Science in Action: Meeting Urgent Field Requirements through Science and Technology on the Ground in Iraq

Chapter 18 Science in Action: Meeting Urgent Field Requirements through Science and Technology on the Ground in Iraq Matthew G. Clark The uniformed Services currently identify capability requirements using a deliberate process that is ineffective in emergency situations. Similarly, operational needs statements take time to validate and even more time to fund and address. The Army Materiel Command/ Research Development and Engineering Command Field Assistance in Science in Technology (AMC/RDECOM FAST) Team and the Rapid Equipping Force lead efforts that capture and address current and urgent requirements on the fluid battlefield. Since early 2005, these programs have been augmented by personnel from the U.S. Army Medical Command (USAMEDCOM), who work with operational units to identify capability gaps for both current and future operations and provide commanders with immediate access to the development centers within the RDECOM and USAMEDCOM. As a result, potential technology solutions can be tested by the warfighter, and performance in the field can be evaluated for immediate and long-term effectiveness. Uniformed Army research psychologists have served on these AMC/RDE- COM FAST teams and have enabled significant equipment programs such as the armored ambulance initiative. Uniformed Army research psychologists serve in roles that span the spectrum of military operations, from the more traditional fields of psychological and biological laboratory and field research, to operational assessments and systems acquisition. In addition to their field of expertise, many Army medical and scientific research officers can also be acquisition professionals. One nonstandard acquisition assignment opportunity for research psychologists and other Army Medical Department (AMEDD) officers involves identifying urgent warfighter requirements for full-spectrum operations as part of the four-man AMC/RDE- COM FAST team in Iraq. 413

414 THE 71F ADVANTAGE Background: Requirements Process Limitations during War Generally, addressing warfighter capability requirements in the Department of Defense (DOD) involves three key components: the requirements process, the acquisition process, and the budgeting and funding process. Previously referred to as the requirements generation and identification process, the requirements process now focuses on the broader capability needs of all Services and is called the Joint Capabilities Integration and Development System (JCIDS). Per the Chairman of the Joint Chiefs of Staff Instruction 3170.01F (2007): The JCIDS process was created to support the statutory requirements of the JROC [Joint Requirements Oversight Council] to validate and prioritize joint warfighting requirements. JCIDS is also a key supporting process for DOD acquisition and PPBE [Planning, Programming, Budgeting, and Execution] processes. The primary objective of the JCIDS process is to ensure that the joint warfighter receives the capabilities required to successfully execute the missions assigned to them. The current JCIDS process was initiated in 2003 and updated in December 2008 to overcome shortfalls in joint Service capability integration, as required by the JROC. An outgrowth of the Goldwater-Nichols Department of Defense Reorganization Act of 1986, the JCIDS is a top-down process in which joint capability requirements (that is, military needs) evolve through a lengthy and deliberate developmental process. Through JCIDS, equipment and capability requirements are validated. With a validated capability requirement, Services can acquire systems to address the specific need. Accordingly, the chosen system is funded and budgeted until the item is removed from the military inventory. The JCIDS is contrasted against the previous requirements generation system, in which Service-unique requirements were captured and developed in Service-specific silos. In the old system, joint interoperability and shared utility were an afterthought at best. In total, JCIDS, the acquisition system, and the PPBE processes are intended to effectively control resources to maximize capability development across and between the Services in DOD. However, as highlighted in a December 2006 article in Defense AT&L, Recent reporting has also brought to light the United States deficiencies in getting innovative solutions to our warfighters rapidly enough to adjust to the changing tactics and techniques of our enemies (Buhrkuhl, 2006). Simply put, the DOD acquisition and budget systems

