MilMed Jan Feb 2007.qxp - SA Military Health Service

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The Human Battle SpaceWritten by Brig Gen P. Oelofse (GOC MMHF) (Dir Ops)Throughout the world there is a legacy with respectto military health services. Often they have onlybeen regarded as, and are therefore managed as,support services. In some militaries the surgeongeneral therefore answers, for example, to the chief oflogistics.In practical terms this often means that, in the planning ofan operation, the military health service is called in as anafterthought. The full role of health in security matters is notalways appreciated and the alignment of effort therefore notoptimised. All stakeholders need to appreciate the fact thathealth matters are actually a war being fought in the internaland external environment of human beings.It is important for a military health service to contextualisehealth care within a military environment, because that iswhere we should be seen and acknowledged as the experts.This is also necessary for our customers; to not onlyunderstand the health care reality, but also to takeownership for the all-important role every member in theorganisation has to play to ensure optimal health.Within the land battle space (army), the air battle space (airForce), the maritime battle space (navy) and the cyber battlespace (all) it is of the utmost importance for a soldier tofocus on the task at hand. The enemy must not only be outfoughtbut must also be out-thought. In the modern openworld of technology, weapons systems are developed fromevery quarter to be of almost similar standards. The cuttingedge, to provide some advantage over the enemy, istherefore no longer so much vested in the hardware of thewar-machine, but in the ability of the soldier to optimallyutilise what is available.Cognitive dominance will be one of the most importantattributes of the modern soldier in order to win the war, notonly the battle. This aspect becomes even more important inthe current wave of asymmetric warfare, where battles arefought within the complex nature of society itself. The relationshipbetween a healthy body and a healthy mind is wellknown and therefore the military health service must strive toensure optimal physical health as well as optimal mentalhealth, towards combat readiness.We do not live in a perfect world and therefore there are amultitude of “enemies” with a total onslaught against thehuman body, the human mind and relationships, renderingthe individual soldier incapable of effectively operating theweapons system designed to win the land, air, maritime orcyber battles against the sovereignty of our country. Withinthis “human battle space” the enemy is as fierce andcunning as you would find in any other battle. On the otherhand the weapons systems to be employed can be veryeffective if optimally utilised. The mentioned battles arefought within the eco-system we inhabit, within ourpopulations and society, within our immediate environmentand within the organs and cells of our bodies. We caneventually, and rightfully so, talk about the enemy within.The challenge is: if we do not win the war in the humanbattle space, we will loose the war in every one of the otheridentified battle spaces!Within the human battle space the enemy has beenidentified:Pathogenic organisms and their vectors (where applicable) -the so-called communicable diseases, dangerous substancesand the abuse thereof.Uncontrolled physical force, or the deliberate malicious andinappropriate utilisation thereof. This includes the enemythreat leading to combat casualties.Harsh climatic conditions and diseases of lifestyle. The socallednon-communicable diseases, malicious humanbehaviour and mental health.Within the human battle space the own forces have beenidentified:Health care providers, stock and equipment, infrastructure,command and control, information, support elements suchas health intelligence, epidemiology and security.The military health service must, within this context prepareits forces, develop and employ its forces. The enemy and itstactics must be analysed and an appropriate counterstrategy developed. An official military health appreciationmust determine the composition of the own forces to beutilised, the operational design, the resources needed andthe theatre of war. An appropriate plan must then beexecuted with dedication and determination.SAMHS members are permanently deployed at staticinfrastructure within the RSA. Our hospitals, sickbays, clinicsand bases are different zones of battle where we perform365/7/24. This is where lasting impressions are formedabout the quality of our service. This is also where we dealwith issues of life and death. From this platform we reachout to support other deployments, be they internal orexternal. A serving SAMHS member is never not at war – forour enemy never sleeps.The SAMHS, and likewise every military health service, isnot merely “another” support service. The impact of healthon security, the complexity of the human battle space andthe reality with respect to the battle at hand, warrant aseparate service with a surgeon general in command over avery real war in a very real battle space. Thundering jets andsilent submarines are no match for infectious diseases whohave killed more humans in the last few decades than all theprevious wars combined.It is understood that the public health fraternity in a countryas well as the private health environment can be seen ascomrades in arms against the identified health-relatedenemy. They can, however, not fight the mentioned warwithin a military environment where wars are simultaneouslyfought in the land battle space, the air battle space, themaritime battle space and the cyber battle space. Themilitary health service is the only force that understands howto fight the health war in a military context. We must beproud of our unique ability and strive to be the best, for thesoldiers of our country deserve the best health care ourcountry can afford.
