Tough Choices

A pair of interesting articles recently by C.J. Chivers of the NY Times. Despite what one thinks in general of the Times, some of their reporters are the best in the field in Afghanistan, including Chivers, Dexter Filkins, Alissa Rubins and Carlotta Gall.

Chivers' latest pieces concern the difficult choices that U.S. Army Medevac crews make on a daily basis when confronted with wounded or injured Afghans. Officially, the U.S. Army position is that non-combat injuries are not their responsibility. As they correctly point out, there simply aren't enough airlift and medical facilities in-country to serve as the first point of treatment for routine injuries. What assets are in place are focused (rightly) on providing the best care they can to wounded soldiers and Marines, and there just isn't enough to go around. No TOC officer wants to be the one to deny a Medevac request to a Marine because the chopper is busy transporting an Afghan with a farming injury.

On the other hand, there are potentially significant benefits to a counter-insurgency operation in treating and assisting the local population with medical emergencies. MEDCAPs (Medical Civil Assistance Programs) are important elements of local COIN operations which build trust and rapport with locals and provide an opportunity to gather valuable information about Afghan villagers.*

*There's even a variant of the MEDCAP called the VETCAP which is, you guessed it, a Veterinarian Civil Assistance Program. Basically, Army vets go out and treat goats with modern medicine. Depressingly, I've heard many more positive reactions from Afghans to the VETCAP program than the MEDCAPs. Apparently, children are cheap but goats are expensive.

Chivers gets to the heart of the problem with two contrasting articles here and here. I noticed that the second article took the form of a blog post rather than an actual piece in the paper, and I can't help but wonder if Chivers is trying to emphasize one aspect of the story over another. Points however for putting up both and thereby illustrating the two sides to the story.

Key passage from the first story:

While the pilots stared at the message board, wondering whether this time the mission for Sadiq would be approved, an officer at the second outpost issued a blunt challenge: would whoever denied the mission, the officer wrote, acknowledge that they knew the boy would die?
The typed answer came back on the screen. The mission was approved

Bravo to the unnamed Marine officer at the outpost who put his higher-up on the spot by insisting on an acknowledgement of the gravity of the situation. Sounds a bit like blackmail, but sometimes it's helpful to remind the FOBBITs that their decisions has consequences.