Summer - United States Special Operations Command

Bart Iddins, MDBrig Gen (S), USAFCommand SurgeonThis article continues with the discussion ofAFSOC Surgeon’s priorities and focuses on Priority 4:Develop an AFSOC healthcare engagement strategy andcapability that supports counterinsurgency (COIN), irregularwarfare (IW), foreign internal defense (FID), security,stability, transition, reconstruction (SSTR),disaster response, and humanitarian operations (seeJSOM, Winter 2009 for complete priority list; JSOM’sSpring 2009 edition for detailed review of Priorities 1through 3).As evidenced by the lessons of history, the contemporaryconflicts in Iraq and Afghanistan, and fromsituations such as those now unfolding in Pakistan, it isclear that the United States of America must maintain arobust and viable capability for conducting COIN, IW,SSTR, disaster response, and humanitarian operations.If, despite the aforementioned examples, one is still unconvincedof this absolute requirement, one only needsto examine Brookings Institution’s Index of State Weaknessin the Developing World. This index factors economic,political, security, social welfare, and per capitagross national income (GNI) data from 141 states intoan overall weakness score of 0.00 (worst) to 10.00(best). According to this methodology, the five weakeststates are Somalia, Afghanistan, Democratic Republicof the Congo, Iraq, and Burundi. Furthermore, 56 of the141 states are listed in the bottom two quintiles and areat significant risk for unrest, instability, and potentialcollapse.Failed states are unequivocally not in the nationalinterest of the United States, nor in the national interestof any other developed nation. While the previousstatement is intuitively obvious, its solution is more elusive,but illustrates the absolute requirement for forcesthat can effectively apply “soft power with a hard edge.”This description by Admiral Eric Olson regarding one ofthe many capabilities SOF contributes to national defensealso perfectly highlights an underutilized SOF medicalcapability. While SOF medical forces serve in traditionalsupportive and enabling roles, they can equally deliver anunrivaled form of “soft power with a hard edge” in supportof COIN, IW, FID, and SSTR operations. Additionally,senior leadership, as demonstrated by the followingquotes, recognizes and espouses the imperative to embraceand deliver “soft power with a hard edge.”“The Nation is at war…whether our contributionis in irregular warfare in Iraq andAfghanistan, the fight to save lives through humanitarianrelief operations, or deterrence and dissuasionof potential adversaries, the Air F o rc eis a key contributor to the national defenseof America.”USAF Chief of Staff, General Norton Schwartz, 2008“…the kinds of [security] challenges Americawill face…from global terrorism to ethnic conflictscannot be overcome by traditional militarymeans alone. Conflict will be…political in natureand will require the integration of all elementsof national power.”“These new realities…should be reflected inour training and doctrine. The Air Force willbe…called on to conduct civil-military or humanitarianoperations with interagency andnon-governmental partners, and deal directlywith local populations.”Secretary of Defense Robert Gates, AWC speech, 200888Journal of Special Operations Medicine Volume 9, Edition 3 / Summer 09