SAMHSLogistics Master PlanWritten by Brig Gen Herman Wallis (D MH Log)The term “log jam” does not refer to logistics as iscommonly thought, but rather to “a mass offloating logs crowded immovably together” whenthrown into a river with the aim of transportingthese logs downstream. The result of a “log jam” is thatthere is no progress with the flow of the logs downstream.The only way to rectify the immovable crowded logs is toseparate them and to “un-jam” each log or each group oflogs individually to ensure that they progress downstreamwith the flow of the river. The end-state will be that eachindividual log or group of logs reachs its downstreamdestiny as a part of the mass of logs. “Un-jamming” theselogs crowded immovably together in a river will not bewithout pain. Workers that have to “un-jam” the logs will gethurt in the process and individual logs damaged due to theirhandling when they are identified as being obstacles. Thereis no point in getting one worker to “un-jam” the logs.Typically someone will get onto a hill or into a high tree todirect the process of “un-jamming” in order to have aholistic picture of what has to be done by the teams ofworkers who have to do the work in order to ensure therequired progress with “un-jamming” the logs.The SAMHS finds itself confronted with “log jams” in thelogistics environment that have become evident whenanalysing the negative reports received from the AuditorGeneral, the Inspector General and the SANDF StoresInspectors. Emanating from various factors, the logisticsfunctions in the SAMHS have become immovably crowdedtogether, resulting in no or limited progress with the flow ofthe logistics functions towards reaching a common goal. Inorder to “un-jam” this unfavourable situation, each logisticstask or group of tasks had to be analysed in order to decidehow they would have to be “un-jammed” to reach acommon goal. As is the case with “un-jamming” logs, thisprocess will also not be without pain. Individuals who willhave to perform these tasks might become injured ordamaged when they are identified as obstacles preventingprogress. The Director Military Health Logistics is the personwho will be on the hill or in the high tree with the holisticpicture of directing the “un-jamming” of the logistics “jam”in the SAMHS. This mammoth task can, however, not beperformed by the director on the hill, but rather by theworkers on the logs in the river.Logistics consists of many facets, from logistics engineeringto supply, support and services. No defence force canfunction effectively without efficient logistic support. Thevision of the Surgeon General that the SAMHS will be a“world class” military health service will also not beattainable if the logistics function is not also “world class”,since a chain is just as strong as its weakest link.In order to “un-jam” the present “log jam” within thelogistics environment in the SAMHS, a Logistics Master Plan(LMP) was developed wherein a large number of logisticfunctions are addressed. These functions include facilitiesmanagement, information communication technologyinfrastructure, clinical technology improvement, vehicle fleetmanagement, supply, support and services, storesadministration, training of SAMHS logisticians and manymore functions.As a first step in rectifying the logistics “log jam” in the , theGOCs, OCs and RSMs attended a course during the latterhalf of 2006 in order to make them knowledgeableregarding the management of logistics at their appropriatelevels. When considering the negative audit reports againstthe fact that almost four hundred SAMHS logisticiansattended formal logistics training courses during 2006, it isquite evident that what is learnt on formal courses is notapplied in the workplace. It is often said that logisticspolicies are not available. For this reason the policies thatare required at grass roots level have been published on theSAMHS Intranet for ease of reference of all concerned.Other relevant documentation, for example how a logisticsrectification plan is to be constructed and executed hasbeen published on the Intranet.The execution of the SAMHS LMP is the responsibility of allSAMHS members, not only the logisticians that areresponsible for the execution of the logistics function. Takinghands in “un-jamming” the present logistics “log jam” willmake it less painful for all concerned in striving to becomea “world-class” military health service.
Page 1 and 2: VOLUME 23 NO 1 - 2007
Page 3: contentsmilmed@mweb.co.zaRegulars
Page 6 and 7: NEWS CLIPSNEWSNEWS CLIPSNEWS CLIPS
Page 8 and 9: World Aids DayWritten by Dr Dhesi A
Page 10 and 11: efore World AIDS Day - and during t
Page 12 and 13: 12AMHU FS,2 Mil Hosp alsoCommemorat
Page 14 and 15: Written and photographed by Lt John
Page 16 and 17: Written and photographed by Lt John
Page 20 and 21: 20PREGNANCYWritten by Lt Col D. Jac
Page 22 and 23: Can Dogs get Malaria?No, but Biliar
Page 24 and 25: Nursing is a HumanScience and ArtWr
Page 26 and 27: An accomplishedSportsmanArticle and
Page 28: Which would make you happier?Living

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