Custom Search

Our Products · On-Line Store

HA Multiservice Procedures for Humanitarian Assistance Operations
FM 100-23-1

Chapter 4

TACTICAL-LEVEL ORGANIZATION AND COORDINATION

This chapter addresses key factors in planning and executing an HA mission--from forming the JTF through terminating it. Phases of the operation include predeployment planning, deployment, employment, redeployment, and transition and/or termination. This chapter identifies unique or critical considerations for HA operations that differ from standard military operations. Lessons learned from recent operations provide the basis for this chapter. Appendix A provides a list of past humanitarian assistance JTFs.

JOINT TASK FORCE TAILORING

In addition to the JTF headquarters discussed in the previous chapter, special staff elements and functional commands mold the force to the particular nature of each HA mission. The JTF is tailored during the unified command's predeployment planning phase; therefore, all of these organizations are not required for a given situation.

The nature of HA may require a JTF to be tailored so that combat support (CS) and CSS forces (CA, engineer, medical, logistics) may have an equal or greater role than other assigned units. JTF organization and composition specific to HA are addressed in terms of special staff sections, consolidated functions, and areas of operations. Figure 4-1 presents a model of notional JTF organization for HA.

Coordinating and managing special functions in a unified manner may be of benefit to the JTF and the mission. Through proper integration of support methods, the JTF can eliminate duplication of effort and conserve scarce resources. Examples of unified functions may include--

  • A joint task force support command (JTFSC).

  • A joint facilities utilization board (JFUB).

  • A joint movement center (JMC).

  • A coalition forces support team (CFST).

JOINT TASK FORCE SUPPORT COMMAND

During Operation Restore Hope (Somalia 1992-1993), the JTF organized a JTFSC. The JTFSC was a functional component command of the JTF. The mission of the JTFSC was to "provide logistics and medical support for US forces and as directed/required coalition forces deployed in support of Operation Restore Hope. . . provide common item support, interservice support, inland distribution of POL and dry cargo, and common used port operations as directed by the commander of the joint task force (CJTF)."

As a separate JTF component and coequal to other JTF service components, the JTFSC serves as an honest broker for setting theater logistics priorities and allowing certain efficiencies and economies of scale to be achieved in logistics operations. Additionally, the Army CSS units in the JTFSC contribute to the theater's line haul and water production requirements.

JOINT FACILITIES UTILIZATION BOARD

The J4 forms the JFUB. In a situation where a large number of coalition forces exist or US military forces operate within the same geographic area, allocation of facilities to accommodate all parties is necessary. The JFUB acts as the executive agent to deconflict real estate issues arising from multiple-user demands on limited facilities and recommends courses of action on unresolved issues. The JFUB can address coalition force accommodations, ammunition storage points, joint visitors bureau, postal facilities, transit facilities, and so forth.

JOINT MOVEMENT CENTER

The combatant commander establishes the JMC to provide support to HA operations. The JMC coordinates strategic movements with USTRANSCOM. In addition, it oversees the execution of transportation priorities. The JMC is responsible for planning movement operations and for monitoring the overall performance of the transportation system. It expedites action and coordination for immediate movements requirements to ensure effective and efficient use of transportation resources. The JMC is normally under the staff supervision of the senior logistics staff officer.

COALITION FORCES SUPPORT TEAM

In a multinational HA operation, a CFST coordinates actions with coalition units. Duties of the CFST may include--

  • Welcoming and orienting arriving forces.

  • Providing initial staging sites, water, rations, and other support.

  • Assessing the capabilities of coalition forces and their potential for prospective JTF missions and employment.

  • Determining political sensitivities (historic hostilities or assistance) between coalition countries and the area of HA operations.

  • Receiving, processing, and providing intelligence to arriving coalition forces.

  • Briefing ROE to arriving coalition forces.

  • Conducting ongoing assessments of coalition capabilities and recommending appropriate missions.

  • Briefing C2 relationships and relationships with NGOs, PVOs, and UN agencies.

PREDEPLOYMENT

The supported CINC commences formal planning on receipt of the CJCS warning order. Initial planning might begin earlier, based on intelligence reports that alert the CINC of a possible HA support mission. Normally, the CINC's J2 or J3 has the lead on interpreting warning signals (such as starvation patterns, seismic or volcanic activity, civil war, or weather trends). Contingency plans for the affected area may already exist to support a HA-type operation.

The CINC determines whether the HA operation is a supporting operation or the main operation. The CINC's intent and the desired end state form the foundation for the mission. In many situations, the CINC will have plans or predesignated JTFs to conduct an HA-type mission. However, the CINC might use a standing JTF, a predesignated contingency JTF, or a newly designated JTF task-organized for the specific HA mission. The CINC organizes the JTF according to joint doctrine and established standing operating procedures (SOPs). Joint Pub 5-00.21 provides specific guidance for the JTF.

During planning, the JTF organization and staff must be tailored to meet the requirements of the HA mission. Planners determine whether military units will operate under neutral humanitarian aid authorities and, where possible, from neutral bases. Clarity of command, control, and communications (C3) relationships among the JTF, DOS, USAID/OFDA, the UN, ICRC, the host nation, and NGOs and PVOs reduces organizational conflicts and duplicative relief efforts.

The eventual transition of HA operations must be an integral part of predeployment planning. Transition activities must begin as soon as the JTF arrives in theater. To ensure that everyone understands and agrees to the transition plan, it should be part of the operations order (OPORD). Transition is discussed in detail later in this chapter.

Readiness--often the success of humanitarian missions to reduce suffering and save lives--hinges on the timeliness of responding units. Predeployment plans should account for streamlined deployment procedures that may be critical in disaster scenarios where time is crucial. Plans should also provide for rapid deployment joint readiness exercises so that coordination and interagency relationships can be tested and refined.

As discussed in Chapter 1, HA operations might involve coalition forces. In such a case, the JTF might form the core of a larger CTF.2 JTF planners should consider coalition operations. The new draft Joint Pub 3-16 3 provides additional considerations. A key question of the JTF is what role the military force will provide to the relief effort. Will the JTF provide the actual relief (food, logistics, medicine, transport relief supplies) and provide security for the UN, ICRC, and NGOs and PVOs?

Upon being assigned a mission, the CINC organizes the appropriate JTF or a single component command to accomplish the mission. As in all military operations, a JTF requires a clear mission statement. The CJTF may have to develop and submit his own mission criteria up the chain of command. For example, the mission statement for Operation Provide Comfort (Northern Iraq) included:

  • Provide medical care.

