# MASCAL: Unity is strength 

/ Published May 28, 2021
ALI AL SALEM AIR BASE, Kuwait, 
Dilapidated ruins in what felt like the middle of nowhere, surrounded by sand, made for the perfect atmosphere for a mass casualty exercise. With heat well over 100 degrees Fahrenheit and the sun beating down their faces, people slowly filled the scene drenched in sweat and fake blood – passersby would have taken one look and assumed a zombie apocalypse was about to take place.Exercise. Exercise. Exercise.The emergency call was made, and the simulated victims came to life – screaming for help, crying in pain and waiting for first responders to arrive.The 386th Air Expeditionary Wing alongside its coalition partners participated in a mass casualty exercise here, May 19. For this iteration, the wing had volunteers to act as simulated casualties with injuries from a staged bombed observation post.MASCAL is an event where the number of patients and/or their care requirements exceed the regular capabilities of the 386th Expeditionary Medical Group. This iteration of the exercise brought in outside help from coalition partners.Exercise non-players, 386th Expeditionary Security Forces Squadron personnel, alongside Italian National Contingent Command Air/Task Force Air Kuwait members, observed the scene to see first-hand how exercise participants reacted to and carried out procedures in an event like this.“These events are typically trying and require complicated coordination with multiple responders, agencies and our joint/coalition partners,” said U.S. Air Force Tech. Sgt. Marie Boulware 386th EMDG medical operations flight chief. “Through exercising MASCALs and oversaturating our medical group with a large number patients, personnel can identify process improvements to increase proficiency which can ultimately save lives.”MASCAL exercises allow the wing to work on critical-care skills that are needed but not regularly practiced.First responders arrived and confirmed the area is safe from further danger before providing care to the simulated victims. This is where self-aid and buddy care training and prior triage skills came into play. Simulated victims received basic care and were organized by injury severity to a centralized location until transportation to the closest medical facility was available.“The most important aspect is learning how to best communicate, integrate and interact with our coalition partners, as routine procedures and protocols often differ,” said Canadian Armed Forces Major Melissa Gear, Operation IMPACT task force surgeon. “Response to a real incident is not the time to learn the system and find out where incompatibilities exist.”This exercise tested safe and rapid patient movement to higher levels of care, while incorporating coalition partners, which is coordinated through the EMDG’s administrative and support staff.Transportation arrived and the simulated casualties were taken to the 386th EMDG. Chaos ensued. With a small number of medical personnel, limited space and medical supplies, the MDG utilized every corner of the facility and reached out to their Canadian partners for aid.“Finding opportunities to work together improves the trust and strength needed during an event like this,” Boulware said. “Our coalition partners have medical resources which can be called in for assistance in case of an emergency. In any disaster, it’s all hands-on deck, and the more we practice, the smoother and more effective we’ll be at working together.”Airmen live alongside coalition partners on ASAB, making everyone equally as vulnerable to a potential mass casualty event.Teams are stronger and more effective when they’re constructed with those from diverse perspective and areas of expertise. This opportunity strengthened partnerships and aided in developing an appreciation for each other’s experiences and backgrounds while also keeping the team proactive for events like this.“The Canadian Health Services team is grateful for any opportunity to participate in joint exercises with our American and Allied medical partners,” said Gear. “Training together as a team increases our readiness and ability to fully integrate together to maximize performance when it counts the most.”