Features

2

6

7

Commentary. Army’s top enlisted soldier, Sgt. Maj. of the Army Ken Preston, 

stresses safety.

Depleted Uranium. DoD issues new 

medical management policy for OIF 

veterans exposed to DU.

Valuable Expertise. Air Force civilians 

find themselves deployed overseas 

providing expertise in the field.

Bringing Families Closer. The National 

Guard Bureau’s Distributive Technology 

Project provides support for deploying 

soldiers and families.

Golden Hour. Researchers test new 

container to transport blood to the 

frontlines in an effort to save lives.

Militarystudent.org. The Defense 

Department launches new Web site 

aimed at helping military youth navigate changes due to moves and deployments.

2004

10

winter

VA Kids. The Department of Veterans Affairs 

establishes new Web site to help today’s 

youth understand what it means to be a 

veteran.

A Soldier’s Story. An Army critical care nurse 

from Kentucky finds a challenge in caring for 

injured soldiers.

Suicide Prevention. Air Force officials urge 

leaders to assess and re-energize suicide prevention efforts among airmen. 

Deployed to Africa. Personnel from Fleet 

Hospital Jacksonville leave Florida for Africa 

in support of the Combined Joint Task Force, 

Horn of Africa.

14

15

13

16

In Every Issue

News From Around The World 3 

No War Trophies Allowed From Iraq, Afghanistan

New Tax Relief Act Aids Servicemembers, Families

Ask Our Doctors 5

Recommended Treatment For Leishmaniasis 

Vaccines, Drugs & Herbs 5

How To Manage Prescription Medications While Deployed

Gulf War Update 9

Military Health Care Doctors Better Prepared 

To Assess Troops’ Health

Health Beat 17

Awareness Is Key To Suicide Prevention 

Resource Guide 20

On the Cover

Spc. Janet Sutter, a gunner 

with the 233rd Military Police 

Company, 519th MP Battalion, 

18th MP Brigade, pulls security 

with her M249 squard automatic 

weapon in Baghdad. 

U.S. Army photo by Staff Sgt. Marvin L. Daniels

14

17

U.S. Army photo by Spc. Clinton Tarzia

Soldiers of Battle Company, 5th Battalion - 20 Infantry, 3rd Brigade, 2nd 

Infantry Division (Stryker Brigade Combat Team) form a perimeter during 

a patrol in Samarra, Iraq, on Dec. 15, 2003. The 3rd Brigade, 2nd Infantry 

Division (Stryker Brigade Combat Team) is under the operational control of 
Deployment Quarterly Winter 2004 • http://deploymentlink.osd.mil

I

guestcommentary

Sgt. Maj. of the Army:

Stresses Safety As A Top 

Priority Among Soldiers

by spc. lorie jewell 

army news service

n his first few weeks as the Army’s top enlisted soldier, 

Sgt. Maj. of the Army Ken Preston, said he’s getting a crash 

course on the ‘big picture’ Army while zeroing in on key 

issues he’ll focus on.

“Right now, I need to understand a little bit of everything 

across the board,” Preston said during his first “Sergeant’s 

Time” interview as sergeant major of the Army with Soldiers 

Radio and Television. “The Army staff is doing a wonderful job in getting me smart. Once they finish, I’ll really start 

focusing on a couple things I can make a difference on over 

the course of the next three or four years.”

Safety is one of those issues. With a mandate from the 

secretary of defense to reduce the accident rate by 50 percent, Preston plans to spearhead plenty of dialogue about 

the subject. So far this quarter, 79 soldiers have died in 

accidents — 20 more than the first quarter of fiscal year 2003, 

Preston said. From fiscal years 2001 to 2003, the number of 

accidental deaths in the Army jumped from 168 to 255, according to the U.S. Army Safety Center at Fort Rucker, Ala.

“It’s about not becoming complacent,” Preston said. “It’s 

ensuring soldiers out there follow procedures established in 

policies, regulations, operating manuals.”

Sergeants have a responsibility for enforcing the standards, for making sure soldiers aren’t taking short cuts or 

taking things for granted, he added.

Preston acknowledged that the current fast-paced operations tempo plays a role in the accident rate, but stressed he 

believes awareness can make a difference. 

“We have 325,000 soldiers in more than 120 countries 

across world, and eight divisions in transition. The operations tempo is much higher, but nevertheless when a soldier 

dies because of accident, particularly when it could be prevented, it’s a tragedy,” Preston said. “I really think that the 

more we focus on it and the more we talk about it, even with 

the current pace of operations, we can reduce the rate.”

The Army’s most pressing priority at the moment is the 

global war on terrorism and upcoming troop movements 

into and out of theaters, Preston said. But leaders are also 

focused on concurrent goals, such as transitioning from a 

current to future force that remains relevant and ready, 

he added.

“As the Army changes and evolves, so must other things,” 

Preston said. “One of the things I want to look at is the 

future of the non-commissioned officer education system. It needs 

to evolve to take into 

consideration the modern battlefield we’re currently on.”

The Army’s current design and organization was for the 

cold war-era fight, for a time when the good guys were at 

one end of the battlefield, the bad guys at the other, and 

they met in the middle for a “clash of the Titans” type 

battle, Preston explained.

“It is truly now a 360-degree battlefield,” he said.

Training centers like the National Training Center in California and the Joint Readiness Training Center in Louisiana 

are evolving to incorporate the lessons soldiers are learning in Afghanistan and Iraq, Preston added. Emphasizing 

the warrior’s ethos is another way of mentally preparing 

soldiers for the new battlefield.

“The warrior’s ethos is what quantifies what soldiers are 

about today,” Preston said. “If you look at what’s going on 

in Iraq, all soldiers there are warriors. The mentality that 

every soldier is a rifleman first is so, so important.”

Balancing the force is another way of better preparing for 

the new battlefield. Preston said the Army’s 100 artillery 

battalions were designed, again, for the cold war era. That 

number will be pared down, while other units in heavy 

demand — military police, for instance — will be increased. 

The current 33 brigade combat teams will be refigured into 

48 brigade units of action, he said.

Such changes will not only make the Army more modular and better able to quickly deploy, but will offer soldiers 

more predictability in when they’ll deploy, 

Preston said.

Soldiers are encouraged to e-mail Preston at smaweb@

hqda.army.mil with their questions and concerns. To learn 

more about the Sergeant Major of the Army, go 

to his Web site at http://www.army.mil/leaders/SMA/. ■

Editor’s Note: Sergeant Major of the Army Kenneth O. 

Preston was sworn in as the 13th Sergeant Major of the 

Army on January 15, 2004. He serves as the Army Chief 

of Staff’s personal adviser on all enlisted-related matters, 

particularly in areas affecting soldier training and quality 

of life. 
http://deploymentlink.osd.mil • Winter 2004 Deployment Quarterly

ASHINGTON — Do not even think 

about bringing back to the United 

States war trophies from your service 

in Iraq and Afghanistan. 

With about 140,000 American 

servicemembers due to rotate out of 

Iraq and Afghanistan, U.S. Central 

Command officials are very clear that 

servicemembers cannot bring home 

weapons, ammunition and other prohibited items. 

A few soldiers of the 3rd Infantry 

Division understand how serious the 

command is. Some soldiers tried to 

smuggle weapons back from Baghdad, and they have gone through 

courts martial. Others received Article 

15 administrative punishments. 

“There is a whole spectrum of 

punishments, depending on the severity of the offense,” said Maj. Robert 

Resnick, an Army lawyer at Fort 

Stewart, Ga. 

Army Gen. John Abizaid, the commander of U.S. Central 

Command, has put out the policy. 

Basically, under no circumstances 

can individuals take as a souvenir an 

object that was formerly in the possession of the enemy. The taking of 

war trophies goes against the coalition 

mission in Iraq and 

Afghanistan, officials said. 

“We didn’t go into Iraq or 

Afghanistan to conquer them, but 

to liberate them,” said Marine Capt. 

Bruce Frame, a CENTCOM

spokesman. “Taking articles from 

those countries sends the wrong message.” 

Servicemembers with questions 

should work through the chain of 

command, CENTCOM officials said, 

adding that servicemembers will 

be given ample briefings on what is 

No War Trophies Allowed 

From Iraq, Afghanistan

allowed and what is not. In the case 

of Iraq, unit commanders will brief 

servicemembers on the policy before 

leaving for Kuwait. 

In Kuwait, military police will explain the policy and will permit an amnesty period before searching gear and 

vehicles. In the United States, U.S. 

Customs Service officials will examine 

individual gear. 

In Afghanistan, unit commanders 

will explain the policy, and military 

police there also will explain it and 

offer an amnesty period before the 

servicemembers board the planes. 

Again, custom officials will examine 

gear and baggage upon return to the 

United States. 

The same prohibitions pertain to 

American civilians serving in the Central Command area of operations. 