  • Provide clothing and shelter.

  • Move into the refugee camps.

  • Provide assistance for the aerial supply effort.

  • Organize the refugee camps.

  • Build a distribution system.

  • Provide transportation and/or supervise the distribution of food and water.

  • Improve sanitation.

  • Provide site and convoy security.

Planners dictate the JTF's composition, which depends on the mission, initial estimates of the situation, and guidance from higher headquarters. As in all operations, major mission areas, such as force security, sustainment, and HA requirements, compete for limited time and assets. Planners should consider the possible need to augment HA JTFs with expertise not typically resident in most commands.

The CJTF should realize that the JTF will encounter NGOs, PVOs, and IOs in the operation. Often, these organizations are in the area before the force arrives, remain while the force accomplishes its mission, and stay in place once the force departs. These organizations are staffed with competent and knowledgeable people who are fully cognizant of the political and cultural traditions of the area. Coordination and cooperation with these organizations can be paramount to the success of the HA operation.

COMMANDER'S CAMPAIGN PLAN

During planning, the JTF develops a subordinate campaign plan in order to outline the commander's intent. The phases of the plan for Operation Restore Hope are shown in Figure 4-2.

AREA ASSESSMENTS

Area estimates or studies are key elements during planning. Current or complete area assessments or studies may or may not exist for the country or area in which the mission takes place. The CA direct support team is capable of updating area assessments. These studies should provide political, cultural, economic, military, geographic, PA, weather, and other information on the area.

HA mission assessments should focus on the factors that led to the HA mission and current situation. These assessments should identify the causes of the HA crisis and not just the symptoms. Tasking may involve the causes or may only address relief of the symptoms of the crisis. The military force must understand that its support to the HA mission may not solve the underlying causes requiring the HA.

Studies also assist planners in identifying information gaps for further intelligence-gathering such as on--

  • Infrastructure.

  • Host nation capability.

  • Food capacity.

  • Security risks.

  • Support assets.

  • Storage facilities and requirements.

  • Roads, air, and port capabilities.

  • Numbers of NGOs, PVOs, and IOs on the ground.

Assessments can answer some of these questions. IPB is tailored and expanded in scope to deal with the ambiguities of HA operations and is critical for planning, force design, and time-phased force deployment data (TPFDD) development. Additionally, USAID/OFDA and NGOs, PVOs, and IOs in the area have experience and knowledge that can supplement traditional information sources.

LOGISTICS

HA missions require integrated logistics assessments. Assessments should include host nation and theater support capabilities. Remote and austere sites place a high priority on early deployment of materials handling equipment and pre-positioned stocks. Detailed logistics planning should include--

  • Identification of time-phased materiel requirements, facilities, and other resources necessary to support the current operation.

  • Determination of logistics planning factors to be used for this operation and development of logistics requirements. Additionally, the method to determine sources for all classes of supply must be defined.

  • Identification of support methods and procedures required to meet the air, land, and sea lines of communication.

  • Provisions for coordinating and controlling movements in the HA area of operations to adjust the materiel flow commensurate with the throughput capability.

  • A description of the interrelationship between theater and strategic LOCs, to include the need for airfields capable of supporting strategic and theater airlift aircraft.

  • Development of a country or theater concept of support.

  • Development of a plan to provide food, equipment, and medical supplies to relieve the suffering in the absence of NGOs, PVOs, and IOs.

The J4 should consider contracting for support capabilities to augment critical supplies, services, real estate concerns. and Contracting support can come from within the host nation or from outside the country. If support is contracted from inside the country, the country logistical resources should be able to support the country first and then the military requirements. Contracted supplies, transportation, labor, and services can aid the host nation's economy and facilitate the transfer of responsibilities back to the nation or NGOs and PVOs. Contracting customs vary by country or region, and contracted services and goods from one country may not be acceptable in the host country for a variety of legitimate reasons.

Logistics support to coalition countries can become a critical issue. Such support burdens US logistics forces but may help bring about the participation of other countries in the HA effort and hasten the departure of US forces. The JTF must establish movement priorities among JTF support requirements, US Government-furnished HA materiel, coalition or UN requirements, and possible NGO and PVO HA materiel. The JTF must work with coalition or UN forces and NGOs and PVOs to ensure their movement requirements are known. The primary means for originating and validating movement requests is the Joint Operations Planning and Execution System (JOPES). The effective movement of materiel requires close coordination among the JTF service components, UN or coalition forces, NGOs and PVOs, the regional CINC, and USTRANSCOM.

Some JTF commanders have successfully developed a multinational logistics command to coordinate the vast array of logistical responsibilities that support a coalition mission. This useful and viable option can be considered but should be focused toward certain common-use consumables such as fuel or rations. Other areas, such as medical and health service support, may require a more narrow national perspective when planning--for example, the provision of blood supply. For UN operations, the JTF commander should obtain specific guidance regarding procedures to be followed for seeking possible reimbursement for supplies and equipment associated with the operation.

RULES OF ENGAGEMENT

The supported CINC establishes ROE, which are critical for force protection, for HA operations. Based on the CINC's guidance and the evolving situation on scene, the CJTF should be prepared to request changes to the ROE and forward them up the chain of command for approval.

All units in the theater must disseminate, understand, and rehearse ROE. Coalition forces must understand the ROE and reduce any discrepancies between the ROE and instructions from their military headquarters. Not all countries have the same ROE or interpret them the same. The CJTF should communicate ROE to other participants, such as NGOs and PVOs, as much as possible without compromising security.

Once the JTF finalizes the ROE, unit commanders must train the force to reinforce the rules. In a perfect situation, training would commence before deployment. Since HA operations may be time-sensitive, training in ROE is continuous. It may be beneficial to condense ROE into ROE cards and rehearse likely situations through HA exercises. Appendix B provides sample ROE for HA operations.

CODE OF BEHAVIOR

The international community has developed a proposed Code of Behavior for Military and Civil Defense Personnel in International Humanitarian Aid; however, this code is not approved. The JTF commander should know that--

  • The code exists.

  • The code has not been endorsed by any international organization and is not binding.

  • Some countries with forces and personnel involved in HA may use the code as a guide to behavior.

  • A copy of the code and other military and civil defense assets (MCDA) documents may be available through the UN or some other international organization involved in a large-scale HA operation.

  • If available, appropriate JTF staff personnel should review the code.

