Download (MEDCOY) Gender Field Advisor Course School Solution

GFOR MNB S MEDICAL COMPANY (MEDCOY)
STANDING OPERATING PROCEDURE (SOP) – DRAFT
GFA Course School Solution – DRAFT
Situation:
The MedCoy commander asked the GFA to have a look at their newly developed SOP
and provide advice on how to integrate gender perspective.
Task for the syndicates:
The GFA students should go through SOP and add a gender perspective where
possible. This document highlights the relevant parts for the GFA and serves as a
school solution.
I. PURPOSE
The purpose of this SOP is to provide guidelines, policies, and procedures. The
implementation of this document will enhance the effectiveness of training and provide
specific procedures for routine tasks during GFOR MNB S MedCoy operations. This SOP has
been prepared to standardize operations and GFOR MNB S MedCoy procedures.
A. Scope.
The scope of this SOP addresses the mission, organization, equipment, and operations of
the MedCoy.
B. Applicability.
This SOP applies to all personnel assigned to the GFOR MNB S MedCoy.
C. Accountability.
All personnel assigned to the MedCoy as a part of their initial orientation are required to
become familiar with and have a working knowledge of this SOP. Thereafter, all medical
personnel in leadership positions will review the SOP every 90 days and update or
recommend changes as required. Personnel not in leadership positions are required to
review the SOP a minimum of every 6 months or as necessary when conducting
operations.
II. GENERAL
A. The MedCoy provides Echelon I Combat Health Support (CHS) for MNB S. They will
also provide life or limb saving medical support to the local population living in the
AOO of MNB S. An additional duty for the MedCoy will be assisting in the collection
of evidence related to conflict related sexual violence, this includes but is not limited
to filling in a sexual assault medical certificate.
B. MedCoy personnel are under the command leadership of the company commander.
The brigade surgeon/medical company leader is a member of the MNB S staff.
C. The MedCoy is dependent on the GFOR Medical Battalion for Echelon II CHS.
This includes medical evacuation from the MedCoy Role 1 facility to the Role II,
patient holding, Class VIII resupply, medical maintenance, x-ray, laboratory, and
operational dental care. The MedCoy requests augmentation/reinforcing support
from the GFOR medical battalion.
III. ORGANIZATION AND MISSION
A. Organization
a. The medical platoon is organized as shown in Annex A (to follow).
b. The headquarters section of the MedCoy, under the direction of the coy
surgeon, commands the MedCoy and ensures resupply for the coy.
c. The field medical assistant, a medical staff corps officer, is the
operations/readiness officer for the coy. He is the principal assistant to the
coy surgeon for operations, administration, and logistics. The field medical
assistant coordinates CHS operations with the brigade G3 and G4 and
coordinates patient evacuation with GFOR Medical Battalion. When a
physician is not assigned, he performs the duties of medical platoon leader.
d. The coy senior NCO assists the coy leader and supervises the operations of
the coy. He also serves as the ambulance section senior NCO. This NCO
prepares reports; requests general supplies as well as medical supplies;
advises on supply economy procedures; and maintains stock of expendable
supplies. He supervises the activities and functions of the ambulance
section, to include operator maintenance of ambulances and equipment and
OPSEC.
e. Treatment squad. This squad is staffed with an operational medical officer
(primary care physician/coy surgeon), a Physician Assistant (PA), two health
care Sergeants (SGT), and four health care soldiers. The coy physician, PA,
and health care SGT are all trained in Advanced Trauma Management (ATM)
procedures, commensurate with their occupational positions/specialties.
f.
Combat medic section. A total of 12 trauma specialists are assigned to the
combat medic section.
B. Mission.
The mission of the MedCoy is to provide Echelon I CHS for MNB S. This includes medical
treatment, medical evacuation, and clearing the battlefield. It includes preventive
medical activities to counter either disease or combat and operational stress disorders.
It includes ATM to save lives, limbs, or sight and to stabilize the wounded or injured
patient for further evacuation. This also includes maintaining accurate field health
records as well as the permanent health record in a base setting.
The MedCoy will also provide life or limb saving medical support to the local population
living in the AOO of MNB S.
The MedCoy will be assisting in the collection of evidence related to conflict related
sexual violence (on request of the military police), this includes but is not limited to
filling in a sexual assault medical certificate.
Important information out of the International Protocol to know / add to the SOP:
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Engaging individuals, their families and communities in order to investigate and
document information of sexual violence must be done in a way that maximises the
access to justice for survivors, and minimises as much as possible any negative impact
the documentation process may have upon them.
When documenting information about sexual violence, practitioners must strive to “do
no harm” or to minimise the harm they may be inadvertently causing through their
presence or mandate.
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Practitioners should have the appropriate level of skills and training to undertake
documentation of sexual violence. In particular, practitioners should:
• Ensure that all members of the team, including interviewers, interpreters, analysts and
support staff are appropriately vetted, and trained to document violations according to
the basic standards as set out in this Protocol.
• Ensure that all members of the team have knowledge and experience of dealing with
cases of sexual violence and, in particular, are familiar with the proper interview
techniques, terminology and strategies to respond sensitively to disclosure of sexual
violence by both female and male survivors/witnesses.
