Features

6

Commentary. U.S. Air Force Chief of Staff 

Gen. John P. Jumper raises the fitness bar and 

announces new PT standards for 2004.

A Balancing Act. DoD officials say rebalancing of 

Reserve Component resources will help reduce 

multiple mobilizations.

Don’t Be Afraid. Air Force technical sergeant 

finds facing a medical evaluation board not 

to be a career ending affair.

All In The Family. One National Guard 

family from North Carolina serves together 

in the desert.

An End Of An Era. The Air Force C-9A Nightingale retirement signals a new era in aeromedical 

evacuations.

Tracking Patients. DoD makes plans to implement a new medical human resources system 

via the Internet in 2005.

2003

8

fall

Vital Research. Mosquitoes are bred weekly

for research to improve repellents, drugs and vaccines at the Walter Reed Army Institute 

of Research in Maryland.

Ditch the Dip. DoD officials challenge current 

and new users of tobacco products to kick the 

habit for good.

News from Around the World 3 

Rumsfeld Outlines Plan For Replacing Troops In Iraq. 

Deployed Troops Get Break On School Loans.

Guard, Reserve Job Center Opens In Virginia.

Ask Our Doctors 5

Information For Returning Troops Inquiring About Donating Blood. 

Vaccines, Drugs & Herbs 5

SERPACWA Makes Debut On Battlefield In 2003.

Gulf War Update 9

Study Finds Increased Frequency of ALS

In Gulf War Vets.

Health Beat 17

Make Flu Protection Your Top Priority.

Resource Guide 20

On the Cover

7

In Every Issue

U.S. Army photo by Staff Sgt. Davis

U.S. soldiers from “Renegade” Platoon, Bravo Company, 

2/8th Infantry attached to 1/67th Armor Battalion located in 

Baqubah, Iraq, patrol a street during a raid of a local village of Diyala 

Province, Iraq. The 2/8th Infantry and 1/67th Armor Battalions are 

part of the 2nd Brigade Combat Team, 4th Infantry Division.

Al Faw, Iraq (Oct. 16, 2003) -- A lone 

Marine assigned to Expeditionary Strike 

Group One (ESG-1) keeps watch on 

supplies while fellow Marines and sailors 

distribute water to the people of Al Faw, 

Iraq. Water distribution is one of several 

humanitarian operations being provided 

by ESG-1 in the Al Faw Peninsula during 

Operation Sweeney. 

U.S. Navy photo by 

Photographer’s Mate 1st Class Ted Banks 
Deployment Quarterly fall 2003 • http://deploymentlink.osd.mil

guestcommentary

fitness should also 

be an area of concern 

for the Air Force civil 

servants. I encourage 

the civilian members 

of our Air Force organizations to join with 

their uniformed peers 

in participating in this 

program. 

While we have weight and body fat standards that we 

must meet, there will be some, weightlifters in particular, 

who may be perfectly fit but not meet these standards. 

This is where I expect commanders to step in and make 

a decision. Everyone will have to pass the commander’s 

eyeball test about how fit we are to wear the uniform. 

Every year we muster out about 400 people from our 

Air Force because of fitness issues. We should ask 

ourselves how many of those people were really trying to 

meet the standard and how many leaders and supervisors 

took an active part — getting out and running with them, 

etc. — in helping them meet the standard.

We will start this program on Jan. 1, 2004. 

To be ready, you need to know how the new fitness program works. At my request, the Air Force Surgeon General 

has developed criteria to assess the fitness and readiness of 

our force. These criteria will bring about significant change 

in the way we currently manage our fitness and weight 

management programs. A new Air Force Instruction will 

be published in November 2003 detailing the changes. 

You can read the new fitness criteria tables at http://www.

af.mil/news/USAF_Fitness_Charts.pdf. The tables give you a 

way to gauge your personal fitness, and just as important, 

the testing gives commanders a measure of their overall 

unit fitness. I want to make very clear that my focus is not 

on passing a fitness test once a year. More important, we 

are changing the culture of the Air Force. This is about our 

preparedness to deploy and fight. It’s about warriors. It is 

about instilling an 

expectation that makes fitness a daily standard — an essential part of your service. ■

Gen. John P. Jumper is chief of staff of the U.S. Air 

Force, Washington, D.C. As chief, he serves as the 

senior uniformed Air Force officer responsible for the 

organization, training and equipage of 710,000 active duty, 

Guard, Reserve and civilian forces serving in the United 

States and overseas. 

Raising The Bar:

Jumper Issues ‘Fit To Fight’ 

Challenge 

By Gen. John P. Jumper 

Air Force Chief of Staff 

ur superb Total Force performance in Operations 

Enduring Freedom and Iraqi Freedom secured our reputation as the greatest Air Force in the world. We should all 

take great pride in that. Our execution of the war plan was 

also consistent with our core values.

Integrity — in that we upheld the highest standards of 

performance — learned from the things we could have 

done better, and will make ourselves better as a result; 

service before self, in that 40,000 warriors deployed forward, supported by thousands more back home, to do the 

right thing for the people of Iraq and to play our part in 

the joint air, land, and sea effort; and excellence, in that we 

demonstrated the ability to plan and execute air and space 

missions with a degree of precision never before achieved. 

When looking at our Air Force overall, I am very 

pleased. One aspect of our Total Force that does need 

improvement, however, is our physical fitness.

About 10 years ago, we transitioned to fitness testing based on the cycle ergometry test. This was done to 

preclude injuries experienced in the previous 1.5-mile run 

format. It was also deemed a more precise and high-tech 

way to measure aerobic performance. 

My belief is that we are a much different Air Force 

today. We deploy to all regions of the world, living in 

tent cities and working on flight lines in extremes of temperatures. Some of our airmen today are operating from 

inside Iraq, subject to attack, and could be called upon to 

help defend the base, a trend that will surely increase in 

the growing expeditionary nature of our business. 

The amount of energy we devote to our fitness 

programs is not consistent with the growing demands 

of our warrior culture. It’s time to change that.

We will soon release a new fitness program that gets 

back to the basics of running, sit-ups, and pushups. There 

will be accommodations made for those who aren’t able 

to run for legitimate reasons. The cycle ergometry test 

may still be used for those not medically cleared to run. 

We are planning to issue physical training gear as part of 

the program and to put responsibility for PT in the chain 

of command, not with the medical community or the 

commander’s support staff. 

I expect this effort to be led from the top, starting with 

commanders and senior NCOs, and I expect those who 

have trouble meeting the standards to be helped by others 

in their unit until they do meet the standard. Physical 
http://deploymentlink.osd.mil • fall 2003 Deployment Quarterly

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W

U.S. Marine Corps photo by Lance Cpl. Monroe F. Seigle 

Lance Cpl. Jared Shaver, a scout sniper with Weapons Co., 2/3, Marine Corps Base Hawaii, 

Kaneohe Bay, keeps a low profile and moves slowly across a field as he attempts to move in 

close to the observers in order to fire off one deadly shot.

Can You See Me Now?

ASHINGTON — Military personnel 

who have been deployed or mobilized 

are not required to make student loan 

payments during their absences. 

Federal regulations require lenders 

to postpone the student loan program 

payments of active duty military 

Deployed Troops 

Get Break on 

School Loans

— Continued on Page 4

ASHINGTON — Whether or not another multinational division is ready 

for deployment in February 2004, the 

101st Airborne Division will come 

home on time, said U.S. Central Command officials. 

A plan unveiled in July called for a 

multinational division to replace the 

101st in Mosul, Iraq, in February. Defense Secretary Donald H. Rumsfeld 

said he still hopes an international 

division will be ready for duty in Iraq, 

but the U.S. 

military is making plans in case 

this does not happen. 

Rumsfeld said getting a multinational division in place is 

Rumsfeld Outlines Plan For 

Replacing Troops In Iraq

complicated and will take time. He 

said the nations providing troops 

would have to work with the U.S. 

Central Command and the Iraqi Governing Council. The nations would 

have to work out a 

memorandum of understanding on 

how the troops would be supplied, 

where they would be based, how 

they would receive orders, and so on. 

“That suggests to me that it will 

take a bit of time,” he said during a 

Pentagon press conference. 

The U.S. military has made 

decisions on what would happen 

if the international troops weren’t 

ready. Rumsfeld and Chairman of 

the Joint Chiefs of Staff Air Force Gen. 

Richard B. Myers said that almost all 

Reserve Component units that might 

be needed have been notified. Some 

combat support and combat 

service support units — mostly in 

the Reserves — have not yet 

been notified. 

The secretary said some support 

may come from other services. 

Beginning in February 2004, the 

1st Cavalry Division, augmented 

by the 39th Infantry Brigade of the 

Arkansas National Guard, will begin 

replacing the 1st Armored Division in 

Baghdad. Beginning in March 2004, 

the 1st Infantry Division, augmented 

by the 30th Infantry Brigade of the 

North Carolina Guard, will begin 

replacing the 4th Infantry Division in 

Tikrit. The 81st Infantry Brigade of 

the Washington National Guard will 

replace the 53rd Enhanced Special Brigade from the Florida National Guard 

around Baghdad. 

Officials in Baghdad said the Mosul 

area is relatively calm. The northern 

area of Iraq has a good number of 

trained Iraqi police and may not need 

a unit the size of the 101st in February. 