Other federal laws pertain to other 

items. For example, servicemembers 

cannot bring back plants, animals 

or other organic materials. Some 

Marines returning from Afghanistan 

in April 2002, for example, tried to 

bring back the skulls of sheep attached to their guidons. The Customs 

agents met the Marines as they landed 

on the beach at Camp Lejeune, N.C., 

and confiscated the items. 

No one can bring back antiquities 

into the United States, and of course, 

no one can bring drugs or drug paraphernalia into the United States. 

The overall prohibition does not 

pertain to souvenirs that can be legally 

imported into the United States, officials said. ■

Casting Call

U.S. Navy photo by Photographer’s Mate 3rd Class Jason R. Williams

Aboard the USS Kitty Hawk (CV 63) — Hospital Corpsman 3rd Class Jontae Moreau, from 

Saratoga Springs, N.Y., applies cast material to the arm of Damage Controlman Fireman Juan 

Campos, from Orange County, Calif. This is one of the many procedures Kitty Hawk’s medical 

department may perform in a normal day at sea. 
Deployment Quarterly Winter 2004 • http://deploymentlink.osd.mil

W

news from around the world

to be fair for the military family who 

was left grieving for their service 

member to get hit with a tax bill,” she 

added. 

Capital gain exclusion for home 

sales is one of the most common areas 

people were looking for tax relief 

in, said Fenton. “This act will allow 

members to suspend the period of 

time which they have to sell their 

home and take the tax exclusion so 

they won’t have to pay that capital 

gains,” said Fenton. “It’s retroactive 

to 1997 so military members who have 

sold their homes since 1997 have one 

year from Nov. 11, 2003, to request a 

refund for any tax they did pay.” 

Since 1997, when the law was previously changed, if service members 

who owned a home got reassigned 

more than 50 miles from that home or 

were ordered to move on post, they 

were no longer able to roll over the 

gain from that sale to the next home 

they purchased. 

Also since 1997, individuals could 

exclude up to $250,000, or $500,000 

for married couples, of gain from the 

sale of a home if they resided in the 

home for two of the five years preceding the sale. Under this act, military 

and Foreign Service personnel can 

suspend — for up to 10 years — the 

time transferred away from home on 

official extended duty for purposes of 

applying the five-year portion of the 

two-out-of-five-year rule. 

The 2003 act also includes abovethe-line deduction for overnight travel 

expenses of National Guardsmen and 

Reservists who have to travel more 

than 100 miles to attend drills or meetings. 

“The act allows for an above-theline, which means you don’t have to 

itemize your taxes to take advantage 

of this deduction,” said Fenton. She 

added that servicemembers will “be 

able to deduct unreimbursed travel 

expenses such as lodging, 50 percent 

of meals and any transportation costs. 

“This part of the act is retroactive to 

Jan. 1, 2003.” 

When the tax code changed in 1986, 

it said any military benefit existing 

in September 1986 would remain 

tax-free, said Fenton. However, it was 

always unclear whether military child 

care was included in that, she added. 

“This act merely makes it clear that 

those provisions of child care were 

intended to be tax-free to military 

members.” 

The tax act also provides for extra 

tax-filing time for troops serving in 

contingency operations. The internal 

revenue code allows servicemembers 

who are serving in combat zones 

or hazardous duty areas to have an 

extension of time — usually 180 days 

from the time the person leaves the 

combat zone — to file taxes. 

“A lot of military operations don’t 

rise to the level of being declared by 

the president as ‘combat,’” said Fenton. “But there are several contingency operations where servicemembers 

are outside the continental United 

States.” 

The act also includes modifying 

eligibility criteria of tax-exempt veterans organizations; tax-free treatment 

of homeowners’ assistance program 

payments; suspension of tax-exempt 

status for designated terrorist organizations; and extension of victims’ tax 

relief to astronauts who die on space 

missions. ■

New Tax Relief Act 

Aids Servicemembers, 

Families

U.S. Marine Corps photo by Lance Cpl. Ruben Maestre

CAMP LEJEUNE, N.C. – Marine Sgt. Chad E. Lindsey, an Arabic linguist and vehicle commander 

assigned to 2nd Radio Battalion, II Marine Expeditionary Force, poses next to his light armored vehicle 

specially outfitted for signals intelligence and electronic warfare. Lindsey, a native of Woolrich, Maine, 

received recognition on Nov. 7, 2003, as the Marine Linguist of the Year and runner-up Linguist 

of the Year for the Department of Defense. Next to Lindsey, is the name of his vehicle, “Jolly 

Roger,” written in Arabic. 

Arabic-Speaking Marine 

Chosen As Linguist Of The Year

ASHINGTON — Legislation signed 

by President Bush on Veterans Day in 

2003 increases the death gratuity payment to $12,000 and provides that the 

full payment is tax-free. 

That portion of the Military Family 

Tax Relief Act of 2003 is retroactive to 

Sept. 10, 2001, to provide for servicemembers who died in the terrorist 

attacks the following day and in the 

ongoing global war on terror, said 

Army Lt. Col. Janet Fenton, director, 

Armed Forces Tax Council. 

“If you are killed on active duty, regardless of whether you’re in theater, 

or in a training accident or die from 

disease, your family receives $12,000 

death gratuity that is not taxed,” she 

added. “And that’s a big change. In 

addition any future increases to the 

death gratuity will remain tax free.” 

The death gratuity has been $6,000 

since 1991, with half of it being taxed, 

said the director. “It just didn’t seem 
http://deploymentlink.osd.mil • Winter 2004 Deployment Quarterly

drugs & herbs

I have been taking a couple 

of prescription medications 

for quite some time, and 

now I am about to deploy 

overseas to a hot, arid, 

inhospitable country. I 

Thank you for the question. Let me say you 

are doing the single 

most important thing 

when it comes to taking 

Q

Q

A

ask doc

vaccines

in a safe and wise 

manner. 

Additionally, you 

were correct in 

seeing your unit’s 

medical officer for 

clearance and deployablity and have 

been given the OK. 

You are on the right 

track. Here is some 

additional information that may be 

helpful:

Store your medications wisely. 

Being on a deployment can present 

some challenges for safe storage of 

your medications, particularly if you 

are in a job that requires you to be in a 

field environment. However, it’s not 

impossible and common sense goes 

a long way. Keep your 

medications in the original container. Those amber prescription bottles 

are actually very good at 

protecting the drug from 

dust, moisture, rough 

treatment, and other 

things one experiences 

when out in the environment. But, remember 

they weren’t designed 

for the field. You must 

do your part to keep 

your medications away 

from heat and moisture, 

which may reduce its potency or even 

totally render them ineffective.

Take at least a three-month supply. 

 Before leaving on deployments 

visit your military pharmacy. Usually 

have been given the OK by our medical 

officer, but there are a lot of little nagging 

questions I have about storage, quantity to 

take, getting refills, etc. Can you provide 

some general information on this topic?

your medication. Which is, not being 

afraid to ask questions! It’s the only 

way you can make informed decisions, 

stay within defined military rules and 

regulations, and use your medicines 

— Continued on Page 8

-— Continued on Page 8

Why are so many 

soldiers in Iraq catching that skin condition 

called leishmaniasis?

We discussed leishmaniasis in the Fall 

2003 issue, where there 

was a description of the 

disease and its impact. 

Since then, the total number of cases 

of skin leishmaniasis among American troops in Iraq and Afghanistan 

has risen to more than 500. This 

infection shows itself as one or more 

open skin sores or ulcers — “Baghdad boil” — that can enlarge and 

form disfiguring scars. Although 

the skin form of this infection will 

eventually heal itself, treatment is 

recommended for cases where there 

are many sores or the sores are large. 

The usual treatment is an investigational drug called Pentostam, 

although other treatments are being 

studied.

The parasite that causes leishmaniasis is spread to 

people by the 

bite of infected 

sand flies. During the sand fly 

biting season 

— March to 

November — in 

Iraq, there are 

plenty of sand 

flies around. 

Even before the 

coalition forces 

entered Iraq, it 

was well known 

that leishmaniasis was common 

there. U.S. military studies have 

confirmed the presence of sand flies 

in great numbers and have shown 

that as many as 2 percent of them in 

some areas are carrying the parasite. 

The recent increase in cases is due to 

bites during the last biting season. It 

can take weeks to months before the 

sores appear at the site of the bites.

Because there is no effective vaccine or protective medicine against 

this disease, the best way to avoid 

getting this infection is to keep from 

getting bitten by the sand 

flies. Each soldier in the 

field has to do this himself. 

There are three ways to 

repel the sand flies, and 

service-members in Iraq 

and Afghanistan should do 

them all.

First, when the weather 

permits, troops should 

cover as much of their 

skin as possible with their 

uniform. Clothing is a 

strong mechanical barrier 

that keeps the bugs away 

from the skin. Second, the uniform 

or other outer clothing should be 

pretreated with the repellant called 

permethrin. A single, good uniform 

treatment will last for months, even 

with laundering. The purpose is to 

keep the sand flies from even landing 

on the uniform, from where they 

could move to exposed skin. 