MEASURES OF EFFECTIVENESS

During HA operations commanders face the difficult challenge of determining whether or not the force is meeting mission objectives.

Commanders need to understand the progress of the mission to make informed decisions about resource allocations and develop or modify military operations. The JTF may develop various MOEs, whether quantitative or qualitative. No single, all-encompassing MOE checklist exists for HA operations. MOEs change with different missions. MOEs cannot cover every aspect of a mission; therefore, commanders should resist heavy reliance on them. A discussion of MOEs for domestic responses is presented in Chapter 5.

Commanders need some means to evaluate operations. Based on past experience, staffs should keep several factors in mind while developing and using MOEs in HA operations. Commanders should ensure that MOEs are appropriate, mission-related, measurable, reasonable in number, sensitive, and useful.

Appropriate

The MOEs should be appropriate to the objective of the MOE effort. If the objective is to present information to those outside the command, MOEs should be broad and few in number; if the objective is to assist on-scene commanders in making decisions, MOEs should be more specific and detailed.

Mission-Related

MOEs should relate to the mission. If the mission is security, for example, MOEs should help commanders judge improvements in or problems in improving security. If the mission is relief, MOEs should help commanders judge improvements in living standards. If the mission expands, so should the MOEs.

Measurable

MOEs should vary with changes in the command's performance in relation to the mission and opponents. Quantitative MOEs are likely to be measured more consistently than nonquantitative ones and thus, when appropriate, are preferable. When using nonquantitative MOEs, the command should establish clear criteria for their measurement and disseminate the criteria to prevent accidental mismeasurement or misinterpretation of the results.

Reasonable in Number

The number of MOEs should be neither so few that they are insufficient to fully portray the situation nor so numerous that they become unmanageable or not worth the effort expended.

Sensitive

MOEs should change when the performance of the command or actions of opponents change; extraneous factors should not greatly influence them.

Useful

MOEs should respond to changes in the situation soon enough for a command to detect and act on them. Commanders should meet, but not be limited to, the above criteria. Accurate and measurable MOEs can contribute to mission effectiveness in many ways. MOEs can help the CJTF answer the following questions:

  • What tactics and/or strategies are or are not working?

  • Should the CJTF shift the mission emphasis or shift resource allocations?

  • Can the operation shift from one mission phase to another?

  • When is the mission complete?

Security and Level of Violence

  • Percentage of relief supplies (in tons) reaching distribution centers

  • Distribution centers to distribution points

  • Distribution points to feeding centers

  • Source: NGOs, PVOs, HAST, OFDA DART

  • Number of violent acts against JTF forces

  • Individual Acts

  • Organized Acts

  • Source: JTF (J2)

  • Number of violent acts against NGOs and PVOs

  • Individual Acts.

  • Organized Acts.

  • Source: NGOs and PVOs

  • Checkpoints and roadblocks manned by factions or bandits

  • Number and location

  • Number of overt acts where tolls are extorted

  • Source: NGOs, PVOs, JTF (J2)

  • Decreasing NGO convoy security requirements

  • Number of security guards used

  • Source: NGOs and PVOs

Infrastructure

Airfield capacity:

  • Number of airfields evaluated as transport aircraft-capable

  • Day-night capability

Source: Joint special operations task force (JSOTF), JTF (J3)

Water sources: number of gallons of potable water per day.

Source: JTF (J4), NGOs, and PVOs

Main supply routes (MSRs): Percent trafficability for key MSR lines of communication to relief sites

Source: JTF (J4), NGOs, and PVOs

Medical and Public Health

Crude mortality rates

Under-five mortality rates

Cause-specific mortality rates

  • Malnutrition

  • Diarrhea

  • Acute respiratory infections

  • Other diseases

Severe malnutrition measurements (less than 70 percent of height and weight measurements).

Source: NGOs and PVOs

Agriculture

Market price of foods

Market price of animals

Household surveys (for example, how much food is available in the home?)

Food production (cultivation) and animal herds

Source: NGOs and PVOs, JTF

Involvement of IOs, NGOs, and PVOs is critical in the development of MOEs. Such involvement encourages communication among the major participants, assists in data collection, clarifies mission priorities, and expedites transition and redeployment of military forces. To develop appropriate MOEs, the JTF should coordinate with military commanders and decision makers representing IO, NGO, and PVO activities. As they are identified, MOEs can then be organized into four main categories.

  • Security and level of violence.

  • Infrastructure.

  • Medical and public health.

  • Agriculture.

For each category, a graphic identifies specific measures and potential information sources. The JTF assigns the section that coordinates these inputs and measures trends over time. Because these trends affect future plans, the J5 should coordinate this analysis. The frequency with which this data is collected and measured may vary by campaign phase.

OTHER CONSIDERATIONS

Provisions should be made for CJTF input to the Worldwide Military Command and Control System Intercomputer Network (WIN) and the JOPES data base. The HA mission requires constant monitoring and updating to ensure timely decisions and allocation of assets to meet the emergency. See Joint Pubs 5-00.24 and 5-03.1.5 During predeployment planning, countless questions require answers.

Predeployment Planning Considerations

  • What is the mission?

  • What is the status of hostile military/paramilitary forces in the area?

  • Who are the key civilian leaders, community elders, and their supporters?

  • What is the status of existing public services, such as water, electricity, communications, sewage collection, transportation systems and assets, and relief agencies already in place?

  • What is the status of doctors, firemen, and police and their availability and levels of expertise?

  • What is the medical and nutritional condition of civilian personnel and the physical locations of medical facilities?

  • What are the unique shelter/food needs and host nation support availability (construction assets, food storage, materials handling equipment, and transportation capacity)?

  • What is the status of sanitation conditions within the AO?

  • What operational facilities and host nation resources are available to support HA forces?

  • What unique social, ethnic, or religious concerns affect the conduct of the operation?

  • What relief organizations are present and what functions are they performing?

  • What is the international community's goal and plan for addressing the humanitarian crisis?

  • What is the communications security plan regarding communicating with NGOs, PVOs, UN agencies, and coalition forces? Do these agencies or forces require equipment augmentation?

  • What are the information-gathering and dissemination requirements? What information can be obtained from host nation, UN/coalition forces, and NGOs and PVOs?

  • What is the legal authority for the mission? What agreements or mandates apply to this operation? Are SJA personnel and assets planned for?

  • Have the appropriate ROE been prepared and published prior to deployment?

  • Has the Armed Forces Medical Intelligence Center (AFMIC) been alerted and a request for a medical intelligence report on the area identified?

