A hospital corpsman with the 2nd Marine Expeditionary Brigade teaches a Marine how to insert a needle into a vein as part of a Combat Lifesaver Course here March 24. Marines gain this knowledge so they can support corpsmen in the field in need of assistance. Photo by Cpl. Aaron Rooks

Combating insurgency in Afghanistan is not the only challenge awaiting the Marines and sailors of the 2nd Marine Expeditionary Brigade.

In addition to enemy combatants, Marines deploying to Afghanistan’s Regional Command-South will also face a number of potential health threats.

The Central Asian country has been labeled by the World Health Organization as one of the least developed countries in the world, with 70 percent of the population living in extreme poverty and health vulnerability.

Several food-, water-, animal-, and vector-borne diseases are found commonly throughout the country. The most common of all, according to Afghanistan’s Ministry of Public Health, is malaria.

More than half of the country’s population, especially women and children, are vulnerable to malaria, according to an April 2008 report from the Integrated Regional Information Networks, the humanitarian news and analysis service of the United Nations Office for the Coordination of Humanitarian Affairs.

The Ministry of Public Health and WHO estimated that up to 1.5 million cases of malaria occur each year throughout Afghanistan, most of which go untreated.

The 2nd MEB Health Services Support Section identified malaria, bacterial and protozoal diarrhea, hepatitis A, rabies, typhoid and paratyphoid fever as the diseases of highest risk in Regional Command-South. The medical staff has also identified tuberculosis, hepatitis E, sand fly fever, typhus, leishmaniasis, west nile fever and anthrax as some of the intermediate risks present in the Marines’ future area of operations.

Navy Petty Officer 3rd Class Matthew Siruchek, a hospital corpsman with 2nd MEB, said preventive medicine is key for Marines and sailors deploying to the region.

The Walden, N.Y., native, who deployed to Afghanistan with the 24th Marine Expeditionary Unit from March to October 2008, said malaria was their largest concern.

“Preventive treatment and education made the difference,” he said. “We always preached to them to take their medications once a week and they would be covered.”

Medication includes Mefloquine, a treatment used to combat malaria, which is transmitted primarily by mosquitoes.

The HSSS is taking these precautions and others. Navy Senior Chief Petty Officer Shannon Dittlinger, medical operations chief for the HSSS, said her team of corpsmen and Navy doctors has worked diligently since February to ensure the brigade is medically ready.

The Weirsdale, Fla., native said they have sprayed uniforms and sleeping systems to deter disease-carrying insects, ordered the necessary medications and conducted health, dental and neurological assessments. They have also performed vaccinations to prevent diseases such as yellow fever, anthrax, smallpox, hepatitis A, typhoid and measles.

But Navy Petty Officer 2nd Class Jose Gonzalezramos, a hospital corpsman and preventive medicine technician for the brigade, said there’s no preventive medicine offered for Marines to combat some of the diseases found in Afghanistan.

The Maunavo, Puerto Rico native said education plays the largest role in combating these diseases and other medical conditions overseas.

“If Marines listen to what we recommend to them, they will be healthier,” he said. “If there is a shot that can prevent you from contracting diseases, why not get it? If you know a water source is contaminated, why go near it? If Marines or sailors contract any of these diseases, they will be taken out of the fight temporarily or permanently.”

The HSSS team members said they are prepared in case anyone contracts one of the many diseases in the country, which the brigade medical planner, Navy Lt. Diana Loffgren, said is possible. She said there are currently several confirmed cases of malaria in troops serving in Afghanistan, but noted that none of these cases involve U.S. service members.

Despite the threats, the MEB medical personnel remain confident in the deployment being a success.

“I’m 100 percent confident in the corpsmen and doctors who will be taking care of the brigade’s medical issues, whether they are combat casualties or diseases,” Dittlinger said.

USMC
by Cpl. Aaron Rooks

This is something the Army has done for generations. In Cuba, Panama, Italy and now in Iraq and Afghanistan.

Staff Sgt. Kim Johnson, light wheeled mechanic, 345th Medical Detachment, collects one of many bug traps set up throughout Victory Base Complex. The traps are monitored daily to give Vector Control an idea of where the highest populations of mosquitoes and sand flies are located. (U.S. Army photo/Spc. Samuel J. Phillips)

The childhood song ‘Shoo fly, don’t bother me’ might make light of the annoyance of pesky insects, but, in Iraq, insects can be much more than an annoyance. Mosquitoes and sand flies can carry harmful diseases such as malaria, West Nile virus and leishmaniasis. Soldiers are battling these miniature invaders on Victory Base Complex.

Vector Control is one of the primary combatants in the ongoing struggle against potentially harmful pests.

“We set out traps to locate breeding areas and areas of high population,” said 1st Lt. Erik S. Foster, entomologist, 345th Medical Detachment. “Once we find the areas, we get with KBR Vector Control, so they can conduct spraying or fogging to bring the problem area under control.”

Kellogg Brown & Root uses truck-mounted foggers called ultra low volume foggers that emit a very small amount of pesticide, harmless to humans, but fatal to insects, Foster said.

“The problem is this is only effective against adults in the air and must be repeated three or four days in a row to impact the insect population.”

ULVs are not the only weapon in Vector Control’s arsenal. They also treat stagnant water, the breeding place for many insects, with larvacide.

“There are many kinds of larvacides available,” Foster said, “there are ones designed to inhibit growth of the larva so that they will never malt into adults, or there are ones that simply kill the larva before they have the chance to reach maturity.”

However, Vector Control Soldiers are not the only ones with the ability to battle against insects.

“Soldiers can protect themselves by using bug repellents and treating there uniforms in the ‘shake and bake’ kits provided to them before deployment,” Foster said. “The truth is most people don’t use repellents.”

The bad news is that the insect population is just starting to emerge.

“When it really starts to get hot, its going to get bad,” Foster said. “We are doing everything we can to keep the populations at a reasonable level.”

DVIDS
By Spc. Samuel J. Phillips
Multi-National Corps – Iraq

CJTF-82

More than 300 Afghans received medical treatment and humanitarian aid from the Afghan National Police and Coalition forces in the Arghandab District of Kandahar province, Afghanistan, Feb. 25.

“I have been two days without food, and this aid that you brought us today is very helpful,” said Gul Mohammad, a local who received aid.

This mission was in response to a visit in early February by the Afghan National Army. ANA attended a community development council where the locals raised concerns about the poor economy and absence of health care resulting, in part, from a harsh winter.

Medics treated villagers for typical cold and flu symptoms, malnutrition, and one case of leishmaniasis on the return visit. A significant number of eye infections were referred to the local clinic.

In a show of increased confidence in the ANA, a large number of women received medical exams and subsequent treatment. Normally patients are men and children with very few female participants.

“The villagers were pleased with the time and effort that was given to them by the ANP and Coalition forces,” said Army Capt. Vanessa Bowman, a Coalition spokesman. “The Kuchis are typically nomads and are facing hard times because of the winter. Kuchis live off of the land and many of their animals died this winter from exposure.”

The combined force handed out rice, beans, tea and sugar to assist the Kuchis. Some of the children and adults displayed the early signs of malnutrition during the medical exams.
“The nutritious foods supplied in the humanitarian aid package will mitigate the risk of malnutrition and help this community get through the rest of the winter,” Bowman said.