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U.S. Department of State

Diplomacy in Action

U.S. Air Force Efforts to Provide Earthquake Relief in Haiti

FPC Briefing
U.S. Air Force Military Official
Foreign Press Center
Washington, DC
January 15, 2010

1:00 P.M. EST
Background Media Roundtable

NOTE: The text below is “on-background” and attributed to “a U.S. Air Force military official.” If you have additional questions or would like to ask the Air Force for permission to use any of the material below “on the record” then please contact Ms. Elizabeth Mauger at or 703-588-7208.

MODERATOR: Welcome to the Washington Foreign Press Center. Today we have an on-background media roundtable with a U.S. Air Force military official who is here to discuss U.S. Air Force efforts to provide medical relief in Haiti. Without further ado, here is our senior U.S. Air Force military official.

SENIOR U.S. AIR FORCE MILITARY OFFICIAL: Let me begin by asking do you have any specific questions of us at the Air Force Medical Service?

QUESTION: Jianing Shen, CCTV – China. Yes. We just need a general introduction first, and then maybe we can ask some questions.

SENIOR U.S. AIR FORCE MILITARY OFFICIAL: Okay. Well, certainly this is an extremely unfortunate series of events. And I think we -- this really shows the best of human nature, by the fact that so many people are responding to this event, not just in the United States, but the United States Government and the Department of Defense. And our effort to that is certainly going to be in collaboration and partnership with many of these agencies.

In fact, this is really one of the strengths of our Air Force Medical Service, is to work very synergistically with our sister services, as partners, as well as with some inter-agency coordination. From the Department of Defense standpoint, the theater of operations down in that area is southern command, and Air Force South, or 12th Air Force, is the agency that is responsible for operations in that area for us. And our 12th Air Force and our SOUTHCOM medical offices are working hand in hand right now with the people that we already have on the ground, as well as those that are continuing to plan further responses.

Additionally, one of the elements and capabilities that the Air Force Medical Service is able to bring to bear is we have a group of specialists. They're known as international health specialists. And these are medical folks of every variety, be they physicians, nurses, technicians, support personnel, with specific cultural and language skills for particular regions throughout the world.

So, we are leveraging those. In fact, we have a specific international health service team that is part of 12th Air Force's staff, and we are also looking more broadly. We have a list of all medics throughout the Air Force Medical Service with particular language and culture skills that we're also drawing from, as we begin to put forces forward. And again, these folks are specifically trained, particularly our IHS teams, in working inter-agency coordination, both within our own government, as we understand is a very large government. Our Secretary of State has lead on this operation, and the Department of Defense supports that effort that is primarily through the Department of USAID. But we also -- our IHS folks are also very well versed in doing coordination with our non-governmental organizations as well, particularly in areas of humanitarian relief. So we are working very hard on that.

In terms of our own intrinsic capabilities, the building block, the fundamental way in which the Air Force Medical Service deploys to any environment is called an EMEDS*, which is an expeditionary medical unit. And we are able to do that in building blocks from an EMEDS basic up to a +10 to a +25, which really just increases our capacity.

But the strength of the EMEDS, it is a very light and lien modular and adaptive capability, okay? We can build it in a building block approach to what we need to with specific capabilities. We have already been tasked and are delivering an EMEDS +10, and that will arrive in Haiti on Sunday. And it includes primary care, preventative care, surgical care, intensive medicine capability for stabilizing purposes. And we have also augmented that with some specific pediatric and women's health capabilities, as well.

And the reason we have done that is, again, our -- the basis of this EMEDS structure, when we started with this concept 10 years ago, was really centered around our ability to respond, obviously, to combat operations. But we have made it -- and found it to be a very adaptive platform -- to also help us in missions involving homeland response and humanitarian aid.

For example, we deployed our EMEDS in support of our own Katrina operations, and it was very successful there. Most recently as well, we took an EMEDS in the Pacific theater, and we married that up with some of our other partners in the Air Force, non-medical assets, that are able to provide us a lot of support. And we took a package of around 100 people and we went in and supported earthquake response operations in Indonesia. And, in fact, we're using that as a model with some of the lessons that we learned as recently as this fall from Indonesia, in modeling, similarly, our response as we're moving into Haiti now, and marrying those same capabilities together.