Plans remain for a multinational division for the area, but officials 

said it may not turn out to be a soldier-for-soldier swap. If changes force 

an American unit to go to the area, 

then there is a back-up plan, Rumsfeld 

said. ■
Deployment Quarterly fall 2003 • http://deploymentlink.osd.mil

A

news from around the world

personnel. This applies to members of 

the National Guard and Ready Reserves 

who have been called to active duty, as 

well as to active duty personnel whose 

duty station has been changed as a 

result of a military mobilization. 

“Many of the brave men and women 

serving our nation right now have 

put their personal lives on hold to 

answer the nation’s call to duty,” said 

U.S. Education Secretary Rod Paige in 

a news release earlier this year. “As 

they defend the freedoms we cherish, 

our soldiers should not have to worry 

about their student loan obligations and 

resuming their studies.” 

He encouraged the higher education 

and lending communities to be 

flexible and provide assistance to 

service members, so they can “easily 

resume their studies and financial 

obligations after they complete their 

tours of duty.” 

The regulations apply to student 

loans made under the Federal Family 

Army Guard, 

Reserve Job 

Center Opens

Education Loan, William D. Ford 

Federal Direct Loan and Federal Perkins 

Loan programs. 

The law also requires that active 

duty military people who have not 

begun the repayment period on their 

loans continue to receive a grace period 

(generally six months) before repaying 

their loans. Students who were in 

school at the time of mobilization must 

also be given a reasonable period to 

resume school before lenders request 

payments. 

Colleges will not be required to 

collect financial aid funds that nowactive duty students were given to 

pay for books and living expenses. 

Additionally, Education Department 

officials encourage colleges and 

universities to either fully refund 

tuition and other institutional charges 

or give comparable credit against future 

charges to students forced to withdraw 

from school to fulfill their military 

obligations. 

Additional information is available 

by calling 1-800-433-3243 or visiting 

the Department of Education Web site 

at http://www.ifap.ed.gov/IFAPWebApp/

index.jsp. ■

Trainees at the U.S. Air Force 

Honor Guard technical school 

at Bolling Air Force Base in 

Washington, D.C., participate in 

a physical fitness routine several times a week. This includes 

push-ups, crunches and a 

1.5-mile run and mirrors the 

proposed Air Force fitness 

s t a n d a r d s w h i c h w i l l b e 

implemented in January 2004. 

You can read the new fitness 

criteria tables at http://www.af.mil/

news/ USAF_Fitness_Charts.pdf. 

U.S. Air Force photo by Master Sgt. Jim Varhegyi

AF Sets 

New PT 

Standards 

For 2004

LEXANDRIA, Va. — The 125,000 

National Guard and Army Reserve 

soldiers currently mobilized for the 

war on terror will have help finding 

jobs when they go home.

The Army Career and Alumni 

Program Demobilization Center that 

opened in Alexandria, Va., Sept. 29 

will help them find new jobs, said 

James Hoffman, program director.

“Things change,” Hoffman said. 

“A soldier gets home after being 

mobilized and finds the job he was 

counting on isn’t there anymore; 

maybe the company folded, or maybe 

that soldier realized he has grown 

and the old job just wasn’t right any 

longer.”

The center responds to questions 

about eligibility for transition services 

and benefits and offers referral to 

other service providers such as the 

Department of Labor, Department 

of State Employment Office and 

Department of Veterans Affairs.

Program officials are giving 

Reserve Component soldiers business 

cards with contact information as 

they demobilize, Hoffman said. 

A returning Guardsman or 

Reservist can be put in touch with 

the person who can help by calling the 

toll-free number (877) 722-2270 

or sending an e-mail to acap4rc@hoffman.army.mil. Additional details are at 

http://www.acap.army.mil.

In addition, soldiers who want to 

return to their jobs have reinstatement 

rights under the Uniformed Services 

Employment and Reemployment 

Rights Act. More information about 

that can be found at the offices of the 

Employer Support of the Guard and 

Reserve at http://www.esgr.org. ■
http://deploymentlink.osd.mil • fall 2003 Deployment Quarterly

A

ask doc

— Continued on Page 16

QBefore combat operations in Iraq 

were initiated, the chemical officers/NCOs of our unit were giving 

us training briefings on something 

they were calling SURPACK. I 

have to admit a lot of training information on numerous topics was 

vaccinesdrugs & herbs

Thanks for the question. Since it was the chemical officers/non-commissioned officers who 

were providing your briefing, I suspect 

the product you are referring to is called SERPACWA. This is an acronym for “Skin Exposure 

chemical warfare agents through the skin.

When applied prior to exposure to 

chemical agents, SERPACWA works by 

simply being a physical barrier. Numerous controlled laboratory studies showed 

reduced or delayed absorption of a variety of chemical warfare agents, including 

sulfur mustard (HD), soman (GD), thickened soman (TGD), T-2 Mycotoxin (VX), 

and CS which is a riot-control gas.

In the rush to put on MOPP gear, 

soldiers may do so incorrectly, which can 

result in a possible leakage of chemical 

agents at the closure points — ankles, 

wrist, neck, and waist. This weak link is why the paste 

was developed. In development since 1993, SERPACWA 

transitioned to full production, fielding, and deployment 

in 2003.

Like most pharmaceuticals, SERPACWA has side effects 

and precautions. Of particular note, the scientific literature 

indicates that one should not smoke cigarettes or any other 

smoking products once SERPACWA is applied — even if 

provided to us during this preparation phase. I 

never had to use it, but now that I’m back in 

CONUS, I’m trying to remember exactly what 

that stuff was. Can you shed some light on this?

Reduction Paste Against Chemical Warfare Agents.” Developed by the U.S. Army Medical Research and Materiel 

Command, SERPACWA received FDA final approval in 

February 2002 for use in conjunction with your Mission 

Oriented Protective Posture gear to reduce absorption of 

A

QI read that soldiers 

who served in Iraq 

can not donate blood 

when they come home. 

Why is that?

All servicemembers 

who have served on 

the ground in Iraq and 

Afghanistan for Operations Enduring Freedom 

and Iraqi Freedom are deferred from 

donating blood for one year after they 

leave those countries. This means 

that blood banks should not accept 

donated blood from deferred persons 

during that one year period. This 

deferral is intended to prevent the 

spread of a disease called leishmaniasis through blood transfusions.

Leishmaniasis is caused by a 

parasite that humans get through the 

bite of an infected sand fly. Leishmaniasis and the sand fly that carries 

the parasite are common in Iraq and 

Afghanistan. Military 

scientists have confirmed 

the presence of sand flies 

carrying the parasite 

around U.S. base camps. 

More than 50 American 

servicemembers have 

developed the skin form 

of the disease, cutaneous 

leishmaniasis, since OEF 

and OIF began.

Cutaneous 

leishmaniasis shows 

itself as one or more 

open skin sores or ulcers that arise 

weeks to months after the bite of an 

infected sand fly. Left untreated, these 

sores can produce disfiguring scars, so 

infected servicemembers are routinely 

evacuated to Walter Reed Army Medical Center in Washington, D.C., for 

treatment.

A more serious form of the disease, 

visceral leishmaniasis, results when 

the parasite moves through the blood 

stream to internal organs, such as 

the liver, spleen, and bone marrow. 

Visceral leishmaniasis 

is potentially fatal, so 

early diagnosis and 

treatment are critical. 

Although no cases of 

visceral leishmaniasis 

have been found in 

Americans serving in 

OEF and OIF so far, 

they remain a definite 

possibility. During 

the 1990-1991 Gulf 

War, there were 20 

cases of cutaneous 

leishmaniasis and 12 cases of visceral 

leishmaniasis among American military personnel.

Scientists have reported the transmission of leishmaniasis through 

blood transfusion in a small number 

of cases. Because of the lengthy 

time lag between the infecting sand 

fly’s bite and the onset of signs and 

symptoms of the disease, the one year 

deferral policy was chosen to prevent 

transfusion of infected blood drawn 

— Continued on Page 19
Deployment Quarterly fall 2003 • http://deploymentlink.osd.mil

U.S. Army photo by Spc. Derek Gaines

A soldier from the 115th Military Police Company, a National Guard unit from Cranston, R.I., guards 

men detained during a raid in Falluja, Iraq, during Operation Iraqi Freedom. The raid was conducted 

following reports of the compound being a storage site for stolen goods and weapons as well as a 

location for counterfeit money production. 

Officials Say Rebalancing 

Will Reduce Multiple 

Reserve Mobilizations

“There is no one single 

solution to rebalancing ...”

— Continued on Page 8

I

by donna miles

american forces press service 

and Reserve Components, and in some 

cases, to civilian contractors. 

Rebalancing, Hall explained, isn’t 

simply a matter of taking high-demand 

Reserve component jobs and moving 

them to the active force. While that 

might work in some situations, it won’t 

necessarily work in all, he said. 

He pointed to examples in which 

mobilized Reservists bring a treasure 

trove of experience to their military 

missions. For example, Army Reservists, who make up 97 

percent of the Army’s civil 

affairs units, are contributing city mayors, public 

works managers, school 

principals, health care 

administrators, banking officials and 

other highly qualified professionals to 

rebuilding Iraq’s infrastructure. 

Another consideration is that building active units “doesn’t happen overnight,” Hall said. “You have to have 

training, you have to grow the leaders, 

you have to recruit. That 

could take three to four to six years. It 

takes awhile.” 

And defense planners aren’t willing 

to take that long to rebalance the force. 

Hall said he expects it to occur “over 

this year and next year, not five, six or 

seven years from now.” The services 

each have plans and “are committed” 

to the concept, he said. 

