Military Review English Edition May-June 2014 | Page 58

Medical Operations in Counterinsurgency Joining the Fight Maj. David S. Kauvar, M.D., U.S. Army; Maj. Tucker A. Drury, M.D., U.S. Air Force C OUNTERINSURGENCY (COIN) CAMPAIGNS generally emphasize nonlethal means more than conventional engagements, but medical units at the battalion and brigade level are deployed in COIN theaters according to conventional doctrine dictating a focus on caring for combat casualties. U.S. military forces have no medical doctrine specific to COIN, and expeditionary health support operations are not mentioned in conventional COIN doctrine. When combat units have primarily engaged primarily in COIN operations in Iraq and Afghanistan, the disconnect between conventional medical support doctrine and operational conditions has resulted in significant underuse of medical assets, particularly at forward surgical teams assigned at the brigade level.1 Maj. David S. Kauvar, M.D., is a vascular surgeon and the chief of surgical research at Dwight D. Eisenhower Army Medical Center and an associate professor of surgery at the Uniformed Services University of the Health Sciences. He commanded the Tarin Kowt Forward Surgical Element as a member of the Combined Joint Special Operations Task Force-Afghanistan in 2012 and served as a combat support hospital surgeon in Baghdad in 2008-2009. Maj. Tucker A. Drury, M.D., is the orthopedic clinic chief at Joint Base Elmendorf Richardson in Alaska. He received his orthopedic surgery training at the University of Vermont. He commanded the Tarin Kowt Forward Surgical Element as a member of the Combined Joint Special Operations Task Force-Afghanistan in 2011-2012. (Maj. David S. Kauvar)