Again, since it's -- even though an EMEDS is fairly light and lean and modular, we can even go even smaller than that, and we were able to get people on the ground within the first 24 to 48 hours, some of our medics out of Hurlburt Air Force Base. And these are some of our most adaptive and agile forces from our special operations command.

And they are perfectly suited to operate in these very austere environments, and as well have some of their own cultural and language capabilities. And they basically brought what almost equates to an EMEDS as well, with -- we have primary care, preventative medicine teams, some site assessment teams, as well as some surgical and critical care capability, also. So that is already on the ground in theater, and was there within 48 hours. So that will then -- our EMEDS will be in addition to that.

And then, as I said, we can build our EMEDS even further. And we are already planning forward, that within 24 to 48 hours, to go from that EMEDS +10, which is a 10 holding bed capacity, up to an EMEDS 25. So it increases our holding bed capacity somewhat, and gives us, just by increasing a few more people, about another 30 folks of mostly nurses and technicians. It just increases our footprint a little bit more.

Now, again, these are still fairly light and lean packages, so they are all predicated on the concept of through-put for patients. None of them have the capability to hold patients for a long period of time, okay? That's where we married up, like I said, very synergistically with our sister services, be they either with an Army capability, if they bring in a permanent hospital, the Navy, like the Navy ships. The Comfort is already in route. So we will be able to -- if patients need more prolonged holding, we will be able to move them out to the ships.

Or, additionally, if we are asked to move patients via air, we will be able to do that. And that is certainly one of our other core competencies of the Air Force Medical Service, is to take those patients from that point of injury through our EMEDS to provide that stabilizing life-saving care, and then move them on to that next level of care, as needed.

It's the exact model that we employed very successfully in Operations Iraqi Freedom and Enduring Freedom, and we have survival rates from 96 to 98 percent of the U.S. casualties that were hurt in the combat zone using this very same model. From the theater we're moving patients out within as short as 12 to 24 hours, back through Germany and back to the States. So, using those same teams, we will be able to take the most critically injured patients that need that most advanced level of care, and move them back to Miami.

Our U.S. transportation command, in partnership with our Air Mobility Command, is in charge of those patient movement aspects. They are moving forward a team down to Miami to start putting together a coordination cell for any patient movement requirements, as well as positioning our air evac crews to include what we call our CCAT teams, our critical care air transport teams. Essentially, these are flying ICU teams. They include a critical care specialist, a critical care nurse, and a respiratory therapist to manage any of our patients who are on ventilators. And we are able to do that -- each team is able to take care of a couple of patients en route with that level of acuity.

Any questions? Sir?

QUESTION: Jorge Banales, EFE, Spain. You indicated that a unit is arriving on Sunday to Haiti. How many people are in the unit, and do you know where it will be located?

SENIOR U.S. AIR FORCE MILITARY OFFICIAL: The number of personnel on an EMEDS +10 is on the order of around 40 personnel. But I will have to check on that number for you. And if we could get your contact information, we will get that back to you to give you an exact number on that.

In terms of the exact location, those are the issues that are currently being worked out by the site assessment team. Again, particularly if we wanted to marry up with patient -- from the airport, then the -- close to the airport, it's certainly advantageous. But there are so many variables that need to be taken into account, as to how much space is available, and if actually we might be needed to go out into the community, away from the air field, based upon the number of injured Haitians who could make it out to the airport.

So, all of those things will be taken under consideration before the SOUTHCOM planners and the surgeons team makes that final assessment, where they want the Air Force medics to set up their operations.

QUESTION: Edouard Guihare, AFP – France. What kind of difficulties are you watching for on the (inaudible)?


QUESTION: Edouard Guihare, AFP – France. What kind of difficulties are you (inaudible) for the field?

SENIOR U.S. AIR FORCE MILITARY OFFICIAL: Are we finding in the field?

QUESTION: Edouard Guihare, AFP – France. Yes.

SENIOR U.S. AIR FORCE MILITARY OFFICIAL: Difficulties? Well, I think that the span of challenges are those that we kind of see in any of these operations. Obviously, a very poor country to begin with, with essentially absolutely no infrastructure left, so issues of safe drinking water, power supply to bring in our operations. And it is a small island nation, so space is, in itself, an issues with a very limited airport capability to move airplanes and supplies in and out of the region.