Another option being considered 

to rebalance the force, Hall said, is 

adding more billets for high-demand 

jobs in the Guard and Reserve. This, he 

explained, would increase the number of Reserve component troops in 

a particular specialty, broadening the 

pool of qualified people available for 

mobilizations. “That way,” Hall said, 

“you wouldn’t have to keep using the 

same ones.” 

Still another way to help rebalance 

the force is to contract out some of 

the jobs Reservists and Guardsmen 

are being mobilized to carry out, 

particularly those that are not 

considered “core” military functions. 

So far, Hall said, DoD has identified 

as many as 370,000 jobs that could be 

performed by civilians. 

For example, when Hall visited 

troops mobilized to Kosovo, he was 

particularly impressed by the 

successful use of a contractor to run 

many typical garrison-type functions. 

Contractors there ran the food service 

operation, all Morale, Welfare and 

Recreation activities, and trash and garbage disposal. “They were also doing 

force protection,” Hall said. “And they 

were doing a magnificent job.” 

Hall said DoD probably will use 

a combination of these options in its 

strategy to rebalance the force. “There 

is no one single solution to rebalancing,” he said. “It’s a multiple-solution 

problem, and we’re looking at all of 

those multiple options.” 

In some ways, he said, the military’s 

heavy reliance on its Reserve Compof you’re a National Guardsman or 

Reservist, chances are about 64 percent 

that you’ve been called to active duty 

during one of seven major mobilizations since 1990. There’s about a four 

to five percent chance that you’ve been 

mobilized two or more times. 

And if you’re among about 8,000 

members of the Reserve Components, 

you’ve experienced the one percent 

chance of being mobilized three or 

more times since 1990. 

As significant as these percentages 

are, they don’t factor in about 7,800 

Guard and Reserve members who 

have been mobilized more than once 

for the global war on terrorism alone. 

Those most likely to have been 

tapped multiple times serve in what 

the Defense Department calls “highdemand, low-density” or “stressed” 

specialties concentrated largely in the 

Reserve Components. These include 

civil affairs, psychological operations, 

mortuary affairs and air traffic control 

positions. 

Thomas F. Hall, DoD’s assistant 

secretary for Reserve Affairs, said 

repeated call-ups for some Reserve 

Component members are putting too 

much strain on families, employers 

and the troops themselves. 

And although Hall reported that 

all the Reserve Components met their 

end-strength targets for fiscal year 2003 

by Sept. 30, he’s concerned that too 

many call-ups for Reserve troops could 

hurt recruiting and retention down the 

road. 

That’s why Hall is committed to 

Secretary Donald H. Rumsfeld’s plan 

to rebalance the force — basically 

shifting missions between the active 
http://deploymentlink.osd.mil • fall 2003 Deployment Quarterly

A

fit to stay in the military and, if 

approved, 

can the individual serve overseas?

An airman found unfit for military 

service may appeal the decision. 

Appeals go to medical officials at 

Randolph 

Air Force 

Base, 

Texas, and 

sometimes 

reach the secretary of the Air Force 

level. There is no appeal process for 

those found still fit for duty.

“We process an average of 4,000 

medical boards each year,” said Air 

Force Col. (Dr.) Ed Taxin, chief of the 

medical standards branch.

One airman whose future rested 

in the board’s hands is Air Force 

Master Sgt. Dan Derlein, a computer 

programmer at the Air Force Personnel 

Center at Randolph Air Force Base, 

Texas. Derlein was diagnosed 

with Parkinson’s disease, a 

debilitating and incurable 

disease of the nervous system 

that afflicts more than 1.5 

million people, according 

to the Parkinson’s Disease 

Foundation.

“It’s difficult going through 

the diagnosis of a chronic, 

degenerative disease,” said 

Derlein, a 37-year-old father 

of three. “To be honest, I was 

more afraid of that board than 

the disease. I still have two 

years before I can retire, and 

I want to be able to finish my 

career.”

Before his medical board, 

Derlein visited a Web site run 

by Tom Berdine, a former 

technical sergeant who also 

suffers from Parkinson’s 

disease and also faced a 

medical board.

“Tom understood what I 

was going through,” Derlein 

said. “He really helped me 

through the diagnosis and my 

medical evaluation board.”

Although he temporarily 

lost his mobility status, 

Derlein passed the medical board and 

is still able to do his job. Medications 

currently keep Derlein’s disease in 

check, but since there is no cure, the 

medicine only treats the symptoms, 

and his nervous system continues to 

degrade; however, he is still productive 

at work.

“Dan feels like he’s really gone 

downhill, but his work doesn’t 

show it,” said his supervisor, Cherri 

Hummel. “He’s top notch, an amazing 

person. People are always coming to 

him for help because he’s 

so good with computers.”

Derlein plans to continue serving 

his country as long as he can and looks 

forward to a computer programming 

job after his Air Force retirement.

“Things may take me a little longer, 

and I might complain a little louder, 

but I’ll get them done,” 

Med Boards Not Always

A Career Ender 

by 1st lt. brandon lingle

air force personnel 

center public affairs

— Continued on Page 18

“To be honest, I was more 

afraid of that board than the 

irmen may think that 

being “medically 

boarded” means an 

end to a military 

career, but that is 

not always the case, 

according to medical 

officials at the Air 

Force Personnel 

Center.

While the goal of 

the medical review 

system is to maintain 

a fit and vital force, 

officials say the 

Air Force does not 

take the prospect of 

separating people for 

medical conditions 

lightly. A multi-step 

evaluation process 

helps ensure that the 

needs of both the 

Air Force and the 

member are served.

“Being medically 

boarded isn’t the 

same as being kicked 

out of the Air Force,” said Lt. Col. 

(Dr.) Leonard Trout, of the medical 

standards branch at the center. “The 

reality is that someone who faces a 

medical evaluation board has a good 

chance of remaining on active duty.”

When an airman is diagnosed 

with any of several hundred medical 

conditions outlined in Air Force 

guidance, he or she may face a medical 

evaluation board. This is the first step 

in the Air Force’s disability-evaluation 

system. The airman’s medical record 

is reviewed by a panel of three baselevel physicians. They forward their 

recommendation to senior reviewers 

at the personnel center who have to 

answer two questions: is the individual 
Deployment Quarterly fall 2003 • http://deploymentlink.osd.mil

A

Rebalance

— Continued from Page 6

Father, 2 Sons And Daughter-In-Law 

Serve Together In NC Unit

by spc. petersi liu, usa

special to american 

forces press service 

being reactivated for Iraqi Freedom 

in March 2003, he volunteered to join 

the unit to serve with his father and 

brother. 

In civilian life, Ryan worked as a 

direct-care provider for youths who 

have been in trouble.

“I joined the National Guard for 

education benefits. It is one weekend 

a month and two weekends a year. 

You can’t beat that,” he said with a 

laugh. He has a bachelor’s degree in 

criminal justice and psychology. Jason 

worked as an independent contractor 

with a landscaping company. 

The staff sergeant and his sons 

used to enjoy fishing together, they 

said. But since their forward deployment to Iraq in August, they had to 

settle for spending their off-duty time 

at the air-conditioned Morale, Welfare 

and Recreation tents at Camp Kohema, a small camp adjacent to Camp 

Arifjan. ■

All in the Family

nents is actually a good news story 

— proof that the military’s “total 

force” concept is working, and that 

Guard and Reserve have proven 

themselves as full partners in 

America’s defense. 

That’s something that won’t 

change through the rebalancing 

effort. America’s Reserve Components, Hall said, will remain 

an important part of U.S. national 

defense plans. 

“We made a commitment in 

the ’90s ... to make our Guard and 

Reserve just as good as the active 

duty force, to totally integrate them 

into the force,” Hall said. The result 

is that today’s Reserve forces are 

equipped and trained just as well 

as their active component counterparts, he said, and they’ve become 

vital to the nation’s defense. 

“These units are superb units, 

and they’re very well trained and 

very capable,” he said. “So we’re 

sending them forward and they’re 

doing the job.” 

When members of the Reserve 

Components are called to active 

duty, Hall said, he’s committed to 

making sure they’re trained and 

ready to do their military jobs, and 

that they’re mobilized only for the 

length of time absolutely required. 

“We don’t want to have one more 

or one less Guardsman or Reservist 

on active duty at any time than we 

need. Not one more or one less,” 

he said. 

“And when we do mobilize, we 

don’t want it to be ‘just in case.’ We 

want it to be ‘just in time,’” Hall 

said. “We don’t want to mobilize 

[you] just in case and let you sit at 

some mobilization station for three 

months.” 

The goal, Hall said, is to “get the 

mobilization timelines down so we 

mobilize you just in time, have the 

required training you need, get you 

over so you can do your job, and 

get you home as quickly as we can. 

“We’re leaving the paradigm of 

‘just in case’ and replacing it with 

‘just in time.’” ■

t least one family in 

a unit deployed to 

Operation Iraqi 

Freedom isn’t complaining much about 

family separation. 

That’s because most of 

the family found itself 

together here. A father, 

his two sons, and a 

daughter-in-law work 

in the same unit. 

The National 

Guard’s 211th Military 

Police Company of 

Clyde, N.C., was reactivated for Operation 

Iraqi Freedom in June, 

just five months after 

returning home from 

Operation Enduring 

Freedom in Afghanistan. The family father 

is Staff Sgt. Michael Coggins, noncommissioned officer-in-charge of 

the company’s motor pool. His first 

son, Spc. Jason Coggins, a military 

policeman, is married to Sgt. Vicky 

Coggins, an administrative clerk in 

the unit. Their son was born two 

days before Jason left for Operation 

Iraqi Freedom. His second son, Sgt. 