Third, troops should apply DEET 

repellant to their exposed skin. 

Military supplies of DEET lotion are 

stronger and last longer on the skin 
Deployment Quarterly Winter 2004 • http://deploymentlink.osd.mil

ingested or inhaled. 

The DoD policy for medical management is based on level of exposure. 

Level I includes individuals who were 

in, on, or near combat vehicles at the 

time they were struck by depleted 

uranium munitions, or who entered 

immediately after the strike to attempt 

rescue. 

Level II includes individuals who 

routinely entered vehicles damaged 

by depleted uranium rounds as part 

of their military occupation or who 

fought fires involving depleted uranium munitions. 

Level III includes individuals who 

have driven through smoke from depleted uranium munitions fires, who 

have entered or climbed on or in battle-damaged vehicles that may have 

been contaminated with depleted 

uranium, or who had other infrequent 

and short-time exposures, which are 

considered incidental in nature. 

“Experience from the 1991 Gulf 

War indicates that individuals with 

incidental exposures are unlikely 

to have experienced any significant 

exposure to depleted uranium,” said 

Postlewaite.

Dr. William Winkenwerder, the assistant secretary of defense for health 

affairs, directed the military service 

surgeons general to identify all Operation Iraqi Freedom servicemembers 

with possible Level I and II exposures 

to DU so that their exposures may 

be clinically assessed. Those with 

primary responsibility for identifying possibly exposed individuals are 

commanders and medical officers in 

the field. 

Another key method to identify 

those servicemembers who may have 

been exposed involves the completion 

of a DoD Form 2796, “Post Deployment Health Assessment,” at the 

time of redeployment. Any returning 

deployed individual who indicates a 

possible exposure to depleted uranium on this form will be referred to a 

health care provider to determine the 

exposure level. 

To document any Level I or II 

exposures that may have occurred, the 

policy requires testing of the urine for 

the presence of depleted uranium. For 

Level III exposures, depleted uranium 

testing is not required, but medical 

care providers may order the testing if 

needed for medical management or to 

address concerns of the individual.

The DoD policy also specifies that 

after wounds are treated and the patient is fully stabilized, depleted uranium fragments should be removed 

unless the medical risk to 

the patient is too great. 

Two potential hazards associated 

with exposure to large amounts of depleted uranium are heavy metal toxicU.S. Army photo by Pvt. Daniel D. Meacham

A soldier from the 4th Infantry Division in an M1A1 Abrams tank guards the north gate at the 

Al Mosul Airport in Mosul, Iraq.

DoD Issues Medical Management Policy For 

Depleted Uranium-Exposed OIF Veterans

— Continued on Page 8

by joan kennedy

n keeping with its strong commitment 

to ensuring the health of servicemembers and civilian personnel, the assistant secretary of defense for health 

affairs recently issued a policy for the 

medical management of individuals 

exposed to depleted uranium during 

Operation Iraqi Freedom. The guidance clarifies who, why, when, and 

how the military services should test 

for possible depleted uranium exposure during and after deployment and 

combat operations. 

“For some 70 Gulf War veterans 

who were in the highest depleted 

uranium exposure group and subsequently enrolled in the [Department 

of] Veterans Affairs’ depleted uranium medical follow-up program, the 

medical community has yet to identify 

any untoward health consequences 

a decade after their exposure on the 

battlefield,” said Craig Postlewaite, 

D.V.M., M.P.H., who leads the environmental health team in the Department of Defense’s Deployment Health 

Support Directorate. 

The purpose of the new policy is to 

identify and test those who may have 

been exposed to significant levels of 

depleted uranium while deployed. 

According to Postlewaite, the 

policy directs compliance with an 

approved medical protocol following 

sound clinical practices; standardizes 

the way depleted uranium tests are 

performed; and helps DoD meet its 

obligations for ensuring 

the health of our 

deployed personnel. 

When depleted uranium 

munitions penetrate armored 

vehicles or 

when depleted 

uranium munitions burn, 

aerosols made up 

of very fine particulates are generated. Individuals are 

exposed to depleted uranium when 

fragments embed in the body or when 

depleted uranium particulates are 

“

The medical 

community has 

yet to identify any 

untoward health 

consequences a 

decade after their 

exposure on the 

battlefield.
http://deploymentlink.osd.mil • Winter 2004 Deployment Quarterly

Deployable Civilians 

Provide Valuable 

Expertise 

and Technical 

Services division. 

“We don’t 

hire people 

right out of 

high school 

or college. 

We want 

people who bring technical expertise 

to the table,” Malone said. “When 

you put three or four [of our civilians] 

together, you probably have about 50 

or 60 years worth of experience. They 

are the go-to guys when you have the 

most critical technical problems.”

The AFETS program began in 1966, 

but limited guidance and logistical 

constraints made deploying its civilians difficult until 1990, he said.

Deploying civilians became easier 

when they began to be viewed as an 

integral part of the total force concept, 

said Bob Harmon, acting chief of the 

division’s communications team. 

“Becoming a part of the deployment footprint allowed the military 

to not only [use these civilians] more 

easily, but we also began to train for 

the deployment phase, as well for 

the technical requirements,” Harmon 

said. “Now we have better guidance 

in place. [The civilians] are part of 

any Phase-I inspection. So now when 

we deploy our civilians, we have line 

numbers associated with them, just 

like the active duty side.” 

Many prior-service civilians see few 

differences between their former lives 

in the military and their current lives. 

They said they still enjoy the training 

and camaraderie of the military but 

have exchanged titles like “airman” 

and “sergeant” for “Mr.” and “Ms.”

“When I deployed to the Middle 

East after Desert Storm, I was part of 

an air control squadron. It was almost 

like being back in the military,” said 

Rich Miller, an ACC command system 

integrator who spent 12 years in the 

Air Force. “I found a lot of acceptance 

in my unit from my active-duty counterparts because they felt I was a very 

important part of the team effort.” 

As a civilian technician, Miller said 

much of the acceptance was fostered 

before the unit deployed, while he 

was training military technicians for 

worldwide contingencies. 

“You stand in line with them at the 

immunization line, put your gas mask 

on during exercises and deploy to the 

field when the unit is practicing local 

communication exercises. When you 

are tasked to deploy, you process the 

readiness line, get on an airplane and 

land in a foreign country ready to accomplish the mission,” he said.

But civilians in the field today do 

more than that, Miller said. 

“They not only train and deploy 

with their home units, but they are 

constantly [on temporary duty], assisting other ... units with training 

and technical support,” he said.

In the past decade, the number of 

civilian deployments has increased 

significantly. They have filled 150 

deployment requirements since Sept. 

11, 2001, Malone said. 

“As the blue-suit environment 

geared up, we got busier. We mirror 

the [operations tempo] of the active 

duty force,” he said. “The more the 

Air Force draws down, the more 

AFETS [civilians] are called upon. We 

used to provide the technical assistance by phone. Now they want us on 

site at the deployed location.”

The program has gained greater 

acceptance by commanders in the 

— Continued on Page 12

by capt. amie brockway

air combat command public affairs

hen their units are called to deploy, 

they line up for their smallpox and 

anthrax shots, they pack camouflage 

uniforms and dog tags, they get 

weapons training, and brush up on 

their self-aid and buddy-care skills. 

But these warriors are not airmen 

— at least not in the traditional sense.

They are Air Force Engineering and 

Technical Services civilians who work 

shoulder-to-shoulder with the activeduty force, providing continuity and 

years of expertise to aircraft maintenance and communication units Air 

Force-wide. 

Though they are noncombatants, 

the civilians deploy worldwide with 

their units supporting the Air and 

Space Expeditionary Force. Being 

willing to deploy is part of their job 

description and a condition of their 

employment.

Of the 540 AFETS civilians throughout the Air Force, 325 are assigned to 

Air Combat Command. More than 

90 percent have served in the military 

before transitioning to a similar field 

as a civilian. They bring with them 

an average of 15 years of technical expertise, said Dr. Frank Malone, chief 

of the Combat Air Forces Engineering 
Deployment Quarterly Winter 2004 • http://deploymentlink.osd.mil

ity and low-level radioactivity. Heavy 

metal toxicity is the major concern and 

can cause kidney damage. The radioactivity is a theoretical risk. However, the 

Centers for Disease Control’s Agency 

for Toxic Substances and Disease Registry has stated no cancer or leukemia 

has been associated with exposure to 

natural or depleted uranium.

The departments of Defense and 

Veterans Affairs continue to partner on 

health care for depleted uranium exposed individuals. The VA established 

an ongoing depleted uranium 

exposure-monitoring program in 1993 

for servicemembers believed to have 

had the most severe depleted uranium 

exposures during the Gulf War. To date, 

according to the researchers following 

those highly exposed servicemembers, 

those with embedded fragments still 

have high urine levels of depleted uranium. However, there have been 

no instances of lung or bone cancer, or 

leukemia. If the urine uranium level is 

normal now, regardless of the 

exposure experienced, there is no reason 

for concern; it is those with fragments, 

who are still being exposed, who need 

to be followed. All 

Operation Iraqi Freedom service-members confirmed with Level I and 

II exposures will be offered referral to 

the Baltimore VA Medical Center’s Depleted Uranium Medical Follow-Up 

Program through their primary 

care physicians. 

