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The "MEDCAP" was the first conducted in the Korengal Valley, long regarded as a sanctuary for enemy fighters before Operation Mountain Lion established a permanent military presence and provided security for the region. That distinction was not lost on the medical staff, made up of Afghans and Americans, who provided care at a transformed lumber yard established as a coalition outpost by the U.S. Marines of Task Force Lava only days earlier.
"Bringing peace and medication, taking care of the elders and all of the people, that's the most important thing," said Dr. Nazirullah Rahimi, brigade surgeon for 3rd Brigade, 201st ANA Corps. "The people here are poor and don't have access to health care," added the doctor, a graduate of the Medical University of Kabul.
Overseeing the MEDCAP alongside Rahimi was Army Lt. Col. Edward Michaud, director of the Cooperative Medical Assistance Team, Combined Joint Task Force 76. Michaud said the true success story of this phase of the operation was Afghans providing care for their fellow countrymen.
"It's very important, and absolutely, the people notice the fact that their soldiers are providing security, their medics are providing triage and helping with the treatment of children, and their physicians are seeing patients," said Michaud, whose hometown is Weston, Mass. "Ours are there helping and present, but what they perceive is important."
Michaud said the success of the MEDCAP also affects the Afghans working within it, as they prove their legitimacy in the eyes of the people.
ANA medic Noorula said he felt "very good" about being a part of the first such program in the region. Noorula, who spent much of the six days administering medicine to children, said he enjoys working as a medic and hopes to continue in the medical field. "The most important thing (the people of this region) need is the prevention part, like de-worming," he said. "Besides that, most of the people have stomach pain because of digestive problems."
The de-worming station, where children were first sent when they arrived at the MEDCAP, served as an example of basic preventive medicine in action.
Worms are endemic in this part of the world, and if not treated, can result in further health problems, according to Navy Lt. Cdr. Tom Davie, Medical Service Corps officer from the Bureau of Medicine and Surgery. As a reward for taking medication, the children received candy and vitamins.
Adult patients, who went first to the triage station while the children received de-worming medication, also attended hygiene instruction. They each received a kit containing basic hygiene implements. Following the class, those who needed a physician consultation could see a doctor for evaluation.
"We enjoy getting medical aid out to people who usually aren't able to get it," said Navy Petty Officer 2nd Class Stephanie Baldonado, assigned to the cooperative medical assistance team deployed from Camp Pendleton, Calif.
Other coalition medical staff members shared a similar outlook, reflecting that the program is as much about building trust as it is about providing immediate care.
"It's not so much medicine as it is prevention," said Navy Cmdr. Sandra Hearn, CMA team member and Chesapeake, Va., native. "I think what we're doing here is making a big difference in having the villagers feel that we are friendly, that we can help them in building schools and roads and other projects, and if we continue to teach the Afghan medical providers to care for them, to take care of hygiene and sanitation, that will improve their health overall."
Afghans who attended the MEDCAP were entitled to receive humanitarian assistance before leaving the outpost known simply as "the lumber yard." Between towering stacks of timber, they passed ANA soldiers, U.S. Marines and U.S. Army soldiers directing them to the distribution point. Items given out included blankets, tarps, metal stoves, grain, beans, rice, cooking oil, tea, sugar, and backpacks for children.
"It gives the elders and villagers a level of trust and confidence in their military, to receive aid directly from them," said Army Maj. Dennis Edwards, civil affairs officer for 1st Battalion, 3rd Marine Regiment. "The thing that was really significant about this MEDCAP, and its associated humanitarian aid distribution, is that it was completely run by the ANA."
It will be the ability of Afghan medical professionals, both military and civilian, to care for the people that will determine success in improving the region's health care, Michaud said. "The group we're working with now has run MEDCAPs on their own," he noted. "We've worked with this group before in Nangarhar province, and they're getting pretty good at this. Their level of care is still not quite with what we do, but they're definitely improving."
"If we can provide a clinic here, the people will be grateful," added Rahimi, echoing a familiar theme. "Prevention, especially with digestive system problems, is the biggest need of the people here."
The initial effort to provide medical care to a previously isolated region has resulted in a grateful response, according to Michaud. "We have lots of patients, particularly the elders, women and children, who tell us they are praying for us, and have even been bringing food to us," said Michaud. "I would say it's had a very positive impact on the people, based on what we've seen."
(Marine Capt. Dan Huvane is assigned to Task Force Spartan public affairs.)