  • What is the priority of HA capability for the mission: medical, logistics, command and control, force security, and so forth?

  • What, if any, coordination systems are in place among PVOs, NGOs, and IOs in the host nation?

  • What coordination is required with the CINC, supporting CINCs, subordinate JTF commands, NGOs and PVOs based in the US, UN organizations, and DOS?

  • What are the liaison requirements?

  • Are interpreters available from the JTF, CINC, US agencies?

  • What are weather and terrain limiting factors?

  • What is the media presence and the public interest (global visibility) of the HA mission and situation?

  • What is the health service support (HSS) mission? Is it clearly stated in the operational commander's mission statement?

  • What medical intelligence is available for the AO? AFMIC provides information on factors that affect human performance capability and well-being such as infectious diseases, sanitation, venomous insects and animals, toxic plants, the environment, and military and civilian health care capabilities.

  • What is the mission's target patient population? Military only or are civilians also treated?

  • What is the local standard of care? Can it be continued after forces redeploy?

  • How do HSS systems receive logistics support? HSS logistics planning is an essential element of the overall planning process for a successful health care delivery system and should include supplies, equipment, medical equipment maintenance and repair, optical fabrication, blood management, transportation, and contracting.

  • Who provides medical laboratory support during assessments and the initial phases of the operation?

The employment of the joint forward laboratory (JFL) in Somalia during Operation Restore Hope was invaluable to the JTF surgeons in directing preventive medicine efforts, and the laboratory's contributions were directly credited with helping minimize morbidity due to infectious diseases among US personnel.

Operation Restore Hope Lessons Learned

DEPLOYMENT

Deployment of the JTF is based on the severity of the situation, political considerations, and mobility assets. Requirements and decisions made during planning affect deployment. The JTF should be structured to deploy in force packages. Rapid response, austere conditions, and lack of infrastructure often place unique demands on the JTF. Initial phases of deployment require only the critical command, control, communications, security, and logistics capabilities. Follow-on forces deploy as capabilities expand to support the forces and conduct the HA mission.

PLANNING

Deployment planning and execution considerations for HA missions are fundamentally the same as in any military operation. Close coordination between the staff sections of the JTF is critical.

COORDINATION

Coordination during the deployment phase is based on guidance developed during the planning phase and conditions as they change regarding the situation. The CJTF must continue to keep the lines of communication open with higher headquarters (CINC); service components of the CINC; subordinate and supporting commands; NGOs, PVOs, and IOs; the UN; and OFDA DART.

USTRANSCOM consists of the Military Traffic Management Command of the Air Mobility Command and the Military Sealift Command. These components provide movement schedules for requirements in the sequence requested by the CJTF. The JTF needs to update subordinate commands on changes to the deployment schedule or changes in the mission. Changes in the mission, such as HA to peace enforcement, may require a shift in force deployment. NGOs, PVOs, IOs, and UN agencies may require JTF support during deployment not already identified during predeployment planning.

Deployment Planning Considerations

  • Are command and control assets more crucial than immediate provisions of HA supplies?

  • Are the requirements of the JTF components being met?

  • Are these requirements complementary or contradictory to the mission?

  • Do the units being airlifted match up with the equipment (for example, is the JTF sending engineers to the area when their heavy equipment and construction material are not scheduled to arrive by ship for another two weeks)?

  • What are the NGO and PVO requirements for transportation, and has the military committed to transporting their supplies (funding and authority)?

  • Have preventive medicine units been scheduled for early deployment?

  • Will media coverage of the initial deployment focus on the JTF's first actions that alleviate the conditions requiring HA?

  • Will conflicting interests for mobility assets strain the JTF's deployment?

  • Will command and control assets, food and medical supplies, security forces, equipment assets, and foreign government restrictions affect the deployment?

  • How do planners ensure the CJTF's guidance and focus of effort is followed?

  • How will accurate and timely submission of information into WWMCCS and JOPES be maintained to schedule movements and keep higher and lower commands abreast of the deployment schedule, particularly deployment coordination of coalition forces?

  • How will the JTF account for personnel in order to report casualties, provide essential services such as mail, and determine the total numbers of personnel for the purpose of national/service reimbursement?

Two disparate types of operations were being conducted simultaneously during Operation Provide Comfort. One was the humanitarian effort and the other the security operation. In many ways they competed and conflicted with one another. The staff ran these as concurrent operations and often had to set aside specific times to focus totally on one operation or the other. Because of conflicting priorities, movement of relief supplies and humanitarian forces competed with the movement of security equipment, ammunition, materiel, and forces. Security operations had to precede humanitarian operations to dear areas of mines and potential hostile forces. While most civilian relief agendas grew more comfortable working alongside military forces performing humanitarian tasks, they were not comfortable around gun-toting security forces.

Operation Provide Comfort After-Action Report

LIAISON

Liaison teams or personnel (military and civilian) assigned up and down the chain of command ensure the JTF can identify concerns and issues. These teams are critical during the deployment phase. Liaison teams in the mission area are critical to keeping the JTF informed of changing conditions and events. They assist the JTF in determining how the HA operation is progressing and whether emphasis needs to shift to avoid further human suffering. The HAST (previously discussed in Chapter 3) can accomplish this critical liaison function if assigned to support or augment the JTF. Liaison procedures extracted from Joint Pub 5-00.22 are provided in Appendix H.

Liaison personnel should be exchanged among major contributors to the force. Their functions include the identification of political and legal constraints, transportation capabilities, logistics requirements, and other factors affecting the employment of coalition units.

EMPLOYMENT

CJTF responsibilities during employment include force and resource monitoring and management, planning for current and future operations, execution, and reporting. The employment of a JTF for HA missions has some unique considerations.

EXECUTION

HA is something most military forces have not normally trained to accomplish. Security concerns, global visibility, political considerations, acceptance, logistics, health factors, and unknown length of mission can affect the force and the mission. Integrating the coalition forces impacts on how the JTF assigns missions and organizes the area.

The mission of the JTF, although consistent in its overall direction to relieve the plight of the populace, may undergo major evolutions in its specific taskings during the early stages of the operation. This can be a positive development in that each new estimate of the situation leads to a necessary refinement or modification of the mission and tasks. Continuing on-scene estimates of the situation and rapid adjustment of the mission and tasks are appropriate. This is sometimes referred to as mission creep.

Employment Considerations

  • What is the JTF's actual role in the HA mission?

