Operation Desert Storm: Full Army Medical Capability Not Achieved

On March 20, 1995, the Assistant Secretary of Defense for Health Affairs signed the Department of Defense Medical Readiness Strategic Plan for 1995-2001. The purpose of the Medical Readiness Strategic Plan 2001 is to provide DOD with an integrated, coordinated and synchronized plan for achieving and sustaining medical readiness through 2001 and beyond. The plan recognizes the contributions of a number of GAO products issued on the readiness and capabilities of DOD's medical forces by stating that Operations Desert Shield and Desert Storm, 1990-1991, though successful, highlighted persistent medical support problems. Several reports by the DOD/IG, GAO, and other agencies called for dramatic changes and improvements.

To ensure that the Department has sufficiently trained medical forces capable of performing its wartime mission, OASD (HA) issued specific FY 1994-1999 Program Objective Memorandum medical readiness guidance and objectives that address the training problem. The degree to which these objectives are met will depend on the program priorities and fiscal constraints imposed on the military medical departments.

The Department of the Army is complying with the direction of the Assistant Secretary of Defense for Health Affairs' strategic plan. The Plan calls for an integrated program to correct the medical problems identified in Operations Desert Shield and Desert Storm.

According to the Army, its Total Army Analysis (TAA) 01 authorized 5 medical logistics battalions; 4 are scheduled to be online by the fourth quarter of FY 1994 and one in FY 1995. TAA-01 also authorized a theater medical materiel management center to be activated in the Army Reserve. In addition, the Total Distribution Action Plan and Army Strategic Mobility Plan are key initiatives related to medical support, transportation, and lift requirements. Draft Joint Publication 4-02.1, Health Service Support Ligistics in Joint Operations, establishes guidance on medical logistics support. Review of Army transportation requirements during TAA-01 resulted in the Army adopting a force packaging methodology to establish priorities for issuing equipment in conjunction with readiness objectives. An AMEDD medical reengineering initiative is under way to analyze the combat health support system and find ways to increase hospital mobility.

At the time Operation Desert Shield commenced, the Army was in the process of completing the development of the doctrine for a new battlefield medical infrastructure known as Medical Force 2000. The various tables of organization and equipment (TOE) for the medical units that comprise Medical Force 2000 have been developed and approved by the Army between 1986 and 1991. TheTOE is the document that contains the units' operating doctrine. The TOE addresses such relevant aspects as the unit's mission statement, capabilities, functional relationships with other units, support requirements, field doctrine guidance and references, etc. The ability to resource individual Army units is based on Army leadership priorities and the fiscal constraints with which they are faced. Because of this, many medical units do not have optimal equipment and funding priority.

The development of new air and ground ambulance units and doctrine for the modern battlefield was another element of Medical Force 2000. The TOE for the new Medical Force 2000 air and ground ambulance units has been developed and was approved by the Army in 1986. These organizations are cyclically reviewed to ensure that they are in concert with current Army doctrine or must be modified for emerging Army doctrine. The modernization of the force is based on mission priority and fiscal constraints. Currently, the Army's final buy of UH-60 Blackhawk helicopters is 300. Of these 300, 15 aircraft are to equip two National Guard medical evacuation units. Under the current UH-60 program, the Army utility helicopter fleet is 50-percent modernized, and the air ambulance fleet is 24-percent modernized.