Marine Expeditionary Force Research Articles

Assessing Corpsmen Training Needs: Enhanced Medical Readiness in the Indo-Pacific for Near Peer.

Naval operations rely on Corpsmen to provide combat casualty and primary care services to the fleet, including the Fleet Marine Force. The United States faces new conflict challenges with near-peer adversaries in the modern geo-political climate. Corpsmen will likely require new skills to care for patients in anti-access/area-denial regions and transport patients across expansive maritime environments. To help them adapt to these new challenges, we evaluated the need for Corpsmen curriculum reform at the III Marine Expeditionary Force (MEF). This model begins with a general needs assessment to target gaps between the current and ideal approaches identified by the stakeholders. We identified 4 primary stakeholders within the Fleet Marine Force community: Marine Commanders (Society), Marines receiving treatment (Patients), Corpsmen providing care (Health Care Workers), and medical providers supervising Corpsmen (Medical Educators). We invited all ranks from III MEF to participate. The participants were interviewed in a mixture of focus groups and individual interviews in conversational and open-ended discussions. Transcripts of these discussions were analyzed and inductively coded using principles of grounded theory to identify prevailing themes that connected across interviews. The study was exempted by the Institutional Review Board at Naval Medical Center San Diego and Headquarters Marine Corps. The study involved 47 participants, including all stakeholders in III MEF and ranks from E1 through general officers. Through interviews and focus groups, 4 key themes emerged regarding Corpsmen's education: "Training," "Tasking," "Performance," and "Impact". "Training" discussions covered formal education, including gaps in basic training and the applicability of skills in civilian settings. "Tasking" examined daily responsibilities and equipment needs, such as teaching roles and first-responder care. "Performance" highlighted the quality of care and challenges in maintaining skills amid non-clinical tasks. Lastly, "Impact" assessed Corpsmen's influence on mission success and job satisfaction, revealing positive and negative perceptions among participants regarding their role and career prospects. The discussion emphasizes the importance of contextual factors in developing a Corpsmen-based curriculum, focusing on themes such as Training, Performance, and Impact. Tasking highlights critical areas for curriculum development, especially in educating Corpsmen as Educators, Leaders, and First-responder Caregivers. Gaps in training were identified, particularly in Non-trauma and First-responder Care, impacting Corpsmen's ability to handle diseases and injuries independently. Drawing parallels with Community Health Worker and Physician Extender (PE) education paradigms, we suggest adapting existing models to meet Corpsmen's needs. The discussion also delves into the history of employing PEs and developing training programs within the Naval Service. We propose a combination of Community Health Worker and PE-based education to enhance Corpsmen's competency and job satisfaction while facilitating their transition to civilian health care. Standardized curricula and training programs could improve skill transferability and readiness for Corpsmen in both military and civilian settings.

COVID-19 Operational Response Cell for the III Marine Expeditionary Force: An Interview With Navy Nurse LT Dana Brackup, NC, USN.

ABSTRACTDuring the coronavirus disease of 2019 (COVID-19) pandemic, overseas military bases faced unique challenges to preserve force health protection while simultaneously caring for military beneficiaries. The response to the rapidly evolving challenges surrounding transmission of the severe acute respiratory syndrome coronavirus 2 in Okinawa, Japan, required innovative solutions. One innovative solution was the COVID-19 Operational Response Cell established at Camp Courtney, Marine Corps Base Camp Smedley D. Butler. This interview describes the COVID-19 Response Cell operations and essential lessons learned by a Navy Nurse Corps officer working with III Marine Expeditionary Force, a forward-deployed force in the U.S. Indo-Pacific Command.

Naval Integration: An Old Approach for a New Era

Current debates on naval integration mostly focus on whether the naval Services’ warfighting concepts are on target—the why of naval integration—or whether integration efforts are jeopardizing the Marine Corps’ ability to fulfill longstanding roles and missions. An underappreciated aspect of this topic is the process, or the how, of naval integration. The actions of the U.S. Navy and Marine Corps during the interwar period are a positive example of naval integration and indicative of the long-term effects that can follow. Many current developments, in particular the growing partnership of the Marine Expeditionary Force (MEF) and fleet commands, are examples of effective naval integration and will help ensure that the Services arrive at the proper end state.