  • Does the JTF provide support to the UN, ICRC, NGOs, PVOs, the actual HA?

  • Does the JTF conduct HA and then transition functions to the UN, ICRC, NGOs, and PVOs?

  • What is the relationship with an OFDA DART?

  • Is the HA operation part of a larger mission?

  • What are the force objectives?

  • How will the objectives of the mission be evaluated to determine success (quantitative or nonquantitative)?

  • What is the personal code of conduct for the HA operation?

Military coordination with the UN; NGOs, PVOs, and IOs; and OFDA DART and its on-scene representative is critical during the execution of the mission. In some cases, 50 or more NGOs and PVOs may be working in the AOR. These NGOs and PVOs may coordinate their efforts, but in some cases, they may operate independently of one another. Military concerns may not be compatible with the concerns of the NGOs and PVOs (security, mission priorities, support requirements, expectations).

Early in the operation, the JTF should establish a dialogue with OFDA DART, NGOs, PVOs, and IOs to ascertain capabilities and limitations and to facilitate future cooperation. This dialogue can be accomplished with a clear mission statement involving OFDA DART and NGOs and PVOs in mission planning--disseminating the view that OFDA DART and NGOs and PVOs are allies and partners.

Employment considerations and factors affecting the outcome of the HA mission depend on decisions made during planning and deployment. These factors include--

  • Getting minimum equipment on the ground to provide the basic service required.

  • Having sufficient equipment on hand for austere jump capabilities responsive to new missions and critical outages.

  • Transitioning key staff positions depending on the emphasis of the phase of the operation (air-to-ground operations).

  • Having each staff establish a continuity file.

  • Providing interpreters for PSYOP and CA teams when dealing with large crowds.

  • Preparing specialized briefing formats to deal with civil-military operations; briefings should emphasize the condition, activities, and especially the needs of the supported population; briefing UN, ICRC, NGOs and PVOs, and OFDA.

  • Establishing preventive medicine strategies to take precedence over therapeutic medicine in the initial stages of an HA situation; emphasizing sanitation and vaccinations.

  • Deploying PA elements early.

  • Avoiding basing mission success on US or western standards; working toward building back the local infrastructure and health care system to the level in place before the disaster.

  • Encouraging civilian groups to step forward and coordinate their valuable expertise and assistance.

  • Coordinating use of transportation assets to ensure that urgent needs are met.

  • Ensuring coordination is conducted between transportation elements and the military police who may provide security and traffic control.

  • Developing plans for recovery operations of transportation assets, including contingency plans for replacement of vehicles.

  • Avoiding black market activity by controlling distribution of food by ration cards; using local trucks and drivers for distribution (to stimulate the economy) and monitoring frequently.

  • Determining requirements to repair MSRs.

  • Determining legal and fiscal authority to conduct civic action projects.

One consideration for organizing the AO is to designate HRSs. Geographic boundaries for such sectors should include ethnic or tribal boundaries, political affiliation, relief agency AO, political acceptance of certain coalition countries, and contiguous sectors with forces assigned (components assigned multiple sectors are connected).

SECURITY

Security is the CJTF's responsibility. JTF planners must specifically address security for NGOs and PVOs in ROE, the mission statement, or both. Depending on the environment, security forces may be necessary. ROE should contain guidance regarding which people JTF forces may protect. Hostile crowds, starving people, armed resistors, or bandits require appropriate responses. It may be necessary to first establish the environment for HA operations to commence peace enforcement. This requirement can adversely affect the speed and effectiveness with which assistance is provided to the area. Security of the JTF is a primary concern. Some concerns include--

  • Ports and airfields.

  • NGO and PVO requests.

  • US Government activities such as OFDA DART.

  • Host nation agencies.

  • HA recipients.

  • HA supplies, convoys, and MSRs.

  • HA distribution centers.

Convoy security for HA follows the same set of tactics for any military convoy operation. If the JTF is tasked to provide convoy security or security for the NGOs and PVOs, then it should plan such with input from all forces and agencies involved. The organization of the AO into component or HRS can cause problems for convoy operations. A movement control center (MCC) established to coordinate transportation coordinates all cross-boundary travel and security responsibilities for convoy operations.

In a hostile environment the JTF may have the added responsibility of weapons confiscation. JTF planners must develop specific plans and procedures and disseminate them to all forces. In addition, the ROE should address the use of force during weapons confiscation operations. Special consideration must be given to the security forces employed by the NGOs and PVOs.

INTELLIGENCE

HA operations require intelligence information because they are politically sensitive, conducted in the midst of civilian populations during times of crisis, and employ forces with substantial capabilities. The commander must continuously and clearly identify information requirements to provide the necessary resources to conduct intelligence operations.

Even more than with other types of military operations, successful HA operations are dependent upon timely and actionable intelligence. As in other MOOTW, intelligence in HA operations must deal with all aspects of the AO, to include personnel and organizations therein. In this environment, military intelligence requirements include such subjects as political, ethnic, religious, and economic factors. Some supporting intelligence publications are listed in the References section.

Host nation populations hold the key as to whether an HA mission succeeds. While US and/or friendly armed forces are tasked to support humanitarian goals, each and every thing has a potential political, economic, military, social, or religious impact on the population or segments of the population. The primary intelligence effort should be to assess the agenda of every faction and determine how it may affect friendly operations. Open sources are employed to determine patterns or methods of operation, factional-associated geography, and factional-associated agendas. The resulting analysis is employed to--

  • Avoid obvious hostilities.

  • Prepare for nonobvious hostilities (ambushes and deliberate attacks on the HA force).

  • Employ appropriate force in order to accomplish the mission.

Human intelligence (people talking to or about people) is a significant portion of any HA intelligence support program. However, it must be accomplished properly. Formal contact with NGOs and PVOs should be directed through CMOC personnel. The result of increased focus on intelligence is units and military personnel with a greater situational awareness. This enhances the ability of US forces to make informed judgments about which areas to avoid, where to take extra precautions, and so forth, based upon their specific mission and the overall HA mission.

COMMUNICATIONS

The ability to communicate with all of the military forces, NGO, PVOs, UN agencies, host nation agencies, and other organizations involved in the HA operation is imperative. See Figure 4-3. Communications with coalition forces, OFDA DART; NGOs, PVOs, and IOs; and other agencies should be established early in the operation.