For those who have concerns 

about potential exposures to depleted 

uranium and its associated health 

risks, they can call the Deployment 

Health Support Directorate’s Direct 

Hotline toll-free phone number at 

(800) 497 - 6261 Monday through 

Friday from 9 a.m. to 9 p.m., 

Eastern Time, to have their concerns addressed. Or, if they prefer, people 

may e-mail at special.assistant

@deploymenthealth.osd.mil. 

More information about depleted 

uranium is available on the DeploymentLINK at 

http://www.deploymentlink.osd.mil/du_library/. ■

DU Policy

—Continued from Page 6

a three-month supply of medications 

is authorized for someone going on 

deployment. There may be some 

exceptions for some type of drugs, but 

talk with the pharmacy staff. They 

will be more than happy to assist you. 

The new Tricare Mail-Order Pharmacy, which began in March 2003, may 

also be useful if you are in a location 

conducive to receiving mail packages. 

This can include temporary, APO and 

FPO addresses. For information on 

Tricare 

Mail-Order Pharmacy visit its Web site 

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

tmop.cfm.

Be familiar with your medication. 

Know both the generic and trade 

name. It’s interesting how many times 

people will say, “I forgot to bring my 

blue blood pressure medications,” 

but when asked the name of the drug, 

they haven’t a clue. Medications often 

are beneficial, but they must be taken 

seriously. In addition to knowing the 

drugs’ name, you should also know 

what the drug does, the strength, 

how much to take, how long to take 

it, any side effects and what to do if 

they occur, what you should do if you 

miss a dose or two, and any precautions. Some medications make you 

extremely sensitive to sunlight. If you 

are going to a desert environment, 

you know you will be exposed to a lot of 

sunlight.

Do not give your prescription 

medication to other people. 

This can be very dangerous. The 

medication is for your specific medical 

condition and may not be the correct 

treatment for someone else. For active 

duty personnel, any prescription medication you are taking must be recorded in 

your medical record.

Again, the most important advice I 

can give is use common sense. If you 

have any doubts or further questions 

when on your deployment, ask your 

medical folks. I appreciate the question 

and your dedication. Keep charging 

ahead. ■

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. 

De Lara is both a pharmacist and medical 

planner, holding the 1805 Plans, Operations 

and Medical Intelligence specialty code. 

Editor’s Note: In December 2003, 

Cmdr. de Lara deployed to Iraq. He will 

continue to provide articles.

Vaccines, Drugs

—Continued from Page 5

Ask The Doc

—Continued from Page 5

than commercial, over-the-counter 

products. Military DEET is a free 

supply item and doesn’t have to be 

applied as often as commercial products, most of which contain the same 

active ingredient — DEET — but, just 

less of it.

Sand flies do most of their biting 

after dark, so the precautions described above should be emphasized 

every evening. As a supplement, if 

troops can sleep under a fine bed net 

that has been sprayed with permethrin, they can increase their level of 

protection.

Getting back to the original 

question, studies have shown that 

soldiers need constant reminders 

and reinforcement to keep up their 

guard against biting insects. It’s 

easy to forget to use the repellant. 

It takes diligence and discipline to 

apply repellant several times a day, 

especially during the hot weather of 

the biting season, when it may not 

be pleasant to put lotion on the skin. 

Some troops prefer to use commercial 

products, but they don’t last as long. 

Furthermore, some troops have relied on bogus remedies that not only 

don’t work but also are potentially 

dangerous. Examples are wearing 

pet flea and tick collars and eating 

match heads. The chemicals in these 

are absorbed into the blood stream 

and are potentially toxic. If they actually worked and if they were safe, 

they would already be commercially 

available. 

The uniform and repellants are 

safe and effective barriers to sand 

flies and greatly reduce the risk of 

leishmaniasis. ■
http://deploymentlink.osd.mil • Winter 2004 Deployment Quarterly

W

gulf warupdate

Health Care Providers 

Better Prepared To Care For 

Returning Troops

— Continued on Page 12

hen American troops who have 

returned from Afghanistan and Iraq 

visit their military doctor for the first 

time, they may be quizzed about their 

deployment experience. Defense Department health officials say that servicemembers should not be alarmed 

by the questions. DoD has simply 

initiated a new policy and procedure 

to ensure that military health care 

providers thoroughly care for military 

personnel involved in deployments 

and their families.

“Answers to the questions will 

help the military health care provider determine if the servicemember 

has any deployment-related health 

problems that may need treatment,” 

said Dr. Francis L. O’Donnell of the 

Deployment Health Support 

Directorate.

The questions are based on the new 

Post-Deployment Health Evaluation 

and Management Clinical Practice 

Guideline, often referred to as the 

post-deployment CPG, put into 

practice more than two years ago 

across the nation at both military and 

Department of Veterans Affairs health 

care 

facilities. The 

guideline 

is 

designed 

to provide 

a

 systematic basis 

of care for 

military and 

VA patients 

who have 

health concerns related to a 

deployment. 

“This guideline serves as a way to 

by lisa a. gates

implement a model of care that we’ve 

been promoting for Gulf War veterans and people with health concerns 

after other military deployments,” 

said U.S. Army Lt. Col. (Dr.) Charles 

Engel. 

The use of clinical practice guidelines within the medical community 

is nothing new. Clinical practice 

guidelines are developed by medical professionals to assist health care 

workers in determining patients’ 

diagnoses and in selecting possible treatments. In many cases, the 

guidelines provide a brief description 

of the particular disease or illness, 

the results of recent research on the 

condition, and possible treatment 

protocols that are most likely to work 

for the patient. 

The post-deployment clinical 

practice guideline was more than 

two years in the making. Developers of the guideline took advantage 

of lessons learned in evaluating and 

treating health concerns presented by 

1991 Gulf War veterans, and incorporated basic advances in medicine, 

especially evidence-based medicine. 

Military health officials are 

confident that the use of the newly 

established clinical practice guideline 

will be a great improvement over 

the way that 1991 Gulf War veterans 

were cared for. The guideline calls 

for primary care providers to ask 

every new patient if the reason for 

their visit is related to a deployment. 

If the servicemember believes that is 

the case, then the provider can follow 

the CPG in assessing the patient’s 

symptoms or concerns. In short, the 

guideline focuses on the potential for 

health consequences of deployments 

and prescribes a thorough, methodical approach to medical evaluation. 

“DoD health care providers are 

committed to taking care of military personnel and their families,” 

said Dr. Michael Kilpatrick, deputy 

director, Deployment Health Support 

Directorate in the office of the deputy 

assistant secretary of defense (health 

affairs) for force health protection 

and readiness. 

“In addition to keeping servicemembers healthy in order to accomplish the military mission,” he 

said, “DoD providers have the other, 

unique challenge of dealing with 

the possible health effects of overseas deployments and combat. If a 

servicemember is injured or becomes 

ill following a deployment, we have 

a special responsibility to deliver the 

best medical care possible.” 

The practice guideline, Kilpatrick 

added, is a very useful and well-designed tool to aid providers in living 

up to that responsibility. 

In the years immediately following the 1991 Gulf War, DoD had no 

special procedures in place to deal 

with the health problems of the veterans of that conflict. When it became 

evident that the usual system of DoD 

health care did not adequately provide for the special concerns of these 

veterans, DoD established in 1994 the 

Comprehensive Clinical Evaluation 

Program as a way of providing indepth medical evaluations. 

Although the emphasis placed 

on the CCEP enabled thousands 

of Gulf War veterans to undergo 

detailed medical examinations, the 

program had several limitations. 

Care within the CCEP tended to be 

“stove-piped,” meaning that the care 

was not well integrated with family 

and non-deployment health care. 

The records of the CCEP evaluations were kept separate from the 

“

”

If a servicemember is 

injured or becomes 

ill following a 

deployment, we 

have a special 

responsibility to 

deliver the best 

medical care 

possible.
Deployment Quarterly Winter 2004 • http://deploymentlink.osd.mil

On Your Mark. Get Set. Go!

National Guard Bureau 

Distributive Training 

Technology Project 

Provides Support 

for Deployments

by maj stephan picard

ngb-j6, joint IT programs

and computers (C4); and energize 

America’s communities by 

providing shared access to high-performance communications, research, 

and development tools. There are 

more than 300 specially designed 

multimedia classrooms throughout 

the country, linked by a terrestrial 

network and emerging satellite technologies. These 

classrooms support such varied activities as military occupational training; language-sustainment training; 

first-responder instruction; terrorismpreparedness training; emergency 

operations support; communications 

support, and 

scientific-education programming 

aimed at school-age children. 

