Advising and assisting an Iraqi army medical clinic: Observations of a U.S. military support mission

Medical civil-military operations are important for deployed military medical units engaged in counterinsurgency missions. There are few reports on military support for a host nation's military medical infrastructure, and we describe an initiative of the 21st Combat Support Hospital in 2010 during the postsurge phase of Operation Iraqi Freedom and Operation New Dawn. The goal was to incrementally improve the quality of care provided by Iraqi 7th Army medical personnel using existing clinic infrastructure and a low budget. Direct bedside teaching to include screening and treatment of ambulatory patients (sick call), focused pharmacy and medical supply system support, medical records documentation, and basic infection control compliance were the objectives. Lessons learned include the requirement to implement culturally relevant changes, maintain focus on system processes, and maximize education and mentorship through multiple modalities. In summary, a combat hospital can successfully implement an advise and assist mission with minimal external resources.