Building the Afghanistan National Army's Defense Health Sector: A Lesson in 'Little Victories' One Day at a Time

The people of Afghanistan who have withstood over twenty-three years of conflict have suffered in many ways, including the lack of an essential and effective health system. This has resulted in one of the worst health situations in the world. The fledgling government of Afghanistan is attempting to establish a stable country where democracy can promote peace, stability and security for its people. The Afghanistan National Army's Defense Health Sector plays a critical role related to those aims that underscores the significant need for collaborative efforts between the Afghan Government, the United States, the United Nations, various non-governmental organisations and the broad international community. The United States (US) Army Medical Department's doctrine of providing Combat Health Support utilises the tenets of science-based health care to deliver: (1) lifesaving services to the soldier and the beneficiary population, (2) restorative treatment, (3) medical evacuation when appropriate, (4) logistics to support all delivery services and services planning, and (5) preventive medicine to preclude illness and injury and effective patient administration services to facilitate positive outcomes. It is within this framework that US military medical professionals have worked jointly with the Afghan Military Medical System to build an effective, efficient and sustainable military medical healthcare system for the Army and a growing beneficiary population which may eventually exceed one million family members and government officials. In this paper we describe the current roles of various civil and military agencies in support of the Afghanistan military medical system and highlight new and ongoing initiatives in logistics, laboratory services, evacuation and preventive health.