Mission Readiness

One of Distributive Training 

Technology Project’s top priorities is 

to ensure that National Guard troops 

are prepared for their missions. To 

do so, it offers its users a wealth of 

training courseware and content, 

covering such topics as 

anti-terrorism; nuclear, biological, 

and chemical warfare; emergency 

first response; combat skills; medical 

training; and military training.

Recently, Distributive Training 

Technology Project added 14 new 

Web-based military training 

packages to its Guard Collaborative 

Learning Source, a system for managing distance-learning and online 

training programs, and for promoting 

collaboration, knowledge management, and document sharing throughout the Distributive Training 

Technology Project community. These 

training packages, collectively known 

as Virtual Mission 

Preparation, were originally 

developed by Pennsylvania-based 

Mountain Top Technologies, Inc., 

to support the 28th Infantry 

“Keystone” Division’s deployment to 

Bosnia.

The VMP training courses, which 

are certified by the Army’s Training & 

Doctrine Command, were designed 

to support pre-deployment training 

for soldiers in advance of new missions. They also satisfy a number of 

the Army’s “common core” training 

requirements — special proficiencies 

such as 

Hot/Cold Weather Injury 

Prevention, Mine Awareness, and Operational Security — that all soldiers 

must demonstrate.

Distributive Training Technology 

Project also offers more than 30 computer-based language courses, ranging from basic “survival” language 

instruction to higher-level proficiency 

training. This content, too, supports 

deployment activities. For example, 

in 2002 the Colorado National Guard 

used the DTTP classroom in Denver 

to enhance the language skills of approximately 

150 soldiers being deployed to Afghanistan. The soldiers used lanT

he past decade has seen a dramatic 

increase in the number of National 

Guard and Reserve Component mobilizations and deployments. In fact, 

more National Guard members and 

Reserve troops have been mobilized 

since the 1991 Gulf War than in the 

preceding 36 years. Since Sept. 11, 

2001, the United States has deployed 

more than 150,000 

National Guardsmen and women, approximately 27 percent of its current 

total force.

With increased deployments come 

an increased need for resources to 

support the mobilized troops and 

their families. The National Guard 

Bureau Distributive Training 

Technology Project, or DTTP, a 

state-of-the-art communications and 

learning-delivery system, is playing 

a key role in meeting this need. By 

leveraging its advanced distributed 

learning and communications technologies, DTTP helps soldiers prepare for 

their missions, take care of personal 

matters prior to 

deployment, and, once deployed, 

communicate with their loved ones 

from thousands of miles away.

Distributive Training Technology Project

DTTP supports the National 

Guard’s expanding operations at 

home and abroad. Its congressionally 

mandated missions are to improve 

military readiness; enhance 

command, control, communications, 
http://deploymentlink.osd.mil • Winter 2004 Deployment Quarterly

guage software and video 

instruction to study Pashto, a main 

Afghan dialect spoken primarily 

along the Pakistan border. Distributive Training Technology Project even 

provided a modified version of the 

courseware on CD-rom so that the 

soldiers could continue their study 

and practice after deployment.

Preparation for Deployment

In addition to their rigorous training activities, soldiers preparing for 

deployment must also ensure that they 

put all their affairs in order prior to 

departure. Many soldiers use DTTP’s 

resources to help ensure that they and 

their families are ready for the challenges associated with their deployment.

In Edinburgh, Ind., for example, soldiers at the Camp Atterbury Federal 

Mobilization site make double use of 

DTTP resources. During the day, the 

classroom is used almost exclusively 

to enhance soldier 

readiness for deployment. In the 

evenings from 5 to 10 p.m., distance 

learning officials open the classroom 

as a “Cyber Café” to all soldiers wishing to check their e-mail and military 

accounts, take care of personal matters, and communicate with family 

members. In March and April 2003, 

when Camp Atterbury was at its busiest, nearly 10,000 soldiers logged in 

more than 327,000 minutes of use at 

the Distributive Training 

Technology Project facility.

To provide additional support 

for deployment preparation, DTTP 

acquired another set of VMP training 

packages — these targeting family 

needs — to help the spouses and families of soldiers who have been or will 

be deployed. The 14 new 

family-support packages cover a range 

of useful information — from details 

on health care and other benefits to 

pay calculators for use in determining 

Overseas and Hazard Duty Pay.

The Next Best Thing to Being There

Once deployed, National 

Guardsmen and women can serve for 

as much as a year before they return to 

their loved ones back home. To maintain troop morale and give peace of 

mind to the deployed troops and their 

families alike, DTTP uses its 

high-tech resources to establish virtual 

visits. These sessions, which leverage 

DTTP’s video-teleconferencing equipment and technologies, 

typically involve multiple families 

and enable each to meet privately with 

their deployed loved ones for 

approximately 10 minutes. Although 

brief, these face-to-face meetings have 

played an enormous role in boosting 

troop morale and alleviating the fears 

and uncertainties of those they leave 

behind. 

The Missouri Army National Guard, 

which has deployed 2,200 men and 

women since March 2003, has been 

especially active in this regard. The 

Missouri Army National Guard conducts at least three video teleconferences weekly from its DTTP facility 

in Jefferson City, Mo. The Missouri 

Army National Guard also makes 

use of portable video teleconferenceing equipment to achieve some surprising results. In June 2003, when 

Excelsior Springs Senior High School 

student David Yadon mounted the 

stage to receive his diploma, he was 

shocked to see his father beaming 

proudly from a large screen near the 

stage. Master Sgt. Michael Yadon, 

deployed to Bosnia, had promised 

his son that he would be back for 

his graduation. When that proved 

impossible, Yadon arranged the next 

best thing: a live video teleconference. On the morning of the graduation, Master Sgt. Yadon watched 

the whole commencement program 

while sitting 5,000 miles — and seven 

time zones — away.

The Missouri Army National 

Guard has also used its communications technologies to support 

such diverse activities as a July 4 

cookout that included U.S. families 

and their loved ones in Bosnia, and, 

most recently, the Engineers Ball at 

Fort Leonard Wood, Mo., which was 

broadcast to a battalion of engineers 

stationed in Iraq. 

As the number of deployments has 

risen, so too has the demand for 

tools that support training and communications. Using its advanced 

technologies, the Distributive Training Technology Project is helping to 

satisfy the needs of 

citizen-soldiers and their families, 

both at home and wherever duty 

takes them.

For more information about Distributive Training Technology Project 

support for deployed troops and 

their families, please contact DTTP 

Business Operations at dttp@busops.

ngbcio.ngb.army.mil, 

or visit the Guard Collaborative 

Learning Source Web site at https://

www.gcls.ngb.army.mil/. ■

An instructor from the military department teaches 

the Transportation-Automated Command and 

Control Information System software to soldiers 

mobilizing at Camp Atterbury, Ind.

Courtesy photo from the Indiana National Guard
Deployment Quarterly Winter 2004 • http://deploymentlink.osd.mil

Health Care

—Continued from Page 9

permanent health records unless the 

servicemember requested them to 

be combined. The CCEP typically 

focused on diagnostic evaluation and 

subsequent care may not have been 

carefully linked to this diagnostic 

process.

As a result of these difficulties with 

health care coordination within the 

CCEP diagnostic process, servicemembers’ usual primary care doctors 

were unaware of CCEP findings 

and unable to fashion complete and 

accurate care plans. Duplication of 

diagnostic tests sometimes occurred. 

These inefficiencies and fragmentation of care detracted from the otherwise well-intentioned effort by the 

CCEP to provide good care to Gulf 

War veterans. 

In recent years, the Institute of 

Medicine of the National Academy 

of Sciences reemphasized the importance of sound medical care for 

previously deployed servicemembers, 

stressing that care should be coordinated in primary care and should 

start as soon as possible after the 

onset of health problems. The IOM 

also endorsed the development of the 

post-deployment CPG as important in 

guiding care, focusing the training of 

primary care providers, and as a tool 

for related research. 

“The IOM’s recommendations 

about practice guidelines were directed largely at unexplained symptoms arising after deployments,” said 

O’Donnell. “The IOM was struck by 

how common such symptoms are in 

military personnel after wars and in 

the general population.”

Now with the post-deployment 

Clinical Practice Guideline in place, 

primary health care providers are able 

to evaluate the total health picture 

of the patient, preserve continuity of 

care, manage specialty referrals, and 

monitor the effects of any needed 

treatments. An added benefit of the 

new guideline is its emphasis on complete and uniform diagnostic coding 

so that registries may be developed 

using administrative medical data. 

This keeps 

everyone up 

to date on 

what kinds of 

medical issues 

are identified 

in returning 

military personnel and families 

and helps to 

ensure that 

anyone with a 

given diagnosis 

gets appropriate, sensitive, 

and maximally 

private care. 

“Basically 

the health care 

process has 

been unified,” 

continued 

O’Donnell. “A 

single provider 

ensures that 

diagnosis and treatment for each 

deployed veteran is continuously 

coordinated, regardless of how many 

different tests or consultants are 

needed.”

