families to send and receive packages.

"(Servicemembers and their families) just have to register, but it's completely secure," said Meredith Leyva, founder of Operation Homefront. "We don't share any private information, not even first names."

When servicemembers or their family members register, they're assigned a number that becomes their eCarePackage identity. Registered users can pass that number to friends and family members, who then can use it to send care packages they create from the requestor's wish list.

Civilians can choose to send packages to servicemembers from specific states, branch of service, or even current duty station. The option to make it a birthday gift also is available.

The program, which began in time for Christmas 2006 and offers specific products for each major holiday, has a wide variety of products from which to choose, thanks to donors. Candy is available, as well as small pillows and "fun stuff," Leyva said.

"You're going to get some fun, higher-end stuff," she said. "It's a heck of a lot cheaper for a servicemember to send a care package this way, since all our care package products are donated."

The only cost to senders is shipping, and even that is discounted.

"We actually have got a deal with DHL, so we do tend to get cheaper rates in general, and we pass that on," Leyva said. "And, because we do have the direct partnership with DHL, we have been able to get valentine stuff out to Iraq as quickly as three days, but it's not guaranteed."

Though there's no cutoff date for sending eCarePackages to or from Iraq, Leyva emphasized that sooner always is better than later.

Another feature offered through the program is the opportunity for senders and recipients to connect via e-mail.

"We like to encourage 'thank You' notes," Leyva said. "They end up striking up a great conversation with the one who sent the care package."

Notes also can be included in the care packages, she said.

Operation Homefront is a supporter of America Supports You, a Defense Department program connecting citizens and companies with servicemembers and their families serving at home and abroad.

Soldiers Learn to Assist With Surgeries

By Elaine Wilson
Special to American Forces Press Service

Feb. 7, 2008 - Up front and in the spotlight, surgeons often are revered by patients and grateful family members for their lifesaving skills and knowledge. However, other lifesaving medical professionals are working just as hard out of the spotlight and behind the operating room doors.

The
Army's operating room specialists, known as "68 Deltas," are trained at the Army Medical Department Center and School here and are responsible for everything from holding retractors and passing instruments to sterilizing equipment and preparing specimens for the lab. Their tasks may sound simple in comparison to those of a highly trained surgeon's, but, in their case, looks are deceiving.

"If an operating room specialist isn't doing his or her job correctly by maintaining sterile technique, then infection rates in the hospital will rise," said Lt. Col. Kathleen McArthur, chief of the 68 Delta branch.

McArthur oversees the operating room specialist training program, which comprises two phases and trains about 400 students a year. The first nine-week phase consists primarily of classroom instruction that culminates in a 72-hour field training exercise at nearby Camp Bullis.

"Our students learn how to carry out their job from the first step, which is setting up the case cart for the operation with a perioperative nurse," McArthur said.

Once the surgery begins, operating room specialists must know how to set up a sterile field, pass instruments to a surgeon, apply dressings, take care of a specimen, and then tear down the room and take equipment to central materiel service for sterilization. Specialists also learn to sterilize equipment.

"The course is very challenging," said student Pvt. Tommy Chavez. "But I'm enjoying it. I've always been interested in the medical field."

The job is not for the faint of heart or weak-stomached, so new students are shown graphic pictures and video of surgeries so they can get a glimpse of what is to come.

"It's common for students to pass out, even out in the field," McArthur said. "Some people have a blood aversion, and others just get nervous the first time they're in a surgical setting."

Phase Two is 10 weeks in length. Students apply their new knowledge and skills in surgical settings at large
Army medical centers or at small Army community hospitals. This phase can occur at any of 14 military medical facilities throughout the nation, including Brooke Army Medical Center here, which is a Level One trauma center.

"Students see gunshots, motor vehicle accidents and burns at BAMC," McArthur said. "It's very similar to the environment in a combat situation and is good preparation for deployment."

Course
leaders always keep an eye on the battlefield and work to weave lessons learned in Iraq into the curriculum to ensure students are ready for any situation.

"Many of our instructors have deployed and share pictures and knowledge that we integrate with the classes," McArthur said.

The operating room specialist role grows in intensity during deployments. The specialists may serve with a forward surgical team, assisting with life-sustaining surgeries, or a combat support hospital farther away from the front lines.

"You have to be able to keep a cool head, which is why realistic training, like we have here, is so important," McArthur said.

After training, students are equipped with the knowledge to assist with all types of operations, including orthopedics, cardio-thoracic, neurosurgery, podiatry, vascular, opthalmic and general surgery. As they gain more experience, "they are given more responsibility such as patient transportation, setting up surgical suites, operating surgical equipment and helping to monitor blood loss," McArthur said.

Upon graduation, 68 Deltas are expected to demonstrate, under the direct supervision of a registered nurse, entry-level operating room specialist skills in the operating room and central materiel service, she said.

While surgeons may garner the spotlight, the
Army's operating room specialists play a vital role in the supporting cast of a medical team.

