Maj. Elizabeth Vinson feeds 1-year-old Malala
as her mother, Zainab, watches. A
partnership between Salerno Hospital, an
Army field hospital in Afghanistan, and the
local ministry of health has transformed the
tent hospital into a virtual pediatric intensive
care unit. Under the program, patients whose
cases are too complicated for local doctors
can get care from U.S. military medics
assigned to Salerno. Hospital officials were
shocked when, one day before she was to be
discharged, Malala died.

Anita Powell / S&S
Picture And Story From Stars and Stripes
The War in Afghanistan (2001–present) refers to the intervention by NATO and allied forces in the ongoing Afghan civil war. The
war followed the terrorist attacks of September 11, 2001, in an effort to dismantle al-Qaeda and eliminate its safe haven by
removing the Taliban from power.

U.S. President George W. Bush demanded that the Taliban hand over Osama bin Laden and expel al-Qaeda. The Taliban
requested that bin Laden leave the country, but declined to extradite him without evidence of his involvement in the 9/11 attacks.
The United States refused to negotiate and launched Operation Enduring Freedom on 7 October 2001 with the United Kingdom.
The two were later joined by other forces, include the Northern Alliance. The U.S. and allies drove the Taliban from power and
built military bases near major cities across the country. Most al-Qaeda and Taliban were not captured, escaping to neighboring
Pakistan or retreating to rural or remote mountainous regions.

In December 2001, the United Nations Security Council established the International Security Assistance Force (ISAF), to oversee
security in the country and train Afghan National Security Forces. At the Bonn Conference in December 2001, Hamid Karzai was
selected to head the Afghan Interim Administration, which after a 2002 loya jirga in Kabul became the Afghan Transitional
Administration. In the popular elections of 2004, Karzai was elected president of the country, now named the Islamic Republic of
Afghanistan.

In 2003, NATO assumed leadership of ISAF, with troops from 43 countries. NATO members provided the core of the force.One
portion of U.S. forces in Afghanistan operated under NATO command; the rest remained under direct American command.
Taliban leader Mullah Omar reorganized the movement and in 2003 launched an insurgency against the government and ISAF.

Though vastly outgunned and outnumbered, the Taliban insurgents, most notably the Haqqani Network and Hezb-e-Islami
Gulbuddin, have waged asymmetric warfare with guerilla raids and ambushes in the countryside, suicide attacks against urban
targets and turncoat killings against coalition forces. The Taliban exploited weaknesses in the Afghan government, among the
most corrupt in the world, to reassert influence across rural areas of southern and eastern Afghanistan. ISAF responded in 2006
by increasing troops for counterinsurgency operations to "clear and hold" villages and "nation building" projects to "win hearts
and minds".

While ISAF continued to battle the Taliban insurgency, fighting crossed into neighboring North-West Pakistan. In 2004, the
Pakistani Army began to clash with local tribes hosting al-Qaeda and Taliban militants. The U.S. military launched drone attacks
in Pakistan to kill insurgnet leaders. This resulted in the start of an insurgency in Waziristan in 2007.

On 2 May 2011, U.S. Navy SEALs killed Osama bin Laden in Abbotabad, Pakistan. About three weeks later, NATO leaders
endorsed an exit strategy for withdrawing their forces. UN-backed peace talks began between the Afghan government and the
Taliban.[32] As of 2013, tens of thousands of people had been killed in the war, mostly militants and civilians. In addition, over
4,000 ISAF soldiers and civilian contractors as well as over 10,000 Afghan National Security Forces had been killed.

Information Taken From Wikipedia:
http://en.wikipedia.org/wiki/War_in_Afghanistan_(2001%E2%80%93present)
The U.S / Afghanistan War




By Janet Boivin, RN
Thursday December 3, 2009
has been hard. Just lask week a medic I trained was my patient, and another medic I knew was shot in the head and died. I need some
time to reflect and be with my family.” — Michelle Racicot, Aug. 16, 2009

Army Capt. Michelle A. Racicot, RN, was sent to Afghanistan this past spring, shortly after newly elected President Barack Obama decided
to send 21,000 more troops there to quell a resurging Taliban. She was sent to two forward operating bases to set up small, mobile
surgical teams referred to in military terminology as an FST (forward surgical team).

An FST is a group of specially trained nurses, doctors, and medics who can operate on wounded soldiers closer to the frontline, stabilize
them, and then transfer them to a battlefield hospital for further care.

The FST Racicot set up at FOB Ghazni was part of Secretary of Defense Robert Gates’ new mandate that there be an FST with medical
evacuation capabilities in each province in Afghanistan so that every wounded soldier, Marine, and airman would receive advanced trauma
life support within an hour of being injured, as they do in Iraq. Gates said he knew that with an influx of service members, and a tough,
tenacious enemy, there would be an increase in deaths and injuries among U.S. and coalition troops.