For those 1991 Gulf War veterans 

still on active duty, it is still possible 

to request an evaluation based on the 

old CCEP model.

“We get four or five calls a week 

from Gulf War veterans who want 

a medical evaluation,” said Marie Martinucci of the Deployment 

Health Support Directorate’s contact 

center. “We usually try to educate 

them briefly about the new post-deployment CPG and encourage them 

to have an evaluation based on that 

guideline. For those who want a 

health evaluation based on the CCEP 

procedures or who want to continue 

the CCEP process, we encourage 

them to call DoD’s toll-free phone 

number at (800) 796-9699 or, if they 

are no longer eligible for DoD health 

care, the VA’s toll-free 

number at (800) 749-8387 to schedule 

an exam.”

According to Engel, who heads 

up the Deployment Health Clinical 

Center at Walter Reed Army Medical 

Center in Washington, D.C., those 

veterans currently enrolled in the 

CCEP and undergoing evaluation 

can complete that process. 

Those whose symptoms no longer 

persist or who choose not to continue 

the process will always be welcomed 

later by their primary care provider 

if their symptoms reappear or if they 

are experience new problems related 

to the 1991 Gulf War or any other 

deployment.

For more information about the 

Post-Deployment Health 

Evaluation and Management 

Clinical Practice Guideline, visit the 

PD Health Web site at http://www.

pdhealth.mil. 

If you wish to speak to someone 

about your deployment-related concerns or problems, call the 

Deployment Health Support Directorate’s contact center at 

(800) 497 – 6261, Monday through 

Friday, from 9 a.m. to 9 p.m. 

Eastern Standard Time. ■

”

A single provider 

ensures that diagnosis 

and treatment for 

each deployed veteran is 

continuously 

coordinated, regardless 

of how many different 

tests or consultants 

are needed.

“
http://deploymentlink.osd.mil • Winter 2004 Deployment Quarterly

research

by karen fleming-michael

u.s. army medical research and material command 

new device inspired by an old idea 

may help save the lives of soldiers on 

battlefields. 

The new Golden Hour blood 

container created by a contractor in 

Minnesota brought to fruition the 

vision of a three-person staff at the 

Blood Research Department at Walter 

Reed Army Institute of Research. 

“Things converged about a year 

ago when the military was in 

Afghanistan,” said Army Col. Tom 

Reid, chief of the blood research 

center at Walter Reed. “A number of 

surgeons who were there came back 

in April 2002 and said they were 

concerned about getting blood far 

forward ... because there are small 

groups going out and face delayed 

evacuation time.” 

During those discussions the recurring question the surgeons asked 

was ‘Do we actually need blood far 

forward and, if so, what are we doing 

about it now?’” Reid said. 

Though carrying blood far forward 

in the field is not doctrine, “obviously medics and soldiers in the field do 

what they have to do. If they think 

they need to get blood forward, they 

will get it forward,” said Dr. Victor 

Macdonald of the institute. 

Transporting blood, which is 

regulated by the Food and Drug Administration, is no simple task, said 

Army Col. John Holcomb, a trauma 

surgeon and the Army Surgeon 

General’s trauma consultant. 

“You can’t just throw it in your 

ruck[sack] like you can with IV solutions,” Holcomb said. 

In the past, medics put units of red 

blood cells in coolers filled with wet 

ice to keep blood at its optimal temperature of between 1 and 10 degrees 

Celsius. 

“When you’re [outside] temperature is 110 degrees Fahrenheit or is 

cold, the units of red blood cells 

‘Golden Hour’ Box Gets Blood To Front Quicker

won’t stay at the right temperature 

for very long,” Macdonald said. 

When blood isn’t kept at the right 

temperature, the cell membranes 

break down in a process called 

hemolysis.” 

“At some point, you start causing 

significant harm to the patient, like 

kidney failure and death,” if you 

give bad blood to patients, Holcomb 

said. 

After creating five or six prototypes, the Minnesota company arrived at the Golden Hour container. 

Its name is based on the tenet that 

beating the effects of shock within 

the first hour of injury — by giving a 

blood transfusion, for instance — is 

vital to trauma patients’ survival. 

“We bleed out the oxygen-carrying capability on to the ground, and 

at some point you get sick enough 

that you need to replace that,” said 

Holcomb, who also is the 

commander of the U.S. Army Institute of Surgical Research in 

San Antonio, Texas. 

The container, a nearly 

10-inch-square box that needs no 

power source to maintain its internal 

temperature, uses a combination of 

the vacuum-insulated panels and an 

internal container that has a 

liquid phase-change material, like 

the reusable freezer packs people 

toss in 

coolers. 

“The 

black, internal portion of the 

container 

is put in 

a refrigerator or 

freezer for 

at least 

two hours, 

then is 

put back 

in the 

container 

along with 

the units of red blood cells. The lid is 

put on, and that’s it,” Reid said. 

The container, which has a strap for 

carrying and holds four units of red 

blood cells, weighs 10 pounds when it’s 

full, Reid said. 

“The point of the box is for the medic 

to have blood with him, ready to use 

when he needs it,” Reid said. 

How long the blood stays useable in 

the container depends on the outside 

temperature, said Army Lt. Col. Frank 

Rentas, assistant chief of blood research 

at WRAIR. 

In tests run at the Blood Research 

Department, when the outside temperature is -9 degrees Fahrenheit (below 

freezing), the red blood cells stayed 

good for more than 97 hours; at 105 degrees Fahrenheit, they’re good for more 

than 78 hours; and at room temperature, they can last 121 hours. 

“The beauty of this is that the box 

isn’t just good for red cells, but for 

anything that needs to be transported 

forward like biologicals, vaccines or 

reagents,” Rentas said. 

The research team at Walter Reed is 

already looking at a second-generation 

box that can constantly monitor the 

internal temperature of the box. ■
Deployment Quarterly Winter 2004 • http://deploymentlink.osd.mil

T

A

he Department of Veterans Affairs announced the launch 

of “VA Kids” in November 2003. The new Web page, 

http://www.va.gov/kids, designed to help young people 

understand what it means to be a veteran. 

“The ideals of military service and patriotism can be 

unfamiliar to some children and 

young adults,” said Secretary of 

Veterans Affairs Anthony J. Principi. “The VA Kids Web page supports President Bush’s initiatives 

on education and volunteerism 

by providing an entertaining and 

informative way for young people 

to learn why veterans are special.” 

The site contains areas for 

students in kindergarten through 

Grade 5, for Grades 6 through 12, 

and for teachers. VA Kids also has 

information about VA, Veterans Day, scholarships, student volunteer opportunities, rehabilitative and special 

by gerry j. gilmore

american forces press service 

Web site, created to help service-members, spouses and children navigate 

the challenges associated with military 

moves and deployments, debuted last 

year. 

Sponsored by the Defense 

Department, the site, http://www.

militarystudent.org, offers advice and 

resource assistance for school transition issues, military deployments and 

more, John Molino, deputy under 

secretary of defense for military community and family policy, noted. 

DoD has long recognized the need 

to disseminate helpful information 

to the field “for students who transition between schools as their [military] parents are reassigned,” Molino 

explained. For years, he noted, the 

department “has tried to provide as 

good information as is available to 

facilitate that transition.” 

The emergence of the World Wide 

Web, he pointed out, “has been an 

Web Site Helps Parents, 

Children With School, 

Deployment Issues

excellent opportunity for us to take 

advantage of that technology, provide that information, and grow from 

there.” 

The site, Molino explained, contains 

school transition and deployment 

information targeted to the concerns 

of military parents, children age 6-12, 

teenagers, families with special-needs 

children, military leaders and 

educators. 

Parents can access education-related 

information on transferring student 

records, graduation requirements and 

more. 

The site also enables military 

children and teens to access tips and 

information to help them cope with 

family moves and military parent deployments, adapting to new schools, 

and making new friends. 

Monitored children’s and teens’ 

“chat rooms” also are available on 

the Web site. The chat rooms, Molino 

pointed out, “will enhance the ability 

of children to share their own experiences, which will be most relevant in 

that age group.” 

Today’s global war on terrorism, 

Molino pointed out, has brought the 

issue of deployments to the front 

burner for military families. 

“In an age of increased deployments, it is more important to have 

this information on the Web site,” 

Molino said. The war, he added, has 

made school districts more aware of 

the concerns of military families. 

The site’s overall purpose, Molino 

said, is to help servicemembers ‘ children succeed within the framework 

of the military lifestyle. 

“These are not insurmountable 

problems,” he said. “These are challenges, much like the challenges they 

will face for the rest of their lives. 

“This [Web site] represents the department’s commitment to facilitate 

success for our military children.” ■

VA Launches ‘Kids Page’ Web Site

events for disabled veterans and links to veteran-related 

sites. 

For younger students, the site has interactive activities such as puzzles, coloring pages, matching contests 

and age-appropriate language to describe a number of 

patriotic topics. 

