Special Forces Practice ‘Tailgate’ Medicine While Rousting Taliban

They are the Army’s elite force, among the best-trained warriors who take on the toughest missions. They are the Green Berets, the Special Forces. A 12-man team has weapons, communication, engineering, medical and multilingual expertise that can be used to train foreign military forces and protect their citizens from aggressors.

In Afghanistan’s tenuous political climate, which has seen a resurgence of the Taliban, Task Force 31, 1st Battalion, 3rd Special Forces Group plays this vital role in Kandahar and the Taliban stronghold areas in the south.

The unit recently redeployed for its fifth time during this war. In the first six weeks back in Afghanistan, the unit has killed 919 anti-coalition militias – the term used for the Taliban and other insurgents – while suffering two deaths and 15 mostly minor injuries. It also has conducted 38 civil affairs missions so far and the medics treated more than 4,200 Afghan patients. This latter role provides a dual benefit: gaining Afghan support as well as building rapport with the populace.

Speaking with Tribune correspondent MyLinh Shattan, Maj. Sean Keenan talked about the unit’s medical role. Keenan, a graduate of the U.S. Military Academy at West Point and a board-certified specialist in emergency medicine, is on his third rotation to Afghanistan. His wife and three little boys – the youngest 10 months old – await his return to Fort Bragg, N.C.

Can you tell us about your assignment? Everything that we do is paired up with companies or platoons of the Afghan National Army, or ANA. My official role is emergency medicine. I’m special staff for the commander and provide medical oversight to our Special Forces medics on 17 teams, which are geographically spread out over 13 firebases. It’s like a civilian medical director for an EMS. I spend half the time at headquarters in Kandahar at the main base, half the time traveling out to the 17 teams to do missions or visit local national health clinics.

What’s the medic’s role on a Special Forces team? Typical medic provides combat trauma care. SF medics are additionally trained in all manner of medical disease, seeing kids, adults, females, as well as preventive medicine, basic dentistry and veterinary skills. Unlike most medics, they are pretty much autonomous in the remote areas. They end up being one of the most experienced providers in the local area.

The advantage our teams have is they live near remote communities [which other organizations] are unable to reach because of security reasons.

A patrol will go to a village that maybe hasn’t seen Americans in a while or where we think there’s Taliban. They’ll go in and clear it out, assess the situation, see what kind of projects they need – maybe run tailgate medical assistance, where they will do an impromptu clinic for a few hours and see the folks in that village. So not only are they clearing out the bad guys, but then they go in and attempt to win the hearts and minds. That’s where we [Special Forces] have an advantage over a purely military role.

What types of patients do you see? Although the media highlights everyone that gets killed and wounded, the actual percentage is pretty low compared to the amount of time we’re potentially exposed. What we’re seeing in this conflict is a lot more extremity wounds. People are getting bad wounds but they’re surviving because of the training we’re giving. Because of body armor and helmets, they’re not having as bad of an injury.

However, we’re seeing a fair amount of shrapnel wounds, a few bullets, RPG [rocket-propelled grenade] wounds, that kind of stuff. Then, of course, IEDs [improvised explosive devices] – which over the past 18 months has risen. Incidence of IEDs was almost none a few years ago in Afghanistan.

There’s combat trauma. It’s the thing that we think about mostly, but it’s a small percentage of what our medics see. When they do see it, they are all over it. Since my last two rotations, they saved four U.S. lives by putting on tourniquets and doing the appropriate things where guys could have easily died.

How is the Afghan health care system? Afghan society has basically no preventive medicine. They’re starting vaccination medicine. They have one of the highest infant death rates. Many of the things that we see are basic medical issues. They don’t have access to an informed provider or medicines that they need. So a lot of times we bridge the gap in these smaller towns by running the clinics.

We’ve been in country operating fully for six weeks now, and we’ve already seen 4,259 local nationals at our clinics. They’re happy to see us.

I saw a guy who was stabbed in the back with a sickle because he was having a water dispute. I saw a guy who decided he was going to pick up an unexploded mine and had 40 percent burns over his body surfaces. Saw another small child burned from a scalding. I’ve seen infections that have gone three weeks. Things you’d never see in the U.S. because people would go to their doctor way ahead of time.

What’s the reaction to Americans? It depends on the town and tribe. Some towns are naturally hostile and supporters of the ACM, and some are glad to see us.

We went into one place and they thought we were still the Russians. They didn’t know 9/11 happened. There’s no TV, no radio, no electricity. You’re dealing with people that are living in the 17th and 18th century. In general they come out of curiosity. We explain what’s going on: We’re here to provide security; these are your own soldiers. They seem very receptive.

If an area is openly hostile, people are a lot more wary because as soon as you leave, the Taliban will come in hours or days later and basically rough up anybody that was collaborating with us, even if they came just to get some medicine. That’s always a challenge.

Any concerns you have? I think it’s important that word gets out about the job folks are doing out here. Our mission out here is going to take more time than folks initially thought. There’s some definite progress being made. It’s unfortunate that the media focuses on the bad side of things. For every unfortunate incident, there are 10 good things going on that never see the light of day. After a while it tends to get frustrating, when only one type of story gets out.

Why the resurgence of violence and the Taliban? If you read the history of Afghanistan, you wouldn’t be surprised. As Americans, we expect a solution in six months, one year. The history of Afghanistan would argue against that. All the adults know is fighting, because that’s the way it’s been for the last 25 years. You have a whole generation of uneducated people because schools were closed during the Taliban. They’re used to war, to people invading. They’re more patient than what we give them credit for.

These folks that are now re-emerging have probably been sitting in Pakistan for the last two, three years just waiting this out. The encouraging thing is that NATO has taken over and put a significant investment into the restructuring and security of this country.

Based on the culture, they are very decentralized. They are loyal to the family unit, the tribes, and they have a hard time accepting and understanding government. It’s self-preservation mode.

There’s one irrigation ditch for four families – life-or-death battle over who gets water that day, like the guy stabbed in the back with the sickle.

And my personal opinion is that Pakistan and some of the surrounding countries could be threatened by a unified Afghanistan. So they probably have a stake [in the unrest].

They’re a patient people. They measure their timeline for success in decades, while Americans like to look at it in months’ time.

Tribune correspondent MyLinh Shattan can be reached at mylinh@mylinhshattan.com. Keyword: Commentary, to read other recent Voices From The Front stories and more on the media coverage of Iraq.

Oct 15, 2006

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About the Author

Mylinh Shattan is a writer who has lived on three continents, served in the Army, worked in corporate America, and taught in college. She loves adventures, in the world and in the mind. Literature is relevant and learning is a lifelong pursuit, so you might as well have a bit of fun along the way.

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