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A Tale of Two MEDCAPs Part I

The following events occurred while I was deployed to Afghanistan. They directly influenced my views on counter-insurgency. Today, I write about what happened; tomorrow, I will write about what I learned.

A few weeks before my company was due to leave Afghanistan, our Company Commander secured the resources to conduct two Medical Civil Action Projects (MEDCAP) within our area of operations. The first MEDCAP would occur in my area of operations in the recently secured village of Pashad. The second would occur two days later in the contentious Chowkay River Valley.

My MEDCAP ended as an unqualified success--we treated so many people our medical supplies ran out. The other MEDCAP ended in an IED explosion: three coalition casualties, a destroyed Humvee and much fewer civilians treated.  

Based on my meetings with village elders, I knew that the village of Pashad lacked any medical facilities. They didn't even have a pharmacy. I have posted about Pashad before and the success of coalition and Afghan efforts in that area. Pashad was special to me, I had connected with the leaders in that village and I wanted to help them.

Before our MEDCAP, I laid the groundwork by continuing my security visits at night to Pashad. At least every three days, my Platoon and I drove down to Pashad and met with the local Afghanistan National Police checkpoint commander Sayed Abdullah. He and I discussed security issues and I started laying the groundwork for the MEDCAP with basic planning. Meanwhile, the newly appointed District Governor Mustafa Khan talked with village elders about the need for a MEDCAP and laid the groundwork on the Afghan side of the house. Somewhere in the middle, the Afghan Army got on board. We also secured a local Afghan doctor and our battalion surgeon to run the medical portion of the MEDCAP.
On the day of the MEDCAP, I led a convoy of eight US vehicles, fifty or so US PAX, eight Afghan Security Force vehicles and an about equal strength of Afghanistan National Army soldiers—the largest convoy I would ever lead. Even though I had told the leaders of Pashad what day I would arrive, I did not tell them the time. I trusted Sayed Abdullah, but even though I trusted him I could never trust who he would tell and what they would do. Fortunately, on our way to the village we we weren't attacked.

When we showed up, the local police had cordoned off an old school. The local Afghans waiting for medicine acted perfectly civil--no pushing, shoving or otherwise inappropriate behavior. Even better, the Afghan police and Afghan Army worked together to secure our perimeter, something that doesn't always happen. Our company's trucks simply provided additional security and, of course, the resources for the MEDCAP. Once we arrived in Pashad, I wasn't too worried about security; a huge crowd was waiting for us and in this region in Afghanistan, the Taliban and other insurgents wouldn't risk injuring civilians. They needed the support of the local population as much as we did. After a short set up, we began treating civilians.

Eventually, a shura began. No one started it, it just sort of accreted out of the ether. Before I knew it, I was sitting in a room in the school eating a meager portion of chicken and rice and beans, a feast in Afghan terms. Whenever you have that many big names in a small village like Pashad, a shura is bound to begin. The locals talked, thanked us for our help, and then asked for more. A typical Afghan shura.

By the end of the day, our US/Afghan medical team treated over 150 children, 50 women and 120 men. Due to their culture, treating women is very unusual in Afghanistan; most get denied medical treatment. This shows both the level of trust we had earned with the locals and their desperation for medicine. Our mission in Pashad proved a humanitarian success, a quality training mission for the Afghanistan National Army, and an intelligence victory for our Tactical Humint Team.

A few days later, a second MEDCAP left from a sister FOB headed out the Chowkay River Valley. VPB Chowkay lay about fifteen kilometers in straight line distance from Camp Joyce or a forty-five minute drive on the roads. A similar force to the first MEDCAP would arrive at VPB Chowkay with both coalition forces and Afghan security forces prepared to treat local civilians. Unfortunately, few locals turned out. The road to VPB Chowkay had a persistent IED threat. When I went into the command post for the nightly update brief, I learned that an IED detonated on the route clearance platoon as my company prepared to return for the day. The blast killed a soldier, wounded two others and completely destroyed a Humvee.

Two crucial missions in Afghanistan, why does one mission succeed in Afghanistan and another fail? Tomorrow I will address the lessons these two patrols can teach us about Afghanistan.

three comments

This is a program close to my heart.

Wasn’t this the day that a ANA truck flipped because the driver was high on hash?

No Ben, that was the HA drop we did about two weeks after the MEDCAP operation, like on 15 July 09 if I remember correctly.