Despite a decade of battle, Afghan security forces remain poorly equipped to care for their wounded, according to a Pentagon report that provides the latest stark warning about the American withdrawal from that war-torn country.
The Defense Department inspector general found that while the Afghan Air Force has made some significant strides in medical evacuations from the battlefield, there are major gaps in the ability to care for the Afghan National Police (ANP) who are the front lines of daily security and the frequent target of bombings and shootings.
The report, released late Friday on the eve of America’s Memorial Day celebration of its own veterans, faults U.S. advisers for not focusing more on the care of Afghan security forces as U.S troops begin their pullout.
“We found that U.S. and Coalition plans and advisory efforts were not consistently focused on developing the ANP medical capability to provide effective point-of-injury and en route care for combat casualties,” the inspector general reported. “Additionally, we found that medical advisory resources were not sufficient or, in some cases, not skilled and trained to aid in the development of ANP medical capability.”
With a resurgent Taliban and al-Qaeda in Afghanistan, the frequency of surprise attacks, car bombings and insider shooting has taken a toll on the national police forces.
But the Pentagon investigators found that the ANP did not have sufficient medics, nor the necessary medical equipment and supplies, to properly care for injured police personnel. Furthermore, ANP ambulances were not stocked with necessary equipment and supplies and not properly utilized to transport casualties to the next level of trauma care.
The report painted a picture of Afghan security forces often unprepared for medical care on the chaotic, front lines of war.
ANP personnel were unable to render effective point-of-injury care to wounded colleagues because the majority of personnel did not have first aid kits or access to vital medical equipment like tourniquets and pressure dressings, the report said.
Although training was provided not all designated ANP staff attended the training and lacked the skills to treat wounds on the battlefield.
In addition, the report noted that there were not enough trained pharmacists to effectively supply medications for patients at hospitals and that ANP facilities often lacked the resources required to treat patients, thus forcing them to transfer to outside facilities, the investigators warned.
According to the report, the ANP hospital, a 74-bed facility, had increased capacity to 161 beds in September 2013 without any increase in medical personnel.
Furthermore, the ANP Office of the Surgeon General requires further assistance to provide effective oversight of medical activities within the Ministry of the Interior, according to the report.
The Inspector General did commend the Afghan Air Force for its progress in developing casualty evacuation programs and improved relations among Government of the Islamic Republic of Afghanistan organizations, which have had a positive effect on healthcare developments.
The inspector general recommended that responsible offices within the Pentagon ensure that sufficient medical personnel, including pharmacists, are hired and trained to carry out proper emergency medical care and that supplies and equipment be provided.
Management agreed with all but one of the Inspector’s recommendations. Investigators suggested implementing an additional eight-week training course for ANP medics if needed. But defense officials argued that there is already a lack of commitment by Afghan forces to sending staff to the lengthy training.
“There is little confidence that changing the course will improve AND attendance. We suggest that the first priority is to get ANP leaders to commit to send their medics to [trauma assistance personnel training] and then keep them as medics,” Colonel Steven Merkel, NATO Training-Mission-Afghanistan Chief of Staff, wrote in an official response.
The Inspector General noted that while management agreed to make improvements and follow the investigators’ recommendations, they did not lay out specific plan designs for improvement and wrote that further comments are required.