Ryan Coggins, a mechanic with 

two children of his own, works under his father’s supervision at 

the motor pool. 

“My old man is very old. He has 

been in the Army since 1972,” said 

Ryan with a laugh. 

“Our grandfather is Furman Coggins, and he was a private in the 

Korean War,” said Jason. 

The family intended to fight 

terrorism together. Michael and 

Jason served together for Enduring 

Freedom. Ryan had belonged to 

the 210th Military Police Company, 

but upon hearing that the 211th was 
http://deploymentlink.osd.mil • fall 2003 Deployment Quarterly

T

gulf warupdate

Study Finds Increased 

Frequency of ALS In 

Gulf War Veterans

— Continued on Page 12

people in the U.S. are diagnosed with 

the disease each year. The incidence of 

ALS is about two per 100,000 people. 

It is estimated that as many as 30,000 

Americans may have the disease at any 

given time. There is also no effective 

treatment for ALS, which generally 

leads to death in two to seven years. 

The study began in March 2000. 

Although previous reviews of data on 

ALS mortality and diagnosis showed 

no increased rate of ALS in those who 

served in the Gulf region, DoD and 

VA recognized the issue merited a 

special review. The $1.3 million study, 

funded by DoD and the VA, was done 

in collaboration with the Department 

of Health and Human Services, the 

Centers for Disease Control and 

Prevention and other academic centers 

of excellence in neurology, along with 

advice from the ALS Association.

The study researchers looked 

for cases of ALS among the nearly 

700,000 servicemembers deployed to 

Southwest Asia and the 1.8 million 

on active duty during the period who 

were not deployed to the gulf. The 

study found 40 cases of ALS among 

deployed veterans and 67 cases among 

the non-deployed. This translates to a 

nearly two-fold increase in the rate of 

this rare, neurological disorder in the 

deployed group. The incidence of ALS 

was highest among deployed Air Force 

personnel, who were 2.7 times more 

likely to have developed ALS than nondeployed Air Force personnel.

The ALS study does not identify a 

cause for the disease or the increased 

occurrence in this group of veterans. 

There have been many hypotheses as 

to the cause of ALS, all of which may be 

reexamined in light of this study. This 

disease is extremely rare, even with the 

two-fold increase found among Desert 

Shield/Desert Storm veterans compared 

to the non-deployed veterans.

Since the preliminary results were 

announced in December 2001, the 

policy of the VA has been to authorize 

disability compensation for veterans 

with ALS who served in the gulf 

between Aug. 2, 1990, and July 31, 

1991. Gulf War veterans who have 

been diagnosed with ALS are eligible 

for about $21,000 in service-connected 

VA medical benefits, as well as in-home 

medical equipment and assistance. 

The ALS Association has sent out a 

“This research ... reflects our desire to investigate 

the medical problems and health concerns 

of Gulf War veterans.” 

by joan kennedy

he results of a scientific study of 

amyotrophic lateral sclerosis, or ALS, 

in veterans of Operations Desert Shield 

and Desert Storm were published 

in the Sept. 23 issue of the journal 

Neurology. The study found that 

veterans who had been deployed to 

Southwest Asia during the Gulf War 

were nearly twice as likely to have 

developed the disease as active duty 

military troops who had not deployed 

there. 

“This research is the product 

of a significant investment by the 

Department of Defense and the 

Department of Veterans Affairs over 

the past several years and reflects 

our desire to investigate the medical 

problems and health concerns of 

Gulf War veterans,” said Dr. William 

Winkenwerder Jr., the assistant 

secretary of defense for health affairs. 

“Scientific research helps answer 

veterans’ questions and holds the 

promise for better protection of the 

health of our men and women during 

future deployments.”

ALS, also referred to as Lou Gehrig’s 

disease, is a rare, chronic disease 

which kills cells in the brain and spinal 

cord that control muscle movement, 

resulting in gradual wasting of the 

muscles. Medical science doesn’t 

know the cause of this progressive 

illness. It most often strikes adults 50 

to 70 years of age, although it has been 

diagnosed in people as young as 19 

years old. Lou Gehrig was 36 when 

he was diagnosed. According to the 

ALS Association, little more than 5,000 

 The onset of ALS is 

insidious with muscle 

weakness or stiffness as 

early symptoms. 

 ALS is not contagious. 

 It is estimated that ALS 

is responsible for nearly 

two deaths per hundred 

thousand of the population 

annually. 

 ALS occurs throughout 

the world with no racial, 

ethnic or socioeconomic 

boundaries. 

Adpated from the ALS Association 

Web site at 

http://www.alsa.org

Facts About ALS
Deployment Quarterly fall 2003 • http://deploymentlink.osd.mil

W

by tech. sgt. mark diamond

air mobility command public affairs

Aeromedical Evacuation 

Changes To Focus On 

Requirements

goodbye to an era

a “requirements-based” rather than 

“capacity-based” system.

According to AMC Command Surgeon Brig. Gen. (Dr.) Thomas J. Loftus, 

although the C-9 is going 

away, the mission of aeromedical evacuation will continue, but with noticeable 

changes.

“In the past, we used a capacity-based 

system. Many of our patients were 

transported from small medical facilities to larger medical facilities simply 

because we had a system in place [the 

C-9] dedicated to moving patients from 

one location to another throughout the 

United States,” Loftus said.

Scheduling of the C-9 was comparable 

to commercial airlines, with mostly 

predetermined stops for any passenger 

needing to travel. The only limit was 

the capacity of the aircraft.

This capacity-based system was used 

extensively from the 1970s through the 

early 1990s. However, the general said, 

the full implementation of TRICARE 

in the early 1990s led to a significant 

decrease in the number of CONUS, 

peacetime aeromedical evacuation missions — from about 70,000 in 1990 

to about 11,000 in 2001. At that rate, 

the number could reach as low as 

3,000 by 2005.

“The full implementation of TRICARE created a shift in health care to 

local medical facilities, which considerably decreased the number of patients 

who required in-flight medical care,” 

said Loftus.

The general said more patients now 

receive medical care in their local area, 

hen the Air Force officially 

announced the retirement of the C-9A 

Nightingale on July 23, 2003, to some 

the announcement simply meant the 

end of an era in Air Force aeromedical 

evacuation.

To others, the retirement of the C-9A 

— the aeromedical evacuation workhorse for the past 35 years — signaled 

the beginning of a new aeromedical 

evacuation environment; an environment where continental United States, 

or CONUS, peacetime aeromedical 

evacuation missions become the exception, rather than the norm. Or what Air 

Mobility Command officials are calling 

The C-9 is a twin-engine, T-tailed, medium-range, swept-wing jet aircraft used primarily for Air Mobility Command’s aeromedical 

evacuation mission. The Nightingale is a modified version of the McDonnell Douglas Aircraft Corporation’s DC-9. It is the only aircraft 

in the inventory specifically designed for the movement of litter and ambulatory patients. The C-9A’s airlift capability to carry 40 litter 

patients, 40 ambulatory and four litter patients, or various combinations thereof, provides the flexibility for Air Mobility Command’s 

worldwide aeromedical evacuation role. A hydraulically operated folding ramp allows efficient loading and unloading of litter patients 

and special medical equipment. 

Official U.S. Air Force photo
http://deploymentlink.osd.mil • fall 2003 Deployment Quarterly

which allows the change to the 

requirements-based system. The Defense Department’s TRICARE program 

has successfully created networks of local doctors and hospitals to take care of 

the medical needs of military personnel, 

retirees and their families.

Educating CONUS military treatment 

facilities on the new requirements-based 

aeromedical evacuation system is a continuous process. Part of that education 

will take place each time a patient movement request is made, according to Air 

Force Lt. Col. Duane Hill of the Global 

Patient Movement Requirements Center 

located at Scott 

Air Force Base, Ill. The GPMRC 

handles aeromedical evacuation mission 

requirements determination, validation 

and coordination. Hill said the 

requirements-based system will be a 

mindset change for everyone involved in 

the aeromedical evacuation process.

“We need to be sympathetic to the 

[patient movement] requests, but at 

the same time, our MTFs need to understand that the C-9 is gone and 

the TRICARE network needs to be utilized,” said the colonel.

Col. Darnell Waun, AMC’s chief of 

health care operations division and the 

AMC command nurse, agreed that the 

new aeromedical evacuation system 

will be a significant change for many 

because patient movement has 

traditionally been synonymous with 

the C-9.

“Now, [aeromedical evacuation] is 

just one way to move a patient,” Waun 

said. “Depending on patient needs, they 

can be moved commercially, by ground, 

or as a space-available passenger on 

military airlift. Moving a patient from 

Point A to Point B does not necessarily mean [military] airevac, unless they 

require en route care.”

Requirements-based, in essence, 

means urgent or priority (or patients 

needing in-flight care) aeromedical 

evacuation is needed, and the Air Force 

aeromedical evacuation system will get 

them where they need to go.

Without the C-9, the Air Force’s CONUS aeromedical evacuation mission 

will continue using other AMC airlift 

and tanker aircraft.

New aeromedical 

evacuation technology, 

called patient support 

pallets, is making it possible 

to transport patients aboard 

aircraft not normally used for 

aeromedical evacuation. The 

patient support pallet, developed at the Human Systems 

Center at Brooks City-Base in 

San Antonio, Texas, is 

built on a standard cargo pallet and 

provides support for six litters or a combination of three airline seats and three 

stretchers. The Air Force uses 

the patient support pallets on KC-135s, 

KC-10s and C-17s airframes.