MEETING URGENT FIELD REQUIREMENTS THROUGH SCIENCE AND TECHNOLOGY 415 and JCIDS are not agile enough to respond to the demands of war when rapid adaptation is required on the battlefield. A change in emphasis from maneuver warfare to full-spectrum operations (as defined by Army Field Manual 3 0, Operations), and specifically the security, stability, transition, and reconstruction missions in Iraq and Afghanistan, revealed significant shortfalls in doctrine, training, and equipment across the Army. Therefore, the Army needed a means to identify and address current shortfalls and unforeseen capability gaps on a fluid battlefield because the capabilities identification and acquisition systems were incapable of meeting the need. Out of necessity, the U.S. Army and DOD developed and continue to employ various approaches to identify and address critical shortfalls for current military operations. Some of these approaches included the Rapid Equipping Force, the Joint Improvised Explosive Device Defeat Organization, the Asymmetric Warfare Group, the Army Asymmetric Warfare Office, and the AMC/RDECOM FAST team, to name just a few. FAST Teams in the Iraqi Theater and Need for AMEDD Input The broader FAST Activity started in 1985 to bring Army Materiel Command Laboratories and Research, Development and Engineering Centers into closer contact with their customers the major Army commands throughout the world (<www.rdecom-fast.army.mil/ about_fast.htm>). Regarding Operation Iraqi Freedom wartime efforts, the first three-member AMC/RDECOM FAST teams, also called Science and Technology Assistance Teams, deployed in 2003. These teams comprised an acquisition corps major or lieutenant colonel (officer in charge), a government civilian scientist or engineer, and a senior noncommissioned officer (staff sergeant to sergeant major). The team was an extension of the RDECOM in AMC. Initially, during the 4-month rotations (extended to 6 months in 2007) they focused largely on issues related to weapons, vehicles, and various other unit, individual, and force protection systems. In 2005, the AMC FAST Headquarters recognized their inability to address requests for new medical capabilities related to the reality on the ground. To meet the growing need, they invited the USAMED- COM and the U.S. Army Medical Research and Materiel Development Command (USAMRMC) to participate in their battlefield rotations.

416 THE 71F ADVANTAGE Accordingly, the science and technology assistance teams were expanded to include an AMEDD officer (captain, major, or lieutenant colonel). As is often the case with new initiatives, the initial rotations that included a medical professional produced mixed results. Sometimes they were well received as a value-added additional staff member across various levels of command, from combat battalions through the Multi- National Corps Iraq (MNCI) and Multi-National Force Iraq (MNFI). Occasionally, however, the officer was viewed with skepticism or resistance in the theater as medical and nonmedical leaders learned and tested the capabilities and limitations of the program. Early FAST successes involving the AMEDD were primarily medical-specific shortfalls such as the need for hypothermia management in combat casualties. This was addressed particularly for those evacuated with truncal or abdominal insult or recently controlled hemorrhage via air medical evacuation (MEDEVAC). This large-scale effort led to broad employment of the hypothermia management kit (North American Rescue Products, Inc., Greenville, SC) in both medical and nonmedical vehicles and settings. These are now used in Humvees, Mine Resistant Ambush Protected (MRAP) vehicles, and with combat, engineer, and explosive ordnance disposal teams. The early FAST teams also assisted by addressing numerous requests for information and leading fielding and feedback efforts on the Improved First Aid Kit. Notably, these teams assisted with initial efforts in the evaluation, deployment, and even developmental feedback of body cooling and ventilation systems, golden hour blood shipment containers, and even new and novel tactical communication headsets with active noise reduction for hearing protection. These efforts were urgently required because of the unique nature of irregular combat, and the need for improved Soldier effectiveness and health in desert and urban environments. More relevant to the traditional role of medical researchers, these efforts also contributed to the long-term health and immediate safety of American Soldiers fighting in an extreme and atypical environment. In early 2006, the medical FAST effort started to build momentum by tackling military medical and materiel issues that required a coordinated AMEDD and AMC effort. One of the major efforts was the analysis of personal protective equipment (PPE). This effort required the shared resources and skills of operationally minded medical, research, acquisition, and materiel development professionals.