"I am pleased to say that the OR branch is staffed with stellar, combat-seasoned NCOs, officers who are
leaders in perioperative nursing, and extremely gifted civilian instructors and staff," said Col. Patricia Patrician, chief of the Department of Nursing Science. "We really can accept no less than that to train those who care for the American soldier."

(Elaine Wilson works at the Fort Sam Houston Public Information Office.)

Army Continues to Treat Blast-Related Injuries

By John J. Kruzel
American Forces Press Service

Feb. 7, 2008 - The
Army is aggressively diagnosing and treating soldiers who suffer concussive injuries and stress related to blast attacks, the Army's surgeon general said today. Lt. Gen. (Dr.) Eric B. Schoomaker, Army surgeon general and commander of U.S. Army Medical Command, told reporters during a media roundtable at the Pentagon today that issues stemming from such combat conditions are a "great concern" to soldiers, their families and the American public.

"We know the importance of prevention of these injuries and illnesses; we know the importance of timely diagnosis and treatment of both concussive and
post-traumatic stress symptoms," Schoomaker said. "And we are aggressively executing programs that are designed to educate, to prevent, to screen and to provide the appropriate care in a timely fashion for all of these deployment-related stresses and injuries."

Concussive injuries and their psychological responses are "not new concepts to us," the general said. He noted that concussions occur domestically -- on America's highways and sports fields -- as often as they do in combat, and that referring to them as the war's "signature injury" is a mischaracterization.

Schoomaker said he doesn't believe the
war on terror has produced any one signature injury. But he believes there is a signature weapon used by insurgents: a blast.

"It's being used very effectively in combat," he said. "It blinds our soldiers in some cases if they're unprotected. It deafens them. If it defeats our protective equipment, it may cause a mild concussive injury all the way to a very severe penetrating head injury."

The general said
military health care professionals must identify and treat blast-related injuries as soon as possible after the event.

"Doing an effective screening as close as possible to the actual event and then making a decision whether that soldier should take a knee and step out of the battle so that they can recover ... is our most important goal," he said

Schoomaker said the
Army created initiatives to increase the rapidity and efficiency of treatment, including arming medics to allow them to more safely treat wounded troops in combat zones, providing servicemembers with improved first aid kits, and training troops in medical techniques. In addition, in 2007 the Army instituted an 800,000-strong chain-teaching initiative -- from the most seasoned commander down to the most junior soldiers -- on concussive injuries and post-traumatic stress.

Army health officials are looking into the role context plays in a concussive injury and its aftermath, Schoomaker said, which may be a more significant factor than originally thought. To illustrate the importance of context, the general made an analogy to a quarterback who is hit hard in the course of a football game. Regaining consciousness while surrounded by thousands of sympathetic fans is a vastly different context from awakening in a combat zone, surrounded by the wounded bodies of your battle buddies, he said.

While screenings performed immediately after returning from deployment might be successful in identifying physical symptoms, the process might allow gaps in detecting latent symptoms related to context. Because certain emotional symptoms related to concussive injuries or combat stress emerge later than their physical counterparts, Schoomaker said, he advocates an additional screening three to six months after deployments. Identifying the root of emotional symptoms may help affected servicemembers avoid family, social, alcohol or other problems resulting from a lack of proper diagnosis and treatment.

Army Col. (Dr.) Loree Sutton said 10 to 15 percent of those with concussive injuries display "persistent symptoms," generally cases when the physical injury is complicated by psychological issues. Sutton is chief of the Defense Department's newly created Defense Center of Excellence for Psychological Health and Traumatic Brain Injury. The center reflects the department's effort to step up the quality of care for wounded warriors and their families.

"We need to ensure that we ... put out the message in general that concussions heal in the vast majority of cases, and that's a good-news story," she said. "In that small minority of cases where symptoms persist, we need to take a comprehensive, holistic view."

Schoomaker emphasized the
military health community's dedication to caring for injured servicemembers.

"America can truly be assured that we are not going to rest until all our soldiers who have been wounded or are injured or are ill in the service to the nation are cared for both competently and compassionately," he said. "They'll receive the best support from the
United States Army, the Department of Defense and the Department of Veterans Affairs."

Gates Urges Passage of Supplemental War Funds

By Sgt. Sara Moore, USA
American Forces Press Service

Feb. 6, 2008 - Defense Secretary Robert M. Gates today urged Congress to provide the remaining balance of President Bush's fiscal 2008 supplemental funding request for the global
war on terror, saying the delay in funding is damaging the Defense Department's operations at home and abroad. "Delay is degrading our ability to operate and sustain the force at home and in theater and is making it difficult to manage this department in a way that is fiscally sound," Gates said at a hearing of the Senate Armed Services Committee. "The Department of Defense is like the world's biggest supertanker. It cannot turn on a dime, and it cannot be steered like a skiff."

The department is waiting on approval of $102.5 billion from the 2008 supplemental request. President Bush asked for $189.4 billion for the
war on terror for fiscal 2008. In December, Congress approved $86.8 billion of that request and deferred work on the remaining $102.5 billion.