His prediction was correct. As of Oct. 23, there have been more U.S. military deaths in 2009 — 253 — than in any year since the U.S. went
into Afghanistan in 2001, according to www.icasualties.org/OEF/. There were 155 U.S. deaths last year and 117 in 2007. August proved the
deadliest month so far with 77 U.S. deaths. There were 70 deaths in September.

“I know that we save a lot of lives,” Racicot wrote in an e-mail Aug. 23. “And our FST is known for our skill so if in flight [medevac team
members] have issues with patients crashing on them, they will stop and have us evaluate them in emergencies. I also know that having
our FST here enables patients to be seen and do damage-control surgery. We can save lives of soldiers who would die if they had not
stopped for care at our FST first.”

FOB Ghazni is in eastern Afghanistan, not in the southern part of the country in Helmand Province where the heaviest fighting takes place.
But heavy fighting occurs near Ghazni, as well, it’s “just not reported,” Racicot said in her e-mails. The violence, she added, increased
leading up to the national Afhghan elections this summer.

“We had a badly injured soldier the other day. He was in a convoy and his MRAP [mine-resistant, ambush protected] vehicle was hit with so
much C4 [plastic explosive] that the force of the explosion caused a degloving of his sacrum and shattered his coccyx,” Racicot wrote. “He
was in severe spinal shock. We had him on Epi and Vasopressin. After we transferred him to BAF [field hospital in Batgram], I went to the
showers and cried. I think it is time for me to have a break, but then I feel like I need to stay and care for our soldiers.”

Racicot returned to the U.S. on Sept. 6. She is now assigned to Brooke Army Medical Center in San Antonio.

Racicot is only one of the many nurses, physicians, medics, and corpsmen who have accompanied the thousands of additional service
members heading to small outposts in Afghanistan. These highly trained medical teams are as important to the fight as the
counterinsurgency tactics that soldiers and Marines will use against the Taliban, said Col. Susz Clark, RN, the second in command of the
Army Nurse Corps and the former top Army nurse in Iraq.

“Combat healthcare is proving to be an important ‘weapon system’ in its own right,” says Clark, deputy chief of the ANC and, from 2007 to
2009, chief, clinical operations/deputy commander for nursing, TF 62 Med, Baghdad.

Although it may seem incongruous to describe medical care as a weapon, Clark explaind that the medical units caring for the wounded in
the counterinsurgencies in Iraq and Afghanistan need to be as flexible, agile, quick, and adaptive as combat troops in these unpredictable
environments. (For more about Clark’s concept for a new, smaller, and more mobile medical unit, see sidebar).

Based on her experiences in Iraq during the 2007 surge when thousands of additional troops were dispersed to small outposts in Iraqi
villages, Clark learned medical units needed to be even smaller and more adaptable, she said in a phone interview with Nurse.com.

When Racicot arrived in Afghanistan this past spring, she was asked to set up a fully functioning FST in less than three weeks with minimal
supplies, equipment, and personnel. The team had less than half of the 20 personnel that usually comprise an FST.

She also had to integrate, assess, and train a Polish medical team also located at FOB Ghazni. “Integrating the Polish team with our team
proved to be a work in progress,” she wrote. “With each trauma and a resulting after-action report, we have improved our trauma process.”

Many times the wounded who are transported to a U.S. medical unit are not American or coalition soldiers. Instead they are Afghan men,
women, and children, who have been hit by rocket propelled grenades, improvised explosive devices or land mines, as Racicot learned.

“I had an interesting moment one day when I was filling out an application for a master’s degree program. One question asked, ‘Briefly
describe your experience working with cultures other than your own.’ Before I could type my response, I was asked to fly with the medevac
team to evaluate three pediatric patients hit with shrapnel from a rocket propelled grenade. We flew to a remote FOB, and I was greeted by
one of the Polish medics who attended my classes.

“One of the children had an eviscerated bowel and was having shortness of breath and nausea. While I was covering his wounds and
drawing up medication to give him, he would not let me let go of his hand. I later learned that he did not survive. It was a reminder that even
with all we can offer with medicine and surgery, sometimes it isn’t enough.”

Janet Boivin, RN, is a senior staff writer for Nursing Spectrum and NurseWeek magazines.


Front Lines Streamlined

One of the Army Nurse Corps’ two top nurses has proposed that a new combat unit called a medical capability team be created to better
meet the needs of a counterinsurgency war environment and “to transform front-line care”.

In an article in the U.S. Army Medical Department Journal last year, Col. Susz Clark, RN, deputy chief of the ANC and former top nurse in
Iraq from 2007 to 2008, says medical units must be as swift and adaptable as the soldiers and Marines who are being sent to smaller
villages and outposts in Afghanistan and who are the targets of rocket-propelled grenades, improvised explosive devices, and landmines.