MEETING URGENT FIELD REQUIREMENTS THROUGH SCIENCE AND TECHNOLOGY 417 These professionals included the AMEDD and AMC FAST team on the ground in Iraq and various individuals from the USAMRMC, RDE- COM, and Program Executive Offices (for example, PEO Soldier) under the Assistant Secretary of the Army for Acquisition, Logistics, and Technology (ASA[ALT]). The PPE project began as a proof of concept conducted by the AMC/RDECOM FAST team where PPE was collected from Soldiers who were wounded or killed in action. Following a combat incident, the FAST team collected Interceptor Body Armor and Advanced Combat Helmets. The equipment was then shipped to PEO Soldier in the United States for analysis. The PPE study included an analysis of operational data from each combat incident co-analyzed with casualty medical data. Effectively, this was the first effort to combine operational information with medical and materiel analyses to help develop the next generation of protective equipment and improve tactics, techniques, and procedures (TTPs) as quickly as possible. This fusion analysis approach, which included the examination of operational, intelligence, medical, and materiel data, eventually developed into the Joint Trauma Analysis for the Prevention of Injury in Combat program. This program is now progressing toward becoming an enduring capability for support to combat operations, materiel developers, and the military intelligence community. After the first three rotations, the USAMRMC prepared a selection process to ensure that the AMEDD provided the most qualified officers for the team. Besides the appropriate rank, command support, and letters of recommendation, the team s only eligibility requirement was completion of the Captain s Career Course. Other career experiences that improved selection for this opportunity included field or deployment experience, certification as a Defense Acquisition Workforce Professional, completion of the Combat Casualty Care Course, and possession of the Expert Field Medical Badge. My FAST Team Experience and the Armored MEDEVAC Challenge In 2006, the first officer selected and deployed through the USAMRMC process was a research psychologist. The FAST mission in Iraq at that time was four-fold: to provide expert technical advice and support to commanders and staff in the theater of combat operations

418 THE 71F ADVANTAGE to query Operation Iraqi Freedom units on science and technology gaps at the user level for both combat and stability and support operations to provide operational commanders immediate access to the development centers within the RDECOM and USAMED- COM to expedite technology solutions to the warfighter and act as an RDECOM/AMEDD forward element to evaluate and integrate solutions. As the research psychologist who was selected for this team, I used a fusion analysis approach similar to that used in the PPE analysis to address various issues including a countersniper effort, burn mitigation, and the need for armored ground MEDEVAC on the rapidly adaptive battlefield. While changes in materiel systems did not occur immediately, TTPs were altered and rapid battlefield feedback and education to warfighters were completed without delay. During this rotation, the FAST team tackled the need for improved ground medical evacuation, arguably the most challenging issue to date because it spanned various sectors of the Army and had to counter widely held and incorrect beliefs and assumptions. Like the PPE analysis, the issues required the shared resources of the AMEDD and AMC FAST team on the ground in Iraq, with the support of stateside activities. Various individuals from the USAMRMC, the U.S. Army Medical Materiel Development Activity (USAMMDA), the AMEDD Center and Schools Directorate of Combat and Doctrine Development (DCDD), and Program Management shops (for example, PM Light Tactical Vehicle) under ASA(ALT) were involved in providing this immediate warfighter need. In the summer of 2006, the heightened threat and record use of improvised explosive devices (IEDs) created several significant challenges for medical care in the austere environment of urban Iraq and Afghanistan. Most notably, the prevalence of IEDs, rocket-propelled grenades, and certain small arms resulted in restrictions that kept all unarmored vehicles to forward operating bases, particularly in Iraq. As reported in January 2007, this restriction applied to all unarmored Humvees, including M996 and M997 ambulances (McDonnell, 2008). Medical support units were severely impacted by the restriction because a comprehensive patient evacuation and medical treatment plan must