Most likely, nonmilitary agencies will have communications networks established for their own uses. These networks may include commercially leased circuits (from the host nation communications agencies and companies), commercially leased satellite services (such as INMARSAT), and high-frequency (ham, long distance) and very high frequency (intravehicular convoy control type) radios. As robust military communications most likely will not be available, close cooperation between nonmilitary agencies and military forces will be required to maximize efficient use of available commercial and host nation communications net works. As military communications assets are phased in for the operation, NGOs, PVOs, and others can be expected to increasingly request access to those communications. Any supporting plans must initially allow for very limited military communications and emphasize reliance on commercial and host nation communications assets. In addition, these plans must closely address needs for secure communications and requirements to control cryptographic materials (secure telephones, keymat, and so forth) and releasability of cryptographic and/or classified information to others.

JTF planners must identify and plan frequency management for the operation. Regulations and orders for integrating coalition forces into the frequency management program have to be deconflicted with security requirements. The use of nonmilitary radios and communications equipment by OFDA DART, NGOs and PVOs, UN, and ICRC can create deconfliction problems. Planners must also consider host nation requirements and restrictions.

PUBLIC AFFAIRS CONSIDERATIONS

PA considerations are important for several reasons. First, the public and the media have an intense level of interest in JTF operations; second, the members of the JTF need PA services; third, commanders and soldiers of the JTF must be able to communicate their intentions and actions to interested audiences. These considerations can be met through planning for establishment of radio and television broadcast stations and a JIB in the theater.

MEDICAL CONSIDERATIONS

Medical considerations for the JTF in an HA environment are significant. The two areas to consider are medical care for the JTF and coalition forces and medical care for the local populace. In general, JTF medical assets support JTF personnel, while host nation facilities, NGOs and PVOs, UN, and ICRC health organizations support themselves and the civilian population. In most cases the AO is austere and environmentally hostile. This can cause the JTF to suffer many medical and sanitation problems. Good medical estimates and preventive medicine planned early in the operation can pay significant dividends. These include immunizations for all personnel, prevention of insect-borne diseases, and prevention of fly, water, and food-borne illnesses.

The JTF should use its preventive medicine assets. Intensive epidemiological monitoring, coupled with sophisticated diagnostic capabilities (serology, bacteriology, parasitology) can help prevent development of epidemics among deployed forces.

Title 10, US Code, prohibits use of military medical assets for treatment of civilians except when specially authorized by the appropriate authority. This can cause problems for the JTF regarding the perception that the US cannot and will not assist the area with medical care. The highly visible nature of US cantonment areas naturally leads civilians to seek medical treatment from these facilities. Because this issue is above CJTF level, he must plan early in the operation how to deal with civilian medical requests.

Medical planners should attempt to coordinate with NGO, PVO, UN, and ICRC medical facilities immediately upon commencing the operation. The JTF should create some type of central point or organization for coordinating medical requirements. However, the differing policies and positions of individual NGOs, PVOs, and IOs; military capabilities and policies; and host nation requirements can create friction. A medical coordination agency formed at the HOC or CMOC can provide a viable solution for medical requirements. Formation of this coordination agency by the JTF and early cooperation by the parties involved in the operation increases efficiency and reduces redundancy. The JTF must establish policies for treating civilians injured by JTF actions and provide air search and rescue and/or medical evacuation assets for civilians.

TECHNICAL ASSISTANCE

The military often provides technical assistance in the form of advice, assessments, manpower, and equipment to host nations or civilian agencies. NGOs, PVOs, and IOs may seek the advice of military personnel to conduct projects necessary to accomplish their mission. Early in the operation, the CJTF should determine policy regarding technical assistance to be provided to NGOs, PVOs, and IOs. Use of military equipment and supplies to conduct civil action-type missions may be limited or forbidden. Early in the operation, the CJTF should establish criteria to provide technical assistance to NGOs, PVOs, and IOs. The JTF may conduct projects to build or improve infrastructure needed to complete the military portion of the HA mission, once approved and funded.

NGOs and PVOs, UN, and ICRC normally distribute food and other supplies by using their own or contract transportation assets. Use of military assets to conduct the actual delivery of supplies is usually discouraged unless the situation is life threatening. Plans to overcome problems or obstacles should be solicited from NGOs, PVOs, IOs, indigenous personnel, and the military.

AIRSPACE COORDINATION

Coordination for air operations follow normal airspace coordination procedures for any joint or coalition operation. The additional burden on coordination involves the HA cargo flights conducted by NGOs, PVOs, and IOs. During a large relief operation, increased numbers of arriving and departing flights may overwhelm the host nation airspace control system. In cases where no airspace control facilities exist, the JTF may have to establish an interim airspace coordination system, to include--

  • Broad policies and procedures.

  • Strategic and theater airlift requirements.

  • Airspace management procedures.

  • Procedures to coordinate both military and civilian sorties.

A good example of technical assistance occurred during Operation Restore Hope during the flooding of the lower Shabelle River. Through the CMOC, a PVO proposed a solution to contain the Shabelle river. The CMOC referred the PVO to the JTF engineer officer for advice. Following consultation, the PVO requested technical assistance in the form of equipment and operators to assist in building dikes. The CMOC and OFDA dispatched a team to the flood region, conducted an assessment, and validated the requirement for JTF support. Based on a need identified by the PVO, technical assistance in the form of advice, assessment, equipment, and personnel was provided by the JTF.

Operation Restore Hope CMOC Operations Officer

The JTF may or may not have air control authority over incoming NGO, PVO, and IO flights. Close coordination and agreements with NGOs and PVOs over control of NGO, PVO, and IO cargo flights reduce airspace safety concerns and add to the efficiency of delivering HA supplies.

COORDINATION WITH RELIEF AGENCIES

Coordination with the host nation and a wide variety of relief organizations lies at the core of HA operations. Mission success depends on the US military turnover of HA responsibilities, including security, to the host nation or relief organization. Close coordination improves this process. Figure 4-3 does not attempt to illustrate all levels of liaison and coordination among participating agencies. It does, however, illustrate the many sources of input to the JTF in HA situations. CJTF options for this coordination use the HAST, the HOC, and the CMOC, which fall under the cognizance of the J3 and J5 staff sections.

Humanitarian Operations Center

To coordinate military operations with the requirements of the host nation or NGOs, PVOs, and IOs, the CJTF can request that a HOC be created. The HOC, if created, is usually collocated with the appropriate headquarters, such as the UN, conducting the operation. HOC functions include--

  • Developing an overall relief strategy.

  • Identifying and prioritizing HA needs to the JTF.

