On May 17th the Department of Defense quietly released a new policy regarding medical stability operations (MSOs). The policy, DoD Instruction 6000.16, states that:
“It is a DoD policy that: … MSOs shall be given priority comparable to combat operations and be explicitly addressed and integrated across all MHS activities including doctrine, organization, training, education, exercises, materiel, leadership, personnel, facilities, and planning …”
And, that the military health system:
“… shall be prepared to perform any tasks assigned to establish, reconstitute, and maintain health sector capacity and capability for the indigenous population when indigenous, foreign, or U.S. civilian professionals cannot do so.”
This is a big f#$%ing deal. Traditionally, the military health system has played a secondary (or even tertiary) role in operations. Their goal was to provide the pointy end of the spear with top rate medical care, and little else. Now, 6000.16 directs war planners to consider medical stability operation a tool in its own right, a carrot to combat operation’s stick.
6000.16 also addresses how the military health system must accomplish its mission. Namely, by supporting the local health infrastructure of NGOs in the area of operations. Warner Anderson of the DoD’s International Health Division (and a friend) put it well in a Marine Corp Times article last month:
“We have to do it smart and talk to the local health department and NGOs in the area … We’re here to make [them] look good.”
To many people this might not seem important, but personally, it is music to my ears. For all their high-horse distain of the military, many NGOs (certainly not all) continue to operate with complete disregard for existing health care infrastructures. They do this in the face of a mountain of research stating that the lack of coordination amongst NGOs is a primary barrier to effective post-conflict health system reconstruction. Rather than building the capacity of the state to provide services itself, these “project-based” NGOs develop their own parallel health care system, diverting much needed financial and human resources from the state health system.
Despite its perceived inexperience at international development projects, Instruction 6000.16 proves that the US military has, at least on paper, a greater understanding of sustainable development than many humanitarians.
Christopher R. Albon is a Ph.D. candidate specializing in armed conflict, public health, human security, and health diplomacy.
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Does this mean that military physicians will work alongside the existing health care infrastructures in Afghanistan through education, or direct providing of health care? Or both? I guess I’m trying to figure out what this instructs the military health system to do, practically.
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