MEETING URGENT FIELD REQUIREMENTS THROUGH SCIENCE AND TECHNOLOGY 419 include effective ground and air MEDEVAC (FM 8 10 6, Medical Evacuation in a Theater of Operations, 2000). Addressing this particular issue required the presence of the FAST team, which could evaluate and address shortfalls across all levels of command, from the company through MNCI and MNFI levels. This issue also required rapid collection, organization, and analysis of data from a highly adaptive and seemingly disjointed battlefield. The data included information about combat incidents, the type, number, and method of threats, the TTPs and equipment used, the method and time of evacuation needed, and the outcomes for Soldiers involved. In total, the data set that had to be synthesized was not simply maintained in one location in a usable or readily accessible fashion. Instead, the data was diffuse and variously collected across several levels of command and staff. One of the key contributions of having a research psychologist on the team was the capability to address the lack of a defined data source. With my research background, I brought methodological integrity, knowledge, and a broader understanding of the analysis of a poorly defined but clearly evident problem. Additionally, the collective efforts of the FAST team identified related needs and provided potential solutions. Addressing the ground MEDEVAC issue required clear and open communication with development centers in the United States. Data was collected from various command, control, communications, computers, intelligence, surveillance, and reconnaissance systems. It was also drawn from Soldiers and Marines on the ground and from generic patient information collected by various staff surgeons for units including MNCI and the Joint Theater Trauma Registry. The analysis required a clear understanding of doctrinal and current medical and combat operations and required support from new, nondoctrinal units like the Combined Joint Task Force, which addressed asymmetric threat and IED defeat issues. The first challenge was that no data had been collected, collated, or analyzed regarding the requirement and magnitude of the ground MEDEVAC problem. Once collected, an initial assessment and discussions with the commander of the 30 th Medical Brigade revealed that the first approach had to be the development of nonstandard vehicles for casualty evacuation (CASEVAC) use. Usually conducted by nonmedical personnel, CASEVAC is the movement of casualties in a combat zone without en route medical care to an initial treatment

420 THE 71F ADVANTAGE location or facility (FM 8 10 6, Medical Evacuation in a Theater of Operations, 2000). This was the most expeditious way to start to address the problem because CASEVAC provided at least some form of armored ground evacuation in an environment with zero ground MEDEVAC capacity due to the threat and a potentially limited air MEDEVAC capability. Stateside, the USAMMDA and DCDD began working on CASE- VAC conversion kits for all up-armored Humvees, an issue that eventually became a reality in late 2007 to early 2008. In theater, we designed two CASEVAC configurations for the Rhino Runner armored buses and prepared rapid conversion kits with the 134 th Medical Company (Ground Ambulance) that could be used in a mass casualty situation. This CASEVAC alternative allowed these buses to be used to evacuate from 5 to 12 litter patients or from 1 to 23 ambulatory patients. However, there were a very limited number of these vehicles, they did not travel on combat missions, and they could only be used in a catastrophic mass casualty situation. These vehicles were designed and employed to keep Servicemembers, government workers, and contractors somewhat safe as they traversed the battlefield between bases much like a very small public transit system. Due to the availability, developing a CASEVAC configuration for the Rhino Runner would only serve as a potential Band-Aid for the greater need that might only be available for the worst cases. As the use and effectiveness of IEDs expanded to record levels, combatant commanders and staff throughout the Iraqi theater of operations began to acknowledge the magnitude of the ground MEDEVAC shortfall. After initially working with a brigade combat team and brigade support battalion commander from the 10 th Mountain Division in the Baghdad area, various division and corps leaders and medical advisors started to realize and accept that air MEDEVAC could not address all urgent evacuation situations. This was particularly true for some urban areas. The need was clearly evident and growing when a resourceful combat medic cut a hole in the back blast wall of his up-armored Humvee to accommodate a casualty as a CASEVAC vehicle (Powell, 2006). In support of the definition of MEDEVAC from Medical Evacuation in a Theater of Operations (FM 8 10 6, 2000), the simple reality was that a timely means of moving patients with en route care by medics on medically equipped vehicles was needed both to enhance casualties potential for recovery and to reduce the potential for long-term disability.