  • Identifying logistics requirements for NGOs, PVOs, and IOs.

The HOC is not as much a location or cell as it is a policy-making and governing body. In the military sense, the HOC does not command and control but attempts to build a consensus for team-building and unity of effort.

The HOC should consist of decision makers from the military forces command (JTF), UN agencies, DOS (USAID [OFDA DART]), regional NGO and PVO representatives, ICRC, and host nation authorities. The HOC coordinates activities and does not necessarily control. The organization of the HOC appears in Figure 4-4.

The HOC normally has a UN director and deputy directors from the JTF and OFDA DART. Within the HOC the policymaking body is the standing liaison committee, which is comprised of UN, JTF, OFDA DART, and NGO and PVO representatives. HOC core groups and committees meet to discuss and resolve issues related to topics such as medical support, agriculture, water, health, and education.

During Exercise Emerald Express conducted in January 1994, the 1st Marine Division used personnel and equipment from its artillery regiment to coordinate HA operations. This innovative concept was explored first because the mission-essential task list (METL) paralleled the requirements for HA coordination (for example, the skills matched); second, the artillery regiment was under-utilized during previous HA missions; and third, much of the artillery unit equipment (transportation and communications) was extremely useful during HA operations.

The liaison and coordination skills essential to fire support teams applied directly to HA. At the same time the supporting perspective possessed by every artillery officer, transferred directly to a military role in support of NGO and PVO food distribution. Additionally, it was unnecessary to establish ad hoc teams to meet coordination and liaison requirements because these units already existed.

Based on discussions with

Civil-Military Operations Center

At the tactical level, the CJTF can form a CMOC as the action team to carry out the guidance and decisions of the HOC. The CMOC is a group of service members that serve as the military's presence at the HOC, as well as the military liaison to the community of relief organizations. Normally, the CMOC director is also the HOC's military deputy director. Figure 4-5 shows the organization of a CMOC.

The CMOC performs the liaison and coordination among the military support capabilities and the needs of the HA organizations. The CMOC, in coordination with OFDA DART, receives, validates, and coordinates requests from NGOs, PVOs, and IOs. The CMOC usually consists of 8 to 12 persons; however, its size is mission-dependent. The commander may add elements as appropriate.

A proposed layout for an effectively organized CMOC is included as Figure 4-6. This configuration is based on lessons learned from previous large-scale HA operations and can be modified as the situation requires. Communications capabilities are an essential component of the CMOC and should be carefully prioritized. The CMOC supports NGOs, PVOs, and IOs by responding to validated logistical and security support requirements. During CMOC meetings (usually daily), the CMOC identifies JTF components that are capable of fulfilling the requests to support the NGOs, PVOs, and IOs. Validated requests go to the JTF operations cell and then to the component or coalition force LNO for action. The CMOC may--

  • Validate the support request in the absence of the OFDA DART representative.

  • Coordinate military requests for military support with various military components and NGOs and PVOs.

  • Convene and host ad hoc mission planning groups involving complicated military support, numerous military units, and numerous NGOs and PVOs.

  • Promulgate and explain JTF policies to NGOs and PVOs.

  • Provide information on JTF operations and general security operations.

  • Serve as a focal point for weapons policies.

  • Administer and issue NGO and PVO identification cards.

  • Validate NGO, PVO, UN, and ICRC personnel required for JTF aircraft tarmac space, space availability (seats on military aircraft), and access-related issues.

  • Coordinate medical requirements.

  • Chair port, rail, and airfield committee meetings for space and access-related issues.

  • Maintain 24-hour operations.

  • Maintain contact with regional and sector CMOCs.

  • Support CA teams, as required.

  • Facilitate creation and organization of a food logistics system for food relief efforts.

Normally, NGO and PVO requests come to the CMOC for action. The proposed NGO and PVO support request flow is based on operational lessons learned.

DISPLACED PERSONS AND REFUGEES

During many HA scenarios, shelter or housing may need to be provided to displaced individuals. A good reference for administration of camps is found in the UN HCR Handbook for Emergencies. The UN designates several categories of affected and displaced person programs. These include externally displaced refugees, displaced populations within a country, and affected populations within a country. CA personnel are trained to establish and administer displaced person and refugee camps.

Support Request Flow

NGOs and PVOs--

  • Prepare complete support request

  • Submit request to DART/CMOC

  • Monitor

DART--

  • Validates requests

  • Submits requests to the CMOC

CMOC--

  • Logs requests

  • Assigns project number

  • Prioritizes

  • Prepares project folder

  • Submits project folder to joint operations center (JOC)

  • Monitors

JTF JOC--

  • Receives project folder and logs request

  • Approves request (uses the attached CA team to analyze the project and apportion the resources to complete the project)

  • Prepares detailed tasking order (file in folder)

  • Publishes detailed tasking order

  • Retains folder and monitor

Individual unit providing support--

  • Receives mission

  • Analyzes the requirements

  • Commits the resources

  • Annotates resources expended

  • Completes the mission

  • Prepares after-action reports with all information

  • Submits after-action reports to the JOC

JOC--

  • Receives after-action report from the unit and files in folder

  • Closes out folder

  • Returns folder to CMOC

CMOC--

  • Receives folder

  • Sends completed report to the NGO or PVO that requested the project. The forms used in the CMOC may include DA 1594 (Staff Duty Journal, Conversation Record) and the locally produced NGO/PVO Support Request Form.

 The requirements for dealing with refugees and displaced persons are extensive. The key UN agency, when dealing with agencies, is the UNHCR. Cultural and religious requirements, acceptable food, medical support, proper registration, categories of refugees and displaced persons, security, camp locations, sanitation, and funding sources constitute some of the concerns. The ultimate goal is to return the refugee population to its home.

POLITICAL-MILITARY ADVISORS

The JTF should work closely with embassies of coalition nations as well as with US embassies in the region. In multinational operations, coalition forces may provide political advisors to their national headquarters. US forces may have a foreign service officer assigned to support operations. The assignment of political advisors provides a direct link to US embassies, DOS, and the political representatives of coalition nations.

LIAISON

Liaison requires extensive personnel and equipment assets in an HA operation. Liaison personnel and teams must be able to communicate with their parent command as well as make certain decisions or commit to carrying out assigned tasks. Liaison personnel should have direct access to their parent command, be kept informed of events and intentions, and be able to brief capabilities and limitations of their commands.