You know, those would be some of the biggest challenges. They are common to pretty much all disasters of this type. We have had success with the people that we have put forward, who were able to take their own communications capabilities in. So, right now, we are having, you know, good luck with talking with our folks there, and they are able to let us know what they need, and again, let those planners start putting in those assets that we need to start now providing to them.

It just -- it takes time, and sometimes with disasters, too, is those areas that are the worst hit, sometimes it's really hard to get an understanding of exactly what they need, because that's where the communication is the most disrupted. Obviously, with as much response as we have had from the entire world, I think we have actually had a very good idea very quickly as to what those requirements are going to be.

QUESTION: Edouard Guihare, AFP – France. What kind of disease?

SENIOR U.S. AIR FORCE MILITARY OFFICIAL: Specific diseases that are common in that area? Particularly among the pediatric population, diarrhea, intestinal type diseases are very common there, both bacterial types of intestinal diseases and parasitic types of diseases, are common among the Haitian population.

HIV and AIDS is also very prevalent within the Haitian population, and it is one of the leading causes of mortality in that country. So that is certainly a background problem which all of our responding medics will have to pay attention to.

Malaria is common within the island, as is dengue fever, which is another disease that is transmitted by mosquitoes. There are certainly a host of other animal-born diseases, as well, within the population.

And then the common illnesses, vaccine-preventable diseases that tend to be somewhat common, are tetanus, diphtheria, and measles.

QUESTION: Edouard Guihare, AFP – France. Could we say that there is a medical state of emergency now?

SENIOR U.S. AIR FORCE MILITARY OFFICIAL: It would be somewhat out of my lane to make that statement officially. I would say within open source reporting, given the numbers of folks who have been impacted by this event, and the baseline medical capability within Haiti, their current capabilities have been overwhelmed, and they have been asking for that assistance already.

QUESTION: Jorge Banales, EFE – Spain. The Government of Cuba has authorized flights through their air space. In which was does this change the operations?

SENIOR U.S. AIR FORCE MILITARY OFFICIAL: That would -- that's a little bit out of my lane, to be able to answer that, in terms of military operations. We would have to defer that to our folks who deal with the mobility air operations to be able to answer that. I'm sorry.

QUESTION: Takashi Fudo, JiJi Press – Japan. Do you have any idea (inaudible) the ground?

SENIOR U.S. AIR FORCE MILITARY OFFICIAL: Again, our Air Force has those capabilities. Whether or not they will be required, I'm not able -- I'm not qualified to answer to that, as to whether or not that's been asked for as a requirement or, again, that we are beginning to plan for those types of events.

QUESTION: Takashi Fudo, JiJi Press – Japan. (Inaudible) ground situation?


QUESTION: Takashi Fudo, JiJi Press – Japan. (Inaudible) ground?

SENIOR U.S. AIR FORCE MILITARY OFFICIAL: Certainly the security situation is going to shape our response efforts and where we lay down our capabilities and what we're able to accomplish. But from what we have understood to this point, the security has been actually fairly stable, with the existing UN peace-keeping forces that were there. I know our Marines are bringing in a large peace-keeping force to help with that, as well, too.

But again, that will shape all of our operations. Obviously, we are going to be very concerned about any Air Force personnel, medics or otherwise, that we put into the theater, to make sure that their needs and safety is addressed.

QUESTION: Jianing Shen, CCTV -- China. How long will the U.S. Air Force relief team be there?

SENIOR U.S. AIR FORCE MILITARY OFFICIAL: It would be premature to be able to answer that. I think we're going to have to see how the situation develops over time, and exactly what those requirements will be, as -- and what our role will be in this response.

Again, what we are able to bring -- and that is, as I mentioned, is part of that synergy -- what we, as the Air Force, are bringing, is to be able to get into a location very quickly with that very small footprint in that very immediate period.

Again, in terms of our other services, it allows them time to mobilize their larger forces, and to get there over a slightly longer time frame. And then, as well too, we are working inter-agency-wise with other government agencies and our non-government agencies, to bring in their assets, and to really be there for more -- sustaining long-term operations.

MODERATOR: Okay. If there are no other questions, we can conclude the background portion of this event, and turn the recorders off.