The Air Force began using C-130s and 

U.S. Air Force photo by Staff Sgt. Justin D. Pyle

A servicemember wounded during Operation Anaconda in Afghanistan is carried off an Air Force 

C-9 Nightingale in March 2002. The wounded arrived at Ramstein Air Base, Germany, where they were 

transported by the 86th Aeromedical Staging Flight to Landstuhl Regional Medical Center in Germany 

for treatment. 

A host of stretcher-bearers, 

doctors and medics place 

Canadian journalist Kathleen 

Kenna on an ambulance at 

Ramstein Air Base, Germany. 

The ambulance took Kenna to 

Landstuhl Regional Medical 

Center in Germany, the largest 

military hospital in Europe, for 

further treatment. 

U.S. Air Force official photo 

by Master Sgt. Keith Reed

KC-135s aircraft for aeromedical 

evacuation within CONUS Aug. 7, 2003. 

According to AMC officials, the KC-135 

missions run cross-country to Scott AFB 

and end at Travis Air Force Base, Calif. 

There will be C-130 routes from each 

of the three areas: Andrews Air Force 

Base, Md., Scott AFB and Travis AFB, 

to transport patients to their final destinations.

AMC officials are confident that the 

new requirements-based aeromedical 

evacuation system will work, but not 

without a few challenges.

“Anytime you make a change, there 

are challenges,” said the general. 

“We’ve been using the C-9 to transport 

patients around the United States for 

many, many years.”

Although current usage of the C-9 is 

— Continued on Page 19

“The full implementation of TRICARE created a shift in health care to local medical 

facilities ... decreased the 

number of patients who required 

in-flight medical care.” 
Deployment Quarterly fall 2003 • http://deploymentlink.osd.mil

ALS Study — Continued from Page 9

message to all neurologists to make sure they convey 

this information to ALS patients who served in the Gulf 

War.

“When in doubt, VA should act in favor of the 

veteran,” said Secretary of Veterans Affairs Anthony

 J. Principi. “We moved aggressively to extend benefits 

to ALS victims in December 2001, based 

upon preliminary data. Now, the full study 

supports the wisdom of that action.”

Earlier this year, VA established a national 

ALS registry to identify veterans with the disease 

— regardless of when they served — and track their 

health status. Veterans with ALS who enroll will 

complete an initial telephone interview, covering 

their health and military service, and will be 

interviewed twice yearly thereafter. 

For more information about VA’s ALS Registry, based 

at North Carolina’s Durham VA Medical 

Center, call 1-877-DIAL-ALS (1-877-342-5257) or 

send an e-mail to norma003@acpub.duke.edu.

The ALS Association has a toll-free information 

and referral service available to patients, caregivers and 

family members. The ALSA Information and Referral 

number is (800) 782-4747. To reach 

ALSA’s Patient Services department by e-mail, 

contact alsinfo@alsa-national.org. ■

A

by joan kennedy

new medical management support 

system has been developed that will 

soon standardize the way human 

resources are tracked and managed 

across all service branches of the 

Military Health System. The Defense 

Medical Human Resources Systeminternet, scheduled to be completed 

and in use by 2005, will manage 

human resources for about 170,000 

medical personnel from the services’ 

entire military and civilian workforce. 

DMHRSi uses the Oracle 11i E-Business 

Suite to integrate processes for the 

Army, Navy and Air Force medical 

communities. 

“We will soon have a single system 

to maintain key human resource 

information on personnel supporting 

military health care,” said David 

Gervais, director of human resources 

for the Resources Information 

Technology Program Office (RITPO). 

“Across the services, this will 

include all active duty, Reserves, 

DoD civilians, contractors, borrowed 

personnel and even volunteers.”

DMHRSi, which has prototypes 

at three test sites, will eventually be 

deployed to approximately 600 sites, 

and be accessible to more than 170,000 

authorized users worldwide via the 

Internet. 

Gervais said that DMHRSi will 

standardize human resources 

management and eliminate the need 

to maintain service-unique systems. 

“This will result in immediate cost 

savings and improved data quality,” 

he said.

DMHRSi is designed to streamline 

cumbersome and time-consuming 

medical business processes, which 

Gervais said will result in improved 

data quality for medical management 

decision-making. The system provides 

tri-service, standardized business 

rules and processes and maintains all 

medical human resource information, 

received from Service Source systems, 

in a single tri-service database hosted 

by the Defense Information Systems 

Agency. DMHRSi will support the 

military health system functional 

areas of Manpower & Personnel, 

Labor 

Cost Assignment, Personnel 

Readiness, and Education and 

Training. 

“DMHRSi will assist medical 

commanders to determine who their 

people are, how much they cost, 

what training they have, and who is 

deployable,” said Gervais. ■

New Human Resources Management System 

Makes Medical Readiness Easier to Track

U.S. Army photo by Sgt. Jack Morse

U.S. Army Maj. Andrew Barr, the brigade surgeon for 3rd Brigade 

Combat Team, 4th Infantry Division out of Fort Carson, Co., eyes 

some X-rays Oct. 26. Soldiers with the 205th Military Intelligence 

Brigade, 64th Forward Support Battalion, 502nd Dental Company 

(Area Support) and 561st Medical Company (Dental Services) were 

at a school in Balad, Iraq, on Oct. 26, 2003, to conduct a medical 

capabilities mission during which they provided services for about 

300 children.

Looking For Signs
http://deploymentlink.osd.mil • fall 2003 Deployment Quarterly

W

research

Institute’s Insectary 

Vital In Repellent, 

Drug, Vaccine 

Research

by karen fleming-michael 

ft. detrick standard staff writer

insects on the lam. Infected mosquitoes 

used in volunteer studies to test the 

effectiveness of vaccines or drugs 

are kept under lock and key, Strickman 

added.

“You sort of have your heart in 

your mouth about having infected 

mosquitoes because if you have one 

loose, you’re going to have people 

infected,” he said. 

Jones is a mosquito master, 

prodding larvae to hatch and grow 

into swimming pupae then flying 

mosquitoes. Only females are used 

in experiments; males are simply 

studs. But before they’ll breed, female 

mosquitoes need a blood meal, which 

in the insectary comes in from the belly 

of anesthetized hamsters. 

Then the ladies mate and lay eggs. 

Blood meals from a living 

creature are unavoidable, Strickman 

said, because researchers need to 

ensure mosquitoes are cooperative 

for experiments. “If they grow 

accustomed to feeding on only expired 

blood or artificial diet through a 

membrane, they may not be attracted 

to human skin to take a blood meal, so 

we wouldn’t know if a repellent truly 

worked or if the mosquito simply lost 

interest in humans,” he said. 

Taking the results of a good egg lay, 

which resembles dense coffee grounds 

on a paper towel, Jones puts the eggs 

in a small bench-top vacuum for 30 

minutes. Low oxygen levels stimulate 

hatching and ensure a batch of 

mosquitoes is approximately the same 

age. Mosquitoes typically live three to 

four weeks, and researchers use them 

when they’re five to 15 days old. 

With a trained eye, Jones notes the 

subtle wiggles that indicate hatching 

has occurred. She moves them to a 

breeding room into a shallow stainless 

steel tub. Other than the bad hair days 

the humid hatchery causes, Jones said 

the only other thing that can cause 

a bad day is underestimating the 

number of eggs. If she falls short, she 

must play catch up to supply enough 

mosquitoes to meet the lab’s weekly 

demand of 4,000 Aedes aegypti. 

After seven days in water, feeding 

on ground-up fish food, bottomfeeding pupae emerge and look like 

tiny tadpoles, or as Strickman noted, 

“all the unused commas in the world.” 

At this stage, Jones pours the pan’s 

contents through a separator, which 

stalls the large ones and lets the small 

pupae return to the pan for more 

growing. 

When it comes to rearing 

mosquitoes, size matters. Jones 

said the larger the mosquito, the 

better the biter. 

“You can take all the proper 

measures to rear good sized 

mosquitoes, but some will never get 

to the pupae stage,” she said. “When 

you’re dealing with Mother Nature, 

U.S. Air Force photo by Airman Samantha Willner

— Continued on Page 14

hile everyone tries to keep their 

summers insect free, the insectary 

at Walter Reed Army Institute of 

Research painstakingly breeds tens 

of thousands of them every week. 

Aedes, Anopheles and Culex

mosquitoes are reared weekly to 

supply the needs for repellent, drug 

and vaccine work the institute does 

to protect servicemembers from 

diseases like dengue fever, malaria and 

encephalitis. 

The Department of Defense has 

about a dozen insectaries around the 

globe; however, WRAIR’s is one of 

the largest and most elaborate, said 

Col. Daniel Strickman, chief of its 

entomology department.

The insectary in Maryland, with 

funding hovering around $750,000 

annually, is “probably the best in the 

world as far as meeting the needs 

we have,” Strickman said. In fact, 

entomologists helped create the 

964-square foot facility that opened in 

2000, keeping things like temperature 

controls, security and hygiene at the 

forefront of design talks. 

Lisa Jones, a research technician who 

breeds Aedes aegypti mosquitoes for her 

own and others’ studies, works within 

the temperature-controlled insectary 

that has double-doored entryways to 

protect the rest of the institute from 

A group of frozen mosquitoes is viewed through 

the eyepiece of an entomologist’s microscope. 
Deployment Quarterly fall 2003 • http://deploymentlink.osd.mil

you can’t be precise like with other parts 

of science.”

