Medical logistics during operation Iraqi freedom

Army Logistician, May-June, 2004 by Edwin H. Rodriguez

On 17 February 2003, the 101st Airborne Division (Air Assault) at Fort Campbell, Kentucky, embarked on another rendezvous with destiny"--this time to participate in what would become Operation Iraqi Freedom. In preparing for deployment to Iraq, the Division Medical Operations Center's Medical Materiel Section and the Installation Medical Supply Activity planned, forecast, and distributed medical supplies and equipment. The Army Medical Materiel Agency (USAMMA) played a role in meeting unit requirements by fielding upgraded equipment. Different initiatives, such as contingency sets, unit-deployment packages, and unit readiness surveys, also contributed to the unit's combat readiness. By the end of January 2003, the division medical units had a 97-percent fill on all of their sets, kits, and outfits.

Battle Preparation

The 101st Airborne Division sent an advance party to Kuwait to establish a key theater Logistics node before its ground forces deployed. The advance party's highest priority was to establish medical supply operations. When the advance party arrived, medical logistics assets already in theater consisted of only two medical Logistics activities--a medical warehouse in Qatar, and the 561st Medical Logistics Company at Camp Arifjan, Kuwait--and a medical warehouse that was part of the clinic at Camp Doha, Kuwait. Transportation and accessibility to immediate sick-call supplies were virtually nonexistent.

The advance party designed a medical Logistics synchronization matrix that included a breakdown of all the medical resupply sets needed for reception, staging, onward movement, and integration (RSO&I); combat operations; and blood resupply. The 424th Medical Logistics Battalion arrived 10 days before the start of combat operations. After combat began, the 561st Medical Logistics Company was to go forward to Logistics Support Area Bushmaster in Iraq to support the 3d Infantry Division (Mechanized) and the 101st Airborne Division.

One major problem was the arrival of combat troops before the division's medical equipment. The medical equipment sets and the Division Medical Supply Office (DMSO) ASL were still weeks out when the troops arrived. This created a dilemma for supplying critical and sick-call medications to the troops. The modes of transportation used to move supplies and equipment were inadequate; for instance, buses were used to distribute sick-call supplies to all of the camps. Faulty communication systems made coordinating resupply difficult; units had to rely on local cell phones to communicate around Kuwait. Connectivity and automation reliability were dreadful. No assistance teams were available to service the Combat Automated Support Server-Medical (CASS--M) or Theater Army Medical Management Information System (TAMMIS) customer Assistance Module (team). It took the DMSO 15 days to get these systems operational.

In effect, the medical units arriving in theater were not combat ready. Even after the offensive operations ended, the 591st Medical Logistics Company struggled to meet customer demands when it first arrived in theater because it did not have authorized stockage list (ASL) supplies and was short of personnel and equipment. The complete ASL did not arrive at the area of operations for 30 days.

The 101st Airborne Division's medical units deployed with 20 days of supplies. During RSO&I and combat operations, combinations of line requisitions and push packages were used to augment the division's supplies. Initially, 30 units of blood were issued to each forward surgical team, 20 to each forward support medical company, 15 to each main support medical company, and 20 to the DMSO.

DMSO Operations During Combat

Once the medical equipment and supplies were available, the 101st medical units were ready for battle. To better support the troops forward, the DMSO conducted split operations. The forward DMSO was composed of four soldiers and was equipped with an ISU96 [a portable refrigerator that can be brought in by airlift or slingload] and 10 days' worth of supplies. The rear DMSO operated out of the division LOGPAD at Camp Pennsylvania, Kuwait, with 20 days of supplies. [A LOGPAD is a staging area used to temporarily house all classes of supply awaiting forward distribution.] Splitting DMSO operations increased Logistics capabilities and resulted in the speedy distribution of medical supplies.

Having the rear DMSO operate from the LOGPAD during combat operations had its advantages. The health service materiel officer (HSMO) created a medical Logistics synchronization matrix that included projected class VIII pushes, drop-off locations, and date-time groups. The HSMO provided movement requirements 72 hours out in order to fit its shipments into the scheme of priorities set for moving other classes of supply to the front line. The 101st DMSO was the only medical supply support activity in theater capable of ordering through the CASS--M throughout the operation. It also used medical resupply set components to replenish open requisitions.