In coalition operations, liaison personnel should be exchanged with the larger contingents of military forces assisting in the operation. The CMOC provides the primary liaison for the JTF with NGOs and PVOs, the UN, and ICRC; although liaison throughout the AO is critical. Due to the presence of ICRC and NGOs and PVOs, liaison may be established with selected NGOs and PVOs, ICRC, and UN agencies. A reference chart of the US military rank structure and insignia is provided in Appendix I.

The need to provide quality personnel on liaison teams cannot be overemphasized. This lesson learned echoed at every level of the CTF. It is critical in joint and combined [multinational] operations to ensure an effective liaison system is in place. Liaison personnel must be highly competent, have direct access to their parent command, and be kept informed of events and intentions.

The teams with initiative; the trust and confidence of their commands; solid access and communications; and knowledgeable, bright personnel greatly enhanced the functioning of the entire organization. Extensive positioning of liaison personnel throughout Turkey and in the provinces along the Iraq-Turkey border permitted the CTF to coordinate efforts, which made for more efficient operations and a closer sense of cooperation, especially on a number of politically sensitive issues. Quality liaison personnel paid dividends in this role.

Report on Operation Provide Comfort

REDEPLOYMENT

Redeployment decisions are based on political and military considerations. The JTF provides assessments for the military. The DOS representative provides the political considerations. The CINC uses this information to recommend redeployment plans to the JCS and NCA.

Simultaneous to JTF deployment, the CJTF should begin planning redeployment. Redeployment considerations depend on whether the JTF has accomplished all or some of its objectives. Redeployment of JTF forces begins as soon as objectives are accomplished or the need for military forces diminishes. Forces not needed to accomplish certain objectives should be redeployed as soon as possible. For extended operations, the CJTF should establish a rotation policy.

The JTF should transfer its HA functions to host nation NGOs and PVOs, the UN, and/or ICRC as soon as possible. As this is accomplished, forces are freed to redeploy. As the operation progresses, political and military guidance will identify functions and units that need to remain in order to accomplish objectives not achieved. The requirement for the JTF to continue supporting HA operations must be identified earlier. This identification affects how the JTF plans for redeployment.

TRANSITION AND/OR TERMINATION

Transition in HA operations involves the transfer of responsibilities and functions to another organization. Transition can occur between service components within the JTF or from the JTF to the UN or host nation. Transition and/or termination is initiated once objectives have been met and authority has been received from national decision makers.

In HA operations, transition presents complex problems. If forces within the JTF are transitioning functions between service components, then the requirements follow standard military handover. If transition involves the JTF transitioning functions or areas back to the host nation, coalition forces, or a UN command, then the requirements may become less clear.

A transition plan is useful. It helps the staff identify transition issues. It is especially important to identify those parties or agencies that will receive functional responsibilities from the JTF. Considerations include which staff sections will write annexes, based on what the UN or transitioning organization will do. The transition plan should identify task force organization, operating procedures, and transition recommendations and considerations. In implementing the transition plan, the transitioning parties should discuss criteria for transferring operations. The plan should be unclassified, clear, and concise, without military jargon.

Military operations end wham the objectives have been attained. The NCA define conflict termination objectives and direct the cessation of operations. Termination plans are designed to secure the major policy objectives that may be attained as the result of military operations. Termination plans must cover the transition to postconflict activities and conditions as well as disposition of military forces. Operation plans and termination plans should normally be prepared together, with the termination plan included as a supporting plan to the operation plan.

Extract from Joint Pub 5-0

One method of transitioning is by function. Another method is by locale. If possible, the transition process should be event-driven and not tied to calendar dates. Functions or areas would transfer only when a similar capability becomes available or is no longer needed. Procedures for transfer of equipment or supplies, either between components of the JTF or with the UN or host nation, must be determined.

JTF planners must identify fiscal guidance, reconstitution of assets, and availability and use of operations and maintenance funds. Several functional areas identified for transition include logistics, medical services, communications, local security, and engineer services. The JTF should develop a series of criteria on transition to be able to track the progress being made. This process may be measured by a statistical analysis of trends; for example, a reduction in infant mortality rates. Figure 4-7 is an example of transition categories and indicators from Operation Restore Hope.

The important part of choosing indicators is choosing the right ones and having a consistent method of measuring them. Some indicators may be weighted more than others, and their importance may shift due to political, military, or HA considerations. The transition plan phases are shown in Figure 4-8.

After conducting a major HA mission, the HA team should address two areas: documentation of lessons learned and what can be termed after-operation follow-up. Lessons learned should be collected in whatever format applies for the specific operation. That may mean collection under the joint system through the Joint Universal Lessons Learned System (JULLS) or through individual service systems such as the Army's Center for Army Lessons Learned (CALL). Whenever possible, commanders should specify which system is to be used early in the operation, so that data can be collected in the required format. Appendix J provides lessons learned from four HA operations compiled by USAID/OFDA from the perspective of participating civilian agencies.

The after-operation follow-up would include any action by US military forces that return to the affected area to measure the long-term successes of the mission. For example, three to six months after a large quantity of medical supplies and equipment had been transferred to host nationals in a disaster area, the geographic CINC might direct a medical survey team to return to the area. The team could determine the extent of the usefulness of particular medicines, the appropriateness of the training provided on particular pieces of equipment, and the requirement for additional actions. JTF planners should incorporate lessons learned during the after-operation follow-up in the same lessons-learned system that was used for the original HA mission.


1. Joint Task Force Planning Guidance and Procedures, September 1991.

2. Throughout this chapter, JTF and CTF are used synonymously.

3. Joint Doctrine for Multinational Operations.

4. Joint Task Force Planning Guidance and Procedures, Appendix A, September 1991.

5. Joint Operation Planning and Execution System, Volume I, 4 August 1993.


 

 

Approved for public release; Distribution is unlimited.
The listing of any non-Federal product in this CD is not an endorsement of the product itself, but simply an acknowledgement of the source. 

Bureau of Medicine and Surgery
Department of the Navy
2300 E Street NW
Washington, D.C
20372-5300

Operational Medicine
 Health Care in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMED P-5139
  January 1, 2001

United States Special Operations Command
7701 Tampa Point Blvd.
MacDill AFB, Florida
33621-5323

*This web version is provided by The Brookside Associates Medical Education Division.  It contains original contents from the official US Navy NAVMED P-5139, but has been reformatted for web access and includes advertising and links that were not present in the original version. This web version has not been approved by the Department of the Navy or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense.

Contact Us  ·  Other Brookside Products

Operational Medicine 2001
Contents