Large pupae are transferred to an ice 

cream cup-sized bowl of water inside a 

half-gallon tub with a mesh top. There, 

they’ll evolve into adult mosquitoes that 

can again start the 10-day breeding cycle 

to meet the lab’s demand. 

Because troops are deployed to 

Southwest Asia, where leishmaniasiscarrying sand flies flourish, the 

insectary’s expertise with the 

phlebotomine family is being tapped. 

Dr. Edgar Rowton, assistant chief of 

entomology, has had a passion for sand 

flies for years. Now his team’s expertise 

is being put to the test as shipments of 

flies from Lt. Col. Russ Coleman, an 

in-theater entomologist, arrive daily for 

identification and testing for “leish.” 

“We get real feedback from the field,” 

Rowton said. “There’s no gap from 

the bench to the real world.” 

From testing that researcher Lisa 

Hochberg completed on 200 pools 

that each contain 10 sand flies, lab 

researchers have been able to 

determine that 1.5 percent of the 

sand flies in theater test positive for 

leishmaniasis, Strickman said. 

“We don’t know which type of leish 

they carry, though we know in the 

civilian population they have some 

cutaneous and lots of visceral leish,” 

he said, adding that the military 

health community could be facing “an 

infectious disease train wreck” when 

troops return. Affecting the spleen 

and liver, visceral leishmaniasis can take 

months to develop and is considered 

fatal if left untreated. For this reason, 

Strickman said, military health providers 

need to know what 

to look for and how to treat it. 

Because of his research, Rowton 

has twice taken a 21-day regimen of 

antimony compound, the remedy 

for leishmaniasis. “It was not a very 

pleasant treatment, but [mucosal 

leishmaniasis, the form of the disease he 

had,] starts with a sore that goes away 

but the parasite later shows up in the 

nose and destroys the whole area,” he 

said. “I thought it was worthwhile to 

get treated.” 

For now, Coleman can take the lab’s 

data and let commanders know what 

troops are facing in terms of disease and 

what precautions need to be taken. 

“If we actually show 

there’s leish in sand 

flies where we have 

soldiers, they can 

pull out all the stops 

to prevent it: treat 

tents, spray pesticides, 

stress repellent use in 

soldiers,” Strickman 

said. “Without help 

from WRAIR’s lab, 

all he could do is say, 

‘We have sand flies,’ 

which may or may not 

prompt a commander 

to spend resources on 

prevention.” 

Sand flies take 45 to 

50 days to 

mature from larvae to adults and have 

their own section of the insectary. Phil 

Lawyer, a retired Army entomologist, 

maintains the sand flies that eat a 

ground up mixture of composted 

rabbit chow and rabbit feces. The 

combination resembles the diet 

found in the burrows sand flies 

naturally live in for their two- to 

three-week life span. 

Amid a background of classical 

music, female sand flies also need blood 

meals before mating. When the flies 

become finicky, Lawyer said, he takes 

matters into his own hands to meet the 

lab’s weekly sand fly quota 

of 5,000. 

“You roll up your sleeve,” he said, 

displaying bites from the previous day. 

Colonies are collected this way as 

well. “Sometimes when we’re out in 

the field and we want to get a colony, 

the only way we can get eggs is to give 

them blood, and so lots of times we’ll 

have 100 to 200 sand flies on our arms,” 

Rowton said. “We don’t like to do that 

because it’s grueling, but sometimes we 

have to.”

The insectary’s colonies hail from 

Kenya, Saudi Arabia, Jordan, Brazil, 

India, Turkey, Peru and Israel and 

range in age from less than a year to 

more than 30 years old. “Right here, by 

far, has the greatest diversity of sand

fly colonies in the world, no question 

about the United States,” Rowton said. 

“It’s probably one of the only facilities 

that produces them in great enough 

quantities that we can conduct serious 

repellent studies, which take a lot of 

flies, and collaborate on a DNA 

vaccine for leishmaniasis.”

The insectary is also loaning lab 

space and mosquitoes to Paul Weldon, 

a researcher from the College of Notre 

Dame in Baltimore, Md., who’s exploring 

materials monkeys use to 

rub on themselves for protection 

from mosquitoes. The rubbing, also 

called anointing, often repels or kills 

mosquitoes. Weldon tests different items 

— compounds from millipedes, bird 

feathers, leaves and frog toxins, to name 

a few — by spreading them on thin 

membranes stretched across a 

well of heated fluid with adenosine 

triphosphate, an energy substance 

put into sugar water that attracts 

mosquitoes. The fluid is also dyed 

with food coloring. 

After letting the mosquitoes spend 

time with the membrane and fluid, he 

can tell if they fed by crushing them to 

see if food coloring is present. Neither 

animals nor people are exposed to bites, 

and he said he gets uniform results 

from test to test. It also saves the amount 

of repellent he needs for each test 

because he needs just enough to cover 

a 9.6 square centimeter area instead of 

enough to cover a human’s forearm. 

Using blood as an attractant, he 

said, would limit him to four test runs 

each day, but his method lets him run 

as many as he likes. 

Though Weldon said he has no agenda 

for product development, leaving that 

endeavor for others to pursue, “it’s a 

good example of how WRAIR partners 

with academic 

groups to further science,” 

Strickman said. “He [Weldon] is 

taking a completely different 

approach and is just doing research. The 

resources he uses are trivial money, but 

the results are not trivial.” ■ 

Insects

— Continued from Page 13
http://deploymentlink.osd.mil • fall 2003 Deployment Quarterly

health protection issue as well. Lives 

depend on how physically fit our military members are. Smoking or using 

tobacco-related products may impact 

their fitness level, putting lives of their 

fellow servicemembers at risk,” said 

Ellen P. Embrey, the deputy assistant 

secretary of defense for force health 

protection and readiness.

Research has shown that smoking is 

a proven risk factor for heart disease, 

which is compounded for women taking oral contraceptives; certain cancers 

including mouth, lung, urinary tract 

and kidney, chronic lung disease, sinusitis, pneumonia and decreased fertility. 

Research has also shown that secondhand smoke is equally harmful to those 

around smokers, especially children. 

Smoking also seriously affects the quality of life to include temporary conditions like bad breath and ruined clothes 

to more permanent conditions such as 

wrinkled skin and stained teeth. 

“Most military members [who 

smoke] want to quit smoking. Many 

will eventually quit after several attempts,” said U.S. Air Force Lt. Col. 

Dean L. Messelheiser, BSC, the Air 

Force Substance Abuse Prevention 

and Treatment Program Manager 

with the Air Force Medical Operations 

Agency in the Office of the Air Force 

Surgeon General. 

“That’s the good news,” said U.S. 

Navy Capt. (Dr.) Larry N. Williams, 

Dental Corps, a clinical champion of 

the DoD and Department of Veterans 

Affairs’ Tobacco Cessation Program. 

“The bad news is that while many 

current military members quit, just as 

many will either resume or begin to use 

tobacco products for the first time after 

basic training.”

According to a recent DoD survey of 

health-related behaviors among military 

personnel, the prevalence of smoking 

among active duty personnel is approximately 34 percent with another 12 

percent using smokeless tobacco. The 

same survey also showed that some 

11.9 percent of active duty are former 

smokers and approximately 54.8 percent of active duty members have never 

smoked. Smoking rates among Reserve 

Component personnel, family members 

and retired personnel are not known. 

Nicotine, the addictive drug in cigarettes, has been proven to be both physically and psychologically addictive. 

The cycle of addiction is very simple. 

Smoking cigarettes may give the smoker 

an immediate charge, but is followed by 

depression and fatigue, which leads the 

user to seek more nicotine.

“Ask yourself, do you want a tobacco-addicted servicemember on 

the battlefield going through nicotine 

withdrawal symptoms which include 

by lisa a. gates

— Continued on Page 16

Kick the habit and stop 

smoking. That’s the message that Defense Department health officials are 

hoping military members 

who currently smoke or use other 

tobacco-related products will take for 

action during this year’s annual Great 

American Smokeout campaign set for 

Nov. 20. 

The annual event sponsored by the 

American Cancer Society is in its 27th 

year and has helped to highlight the 

health risks associated with smoking 

and tobacco use as well as recognizing 

the challenges associated with kicking 

the habit. While the Great American 

Smokeout places an emphasis on quitting smoking for a full 24 hours, DoD 

health officials are hoping that current 

users of tobacco products will think of 

this day as the day to quit for good.

According to the American Cancer 

Society, it is estimated that cigarette 

smoking alone causes approximately 30 

percent of all cancer deaths and an annual total of 440,000 premature deaths 

due mostly to heart disease and cancer. 

An estimated 47 million adults in the 

United States currently smoke, and 

approximately half will die prematurely 

from smoking. Defense health officials 

estimate that approximately 16 percent, 

or one in six, of all deaths in both current and former military personnel is 

from smoking and using other tobaccorelated products.

“Smoking or using tobacco products 

is not only a health issue, but a force 

http://deploymentlink.osd.mil • fall 2003 Deployment Quarterly
Deployment Quarterly fall 2003 • http://deploymentlink.osd.mil

applied in small amounts. Apparently, 

smoking products contaminated with 

polytetra fluorosthylene, or PTFE, a 

component of SERPACWA generates 

harmful fumes. A flu-like syndrome 

called polymer fume fever has been 

reported in individuals exposed to 

these fumes. Long term effects of this 

fume-fever have not been determined. 

