Feral Jundi

Monday, February 21, 2011

Medical: ‘Experts’…. Look At Civilians Hurt Supporting War

     The most prevalent diagnoses for civilians were musculoskeletal/spine injuries (19 percent), combat-related injuries (14 percent) and circulatory disorders (13 percent). Among members of the military, the most common diagnoses were musculoskeletal (31 percent, 6.4 percent of them considered war-related), combat (14 percent) and psychiatric (9 percent).

     Cohen noted that civilians with psychiatric diagnoses were significantly more likely to return to duty (16 percent, versus 9 percent for soldiers). “Despite the military’s emphasis on screening and early treatment for psychiatric disorders, they still take a much greater toll on military personnel than nonmilitary personnel,” said Cohen, who is also director of Chronic Pain Research at Walter Reed Army Medical Center.

 

    After looking through this, I had some objections with the study. It is lumping in civil servants or federal employees with non-federal employees or civilian contractors.  The reason why I disagree with this combination is that federal employees would have different motivations and different compensations than civilian contractors. It would have been better to completely separate the two.

    Dr. Cohen said this as well–‘Civilians, who often work in security and transportation jobs, are less likely to be in the line of fire and don’t expect to be injured in combat‘. I absolutely disagree with this statement and I am not sure how he came to this conclusion?  Even the KBR truck drivers that were hired to work in Iraq at this specific time line of the study (2004 to 2007) would have had to have known through the news and through word of mouth, that they were signing up for a very dangerous contract in an active war zone.

    The security contractors that worked at that time, and especially in Iraq, all considered the idea of being ‘injured’ or killed in combat every day they worked there.  How could a person in this position not consider this?

    This study also highlights some strengths and weaknesses of the contracting model in war zones, as it pertains to the medical side of things.  It shows how contractors view their job as a profession that will help to feed their family and pay the bills. The study makes no mention of that contractor’s patriotism or their desire to be with the team. The various motivations for them to continue going back to that war zone is varied, and this study does not differentiate. This study also represents a very dangerous time period to be a contractor, and a key time period of the development of the industry.

    On the other hand, the study pointed out that after civilians were wounded from ‘combat related’ injuries, they were more likely not to return.  Is that because they lost heart for the work or is that because the injury was debilitating enough to where they could not go back? Does the study make any mention of how many incidents that an individual had been through, both in their military history and contractor history?  Or how many of these folks have returned back to work after such incidents, but years later. This is happening in this industry, and the contracting model allows individuals to do this, dependent upon their resume and vetting.

    The other interesting statistic was this one. ‘Cohen noted that civilians with psychiatric diagnoses were significantly more likely to return to duty (16 percent, versus 9 percent for soldiers).’  This statistic needs to be clarified. How many of these folks that were questioned, were military veterans or police veterans that had carried their mental issues with them into their contract? Or what kind of diagnosis is given for each individual questioned, and was it related to combat and the war, or were these psychiatric issues a carry over from something else going on in their lives?

    With that said, the drive for a contractor with mental problems to continue working to feed their family and pay the bills, might be stronger than seeking help and not working.  At this time period of the study, a secret clearance was not mandatory. But there was the infamous CRC that many contractors had to cycle through at that time, and the military was tasked with medically screening folks.  At the bases that conducted this screening, contractor’s medical backgrounds were reviewed.

    Even with these screening processes, contractors still slip through.  Danny Fitzsimons is just one case of a contractor with mental issues making it through the system. There is also the peer review or on the ground management of teams that helps to screen folks as well. If there is an individual that is mentally unstable, they will be identified and removed from contract due to their liability. Everyone has to be a little crazy to do this work, but no one wants to depend their survival on some dude that is mentally gone.

     The high musculoskeletal/spine injuries statistic is the one statistic that was intriguing to me.  With the use of body armor and how heavy it is, as well as the hours of standing around or driving around wearing it, this can have adverse effects on the body.  Even though the armor can save a life, it still can injury a person just because of it’s weight. This is a problem for the military, and for contractors, and back injuries and the pain medications required to deal with those injuries will become very common place as contractors and military continuously work in war zones and wear this stuff. Armor is a paradox of sorts, and not to mention it’s limitations on the mobility of a war fighter. It may save your life, but it will also allow enemy combatants to out run you and give them a chance to fight again.

     Now what would be an interesting study is to pick up where they left off and see how things look now(2007 to 2011)?  A lot has happened since then.  If the study was better targeted and consultants outside of the medical group were asked to help guide the process, then that would be a more thorough and respected study. People will support what they help to create…. –Matt

Experts look at civilians hurt supporting war

February 21, 2011By Stephanie DesmonAfter analyzing data on 2,155 private contractors, diplomats and other civilians supporting war efforts in Iraq and Afghanistan who were medically evacuated from combat zones, researchers have found that such civilians are more likely to be evacuated for noncombat-related injuries but more likely to return to work in-country after treatment for these conditions.