A Moment of Silence to Honor our Heroes Both Dead and Living

Here are nearly 50,000 reasons for me to keep the needs of our service members closest to my heart and on the front burner in my mind as well as front and center in the public square. One of the heroes who gave his life is Staff SGT James M. Malachowski, USMC. He was 25 when he died in the Helmand Province, Afghanistan. He was in 2nd BN, 8th Mar. Regiment, II Marine Div. II Marine Expeditionary force, based in Camp Lejeune, NC. I picked his name out of the list of heroes because I have two powerful links to the II Marines and Camp Lejeune. 1. I am father of USMC Officer who saw action in the Al Anbar Province when the II Mar Div. took over this totally broken down region. (2006-2007) and 2. The Spearhead Insignia which was a shoulder patch when it was introduced during action in Pacific theater relates very well to the Surname of our family namely Velandy which is a Tamil word meaning bearer of the Spear. The Hindu deity who is referred to as Velandy is revered especially in South India and Sri Lanka. This deity is both a scholar and warrior who like Pericles lead the forces of Good to a great triumph over the forces of evil. I could hardly contain myself and felt extremely gratified when I fully appreciated this link between our Surname Velandy- the Spear bearer and the Spear head Symbol of the II Marine Division. This Division stabilized the once deadly and desperately chaotic region of Iraq- the vast badlands of the Al. Anbar province a couple of years ago and handed over control to the Iraqis.

Routine TBI screening following combat deployments

A precise estimate of the rates of traumatic brain injury (TBI) in returning combat troops is difficult to establish given the challenges of screening large numbers of military personnel returning from combat deployments. The Brief Traumatic Brain Injury Screen (BTBIS) was implemented in the First Marine Expeditionary Force between 2004 and 2006. Nine percent of the 7909 marines who completed the BTBIS were considered having a positive screen; that is, they endorsed at least one injury mechanism and indicated a change in mental status at the time of injury. The majority of combat-related TBI's were due to multiple injury agents with the next largest group related to blast exposure only. Most importantly, of those who screened positive for TBI 70.5% (n=500) were first identified by the screen. Service members who endorsed items on the BTBIS were contacted for follow-up assessment of persistent symptoms related to TBI and clinical referrals were made as needed. Given the rate of positive TBI screens in this non-referred sample of military personnel returning from a combat deployment, routine TBI screening appears valuable in screening individuals who might not be identified otherwise. Furthermore, this study appears to refute the contention that routine TBI screening will result in an over-identification of TBI in this population.

Invasion vs Insurgency

The transition from maneuver warfare to insurgency warfare has changed the mechanism and severity of combat wounds treated by US Marine Corps forward surgical units in Iraq. Case series comparison. Forward Resuscitative Surgical System units in Iraq. Three hundred thirty-eight casualties treated during the invasion of Iraq in 2003 (Operation Iraqi Freedom I [OIF I]) and 895 casualties treated between March 2004 and February 2005 (OIF II). Definitive and damage control procedures for acute combat casualties. Mechanism of injury, procedures performed, time to presentation, and killed in action (KIA) and died of wounds (DOW) rates. More major injuries occurred per patient (2.4 vs 1.6) during OIF II. There were more casualties with fragment wounds (61% vs 48%; P = .03) and a trend toward fewer gunshot wounds (33% vs 43%; P = .15) during OIF II. More damage control laparotomies (P = .04) and more soft tissue debridements (P < .001) were performed during OIF II. The median time to presentation for critically injured US casualties during OIF I and OIF II were 30 and 59 minutes, respectively. The KIA rate increased from 13.5% to 20.2% and the DOW rate increased from 0.88% to 5.5% for US personnel in the First Marine Expeditionary Force area of responsibility. The transition from maneuver to insurgency warfare has changed the type and severity of casualties treated by US Marine Corps forward surgical units in Iraq. Improvised explosive devices, severity and number of injuries per casualty, longer transport times, and higher KIA and DOW rates represent major differences between periods. Further data collection is necessary to determine the association between transport times and mortality rates.

Combined Support Force 536: Operation Unified Assistance

The coordinated and combined use of military and civilian resources in response to large-scale natural disasters have not been frequent or well documented. Historically, the overall efficacy and successes of such endeavors are mixed. The benefits of early decisive military leadership, time-phased implementation of resources, a stratified assistance program, and a working relationship is illustrated during the tragic Asian tsunami disaster of 2004 to 2005. The tasking of III Marine Expeditionary Force and my experience as Joint Task Force Surgeon suggest deliberate civil-military planning is beneficial and can significantly reduce human suffering.