For older students, the page has 

information on volunteer programs, 

scholarships and more sophisticated 

educational resources, games and 

reference links. The teachers’ section 

contains more information, links and 

suggested classroom activities. 

“The title ‘veteran’ is bestowed by 

a grateful nation on citizens willing 

to sacrifice everything to preserve 

our freedom,” Principi said. “It is 

our responsibility to honor these 

heroes by ensuring that each American generation understands what this prestigious title means.” ■
http://deploymentlink.osd.mil • Winter 2004 Deployment Quarterly

rmy 1st Lt. Sarah Grivicic wanted a 

challenge when she joined the Army 

three years ago. Now, she’s an intensive-care nurse assigned to the 28th 

Combat Support Hospital, 

in support of Operation Iraqi Freedom.

Grivicic, 25, from Louisville, Ky., 

has the responsibility and challenge 

to ensure the most critically injured 

patients, both American and Iraqi, 

have the best medical care in the heart 

of Iraq.

“The hardest part is also the best 

part of my job — being with a dying 

soldier,” Grivicic said.

Grivicic said she feels extremely 

Courtesy photo

Army 1st Lt. Sarah Grivicic, 25, from Louisville, Ky., is 

an intensive care nurse assigned to the 28th Combat 

Support Hospital. 

Army Nurse Thrives On 

Patient Care During OIF 

privileged to be with a soldier during the soldier’s last hours. “I never 

understood what ‘an angel with a face’ 

meant until my arrival in Baghdad,” 

she said. “We are the last ones that 

they see or the last voice that they 

hear. It is our privilege to ensure that 

they are pain free in their last hours, 

that they are not alone and are never 

forgotten.”

Just at the hospital barely over a 

month, Grivicic has already proven 

her abilities to the hospital’s chief of 

nursing, Army Lt. Col. Theresa Sullivan, from New Jersey.

“She is motivated to do the job 

here,” she said. “She truly cares for 

her patients. This little girl is what an 

Army nurse is all about.” ■

by army public affairs
Deployment Quarterly Winter 2004 • http://deploymentlink.osd.mil

fter experiencing 11 active-duty 

suicides since Jan. 1, 2004, and 14 

during the final quarter of 2003, 

Air Force senior leaders are asking 

commanders and leaders across the 

service to assess and re-energize 

suicide prevention efforts at all levels. 

The Air Force’s 2003 calendar year 

suicide rate of 10.5 per 100,000 people 

was the lowest of all the military 

services and one-half the rate of a 

comparable civilian population of 

males between the ages of 20 and 

50. As of Feb. 24, 2004, the service’s 

suicide rate was 18.1.

In a letter sent to all major 

commands, the Air Force’s acting 

assistant vice chief of staff urges all 

airmen to continue pitching in to 

reduce the number of suicides. 

“Suicide is not stopped by medical 

personnel in emergency rooms; it is 

stopped by addressing quality-of-life 

issues in the unit on a daily basis,” 

Air Force Lt. Gen. Richard E. 

Brown III wrote in the letter. 

“The major components of the 

Air Force Suicide Prevention Program 

are active leadership involvement, an 

emphasis on community involvement 

and a focus on prevention throughout 

the life of airmen and their families, 

not just when they are suicidal,” 

General Brown wrote. 

“Pay special attention to the quality 

of your suicide-prevention briefings,” 

wrote General Brown. 

The Air Force requires active duty 

and civilian personnel to attend 

suicide-prevention briefings once 

during the 15-month air and space 

expeditionary force cycle.

In light of the recent suicides 

— none of which occurred during 

operations Enduring Freedom or 

Iraqi Freedom — General Brown 

urged commanders to “review how 

well we continue to implement 

the 11 initiatives that serve as the 

foundation of the Air Force Suicide 

Prevention Program.”

The 11 initiatives are outlined 

Leaders Call For Re-Energized 

Suicide-Prevention Efforts

by g.w. pomeroy

air force surgeon general public affairs

in Air Force Pamphlet 44-160, Air 

Force Suicide Prevention Program: 

Description of Program Initiatives 

and Outcomes. The 11 initiatives 

are: build community awareness; 

leadership involvement; investigative 

interview policy; professional military 

education; epidemiological 

database; delivery of community 

preventive services; community 

education and training; critical 

incident stress management; 

integrated delivery system; limited 

patient-psychotherapist privilege 

and unit risk factor assessment.

Air Force leaders take a community 

approach in suicide prevention, 

encouraging every airman to take 

responsibility in reducing the number 

of suicides. 

A key element of the program is 

to make a steady pipeline of suicide 

prevention tools available for Air 

Force people at all levels. So far 

in 2004, the Air Force Medical 

Service has issued the 2004 Leader’s 

Guide for Managing Personnel in 

Distress, which is geared to help 

commanders, first sergeants and 

other leaders recognize when their 

people are distressed and how to 

respond appropriately. It also helps 

commanders link their people to 

resources and get them help as soon 

as possible. 

The guide presents information on 

35 distressing situations, provides 

checklists detailing potential 

behaviors or signs reflective of the 

person’s reaction to the distressing 

event and responses or resources 

the leaders may want to use in 

responding to the person’s needs. 

The guide was widely distributed 

as a CD-ROM to every squadron 

commander and first sergeant in the 

Air Force. The guide can be viewed 

on the dot-mil-restricted Air Force 

Suicide Prevention Program Web site,

https://www.afms.mil/afspp. 

Other suicide-prevention tools 

include: 

 “The Air Force Guide for 

Managing Suicidal Behavior: 

Strategies, Resources and 

Tools,” an 88-page clinical 

guide designed to assist 

mental-health professionals in 

assessing and managing highrisk behavior. 

 The Air Force Suicide 

Prevention Web site, which 

is geared toward greatly 

improving access to suicide 

prevention information and 

materials. 

 The 2003 Community Suicide 

Prevention Briefing, a new 

multimedia briefing that 

includes slides and video. 

 The 2003 Leadership Suicide 

Prevention Briefing, a new 

multimedia briefing involving 

slides and video. This is 

geared toward wing, group 

and squadron commanders.

The service’s suicide prevention 

program has received a great deal 

of acclaim and is commonly hailed 

as the best program of its type in 

the world. In December 2003, a 

landmark University of Rochester 

study of suicide in the U.S. Air Force 

concluded that the service’s suicide 

prevention program reduced the risk 

of suicide by 33 percent during the 

past six years. 

Also in 2003 the Air Force’s 

Suicide Prevention Program was 

hailed as a “model program” in 

a landmark report released by 

the president’s New Freedom 

Commission on Mental Health. In 

2001, then-U.S. Surgeon General 

Dr. David Satcher made the 

program a model for the nation and 

incorporated it into the National 

Suicide Prevention Strategy.

In the mid-1990s — amid rising 

suicide rates in the military — Air 

Force leadership recognized that 

suicide is a community problem 

and the formal program was 

implemented in 1996. From 1991 to 

1996, the active duty suicide rate 

was 14.1 per 100,000. During the 

seven years of the Air Force Suicide 

Prevention Program’s existence, 

through the end of 2003, the suicide 

rate was 9.2 per 100K population. ■
http://deploymentlink.osd.mil • Winter 2004 Deployment Quarterly

S

healthbeat

— Continued on Page 18

uicide is one of the top three causes 

of death in the Navy, according to 

the Department of the Navy Suicide 

Incident Report. It’s a concern that 

hasn’t subsided in recent years, and 

new approaches are being made to 

make sailors aware of the signs. 

“More people die by suicide every 

year than by homicide, which is unbelievable to me,” said U.S. Navy Lt. 

Cmdr. J P. Hedges, 

staff chaplain at 

Naval Station 

Pearl Harbor. 

“More service 

members have 

killed themselves 

than have died in 

battle.” 

There are many indicators that all 

sailors should look out for in their 

workplace. The acronym AID LIFE 

helps co-workers to remember the 

process of intervening and approaching sailors who might be in trouble. 

by journalist seaman ryan c. mcginley, 

commander, navy region hawaii 

public affairs

Awareness Key To 

Suicide Prevention

The first step is to ask if 

there is a problem. A shipmate might be noticeably depressed, or their work might 

be inconsistent with prior 

efforts. Asking the person if 

there is anything wrong is the 

first step to prevention. 

“Open-ended questions are 

good, and you can quickly 

assess how 

bad off it is,” said 

Hedges. 

The next step is 

to intervene immediately. If the warning 

signs are evident, 

it’s important not to 

dismiss or shy away 

from a problem. 

“The handwriting is clearly there 

that there’s something wrong with 

this picture, but because we don’t 

like pain ... we stray away from it 

and we minimize it,” said Hedges. 

“Above all else, someone who is 

contemplating suicide wants to know 

that someone else is concerned.” 

Once intervention is established, 

don’t keep it a secret. Keeping the 

problem a secret denies the person 

help that they may need. 

“It’s about people,” said Hedges. 