Vaccine

— Continued from Page 5

inattention, irritability, anger, frustration, anxiety and depression?” continued Williams. “And, at the same time, 

how do you make the choice whether 

to carry bullets or more cigarettes and 

dip to the battlefield so that you don’t 

go through withdrawal?”

While the DoD study shows that 

overall rates of cigarette use among 

military personnel are similar to the 

civilian population, the largest group in 

the military to use cigarettes and other 

tobacco products continues to be 18- to 

24-year-old males. 

“Most of those entering the military 

for the first time fall within this age 

group,” said Williams.

Both Messelheiser and Williams 

agree that basic recruit training is one 

of the best times to get the military’s 

newest and most vulnerable members 

to quit using tobacco products. All four 

services prohibit the use of any tobacco 

products during this period. Aside 

from the restrictions on tobacco use 

in basic training, there may also be restrictions on tobacco use at other levels 

of training throughout each of 

the services.

“While this is not a complete ban on 

tobacco use,” said Messelheiser. “Airmen are prohibited from using tobacco 

products during the early phases of 

technical training.”

One program designed to take 

advantage of the tobacco-free recruit 

environment is the Navy’s Reinforcing Education to AChieve Health, 

or REACH, Program. This program 

introduces the Navy’s newest sailors to 

military readiness, health and financial 

benefits that will result from a tobaccofree lifestyle. 

“Recruit training is the perfect time 

to talk about the benefits of being tobacco free,” said Williams. “Just prior to 

graduation [from recruit training], we 

show them that being tobacco-free is 

not only about being healthier, but 

also how they can benefit financially 

from being tobacco-free. We remind 

them how much money they saved 

by not using tobacco products during basic training.”

Williams said that the financial aspects of how much money was saved 

and how that money can be spent 

differently hits home for the tobaccofree recruits. The REACH program 

has resulted in a 50 percent reduction 

in tobacco use resumption within 

30 days of recruit graduation and a 

67 percent reduction of tobacco-use 

among first-time users.

“For most of recruits, the financial 

aspects of remaining tobacco-free 

after basic training encourages them 

to maintain a tobacco-free lifestyle,” 

said Williams. 

There are a number of options 

people can choose to stop smoking, 

from developing a “buddy system” 

with a friend who smokes and also 

wants to quit, to working with a 

health care provider on getting 

involved in a program with smoking 

cessation techniques and products. 

“Sometimes, the ‘one-size fits all’ 

approach doesn’t always work,” said 

Williams. “Sometimes tobacco users 

are too busy to attend quit classes. Providers at military medical and dental 

clinics may be able to help patients quit 

by offering medications and cessation 

help during clinical visits. This combination of medication and 

[behavior modification] therapy during 

a clinical visit is an additional way to 

help kick the habit, especially for those 

members who state they want to quit 

during their office visit.”

Cessation classes for smoked and 

smokeless tobacco are available on most 

military installations at health and wellness centers, clinics, family 

support centers, and hospitals. 

“The bottom line is, we want our 

military members to be healthy, and 

we are dedicated to helping people 

stop smoking or using other tobacco 

products,” said Embrey. ■

Smoking

— Continued from Page 15

So follow the product instructions to 

the letter.

If exposure to CWA is ever confirmed or suspected, you must 

follow the appropriate protocol for 

decontamination. As usual, you 

must follow all guidance issued by 

your commanders.

This is an excellent example of a 

pharmaceutical product developed to 

increase force health protection and 

the capability of our fighting forces. ■

Cmdr. Gene de Lara, Medical Service 

Corps, U.S. Navy, serves as the medical 

planner in the Deployment Health Support 

Directorate. He has a Doctorate of Pharmacy and a Masters of Business Administration. DeLara is both a pharmacist and 

medical planner, holding the 1805 Plans, 

Operations, and Medical Intelligence 

specialty code.

The National Cancer Institute

http://www.smokefree.gov/

Quit line: (877) 44U-QUIT 

or (877) 448-7848

The Office of the U.S. Surgeon General 

http://www.surgeongeneral.gov/tobacco/

The Centers for Disease Control 

and Prevention

http://www.cdc.gov/tobacco/how2quit.htm

The American Cancer Society

http://www.cancer.org

Quit line Service: (877) 937-7848 

The American Heart Association

http://www.americanheart.org

Phone: 800-AHA-USA1 or (800) 242-8721

The American Lung Association

http://www.lungusa.org/tobacco/quitting_

smoke.html

Quit line Service: (800) 548-8252 

For More Information 

To learn more about how you can quit, here is a list of resources you can visit 

or call for more information.
http://deploymentlink.osd.mil • fall 2003 Deployment Quarterly

healthbeat

people die each year from the flu and 

there are about 114,000 hospitalizations. Earlier this year, the CDC announced there are sufficient supplies 

of the flu vaccine. During the previous 

two years there was a vaccine shortage. 

The Food and Drug Administration 

has recently approved the use of a nasal spray using live vaccine. This spray 

is not part of the DoD core formulary 

in part because of its prohibitive cost 

and stringent storage requirements. 

If servicemembers need to receive 

their flu shots from civilian providers 

because of unusual assignment locations where they do not have ready 

access to a military treatment facility, 

they should ensure the information 

gets recorded in their military medical 

records. U.S. Navy Capt. Edward Kilbane, director of preventive medicine 

and occupational health, fleet operation support at the U.S. Navy’s Bureau 

of Medicine and Surgery, explained. 

“All sailors should make sure their 

flu shot is recorded in three places; 

their medical record, their International Certificate of Vaccination, also 

known as the yellow shot card, and in 

the Navy’s SNAP Automated Medical 

System, even if they receive their shot 

from a civilian provider.” 

The Army and Air Force had similar 

concerns. 

“We do not encourage people to go 

outside the military health care system 

to receive the influenza vaccine,” said 

U.S. Army Col. Paula Underwood, a 

preventive medicine staff officer in the 

office of the Army’s Surgeon General. 

“Part of implementing a quality vaccination program is being able to ensure 

compliance. The Army tracks compliance through MEDPROS, its Medical 

Protection System.” 

U.S. Air Force Maj. Mylene Huynh, a 

preventive medicine officer with the Air 

Force Medical Support Agency, added, 

“all Air Force vaccinations will be 

documented in the Air Force Complete 

Immunization Tracking Application, 

AFCITA. Any workplace vaccination 

campaigns or mass immunizations 

within the Air Force need to plan for 

this requirement.”

The flu virus is constantly changing 

so the flu vaccine changes each year 

U.S. Air Force photo by Staff Sgt. William Greer

Staff Sgt. Charles Halcome, from the 438th Expeditionary Medical Squadron, administers a flu shot 

to Col. Cynthia Snyder, commander of the 438th Expeditionary Mission Support Squadron, at a 

forward-deployed location supporting Operation Enduring Freedon. 

Make Flu Prevention Your Top 

Priority 

— Continue on Page 18

T

by melissa burslie

he military services are beginning 

their annual influenza vaccination 

programs. Influenza, commonly referred to as the flu, is a highly contagious viral infection of the respiratory 

tract. It often comes on suddenly and 

causes more severe symptoms than the 

common cold. These symptoms may 

include fever, cough, sore throat, runny 

or stuffy nose, headache, muscle aches 

and extreme fatigue. Most people 

recover in one to two weeks, but some 

people will develop life-threatening 

complications as a result of the flu. The 

most effective protection against the 

influenza virus is the flu vaccine. 

The best time to be vaccinated is in 

October or November, although people 

can still be vaccinated in December and 

beyond. The Army program officially 

began Oct. 15. The Navy and Air 

Force programs are already under way. 

Department of Defense policy requires 

influenza vaccination for all active 

duty personnel and Reserve personnel 

on active duty in excess of 30 days.

“Vaccines are important tools in 

the force health protection strategy,” 

said U.S. Navy Cmdr. Eugene de Lara, 

deputy program manager, health 

readiness, Deployment Health Support Directorate. “Influenza vaccination is especially important to the 

military because high sick call rates 

can undermine readiness. Many may 

not know about the influenza pandemic of 1918-1919, cited as the most 

devastating epidemic in recorded 

world history. It caused a four-month 

delay in U.S. troop deployments to the 

European theater during WWI. Also, 

military members and their families are 

stationed where new strains are likely 

to appear, and due to their mobile 

lifestyles that can easily spread the flu, 

immunizations are especially important.” 

According to the Centers for Disease 

Control and Prevention, about 36,000 
Deployment Quarterly fall 2003 • http://deploymentlink.osd.mil

Medical Board

— Continued from Page 7

U.S. Navy photo by Photographer’s Mate 2nd Class (NAO/SW) Michael Sandberg

Chief Warrant Officer Paul Holton of the Utah Army National Guard, 141st Military Intelligence 

Battalion, speaks with an Iraqi mother whose child is being treated at a Baghdad children’s 

hospital. Holton put his story on his Web site, http://chiefwiggles.blog-city.com, about Iraqi 

children needing toys. Donations came from more than 2,000 friends, family and other 

individuals from across the United States. Toys that were distributed included soccer balls, 

dolls, puzzles and other items. The Web site details what type of toys to send, the mailing 

address and photos of the actual distribution process. 

Toys For Iraqi Tots

as well. For that reason, it is important for servicemembers to get the flu 

shot annually. There are some minor 

side effects associated with the shot. 