MEETING URGENT FIELD REQUIREMENTS THROUGH SCIENCE AND TECHNOLOGY 421 An armored wheeled ground MEDEVAC vehicle (that is, an armored ambulance) was badly needed. Unfortunately, the misunderstanding of the MEDEVAC problem was perpetuated by poor communication across the combat theater. Incorrect information existed at all levels of command and even within the stateside military medical community. They believed that the problem was already being addressed and that a solution was on its way. To gather the facts on the issue, the FAST team constantly communicated with PEO and PM shops in the United States. The team learned that the reason that M996 and M997 Humvee ambulances were not available was because it was not technologically possible to up-armor these specific vehicles. That is, the solution many believed was already in production could not be implemented because these vehicles could not support the weight of armor in an ambulance configuration along with the weight of all personnel and related equipment. Despite repeated efforts to communicate this reality, a widespread misunderstanding of the situation made it very difficult to address the issue within the Army. Adding to the state of affairs, the MEDEVAC problem was viewed as unique to Army units. This incorrect and widely held belief limited the possibility of any joint Service request because all joint requests had to address an inherently joint problem that involved other Services (for example, the Marines). Despite the FAST team s work with Soldiers and Marines at the MNCI and MNFI levels, U.S. Central Command (USCENTCOM) did not understand the situation until the end of 2006. Eventually, with the support of the MNFI Surgeon, the late Colonel Brian Allgood, I presented the issue at the USCENTCOM Surgeon s conference in November 2006, which educated and energized the appropriate levels of leadership across the military Services. The result was that the Navy surgeon representing the Marine Corps Central Command and surgeons and staff covering the USCENTCOM area of responsibility finally understood the full nature of the situation. This realization, along with the help of Frank Van Syckle, a key science and technology advisor in USCENTCOM headquarters, led to the identification of and required support for a joint immediate warfighter need request for armored ambulances. As the AMEDD FAST representative on the ground, I collected the data, analyzed the issue, and then wrote the urgent requirement request that was initiated with an MNCI endorsement and forwarded to the Joint Staff through USCENTCOM. When we returned

422 THE 71F ADVANTAGE stateside at the end of 2006, I worked through USCENTCOM, the Joint Staff, and up to the Joint Rapid Acquisition Cell and Office of the Deputy Secretary of Defense to procure funding approval for the first 16 heavy armored ground ambulances (HAGA) for Soldiers and Marines in Iraq and Afghanistan. This modest request was approved by the Deputy Secretary of Defense in May 2007. However, delivery of the urgent request for 16 vehicles was only the beginning of addressing a much larger requirement. Accordingly, in a follow-on appointment I served as one of the primary subject matter experts in the design of the HAGA and MRAP ambulance along with representatives from the AMEDD DCDD and USAMMDA. The development and production of the vehicles was achieved through work with the Marine Corps Systems Command and the MRAP Joint Program Office. The vehicle that met the identified need was produced by BAE Systems. By the end of 2008, nearly 700 armored ambulances were fielded for use in current operations. Progress on a materiel solution to the armored ambulance requirement had been stalled prior to fall 2006. Therefore, the recognition and fielding of this urgent warfighter requirement was a major success for the AMEDD. Even with increased interest in armored vehicles and the larger MRAP effort that developed at the beginning of 2007, an armored ambulance was not included as one of the first vehicles until the FAST team entered the process. This success required the skills of personnel who could rapidly collect, analyze, and merge data from diverse levels of command, locations, and sources. It required personnel who could think strategically, yet understand the people and processes so that they could coordinate action and move between tactical and operational levels through a highly convoluted, constantly changing bureaucratic process. Lastly, the number of ambulances and the seemingly low density of the requirement meant that its success was dependent on personnel who could speak across levels of combat leadership, champion the effort through to the highest levels of the Department of Defense, conduct and translate the analysis of data employed, and communicate the strategic and psychological impact of medical support to American forces. Collectively, these qualities were key in accelerating the timeline to make armored ambulances a reality. These are also qualities required for success as an Army research psychologist.

