Afghanistan — Group Develops Afghan Forces’ Health System

WASHINGTON — A med­ical advi­so­ry group is work­ing to devel­op health care capa­bil­i­ties and cre­ate med­ical and health care train­ing pro­grams for Afghanistan’s secu­ri­ty forces.

“We have a large mis­sion to devel­op the Afghan nation­al secu­ri­ty forces health care sys­tem,” Air Force Col. (Dr.) Schuyler K. Geller, NATO Train­ing Mis­sion Afghanistan com­mand sur­geon and com­man­der of the Med­ical Train­ing Advi­so­ry Group at Camp Eggers, Afghanistan, said dur­ing a “DoD Live” blog­gers round­table yes­ter­day.

Geller said the group’s mis­sion is to get the health care sys­tem run­ning to a com­plete­ly self-sus­tain­able lev­el, for both the army and police, in all oper­a­tions.

The group has about 155 med­ical men­tors placed in the offices of the sur­geons gen­er­al for Afghanistan’s nation­al police and army around the coun­try, as well in the nation­al mil­i­tary hos­pi­tal in the Afghan cap­i­tal of Kab­ul, region­al hos­pi­tals and the police hos­pi­tal.

Geller said the group is fac­ing many obsta­cles in devel­op­ing the health care sys­tem, but the most-press­ing issue is a lack of physi­cians to fill vacan­cies at the facil­i­ties. “They are 37 to 39 per­cent filled,” he said.

A lack of recruit­ment for Afghan mil­i­tary doc­tors and the dura­tion of med­ical school in Afghanistan con­tribute to the physi­cian short­age in the country’s secu­ri­ty forces, Geller said. The process, he said, takes sev­en years from the time of high school grad­u­a­tion to the com­ple­tion of a med­ical pro­gram.

“The uni­ver­si­ties prob­a­bly pro­duce over 100 physi­cians every year, but a very small por­tion of those join the army or police at the present time,” he said.

The group hopes to attract more doc­tors to the pro­gram, because there are more physi­cians in Afghanistan than there are jobs avail­able for them. Geller said one of his main pri­or­i­ties is to aggres­sive­ly attract unem­ployed physi­cians to the secu­ri­ty forces med­ical sys­tem.

The team also has a deficit in allied health sup­port, and has devel­oped branch schools with an Army-based cur­ricu­lum to help in cre­at­ing more posi­tions for nurs­es. The school grad­u­at­ed 20 licensed prac­ti­cal nurs­es from the pro­gram last year and dou­bled the num­ber of grad­u­ates this year.

“We expect to meet all of our nurs­ing deficit through train­ing with­in the next two, to two-and-a-half years,” Geller said.

The group also is start­ing a physician’s assis­tant pro­gram in the fall, with at least 80 stu­dents enrolled. This pro­gram will help with the deficit in mil­i­tary doc­tors through­out the sys­tem, espe­cial­ly in bat­tal­ions where the coali­tion is pro­vid­ing health care until the Afghan forces’ health care sys­tem can stand on its own.

Geller also said the group is train­ing women to work in the health sys­tem. Since Afghan forces have no female com­bat medics because of cul­tur­al cus­toms, the major­i­ty of women serve as nurs­es in pedi­atrics and obstet­rics depart­ments.

“We are train­ing women in skills that they can exer­cise in their home com­mu­ni­ty so that they can live at home and go to work,” Geller explained.

When asked about the med­ical tech­nol­o­gy in Afghanistan, Geller acknowl­edged that it could be bet­ter, but said the Afghans have sur­gi­cal capa­bil­i­ty and ade­quate tech­nol­o­gy. “What is real­ly need­ed is very sim­ple pre­ven­tive med­i­cine and treat­ment and treat­ment of infec­tious dis­ease,” he said. “That kind of thing has the biggest impact.”

Many areas of the Afghan forces’ health sys­tem are becom­ing self-suf­fi­cient and will be turned over to the Afghans, Geller said. The school for com­bat medics has been in place for close to three years, he said, and is almost ready to be tran­si­tioned entire­ly to the Afghans to run on their own.

But before the sys­tem can com­plete­ly be turned over to the Afghan secu­ri­ty forces, he added, quan­ti­ty and qual­i­ty issues must be solved. When the group has enough physi­cians in place, he said, then, a select group can go through improved grad­u­ate-lev­el med­ical pro­grams and receive more hands-on clin­i­cal train­ing.

“I believe that with­in the next four or five years, both the quan­ti­ty and qual­i­ty prob­lem here will be sig­nif­i­cant­ly resolved,” he said. “Our spe­cif­ic area in devel­op­ing the Afghan nation­al secu­ri­ty forces health care sys­tem is a val­ue.”

U.S. Depart­ment of Defense
Office of the Assis­tant Sec­re­tary of Defense (Pub­lic Affairs)