• Where possible, train staff in dealing with trauma and the ways in which to recognise
and respond to post-traumatic stress disorders and risks of suicide and self-harm.
When working with child survivors and witnesses, practitioners should in particular:
• Have training specific to approaching, interviewing and referring children to enable
practitioners to respond to the specific vulnerabilities and capabilities of the child.
• Understand how to apply the principles of “do no harm”, confidentiality and informed
consent specifically to working with children, including the use of age-appropriate
techniques when communicating with survivors and other witnesses.
• Have training on child interviewing skills that are age-sensitive, and take into account
that interacting with very young children requires different skills from those required
when dealing with adolescents.
• Have training on techniques to prevent re-traumatising children, such as allowing
them to feel bodily sensations and emotions (trembling, shaking and crying).
• Understand the distinct challenges that different groups of vulnerable children may
face, such as the risk of rejection by communities that young girls associated with armed
groups and forces can experience.
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Assessing risks to information
• Do you have a plan in place to safely collect and store information?
• How will you keep information that you gather safe and confidential? When, why and
how will you destroy information at risk of confiscation?
• How will you transport any information and evidence you gather?
• Are you able to maintain “Chain of Custody” and do you have the capacity to safely
secure the information for long periods of time?
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Interpreters are often a key part of the practitioner’s team. Interpreters should be
appropriately trained, not only in interpretation itself but also in working with
survivors/witnesses of sexual violence and, where relevant, with children.
Interpreters should be able to provide the practitioner’s team with interpretation during
any interaction practitioners may have with members of the community, including
during interviews. They should also be able to provide practitioners with the right
linguistic and cultural interpretations of key words, behaviours and expressions
associated with sexual violence in a particular setting, without changing or influencing
the information as provided by the survivor or other witness.
During interviews in particular, interpreters must be able to work sensitively and
professionally, and according to the ethical principles of “do no harm”. They must also
fully understand the concept of informed consent, and abide by the team’s codes of
confidentiality.
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Physical evidence refers to any physical object or matter that can provide information
and help to establish that a crime took place, or provide a link between a crime and its
victim or between a crime and its perpetrator. As a general rule, practitioners should not
collect any item of physical evidence unless they have been trained as an investigator or
as a health practitioner in the proper collection of forensic evidence. If practitioners
choose to collect physical evidence without having undertaken the proper training, they
can severely harm a survivor, and may contaminate evidence, making it unusable. That
said, in some very limited circumstances, where safe and where it is the only viable
option, the collection of physical evidence may be appropriate.
The decision to collect physical evidence should be taken with seriousness and care, and
be thought through very carefully. Practitioners may come across physical evidence of
sexual violence:
• On survivors/witnesses themselves, depending on the time frame and nature of
injuries;
and/or
• At the site where the sexual violence took place.
Depending on the time frame involved and the nature of the injuries, survivors of sexual
violence may have physical signs on their bodies in the form of marks or injuries that
corroborate their accounts of the attack. They may also have medical consequences of
the assault, including internal physical injuries, pregnancy, sexually transmitted diseases
and mental trauma. Ideally, a victim should be able to access immediate medical
assistance following a sexual assault and a trained clinician should record any injuries
and the other health impacts in a confidential medical record which a survivor can
access at any time (see, “Sample Sexual Assault Medical Certificate”).
IV. MEDICAL EVACUATION OF SICK AND WOUNDED
A. General.
a. Evacuation is based on the principle that rear higher echelon medical units are
responsible for evacuating patients from supported units. Lower echelon
supported and supporting units must ensure evacuation support plans are
complete and current by close, direct coordination.
b. Patients are evacuated no further to the rear than that necessary to obtain the
medical care that will return them to duty. Patients are evacuated by the means
of transportation that most clearly meets the treatment demands of their
wounds, injury, or illness.
c. The preferred method for evacuation of neuropsychiatric casualties who can be
managed without medications or physical restraints is a non-ambulance ground
vehicle. If physical restraints and/or medications are required during
transportation, ground ambulance is preferred. An air ambulance should only be
used if no other means of evacuation is available. Physical restraints are used
only during transport and medications are given only if needed for reasons of
safety. Those neuropsychiatric patients with life- or limb-threatening conditions
are evacuated by the most expedient means available.
B. Responsibilities for Medical Evacuation.
a. The medical platoon leader—
1. Develops an evacuation plan which will best support the operations being
conducted.
2. Prepares/obtains the necessary maps of the AOO and overlays from the G3.
3. Does reconnaissance of MEDEVAC routes, either map or on the ground.
4. Provides ambulance teams with strip maps; briefs the plan; and rehearses
the MEDEVAC plan with the ambulance section when time permits.
5. Identifies and coordinates with the brigade TOC on the location of primary
and alternate helicopter landing sites that are established.
6. Oversees medical evacuation operations to ensure expedient evacuation
from the battlefield.
b. The medical platoon SGT—
1. Ensures that evacuation wheeled assets are maintained and preventive
maintenance checks and services (PMCS) are accomplished in accordance
with standards.