Evaluation of a USMC combat service support logistics concept

One of the primary responsibilities of a Marine Corps Combat Service Support Element (CSSE) is to provide water, fuel, and ammunition requirements for the primary task forces and other Marine Expeditionary Force elements. This paper evaluates a proposed concepts on how to best use the CSSE resources of a Force Service Support Group (FSSG) to transport supplies to Regimental Combat Teams over constrained networks with time constraints. A model was developed that optimizes the use of resources, assets, and network routes. The model first solves a capacitated vehicle routing problem, where a set of customers has to be served by a fleet of vehicles within a certain time. The stochastic aspects of the problem were modeled through the use of a discrete event simulation that uses the results of the optimization model. The optimization model goes beyond the traditional routing problem by accounting for special features such as vehicle capacity for each commodity and cargo incompatibility (e.g. fuel and ammunition).

Transformation: Let's Get it Right this Time

The lessons of Task Force Hawk and Kosovo have rung loudly in the halls of Congress and the Pentagon. However, the immense difficulty the US Army faced in deploying a capable, warfighting force to northern Albania is only symptomatic of a much larger problem that the Army has grappled with for several decades: how to develop a force light enough to get where it is needed quickly and yet lethal enough to win when it gets there. Task Force Hawk was just the most recent manifestation of this problem, demonstrating yet again that the Army is still far from a solution. In response, General Eric Shinseki, the Army's Chief of Staff, has launched the Army on a path to transform itself into a deployable force fully capable of meeting the national strategic challenges of this new century. This is a path the Army has trod before. Unfortunately, it is strewn with dashed hopes and lost opportunities, victims of the landmines of the Army's own institutional nature. As George Santayana wrote, Those who do not remember the past are condemned to relive it. This article, then, is a cautionary tale; its purpose is to relate the story of the Army's effort to transform itself in the 1980s in the hope that the current generation of transformers will learn to avoid these landmines by studying the failures--and successes--of their predecessors. Saudi Arabia, 1990 When the United States responded to the Iraqi invasion of Kuwait in the summer of 1990, US forces faced the prospect of a major military defeat. Had Saddam Hussein continued to attack south, there was the very real possibility of a disaster unmatched since the lightly armed troops of Task Force Smith had been brutally overrun by North Korean armor in the opening episode of our involvement in the Korean War. At the beginning of the Gulf War, American soldiers and the success of our overall Mideast policy were placed in grave danger, not only by Saddam Hussein but also by an Army decisionmaking process that years earlier had deprived the United States of air-deployable forces capable of defeating heavy armor on Middle Eastern terrain. When President Bush drew his famous in the sand to thwart the potential advance of Iraqi forces into Saudi Arabia, the line was held for several weeks by only the lightly armed and relatively immobile 82d Airborne Division and a Marine Expeditionary Force. The airborne division--even backed by considerable air power--was no match for the heavy Iraqi armored forces poised north of the Saudi border. Had Saddam Hussein elected to invade Saudi Arabia, this light infantry force--the only type of Army force that could be rapidly deployed by air--might have been quickly overrun. This force imbalance created an extremely dangerous of that closed only when reinforcing heavy forces arrived by sea several weeks later. Until the arrival of the Army's heavy force, the deployed ground units were left to hope that Baghdad would be deterred by the possible adverse implications of directly attacking American forces. It's worth repeating: we hoped they would be deterred. Although this wishful det errence worked in this instance, as former Army Chief of Staff Gordon Sullivan is fond of saying, Hope is not a method. Few if any of the paratroopers anxiously scanning the northern sky for the telltale dust columns of Iraqi armor advancing south knew that this window of vulnerability could have been avoided. For years the Army had been preparing to field a high-technology light division that combined the air deployability of a light infantry division with the firepower and mobility of a heavy division. It was also intentionally designed to fight heavy armored forces in the Middle East. Unfortunately, this division disappeared completely from the Army force structure in 1989, only a year before it was critically needed. Why did this happen? An analysis of the internal Army decisionmaking involved provides a few answers--and perhaps hope of avoiding past mistakes. …

Applying a bootstrap approach for setting reorder points in military supply systems