Still, the findings of the Johns Hopkins–led research team, published online in CMAJ, the journal of the Canadian Medical Association, note that 75 percent of the nonmilitary group medically evacuated from the war zones to Landstuhl Regional Medical Center in Germany between 2004 and 2007 did not return to the field.

(more…)

Wednesday, February 9, 2011

Industry Talk: CIGNA Provides Access To Health Care For Workers On Military Bases In Afghanistan

     This is excellent news and I am glad CIGNA is providing this access. It sounds like about 20,000 folks will benefit from this latest move. –Matt

CIGNA Provides Access to Health Care for Workers on Military Bases in Afghanistan

February 08, 2011

Customers now have access to high-quality medical care on military bases in Afghanistan through new agreements establishing onsite health care clinics on the Kandahar and Bagram air bases. The new clinics serve government contractors and other employees working in Afghanistan and are endorsed by the U.S. military, which, in 2008, began encouraging contractors to develop alternatives to military hospitals for routine care. CIGNA covers approximately 20,000 customers currently in Afghanistan.

To make the clinics possible, CIGNA, the global leader in benefits for expatriates and other globally mobile individuals, forged new relationships with TMH Medical Services and Onsite OHS to establish two health care clinics on the Kandahar air base. In addition, through CIGNA’s arrangement with Onsite OHS, a clinic will open soon on the Bagram air base.

”CIGNA is responding to our clients’ concerns and has already taken important first steps to make primary medical care more accessible for those assigned to work in Afghanistan,” said Timothy Blevins, chief network officer for CIGNA International Expatriate Benefits (CIEB). “We want to ensure that all customers, wherever they live or work, have easy access to high quality, affordable health care.”

(more…)

Sunday, February 6, 2011

Medical: Like With The Military, Lack Of Sleep For Contractors Could Lead To Bigger Problems

     I am not an expert on sleep disorders or the act of sleeping, but after reading this article it only solidified my opinion on the matter. Sleep is vital not only to the military, but to contractors.  A lack of sleep could be a contributor to mental disorders and to poor decision making out in the war zones. Companies would be wise to pay attention to this little talked about aspect of contractor life.

     Actually, I would also take it a step further and say that long deployments/contracts are also a contributor to mental disorders and poor decision making out there, because this too is stress on the brain’s processes.  But that discussion requires a different post–this post is about sleep.

    The article below mentioned some key things that military folks experience as factors for a lack of sleep that also apply to contractors.  From drinking Monster Energy Drinks and Rip Its, to playing video games and hanging out on the Internet late into the night, there are many distractions that keep the brain and body awake.  Not to mention the day to day combat and operations tempo that both military and contractors experience.

     What’s funny is that I found an article on FJ that actually talked about a military program to keep soldiers awake and operating efficiently with little sleep.  My commentary on that piece was spot on and I still stand by it.  Sleep is vital and it must be a part of the operational planning if possible. To depend on drugs to keep effective is a dangerous path to go down. What I think is smarter is an emphasis on 7 to 8 hours of sleep in this current article, and to me that is the best solution to keep effective.

    The other interesting angle on this is that contractors are usually on their own after their shift or whatever, and free to do what they want to do.  That means watching a movie, playing video games, working out, going to the range, or just hanging out with the bros. But sleep seems to always be the ‘uncool’ thing to do when it comes to the list of things to do in your off time.  I suggest otherwise and you must make sleep a priority.

    My sleep goals for overseas contracting are simple.  My room or bunk is a place for sleeping.  If I have a room, I blacken it out completely, set the temperature gauge to a cool setting, and go to bed at the same time every night (or day for day shift).  I always try to shoot for 7 to 8 hours of sleep every time I lay down. Oh and I cut off my caffeine intake and eating about two hours prior to sleeping, or at least try to.

    Now for contracts with very little in the way of accommodations or privacy, that is a little tougher.  You might be stuck near someone that snores, and if you are a light sleeper, that can be hell.  It might be very hot or cold and extremely difficult to just sleep, and especially if you are having to wake up for guard duty at odd hours.  All I can say with these scenarios is to ‘build a snowmobile’ and figure out an innovative way to get that sleep. Make a good bed and find a safe but quiet place to sleep. Have a sleep ritual and do whatever it takes to pay your sleep bill. Because if you do not, it will definitely impact your job performance in a negative way out there.