Recipients may have some soreness 

at the injection site or a headache or 

low-grade fever for about a day after 

vaccination. These side effects are usually mild and do not affect a person’s 

ability to perform their normal daily 

activities. More often they occur in 

people who have not been exposed 

to the flu virus in the past. Contrary 

to popular belief, the injectable flu 

vaccine, which is offered by DoD, is 

incapable of causing actual influenza 

disease because it is made from killed 

flu viruses. 

The CDC’s Advisory Committee on 

Immunization Practices recommends 

that all persons who meet the following criteria be vaccinated against 

influenza: Age 50 years and older, age 

six months to 49 years old with 

high-risk medical conditions (asthma, 

chronic obstructive pulmonary disease 

— often referred to as COPD — cardiovascular disease, diabetes, other 

conditions affecting the immune 

system), pregnant women who will 

be in the second or third trimester of 

pregnancy during influenza season, 

children or teenagers on chronic longterm aspirin therapy or residents of 

nursing home or other chronic-care 

facilities, those likely to transmit 

influenza to persons at high risk such 

as health care workers, caregivers or 

household members in contact with 

persons having high-risk conditions, 

household contacts or out-of-home 

caretakers of infants and toddlers up 

to 23 months of age. The advisory 

committee also recommends influenza vaccination for children six to 23 

months of age because of their higher 

risk of hospitalization from influenza. 

Any other person six months of age or 

older wishing to reduce the likelihood 

of becoming ill with influenza may 

consider getting vaccinated.

Some people should not get vaccinated against influenza, says the CDC. 

These include people who are allergic 

to eggs, those who have had a severe 

reaction to the flu shot in the past, and 

pregnant women in their first trimester unless they have high risk medical 

conditions. If someone does get the 

flu, a doctor may recommend bed rest, 

at least six cups of clear fluids a day, 

and over-the-counter pain relievers 

and nasal decongestants to ease symptoms. Because influenza is a viral 

infection, antibiotics are not effective.

The flu vaccine prevents flu-related 

deaths, prevents severe illness, and 

protects other people. The DoD vaccination program is one way the Defense Department is safeguarding the 

health of its servicemembers and their 

families while maintaining mission 

readiness and accomplishment. If a 

servicemember or family member has 

a question or concern about the vaccination, they can get more information 

from their local health care provider at 

their military treatment facility or on 

the Internet 

at http://www.cdc.gov/nip/flu. ■

Flu Season

— Continued from Page 17

he said.

For others facing a medical 

board, officials said there are 

some things people can do to help 

ensure the board has the most 

accurate information so 

the best decision is made.

It is important to keep a 

dialogue going with both the 

physician and the physical 

evaluation board liaison officer. 

The liaison officer provides 

counseling and monitors specific 

cases. They know the process and 

can provide advice. 

Ignoring or delaying doctor’s 

appointments and paperwork 

deadlines only drags things 

out and could result in 

administrative problems. ■

“It’s difficult going through 

the diagnosis of a chronic, 

degenerative disease.”
http://deploymentlink.osd.mil • fall 2003 Deployment Quarterly

Training Down Under

Queensland Australia — U.S. Marines from 2nd Battalion, 3rd Marines, Kaneohe Bay, Hawaii, tend to a 

mock casualty inside the Shoalwater 

Bay Training Area, Queensland, 

Australia, for a Quick Reaction Force 

exercise during Exercise Crocodile held 

in September 2003. The goal of 

the Exercise Crocodile is to improve 

bilateral combat readiness and interoperability between American 

and Australian Armed Forces through 

combined training operations. 

U.S. Marine Corps photo by 

Lance Cpl. James P Douglas 

Ask The Doc

— Continued from Page 5

from donors whose symptoms had 

not yet begun.

In addition, any servicemember 

who actually comes down with 

either cutaneous leishmaniasis or 

visceral leishmaniasis disease will 

be permanently deferred from 

blood donations. This precaution 

is similar to the usual lifetime deferrals for people who have 

ever had viral hepatitis.

In recent years, the Armed Services Blood Program had to defer 

donors due to malaria risks around 

the world, and also had 

to defer people who might have 

been exposed to a variant of 

Creutzfeldt- Jakob disease — better known as “Mad Cow” disease 

— or who lived in certain parts of 

Europe for specified time periods 

between 1980 and 1996.

Both the Armed Services 

Blood Program, http://www.tricare.

osd.mil/asbpo/index.htm, and the 

American 

Red Cross, http://www.givelife.org, 

offer information about donating 

blood and donor eligibility guidelines. To learn more, 

call 1-800-GIVE-LIFE or 

 is very low, Loftus said he realizes 

the retirement of the C-9 will affect 

some people who have relied on 

that system for a variety of reasons, 

including specialized medical care 

and space-available travel.

“This is all 

about taking care 

of patients,” said 

the general. “And that’s what 

we’re all about.”

Col. George Tirabassi, deputy 

chief of AMC’s Operations 

Management Division, AE, said the 

C-9 Retirement

— Continued from Page 11

“This is all about taking 

care of patients.”

people who have been involved in 

AE operations for more than a few 

years know that the AE system has 

always been bigger than the C-9.

“The C-9 was undoubtedly the 

flagship of aerovac,” Colonel Tirabassi 

said. “But we know there 

is an awful lot of aerovac that goes 

on in the world that 

doesn’t 

involve the C-9. 

[During wartime 

operations], the 

Army medevacs patients using helicopters within the theater, and 

the Air Force moves patients using 

any available AE capable mobility 

aircraft. The wartime AE system has 

worked 

very well 

without 

C-9s.”

AMC officials 

are 

confident 

a CONUS 

aeromedical 

evacuation 

system 

without 

C-9s will 

work 

equally 

as well. ■
Deployment Quarterly fall 2003 • http://deploymentlink.osd.mil

other resources

Air Force Association

1501 Lee Highway

Arlington, VA 22209-1198

Phone: (800) 727 - 3337

http://www.afa.org

American Legion

1608 K St., NW

Washington, DC 20006

Phone: (202) 861 - 2700

http://www.legion.org

American Red Cross

17th & D Streets, NW

Washington, DC 20006

Phone: (202) 639 - 3520

http://www.redcross.org

American Veterans

4647 Forbes Blvd.

Lanham, MD 20706

Phone: (877) 726 - 8387

http://www.amvets.org

Association of the U.S. Army

2425 Wilson Blvd.

Arlington, VA 22201

Phone: (800) 336 - 4570

http://www.ausa.org

Department of Veterans Affairs

810 Vermont Ave., NW

Washington, DC 20400

Phone: (202) 273 - 4300

http://www.va.gov

Disabled American Veterans

807 Maine Ave., SW

Washington, DC 20024

Phone: (202) 554 - 3501

http://www.dav.org 

Enlisted Association of 

the National Guard

1219 Prince St.

Alexandria, VA 22314

Phone: (800) 234 - 3264

http://www.eangus.org

Fleet Reserve Association

125 N. West St.

Alexandria, VA 22314-2754

Phone: (703) 683 - 1400

http://www.fra.org

Marine Corps Association

715 Broadway St.

Quantico, VA 22134

Phone: (866) 622 - 1775

http://www.mca-marines.org

Marine Corps League

8626 Lee Highway, #201

Merrifield, VA 22031

Phone: (800) 625 - 1775

http://www.mcleague.org

National Association for 

Uniformed Services

5535 Hempstead Way

Springfield, VA 22151

Phone: (800) 842 - 3451

http://www.naus.org

National Committee for Employer 

Support of the Guard and Reserve

1555 Wilson Boulevard, Suite 200

Arlington, VA 22209-2405

Phone: (800) 336 - 4590

http://www.esgr.org

National Guard Association

of the United States

1 Massachusetts Ave., NW

Washington, DC 20001

Phone: (202) 789 - 0031

http://www.ngaus.org

Naval Reserve Association

1619 King St.

Alexandria, VA 22314-2793

Phone: (703) 548 - 5800

http://www.navy-reserve.org

Navy League

2300 Wilson Blvd.

Arlington, VA 22201

Phone: (800) 356 - 5760

http://www.navyleague.org

Non Commissioned 

Officers Association

225 N. Washington St.

Alexandria, VA 22314

Phone: (703) 549 - 0311

http://www.ncoausa.org

Reserve Officers Association

1 Constitution Ave., NE

Washington, DC 20002

Phone: (800) 809 - 9448

http://www.roa.org

Military Officers Association 

of America 

201 N. Washington St.

Alexandria, VA 22314

Phone: (800) 245 - 8762

http://www.moaa.org

Veterans of Foreign Wars

200 Maryland Ave., NE

Washington, DC 20002

Phone: (202) 543 - 2239

http://www.vfw.org

Vietnam Veterans of America

8605 Cameron Street, Suite 400

Silver Spring, MD 20910-3710

Phone: (301) 585 - 4000

http://www.vva.org

By Phone 

Direct Hotline for Servicemembers, 

Veterans and Families 

(800) 497 - 6261

Deployment Health Clinical Center

(866) 559 - 1627

Department of Veterans Affairs

(800) 827 - 1000

VA Gulf War Registry 

(800) 749 - 8387

VA Benefits and Services 

(877) 222 - 8387

On the Web

Department of Defense

http://www.defenselink.mil

Department of Veterans Affairs

http://www.va.gov/

DeploymentLINK

http://deploymentlink.osd.mil

GulfLINK

http://www.gulflink.osd.mil

TRICARE

http://www.tricare.osd.mil/

re- guide