This paper develops and applies a nonparametric bootstrap methodology for setting inventory reorder points and a simple inequality for identifying existing reorder points that are unreasonably high. We demonstrate that an empirically based bootstrap method is both feasible and calculable for large inventories by applying it to the 1st Marine Expeditionary Force General Account, an inventory consisting of $20–30 million of stock for 10–20,000 different types of items. Further, we show that the bootstrap methodology works significantly better than the existing methodology based on mean days of supply. In fact, we demonstrate performance equivalent to the existing system with a reduced inventory at one-half to one-third the cost; conversely, we demonstrate significant improvement in fill rates and other inventory performance measures for an inventory of the same cost. © 2000 John Wiley & Sons, Inc. Naval Research Logistics 47: 459–478, 2000

Words at war: Reflections of a marine public affairs officer in the Persian Gulf

This article covers my personal experiences in dealing with the media and the military during my stay in Saudi Arabia from August 17, 1990 to April 9, 1991. The first four months I was assigned to the Joint Information Bureau (JIB) in Dhahran, Saudi Arabia. The remaining time I was assigned to I Marine Expeditionary Force (MEF). This will not be a comprehensive review nor an academic article. Instead, this will cover some of the pertinent issues which had to be addressed by the military and the media; a look at some insights into how the two institutions operated during the build-up and the war; and a presentation of incidents involving media-military relationships. When addressing the issue of news media coverage of military operations (i.e., combat) the ultimate goal for all parties should be not to allow personalities to dominate over principles. And the underlying principle should be that the American people must be kept informed of how their soldiers, sailors, airmen, and Marines are doing. That is the bottom line upon which I believe the military and media agree. The disagreement is over how this will be accomplished within security and safety restraints. Yet so greedy are the people at large for war news, that it is doubtful whether any army commander can exclude all reporters, without bringing down on himself a clamor that may imperil his own safety. Time and moderation must bring a just solution to this modern difficulty.1

The rapid deployment digital satellite network

The ground mobile forces (GMF) satellite digital multichannel radio, which provided the US Marine Corps with the primary transmission links for its switched backbone during Operations Desert Shield and Desert Storm, is discussed. Reliable and highly mobile, the multichannel terminals provided clear and consistent digital pipelines for the Marine Corps circuit switched network and were rapidly deployed on military HWMMV vehicles. The GMF multichannel radios use the defense satellite communication system (DSCS) II and III super-high-frequency (SHF) wideband satellites as retransmission platforms enabling them to be operated theater-wide with no limit on transmission link distance. The deployment and installation of GMF assets in support of the 1st Marine Expeditionary Force during Desert Shield/Desert Storm, including the minimization of outage time due to Sun passage through the radio beam, are described. >

Mexico, the United States, and the 1926–1927 Nicaraguan Crisis

V VICTORY over Spain in 1898 provided the United States with the opportunity pursue the various options that imperial status now offered. Indeed, under the influence of the strategic precepts of an Alfred Thayer Mahan, the messianic expansionism of a Josiah Strong, the extended frontier concept of a Frederick Jackson Turner, and the now seemingly obtainable economic aspirations of a James G. Blaine, North Americans looked their newly established imperial arena with anticipation and confidence. It would be the adjacent circum-Caribbean region, for the most part, where the United States government would attempt create the appropriate climate for the attainment of its strategic, economic, and altruistic goals. Acquisition of the Canal Zone in 1903 served in particular focus U.S. attention on the isthmus. Accordingly, whenever revolutionary violence erupted in Central America, the United States government invariably took vigorous action ensure the survival of governments and factions which were supportive of North American interests. Such action was even more energetic and precipitous if U.S. officials perceived an external threat their interests in the region. In reviewing the pattern of inter-American affairs during the early twentieth century, the relationship between the United States and Nicaragua stands out as one of the most instructive examples of the sustained efforts on the part of U. S. policy makers promote an isthmian Pax Americana. At no time was this commitment more evident than during the mid-192os when Nicaraguan civil strife, exacerbated, in the estimation of Washington, by the intrusion of foreign material as well as ideological forces, prompted the United States government mount a major military intervention on the isthmus. It was in late December 1926 when the first elements of a marine expeditionary force landed on Nicaragua's Atlantic coast. Initial newspaper accounts indicated that the U. S. forces were needed to protect American and foreign lives and property threatened as a result of the ongoing con-