MCTs would at a minimum consist of an emergency medicine nurse, emergency medicine physician, and a specially trained medic. Care
would be organized around patient-care problem sets such as resuscitative, surgical, intensive, and acute care. Healthcare professionals
would be assigned to an MCT, preferably at the start of their careers, and then would train and deploy with the team throughout their
careers.

More healthcare personnel could be added to the MCT to provide additional types of care or accomodate increased patient capacity
depending on the needs of the combat unit to which the MCT would be attached, Clark told Nurse.com in a phone interview. For example, a
unit might be tasked to a combat support hospital, an area support medical company, or a forward surgical team.

Combat medical care was dramatically reorganized after Operation Desert Shield/Desert Storm when the Army, Air Force, Navy, and
Marines all realized the military needed smaller, more mobile units that could provide resucitative and surgical care closer to the frontlines.
The well-known MASH units of World War II gave way to combat support hospitals and forward surgical teams that brought nurses,
physicians, and medics closer and more quickly to the front lines than ever before.

Training for an MCT would be more team oriented than the training that currently exists for military medical units. “There is a need for better
preparation of health professionals in teamwork,” Clark wrote in her article. “Many studies have identified teamwork as a requirement for
high-quality, safe care.”

Although team-delivered healthcare is found in Army military facilities, current combat care is different in that many of the teams do not meet
or work with each other until they deploy into the combat zone, Clark says. The MCT would be a small, interdependent group of
professionals who regularly work and train together, optimally from the start of their careers, in order to develop into highly proficient
specialized medical teams that can provide combat healthcare to specific groups of patients immediately upon arrival into a combat zone,
she adds.

But based on Clark’s experiences in Iraq during the 2007 surge when thousands of additional troops were dispersed to Iraqi villages, she
learned medical units needed to be even smaller and more adaptable than they are.

“In a counterinsurgency environment, such as Iraq or Afghanistan, medial care must occur ‘curbside to combat’ for the wounded to optimize
care delivery and prevent degradations in combat operations,” she says.
Click On Nurse Logo To Visit Website
Pictures Of Nurses In Afghanistan
Click On Bagram Airfield Logo To Visit
The severe trauma platoon nurse with the Female (Courtesy Photo)
Click On SCRUBS Logo To Visit
Department said.
killed in Sunday's blast in the Zhari District of Kandahar Province were Sgt. Patrick C. Hawkins, 25 of Carlisle, Pa.; Sgt. Joseph M.
Peters, 24, of Springfield, Mo.; and Pfc. Cody J. Patterson, 24, of Philomath, Ore.

All four service members were killed by an improvised explosive device while conducting combat operations in Kandahar
Province, Afghanistan.
Army officials said 1st Lt. Moreno was on her first deployment to Afghanistan.
She was born June 25, 1988, in San Diego, Calif. After graduating from San Diego High School, she was commissioned in the U.
S. Army as a Nurse Corps officer after graduating from the University of San Francisco with a bachelor of science degree in
nursing.  Moreno completed the U.S. Army Airborne Course 2009 at Fort Benning, Ga., and the Army Medical Department Officer
Basic Course 2010 at Fort Sam Houston, Texas.
Moreno was then assigned to Madigan Army Medical Center, Joint Base Lewis-McChord, Wash., where she served as a clinical
staff nurse on a medical surgical unit. She volunteered and was successfully assessed and selected into the U. S. Army Special
Operations Command Cultural Support Team program and deployed in June 2013.

“Our unit mourns the loss of 1st Lt. Jennifer Moreno,” said Lt. Col. Patrick J. Ellis, Commander of 3rd Battalion, 75th Ranger
Regiment. “She was a talented member of our team who lost her life while serving her country in one of the most dangerous
environments in the world.

"Her bravery and self-sacrifice were in keeping with the highest traditions of the 75th Ranger Regiment. She was making a
difference in Afghanistan and that legacy will live on. The Moreno family is in our thoughts and prayers.”

Moreno's awards and decorations include the:  
Parachutist Badge, Army Achievement Medal, National Defense Service Medal,
Global War on Terror Service Medal
and Army Service Ribbon.
1st Lt. Moreno was posthumously awarded the:  
Combat Action Badge, Bronze Star Medal, Meritorious Service Medal, Purple
Heart, Afghanistan Campaign Medal, and NATO Medal.