“We have to take care of people; 

that’s really what suicide prevention 

is all about.” 

Then locate help immediately. 

“

”

Suicide, it’s a 49 to 51 

vote, teetering back and 

forth, wanting the pain to 

stop but struggling, 

knowing [you] want 

to live.

by loren barnes

naval hospital jacksonville 

public affairs

Fleet Hospital Jacksonville 

Personnel Deploy To Djibouti

M

ore than 30 doctors, nurses and hospital corpsmen from Fleet 

Hospital Jacksonville deployed to the 

African nation of Djibouti Feb. 19. 

They will join an expeditionary 

medical unit currently supporting 

the Combined Joint Task Force, 

Horn of Africa.

They will relieve 41 Fleet Hospital 

Jacksonville medical personnel who 

deployed with the expeditionary medical unit to Camp Lemonier, Djibouti, in 

September 2003, who 

are slated to return to Jacksonville 

in March.

“After being in the Navy 18 years, 

this will be a new experience for me,” 

said Hospital Corpsman 1st Class 

Alan Scott.

Saying farewell to his wife and three 

children, Scott added, “I realized that 

the separation will be hard on them, 

— Continued on Page 18

Dorale, Djibouti — U.S. Navy Cmdr. Philip W. 

Perdue, a trauma surgeon with the Combined 

Joint Task Force - Horn of Africa Navy 

Emergency Medical/Surgical Team, checks the 

vital signs of a Djiboutian woman. 

U.S. Marine Corps photo by Cpl. Paula M. Fitzgerald
Deployment Quarterly Winter 2004 • http://deploymentlink.osd.mil

Suicide Prevention

— Continued from Page 17

Listed below are Web sites that offer information 

about suicide prevention: 

Suicide Prevention Web Sites

The Centers for Disease Control and Prevention

http://www.cdc.gov/ncipc/factsheets/suifacts.htm

National Strategy for Suicide Prevention

http://mentalhealth.samhsa.gov/suicideprevention/

U.S. Navy Personnel Command’s 

Behavioral Health Branch

http://www.persnet.navy.mil/pers601/index.html

U.S. Navy Environmental Health Center’s Suicide 

Prevention Web Site

http://www-nehc.med.navy.mil/hp/suicide/SLinks.htm.

U.S. Army Suicide Prevention 

http://134.11.73.3/Suicide%20Prevention%20Resources.

htm

U.S. Marine Corps Suicide Prevention 

http://www.usmc-mccs.org/perssvc/prevent/suicide.asp

U.S. Coast Guard Suicide Prevention Program 

http://www.uscg.mil/css/worklife/SUICIDE1.html

“Suicide, it’s a 49 to 51 vote, teetering back and forth, 

wanting the pain to stop but struggling, knowing [you] 

want to live,” said Hedges. 

After that, inform the chain of command. The chain of 

command is there to help sailors and make sure they get 

the proper treatment that someone might need. 

The final two steps are to find someone and expedite 

the process. Waiting too long can be a crucial mistake that 

could cost a life. 

There are many reasons someone might consider taking 

their life. 

“Relationship problems are the number one reason that 

we have problems,” said Hedges. The relationship can be 

with a spouse, boyfriend, girlfriend, family or co-workers. 

The problem will lead to feelings of depression, anxiety or 

guilt, or to alcohol abuse. Other problems that can lead 

to suicide include financial, work, legal or disciplinary 

problems. 

“With suicide, it’s a desire to feel something other than 

pain.” 

Hedges hopes that everyone will take a proactive approach and care about their shipmates. 

“They don’t care how much you know, they want to 

know how much you care,” said Hedges. 

For more information, log onto http://www.nhrc.navy.

mil/programs/donsir/. ■

Hospital Deploys

— Continued from Page 17

the largest of the hospital’s deployable platforms. As part of the 

hospital’s dual mission, most of the 

military staff are assigned to platforms that stand ready to deploy 

anywhere in the world. 

This unit is the Navy’s first 

expeditionary medical unit. This 

deployment will expand medical 

care to personnel 

supporting coalition forces in the 

region by providing 

expanded sick call 

hours, casualty receiving, an intensive 

care/medical-surgical unit, operating room, laboratory 

and radiology unit. The EMU also 

provides specialty consultation 

services in orthopedics, general 

surgery, sports medicine, hand 

surgery and internal medicine. This 

significantly expands medical care 

to those who might not otherwise 

have access to these specialists, 

prevents needless medical evacuations out of theater, and directly 

translates to quicker recovery for 

injured or ill personnel. ■

but the experience should prove 

challenging and rewarding.” 

“I really don’t know exactly 

what to expect,” said Hospital 

Corpsman 2nd Class Christine 

Hobbs. “From what I’ve heard, it 

should be pretty 

exciting.”

The CJTF-HOA, 

including medical 

personnel from 

Fleet Hospital 

Jacksonville, has 

been involved in 

humanitarian aid through the 

Medical Civil Action Program, 

reaching out with much needed 

medical care to the civilian population of Djibouti City. 

Delivering a prayer as the 

medical personnel prepared to 

ship out, Hospital Chaplain Lt. 

Jason R. Hefner said, “You will 

be bringing a lot of caring to 

people who need it — and who 

better to deliver it?”

Fleet Hospital Jacksonville is 

U.S. Navy photo

Horn of Africa — Hospital Corpsman Chris Barnes, assigned 

to the expeditionary medical unit, x-rays a patient’s arm in 

the newly built radiology room. The Navy’s first expeditionary 

medical unit has expanded their medical care to a Level III 

environment for personnel supporting Combined Joint Task 

Force - Horn of Africa.

”

“I realized that the 

separation will be hard on 

them, but the experience 

should prove challenging and 

rewarding.
http://deploymentlink.osd.mil • Winter 2004 Deployment Quarterly

re- guide

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

AMVETS

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 St., SW

Washington, DC 20024

Phone: (202) 554 - 3501

http://www.dav.org 

Enlisted Association of 

the National Guard

3133 Mount Vernon Ave.

Alexandria, VA 22305

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, Suite 201

Merrifield, VA 22031

Phone: (800) 625 - 1775

http://www.mcleague.org

The Military Order of the 

Purple Heart 

5413-B Backlick Road 

Springfield, VA 22151-3960 

Phone: (703) 642-5360 

http://www.purpleheart.org

Military Officers Association

201 N. Washington St.

Alexandria, VA 22314

Phone: (800) 234 - 6622

http://www.moaa.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 Blvd., 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

National Military Family Association

2500 North Van Dorn St., Suite 102

Alexandria, VA 22302

Phone: (800) 260 - 0218

http://www.nmfa.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

http://deploymentlink.osd.mil • Winter 2004 Deployment Quarterly
Deployment Quarterly Winter 2004 • http://deploymentlink.osd.mil

By Phone 

Direct Hotline for Servicemembers, Veterans and Families

(800) 497 – 6261

Deployment Health 

Clinical Care Center

(800) 559 – 1627

TRICARE Active Duty Programs 

(active duty and family members)

(888) DOD – CARE 

or (888) 363 – 2273

TRICARE Mail Order 

Pharmacy - Express Scripts 

(866) 363 – 8667

TRICARE Dental Program 

(TDP) - United Concordia 

(800) 866 – 8499

TRICARE Pharmacy Program 

(877) DOD – MEDS 

or (877) 363 – 6337

TRICARE For Life

(888) DOD – LIFE 

or (888) 363 – 5433

other resources

re- guide

Non-Commissioned 

Officers Association

610 Madison St.

Alexandria, VA 22314

Phone: (703) 549 - 0311

http://www.ncoausa.org

Paralyzed Veterans Association

801 Eighteenth St., NW

Washington, DC 20006-3517

Phone: (800) 424 - 8200

http://www.pva.org

Reserve Officers Association

1 Constitution Ave., NE

Washington, DC 20002

Phone: (800) 809 - 9448

http://www.roa.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 TRICARE Retiree Dental 

Plan – Delta Dental 

(888) -838 – 8737 

Defense Enrollment Eligibility Reporting 

Systems (DEERS) 

(800) 538 – 9552

TRICARE Online 

(866) DOD – EWEB 

or (866) 363 – 3932

Health Insurance Portability 

Accounting Act (HIPAA) 

(888) DOD – HIPA 

or (888) 363 – 4472

Department of Veterans Affairs

(800) 827 – 1000

VA Gulf War Registry

(800) 749 – 8387

VA Benefits and Services

(877) 222 – VETS 

or (877) 222 – 8387

Web Links

Department of Defense

http://www.defenselink.mil

DeploymentLINK

http://deploymentlink.osd.mil

GulfLINK

http://www.gulflink.osd.mil

MedSearch

http://www.gulflink.osd.mil/medsearch

DeployMed

http://deploymentlink.osd.mil/deploymed/

PDhealth

http://www.pdhealth.mil

Hooah 4 Health

http://www.hooah4health.com/

TRICARE

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

Department of Veterans Affairs

http://www.va.gov/