Military Review English Edition July-August 2015 | Page 82

the Forward Resuscitative Surgical System from the
Special-Purpose Marine Air-Ground Task Force to
provide Level II care.8 MV-22 Osprey aircraft from the
same force provided on-call casualty evacuation.
Externally, the JFC rapidly leveraged Navy and
Army capabilities to provide six mobile labs that could
test for Ebola. Given the paucity of infrastructure in
Liberia, it had been taking four to five days for a care
provider to get lab results confirming a case of Ebola.
The mobile labs allowed for Ebola determination in
three to four hours, which significantly changed the
rate of detection and, therefore, of containment. These
labs’ geographic disbursement provided both direct and
regional support to ETUs.
In addition to the labs, the JFC established a fiveday training program for Ebola care providers focused
on the disciplined donning and doffing of personal
protective equipment as well as the clinical assessment
of patients. This instruction occurred in a fixed facility
in Monrovia and elsewhere through mobile training
teams. This training leveraged DOD’s ability to provide
a clinically agile and disciplined force able to effectively
train a detailed process. Given Ebola’s high mortality
rate and the lack of advanced medical treatment, many
NGOs had left Liberia, and many Liberian health-care
workers were on strike. The Monrovia Medical Unit
was established to assure all national and international Ebola responders that care was available to them.
Assured access to care at this facility was the most
common request from partnering militaries before
providing their personnel to support the Ebola fight.
Sustainment. Sustainment efforts focused on enabling medical and engineering tasks and establishing the
expeditionary infrastructure needed to sustain the flow
of personnel and equipment. Sustainment challenges inherent to operating in Africa include vast distances over
a generally inadequate transportation infrastructure.
The initial planning guidance only directed the delivery
of 2,500 cots, but it rapidly expanded to include directing extensive construction efforts for ETUs, establishing
training programs, and delivering supplies across Liberia
in the rainy season. Force flow and sustainment quickly
became a balancing act between throughput capacity in
Monrovia and the forces required to increase that capacity to enable the mission.
Our experience on the continent enabled us to
leverage joint logistic capabilities that most operational
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Army headquarters do not regularly exercise, such as
those provided by the Defense Logistics Agency, Air
Mobility Command, Surface Deployment Distribution
Command, and U.S. Transportation Command. Prior
to the mission transition on 25 October 2014, the JFC
moved almost seven hundred U.S. service members
to the region. This team designed and constructed the
Monrovia Medical Unit, mobile labs, and a medical
training facility. It fulfilled nineteen taskings from the
USAID mission tasking matrix, delivered 106 tents and
4,400 cots, established air and seaports of debarkation
in Liberia and Senegal, established an intermediate
staging base in Senegal, and executed ninety-four contracts valued at more than $57 million.

Beyond the Lines of Effort
In addition to C2, engineering, medical, and
sustainment, the JFC also worked to build relationships with partners. The previously established role of
USARAF as a trusted and respected partner in both
the interagency context and the international context
(on the African continent) was critical to the JFC’s
success. These efforts were supported by robust strategic communications. They set the conditions for a successful transition with the 101st Airborne Division.
Relationships played a key role in enabling rapid
synchronization with the Armed Forces of Liberia
and the U.S. embassy team to set the theater and
shape the security environment. Worki