In his testimony defending the fiscal 2009 defense budget request of $515.4 billion, Gates also said he was unable to provide a realistic estimate of costs for the
war on terror for fiscal 2009. The administration has asked Congress for a $70 billion emergency "bridge fund" for the first quarter of fiscal 2009, which would cover operations in Iraq and Afghanistan through December.

The Defense Department has tried to be very open with Congress about the war costs, Gates said, but it cannot provide an estimate for 2009 war costs until
leaders know when and if the department will receive the 2008 supplemental funds, and what adjustments commanders will recommend to troop levels in Iraq. When pressed, Gates said 2009 war operations could cost around $170 billion, but he stressed that he has no confidence in that figure due to these unknown factors.

Gates also pointed out that nearly three-quarters of the fiscal 2009 supplemental request will be spent by the next administration, which makes it even more difficult to make an accurate projection of what will be needed.

"While I would like to be in a position to give you a realistic estimate of what the department will need for FY 2009 supplemental funds, I simply cannot at this point," Gates said. "There are too many significant variables in play."

The overall defense budget request for fiscal 2009 represents about 3.4 percent of the U.S. gross domestic product, Gates said. This compares to levels during the Korean and
Vietnam wars, when the percentages of the GDP going to defense were 14 percent and 9 percent, respectively. The request includes $183.8 billion for strategic modernization; $158.3 billion for operations and training; $149.4 billion for military pay, health care, housing and quality of life for servicemembers and families; and $20.5 billion to increase the size of the Army and Marine Corps.

The budget request must be considered in light of the current strategic landscape, in which old hatreds and conflicts have combined with new threats and forces of instability, Gates said. Current challenges include
terrorism, extremism, and violent jihadism; ethnic, tribal and sectarian conflict; proliferation of dangerous weapons and materials; failed and failing states; nations discontented with their role in the international order; and rising and resurgent powers whose future paths are uncertain, he said.

"In light of this strategic environment, we must make the choices and investments necessary to protect the
security, prosperity and freedom of Americans for the next generation," Gates said.

Joint Chiefs Chairman Urges Passage of Fiscal 2009 Defense Budget

By Sgt. Sara Moore, USA
American Forces Press Service

Feb. 6, 2008 - The Defense Department will continue to need the support of Congress and the American public to sustain the success it has achieved in the
war on terror so far -- success that, though impressive, is still tenuous, the chairman of the Joint Chiefs of Staff said today. Navy Adm. Michael G. Mullen testified before the Senate Armed Services Committee, defending the $515.4 billion fiscal 2009 defense budget request President Bush submitted to Congress on Feb. 4. The budget includes a 3.4 percent military pay raise, a 2.9 percent civilian raise, money to continue to grow the Army and Marine Corps, and a funding increase to maintain readiness. The administration also requested a $70 billion emergency supplemental request for the war on terror in fiscal 2009.

Mullen noted that budgets are really a type of strategy, and this budget "reveals great balance in our strategy for the future -- a realization that, while we continue to fight and develop counterinsurgency warfare, we must also prepare for, build for, and train for a broad spectrum of traditional warfighting missions."

To sustain the force and prepare for future requirements, this budget includes more than $180 billion for strategic modernization, including $3.6 billion for the
Army to continue to develop future combat systems and another $3.5 billion to procure 20 more F-22 fighters and another $700 million in research and development, Mullen said. The budget also includes money to continue to build the next-generation aircraft carrier and guided-missile destroyer, increased spending on missile defense, funding to complete the stand-up of U.S. Africa Command, and more than $20 billion to increase the size of the Army and Marine Corps.

Mullen acknowledged that the fiscal 2009 budget doesn't include any big surprises, but said that is because the department has looked at all its requirements and has a good handle on where it should go fiscally.

The United States has made significant progress in Iraq and Afghanistan, Mullen said. In Iraq, violence is down, business is on the rise, and al Qaeda is on the run. He praised commanders on the ground for their innovative techniques and use of surge forces to improve security. Progress in Afghanistan has been mixed, but the coalition is doing all it can and the additional 3,000 Marines being sent there will make a big difference, he said.

But progress in both countries is still tenuous, and conditions on the ground could change at any time, he said.

Mullen also cautioned about long-term risks the United States faces to its
security commitments around the world if the Defense Department doesn't address the toll that ongoing combat operations are taking on military forces, gear and families.

"The well is deep, but it is not infinite," he said.

DoD and Congress must work together to reduce
Army deployments to 12 months from the present 15-month tours, restore the Marine Corps' expeditionary capabilities, and stay dominant at sea, in space, and in cyberspace, Mullen said. Also, the department needs to do a better job at identifying and treating wounded servicemembers, especially those who suffer from conditions such as post-traumatic stress disorder and traumatic brain injuries.

The admiral also urged Congress to enhance quality of life for military family members by broadening federal hiring preferences for
military spouses and expanding child care benefits.

The U.S. military is still the most powerful, capable force on Earth, Mullen said. This power is a testament to the brave, talented men and women who serve in the military, but also to the support of Congress and the American people, who have invested heavily in national defense, he said.

"We will continue to need that support, for however powerful we may be today, that power is not assured tomorrow," Mullen said.