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Aeromedical evacuation technician with 651 st Expeditionary Aeromedical Evacuation Squadron checks on Afghan man in critical but stable condition for transport, Forward Operating Base Tarin Kowt, Afghanistan (U.S. Air Force/Greg Biondo) flicts, but the lessons are forgotten afterward and have to be relearned again during the next war, thus repeating the cycle. The Walker Dip can be traced from the American Civil War through every U.S. conflict since, including Iraq and Afghanistan. The author hopes this discussion will help the U.S. military health system avoid the Walker Dip and thanks Dr. Walker for his inspiration. 2 Brian J. Eastridge et al., “Death on the Battlefield (2001–2011): Implications for the Future of Combat Casualty Care,” Journal of Trauma and Acute Care Surgery 73, no. 6, Supplement 5 (December 2012), S431–S437; Joseph F. Kelly et al., “Injury Severity and Causes of Death from Operation Iraqi Freedom and Operation Enduring Freedom: 2003–2004 Versus 2006,” Journal of Trauma and Acute Care Surgery 64, no. 2 (February 2008), S21– S26; discussion S27. 3 Robert L. Mabry and Robert A. De Lorenzo, “Improving Role I Battlefield Casualty Care from Point of Injury to Surgery,” Army Medical Department Journal (April–June 2011), 87–91. 4 Frank K. Butler, Jr., John Hagmann, and E. George Butler, “Tactical Combat Casualty Care in Special Operations,” Military Medicine 161, no. 1, Supplement 1 (August 1996), 3–16. 5 John B. Holcomb et al., “Understanding Combat Casualty Care Statistics,” Journal of Trauma and Acute Care Surgery 60, no. 2 (February 2006), 397–401. 6 Ibid. 7 Eastridge et al. 8 Brian J. Eastridge et al., “We Don’t Know What We Don’t Know: Prehospital Data in Combat Casualty Care,” Army Medical Department Journal (April-June 2011), 11–14. 9 Russ S. Kotwal et al., “Eliminating Preventable Death on the Battlefield,” Archives of Surgery 146, no. 12 (August 2011), 1350–1358. 10 Author correspondence with Dr. Elon Glassberg, Head of Trauma and Combat Casualty Care Branch, Israel Defense Forces, August 20, 2013. 11 Robert L. Mabry et al., “Impact of Critical Care-trained Flight Paramedics on Casualty Survival during Helicopter Evacuation in the Current War in Afghanistan,” Journal of Trauma and Acute Care Surgery 73, no. 2, Supplement 1 (August 2012), S32–S37. 12 R.F. Bellamy, “The Causes of Death in Conventional Land Warfare: Implications for Combat Casualty Care Research,” Military Medicine 149, no. 2 (February 1984), 55–62. 13 Melony E. Sorbero et al., Improving the Deployment of Army Health Care Professionals: An Evaluation of PROFIS (Santa Monica, CA: RAND, 2013). 14 Kotwal et al. 15 Robert T. Gerhardt et al., “Out-of-Hospital Combat Casualty Care in the Current War in Iraq,” Annals of Emergency Medicine 53, no. 2 (February 2009), 169–174. 16 Mabry et al. 17 Sorbero et al. 18 Robert A. DeLorenzo, “Improving Combat Casualty Care and Field Medicine: Focus on the Military Medic,” Military Medicine 162, no. 4 (1997), 268272. 19 Robert A. DeLorenzo, “How Shall We Train?” Military Medicine 170, no. 10 (2005), 824–830. 84 Features / Improving Casualty Survivability on the Battlefield JFQ <strong>76</strong>, 1 st Quarter 2015
Public health officers releasing P. reticulata fry into artificial lake in Lago Norte district of Brasília as part of a vector control effort (Fábio Rodrigues Pozzebom/Agência Brasil) Mosquitoes A Viable 21 st -Century Soft Power Tool By Mary Raum and Kathleen J. McDonald Militaries and soft power have been interlinked since Alexander the Great began assisting the populations his armies conquered by rebuilding infrastructures and distributing food and first aid. Humane gestures by armies were considered important to winning loyalties. During the Napoleonic wars, military altruism had become customary enough to be included in soldiers’ military science studies. Napoleon viewed humanitarian assistance as a form of philanthropy that helped change civil social order among those populations his troops defeated on the European continent. Over time, Mary Raum is a Professor of National Security Affairs at the U.S. Naval War College and is currently Chair for the Women, Peace, and Security Series. Commander Kathleen J. McDonald, MC, USN, is a Cardiothoracic Anesthesiologist in the U.S. Navy Medical Corps. She is currently serving as Inspector of the Naval Medical Inspector General Office in the Bureau of Medicine and Surgery. measures of humanitarian aid have shifted as the sizes, types, and durations of conflicts have changed. Military roles now involve functioning as relief agents, participating as surplus disposal entities for old or outdated materials and machines, acting as international peacekeeping forces or as liberators, and delivering organized and rapid natural disaster relief. The latest addition to these scenarios is the performance of long-term humanitarian roles in peaceful settings with nations that may have a future potential value as allies. 1 JFQ <strong>76</strong>, 1 st Quarter 2015 Raum and McDonald 85
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