She is survived by her mother, Marie V. Cordero, and her sisters Jearaldy Moreno and Yaritza Cordova of San Diego, Calif., and
her brother, Ivan F. Moreno, currently serving in the U.S. Army.
Click On Logo To Visit Nurses "In Memoriam"
Song Is "Revolution" By The Beatles

Sitting in a Fort Collins coffee shop Thursday, the two listed different organizations designed to help
wounded veterans.  The Honor Group gave Hallett an all-terrain wheelchair he can eventually use on hunting
trips. American Strong, based in California, took him to a truck race once, where he got to ride in one of the
vehicles. Sit Means Sit has been helping the couple train their service dog, Cash. And Homes for Our Troops
is working on building them a house on a Windsor plot donated by developer Martin Lind, who runs Water
Valley Land Co.
“The military and veteran community I feel isn’t really as strong here as it was in San Diego (where Hallett
rehabbed his injuries),” said MacVean, 21, who is her fiancé’s full-time caregiver. “It’s weird coming from
there, where there were so many amputees and veterans, to here, where it’s very rare to find someone his
age who he can relate to.”
That’s why the couple makes a point of getting out into the community and supporting nonprofits that benefit
veterans. They wear T-shirts advertising organizations and attend different events or volunteer days.
“Maybe if there are any amputees around here who don’t know of any resources, we can help them find
some,” MacVean said.  Both MacVean and Hallett grew up in Fort Collins, where they went to school together
at Ridgeview Classical Schools. They first started dating in the eighth grade.
“He used to tease me all the time, you know, like flirting,” MacVean said. “And he would steal my backpack,
and we would pass notes a lot in class. Teachers would have to separate us.”
But, because MacVean’s family thought she was too young to date, her father told Hallett to come back in five
years when he had achieved his dream of joining the military, and her family would give him a second
chance.
The two separated. MacVean went to a different school; Hallett moved out of state. He graduated from Job
Corps and enlisted in the Marines when he was 17.
“Sure enough, five years later, he was injured; and then after he fully recovered, he added me on Facebook,
and we just hit it off,” MacVean said.

After his injury in October 2010, Hallett spent months in and out of an intensive care unit in Bethesda, Md.,
and eventually ended up in San Diego, where he went through rehabilitation.
“I’d look at her picture and I’d think about (messaging her) and then I’d wait and say, ‘No, not yet,’ and then
last summer, I thought it was time so I added her (on Facebook), and she messaged me,” Hallett said.

MacVean flew out to visit Hallett in San Diego a couple of weeks later.
“At first, it was weird to get used to (his injuries) in my mind, but once I saw him, it wasn’t even a big deal,”
Mac-Vean said. “When you see him, you just notice the person and who he is on the inside. He’s still that
same kid from eighth grade.”
MacVean eventually moved out to San Diego to be with Hallett. Months later, surrounded by her family on
Thanksgiving, Hallett proposed.
“Since I didn’t have my legs, I got down on my stumps,” Hallett said.
“And I was sobbing,” MacVean added.

After getting engaged, the two decided they wanted to raise their family in Colorado so they moved back to
Fort Collins in December 2013. Their wedding will be in Estes Park on June 14 — their one-year anniversary.
“It’s very encouraging and inspiring,” said Hallett’s grandmother, Kathy Paris. “Their love is true; it’s a very
genuine love, and when you’re with them, it’s just enlightening.”
Paris said the first thing you see when you look at Hallett is always the smile on his face and, even when he
was just in the beginning stages of dealing with his injuries back in 2010, he stayed positive and always
said he was “good,” no matter what.
“It’s like he didn’t even miss a beat; he just kept going,” Paris said.

As his grandmother, Paris said she was afraid Hallett would worry about being able to find someone after
becoming an amputee.
“I just wanted him to know that God had a plan for him,” Paris said. “And when Rachel came into his life and
they reunited, she was his angel. She can do no wrong in my eyes. She’s just a pure, sincere woman.”

As far as them wanting to help others in similar situations, Paris said it just goes to show you what kind of
people they both are.
“They’re not closing a chapter on anything, they’re opening a book on how they can help other people,” Paris
said. “It’s a blessing and privilege to be in their lives,” she added.


This was sent to me by a friend and Rachel MacVean is the daughter of a friend of hers.
Permission To Use This Story Was Approved By My Friend That Sent Me This. All Of My Web Pages Are Copy
Righted ©.
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Mission Accomplished on Jan. 31, 2015
Jason Hallett

Marine Corporal Jason Hallett was one month into his first deployment when he sustained the
traumatic amputation of both legs and his right arm, and extensive injuries to his left hand when
he stepped on an improvised explosive device (IED) in Sangin, Afghanistan on Oct. 23, 2010.

While clearing a compound as part of the 3rd Battalion, 5th Marines, Cpl Hallett and his squad
had cleared three IED’s from the area when a fourth IED was detonated by a single step.
Thrown through the air, Cpl Hallett was dug out of the rubble by his teammates who
immediately began treating his severe injuries.

Read More About Jason and His Wife, Rachael, and How They Accomplished Their Mission.


https://www.hfotusa.org/hallett/
Compliments Of  NURSE Magazine