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Medical Care in Bosnia

By Jim Garamone
American Forces Press Service

WASHINGTON, Jan. 4, 1996 – American service members deployed to Bosnia will have the best possible military medicine supporting them.

Active duty and reserve component medical personnel have already started treating service members in Bosnia, Croatia and Hungary, said Army Surgeon General Dr. (Lt. Gen.) Alcide M. LaNoue.

Medics have set up a 120-bed combat support hospital in Taszar, Hungary. The medics will soon have a 30-bed mobile Army surgical hospital in Tuzla, Bosnia. The hospitals are set to handle the range of casualties. It takes 2 hours to evacuate a patient by air from Hungary or Bosnia to Ramstein Air Base, Germany. A service member requiring more than five days' hospitalization will be sent back "home." "Home for most of the folks is in Europe," LaNoue said. "But if their homes are [in the United States], we'll bring them back home."

LaNoue said his major concern is disease. "We have a variety of functions that we provide on the battlefield, and the most important is to keep the Army healthy," he said. "If you look back over history, there have been more armies defeated by disease than by other armies."

LaNoue said he has heard the horror stories about living conditions for U.S. service members in Bosnia. There is a general lack of sanitation, and many places American troops stay in are infested with rats. "Yes, I'm aware of [the conditions], and yes, I'm tuned in to it," he said. "Yes, I'm worried about the number of rats and the number of lice on the rats."

He said the command in Bosnia is aware of the health risks, but American service members are entering an area that is stark. "First, you've got to get there," he said. "And then, you've got to start fixing things. I'm assured [the command and medical authorities] are doing that."

LaNoue said the command is making progress considering the size of the deployment. "What we're doing is taking a city the size of Frederick, Md., and we're moving it into a very remote area in the middle of winter," he said. "We do not accept that the way things are is the way they are going to remain."

LaNoue said he is concerned about a tick-borne encephalitis reported in Bosnia. There is a vaccine for it, but it has been approved by only a couple of European countries.

Good mental health care is also a part of the medical support effort in Bosnia. The Army is deploying combat stress detachments. Desert Storm was the first American effort in this arena. LaNoue said the Army learned from the Israelis, who found far-forward mental health care can limit mental health casualties.

The Army places combat stress detachments -- generally made up of a psychiatrist or psychologist and an enlisted person trained in counseling -- at battalion aid stations. They provide advice and support to service members having adjustment or mental problems, LaNoue said. If the detachments find a unit is having a pattern of problems, the specialists are trained to work with the command to alleviate or minimize the cause. "And of course, during combat, combat stress becomes a significant factor," he said.

The Army has also mobilized veterinarians to ensure food and water U.S. service members eat and drink is safe. Each hospital also has laboratories not only to do normal medical tests, but to monitor environmental conditions.

Service members in Bosnia will also benefit from DoD experiments in telemedicine. LaNoue said physicians in the area who run into a particularly puzzling case can transmit massive amounts of digitized information -- including high-definition pictures -- to the experts, wherever they may be. "Rather than transporting the casualty to the experts, we can just send the information back and get a diagnosis and treatment started," LaNoue said.

Some Army medical reservists are going to Bosnia, but most will go to Germany or stateside units to replace deployed active duty medical personnel, LaNoue said. The reservists will ensure service members and family members still receive medical care during the deployment.

Tracking patients in the medical system is computerized now. Medical personnel up and down the chain of command know precisely who is receiving care, where and what the diagnosis is.

Finally, the military is gathering every bit of medical information it can about those deployed into Bosnia. Medical personnel also will set up environmental monitoring stations in the country. All information will be placed in a data base. This way, if an unknown illness shows up later -- such as illnesses that have affected some veterans of the Persian Gulf War -- medical authorities can use the data base to track the person.

"This is a brand new data base," LaNoue said. "How it's going to work, we don't now, but we think it makes sense, and we think it's worth the effort."

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