MEETING URGENT FIELD REQUIREMENTS THROUGH SCIENCE AND TECHNOLOGY 423 Summary: Uniformed Army Research Psychologists in Combat Operations It is important to understand the value that this assignment provided to both research psychologists and the Army. First, the FAST position provided scientific and acquisition officers the opportunity to work in an area that is immediately relevant to current operations, instead of the more traditional roles of researching post-traumatic stress disorder, battle stress, and mild traumatic brain injury. It also allowed research psychologists to work on medical integration across functional areas, branches, and Services, thereby expanding medical lessons learned and improving the understanding of medical research shortfalls. This understanding will enhance future medical research and development. Similarly, several research psychologists have completed research on medical, chemical, and biological defense issues as is presented in other chapters in this publication. They have knowledge and expertise that can serve as a force multiplier on the current battlefield for current operations. While serving on the FAST team, I served on the MNCI Corps Chemical Officer s chemical, biological, radiological, nuclear, and explosive working group. Thus, a medical chemical defense researcher was able to impact and assist current chemical defense issues in real time. The combatant command benefited from relevant and timely research expertise on urgent and unexpected events. In short, research psychologists were immediately relevant to the current fight rather than just future or investment operations through research and development. Additionally, the Army and the research psychology specialty shared the advantage of applying the core acquisition abilities of a highly skilled and motivated workforce to some of the more challenging analytical and operational challenges facing combat and military medical operations. This is particularly apparent because the FAST assignment was accomplished one-on-one with Soldiers and Marines from the level of combat and the battalion aid station, through combat support hospitals, or even through the combatant command, Department of the Army, and joint levels of command. Thus, the core research and acquisition capabilities were applied and extended to the benefit of both the Army and the individual. Groups like the FAST team provide the Army immediate relevance and utilization of research and analytical subject matter experts for current operations. This flexibility of assignments raises questions about the future role and placement of research psychologists across the

424 THE 71F ADVANTAGE Army. A full mission analysis of the requirements for this specialty in full-spectrum operations will likely lead to the conclusion that research psychologists can and should play a greater role in defense acquisition, both medical and nonmedical research and development, and military intelligence analysis and fusion. This conclusion may be particularly compelling when considering irregular and asymmetric warfare, and it is amplified by the recent placement of a research psychologist in the Army Asymmetric Warfare Office of the Army Operations Center (under the Deputy Chief of Staff for Operations, Headquarters Department of the Army G-3/5/7). While a full consideration of the future assignments for this specialty is beyond the scope of this article, the success of research psychologists in the field illustrates the need for a comprehensive evaluation of their role, particularly for positions outside of the USAMEDCOM. In conclusion, research psychologists serve in various assignments that include roles as acquisition and analytical professionals. They must continue to be prepared to meet general medical, Army, or even joint requirements as a commissioned officer of the United States. Uniformed research psychologists of all backgrounds must be prepared to modify, develop, create, and execute efforts outside more traditional assignments in laboratories. The success of research psychologists in various relevant, nontraditional assignments like the AMC/RDECOM FAST team in Iraq underscores the potential future role this specialty can play across the U.S. Army. These accomplishments clearly show that the analytical and leadership skills of research psychologists are useful well beyond the medical research realm. References Buhrkuhl, R.L. (2006, November/December). When the warfighter needs it now. Defense AT&L, 28 31. Joint Chiefs of Staff. (2007). Chairman of the Joint Chiefs of Staff instruction 3170.01F. Washington, DC: U.S. Government Printing Office. McDonnell, J.J. (2007). Instilling innovation in Iraq. Army Logistician, 39. Powell, A. (2006, July 27). Medics humvee design not much of a stretch. Stars and Stripes, Mideast Edition. RDECOM FAST. (n.d.) About FAST. Retrieved December 8, 2008, from <www.rdecom-fast. army.mil/about_fast.htm>. U.S. Army. (2008). Field Manual 3 0, Operations. Washington, DC: Headquarters Department of the Army. U.S. Army. (2000). Field Manual 8 10 6, Medical operations in a theater of operations. Washington, DC: Headquarters Department of the Army.