     Also, for those of you who are looking for some advice on sleeping, Angela Benedict from the Military Healing Center has some good pointers for you.  I posted an article she wrote awhile back on the subject and feel free to contact her if you would like to add some more tools to your ‘sleeping tool kit’. –Matt

Seeking better sleep

Sleep Deprivation and Operational Effectiveness 

Military’s Sleep-reduction Program

Seeking better sleep

Lack of sleep could lead to bigger problems for U.S. troops, researchers warn

By SETH ROBBINS

February 5, 2011

Soldiers often find it hard to get a quality night’s sleep when deployed to a combat zone, and doctors think this lack of sleep could lead to long-term mental problems. Some researchers think sleep deprivation could be a cause of the high suicide rate among military members.

Researchers are finding that longtime sleep deprivation can have devastating consequences, including chronic insomnia and psychological disorders.

Especially vulnerable are downrange troops on repeated deployments, experts say.

Army doctors now recognize that sleep-deprived troops can be a danger to themselves on the battlefield, with slower reaction times, fuzzy memories and impaired judgment. But as suicides continue to spike within the military and more servicemembers are diagnosed with PTSD, some researchers and doctors have focused on sleep deprivation as a possible root cause of those issues as well.

Lt. Col. (Ret.) Dave Grossman, a former West Point psychologist who has written and lectured extensively on the psychological impact of combat, is convinced that chronic sleep loss is contributing to the rising suicide rate in the military.

Suicide “is a very complex topic,” Grossman said. “But this chronic sleep deprivation is the new factor, a major new factor.”

(more…)

Wednesday, September 22, 2010

Cool Stuff: Angela Benedict–A Walk For The Troops 2010

Saturday, August 14, 2010

Paracargo: GPS-guided Parachutes May Soon Drop Blood, Medical Supplies To Wounded Troops In Afghanistan

     I like this, but I have to think, what took you guys so long to think it up?  I mean they have already been using these types of paracargo systems for years, and just now the military is thinking about using it for medical resupply?

     What really kills me is that they predict they might be up and running with the project by January? I am sorry, but this is ridiculous and so typical of how government operates.  Put the stuff in a box, and drop it out of the airplane like you would with ammo, food, and water. Surround it with as much cushioning as it takes to insure it lands in one piece, but either way, get it done.

     In the smokejumpers, we have been dropping medical paracargo for a long time.  Stuff like oxygen bottles, IV’s and whatever else the mission required. Which is another point to bring up.  If they are going to drop this kind of bundle in any kind of wooded areas, it might be wise to also have a set of tree climbing equipment that you can toss out of the aircraft as well.  Maybe something that you could drop by GPS chute, and then at a certain altitude the tree climbing box is released with a small drogue keeping it straight but still allowing for speed of the bundle.  That way the thing can plow through the trees to the ground.

     Or if the aircraft can do a low pass, they could toss out the thing as well. In the jumpers, this is how we would do it, and those boxes would plow through the trees just so the guys on the ground could get to it for tree climbing operations.   Because getting medical supplies out of a tree requires the right equipment, and you definitely do not want to keep your patient waiting because of a bundle that is hung up.

    The aircraft could also just drop another medical bundle, but if that one gets hung up in the trees or gets lost in a river or destroyed by enemy fire, it will be equally problematic.  So it pays to have some back up tree climbing equipment just to be prepared.  That is how we did it in the smokejumpers. I realize that most of Afghanistan is not that bad tree-wise, but for those areas that guys are operating in where trees are tall enough, it is something to think about.

    Another idea is to use UAV helicopters for the task. If you want to put medical supplies on the ground and with precision, use something like that.  That’s if it is too dangerous or the conditions suck for manned flight into that spot.

     But going back to the time frame for this.  Imagine how many folks have already died, just because this capability was not in place?  I say do a couple of test runs to figure out the right kind of packaging for the load, and start this program immediately. You could get this done in a week or two, and not wait until January of next year.  Lives could be saved because of it. –Matt

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GPS-guided parachutes may soon drop blood, medical supplies to wounded troops in Afghanistan

By MARK PATTON

August 11, 2010

WIESBADEN, Germany — GPS-guided parachutes soon could be dropping blood supplies to medics on the battlefield, cutting down the time life-saving medical supplies reach wounded troops.

The military already uses the technology to deliver food, water and ammunition to U.S. forces in remote parts of Afghanistan. Now, the Armed Services Blood Program is working with an Army research center to put blood and other medical supplies under the parachutes instead.

If testing goes as planned, the system could be up and running by January.

Troops needing blood on the battlefield usually have to be evacuated and transported to the nearest medical facility. But evacuation is not always possible when units are under fire or if the weather prevents an emergency vehicle from traveling.

That’s when the Global Position System-guided parachutes can be a lifesaver and allow a wounded servicemember to receive blood during the critical period following an injury, said Air Force Maj. David Lincoln, Armed Services Blood Program deputy director for operations.

(more…)

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