2. Ensures that ambulances are properly stocked with requisite Class VIII
supplies and equipment.
3. Ensures computers and communications equipment are functioning.
4. Keeps the MedCoy updated on road conditions and the threat levels.
5. Maintains prescribed Class VIII supplies on hand.
c. The brigade G4—
1. Is involved in developing the mass casualty plan and the use of nonstandard
vehicles to evacuated casualties.
2. Is responsible for coordinating with graves registration personnel for the
transport of deceased personnel.
3. Provides transportation assets for deceased personnel.
C. Control of Property and Equipment
a. Soldiers evacuated from their unit to the medical facility, as a minimum, have
their protective mask and clothing.
b. Any property and equipment arriving with casualties other than the protective
mask and clothing or individual weapon for ambulatory patients will be collected
and turned in to the brigade G4 for return to the parent unit. The G4 coordinates the
return of property and equipment to the casualty’s unit.
c. Under combat conditions, protective masks are kept in the immediate proximity
of each patient (this included local population if they become a patient, this means
MedCoy will have to provide the mask and or other equipment) throughout their
period of evacuation. In other operations, the protective mask policy for patients
will be based on the CBRN threat and the policy established by higher headquarters.
D. Use of Aeromedical Evacuation.
a. Aeromedical evacuation is the preferred method of evacuation and will be used
when—
1. Life, limb, or eyesight is in jeopardy (URGENT or URGENT-SURGICAL
category). This is not limited to support for GFOR soldiers, but also for the
civilian population.
2. Speed, distance, and time are factors in assuring prompt and adequate
treatment.
3. There is a critical need for resupply of Class VIII supplies or whole
blood/blood products.
4. There is a critical need for movement of medical personnel and
equipment.
5. Civilian patients will be searched prior to each move in the MEDEVAC
system.
V. PRISONERS OF WAR (PW)
A. All PW will be provided medical care according to the articles of the Geneva
Convention for the wounded and sick, dated 12 August 1949.
B. PW patients will be segregated from GFOR personnel.
C. PW patients will be reported through normal medical reporting procedures.
D. Enemy medical personnel are considered retained personnel and shall
receive the benefits provided by the Geneva Conventions. Retained enemy
medical personnel will be used to the maximum extent possible to care and
treat PW patients.
E. PW patients will be under armed guard at all times. Guards are the
responsibility of the echelon commander. Medical personnel will not be
used as guards for PW according to the Geneva Conventions.
F. PW patients will be searched prior to each move in the MEDEVAC system.
VI. CLASS VIII SUPPLY
A. The MedCoy maintains a 2-day (48-hour) stock of Class VIII supplies.
B. Medical supply items authorized for use by the MedCoy are normally those
items that are identified as part of the equipment stock (Annex B, to follow).
Items that are not in this stock must be approved by the brigade surgeon.
This includes both expendable items and pharmaceuticals.
VII. MANAGEMENT OF MASS CASUALTIES
A. Mass casualty situations occur when the number of casualties exceeds the
available medical capability to rapidly treat and evacuate them. The brigade
surgeon working with the G4 and the G3 advises COM MNB S on integrating
all available resources into an effective mass casualty plan.
B. All medical units must have procedures in place to respond effectively to
mass casualty situations. The potential of disasters in war and other
operations requires that the medical element be prepared to support mass
casualty situations. They must be able to receive, triage, treat, and evacuate
large numbers of casualties within a short period of time. Contingency plans
for supporting mass casualty operations must be developed by MNB S. Unit
mass casualty plans, as a minimum, will address the following subject areas:
1. Planning and training requirements.
2. Medical duty positions.
3. Non-medical personnel positions and duties, including litter teams,
perimeter guards crowd control, and information personnel.
4. Location of treatment areas, to include triage, immediate care, minimal
care, delayed care, and expectant care areas.
5. Support requirements beyond the unit’s capability.
IIX. GENEVA CONVENTIONS COMPLIANCE
A. Medical Facilities.
1. All GFOR medical facilities and units will display the distinctive flag of the
Geneva Conventions. This flag consists of a red cross on a white background.
It is displayed over the unit or facility and in other places as necessary to
adequately identify the unit or facility. Non-display of the flag can be
ordered by a brigade or higher level commander.
2. Camouflage of the medical facility (medical units, medical vehicle, and
medical aircraft on the ground) is authorized when a lack of camouflage
might compromise the tactical operation.
B. Defense of Medical Units.
1. Medical personnel may carry small arms for personal defense of
themselves and defense of their patients. Self-defense of medical personnel
or defense by medical personnel of their patients is always permitted. This
does not mean that they may resist capture or otherwise fire on the
advancing enemy. It means that, if civilian or enemy military personnel are
attacking and ignoring the marked medical status of medical personnel,
medical transportation, or the medical unit, the medical personnel may
provide self-protection. If an enemy military force merely seeks to assume
control of a military medical facility or a vehicle for the purpose of
inspection and without firing on it, the facility or vehicle may not resist.
2. All civilian patients will be searched before entering a GFOR medical
vehicle or facility.