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Friday, August 14, 2020

One of the largest DoD health care Foreign Military Sales cases ever implemented is being fulfilled in the form of a joint, multinational Trauma, Burn and Rehabilitative Medicine program in the United Arab Emirates.

The Trauma, Burn and Rehabilitative Medicine (TBRM) mission is to advise, train, mentor and provide technical support to United Arab Emirates (UAE) medical forces, the Sheikh Shakhbout Medical City (SSMC) hospital and referral facilities within the Abu Dhabi network while enhancing regional trauma, burn and rehabilitative medicine capabilities that would strengthen medical capabilities within the region and someday benefit U.S. forces in the area.

“This was a combatant command priority case that provided, for the first time ever, the TBRM capability to a partner force in the [U.S.] Central Command region,” said Scott Huther, a U.S. Army Security Assistance Command country program manager. “Having this regional medical capability will be a critical enabler for our forces in the [Central Command] region.”

The TBRM bilateral medical initiative is funded by the UAE government via a Foreign Military Sales case between UAE and the U.S., which Huther monitors as part of his duties as a liaison between Security Assistance Command headquarters in Alabama and Central Command headquarters in Florida.

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Members of the Trauma, Burn and Rehabilitative Medicine team pose for a photo.
(Credit: Courtesy Photo)

In planning since 2018, the TBRM effort is an active partnership with the UAE Armed Forces Medical Services Corps, the Abu Dhabi Health Authority and SSMC LLC (with the Mayo Clinic serving as its operating entity). As such, it is an excellent example of a fully integrated military-civilian partnership.

“This TBRM program is on the front end of a critically important strategic endeavor to support UAE in establishing a Level 1 trauma center at the SSMC that will provide combat casualty care and subsequent recovery and rehabilitation for military and civilian personnel,” said Col. Brigilda Teneza, TBRM’s executive officer and a 22-year active-duty Army physician.

Exercise in the Desert

During the recent Exercise Native Fury 2020 held in the deserts of the UAE, more than 4,000 U.S. and Emirati forces responded to simulated contingencies, natural disasters and other scenarios in the region.

U.S. Ambassador to the UAE John Rakolta Jr., who was on hand for some of the demonstrations during the exercise, praised the partnership shown, telling reporters, “Trust is a huge, huge factor. Transparency, common values, all work into a partnership.”

Had the training exercise been a real conflict, rapid treatment and stabilization of life-threatening injuries would be paramount for the successful recovery of critical patients.

Exercise Native Fury showcased the value of the TBRM. During one of the training events, a Marine was air-evacuated to SSMC due to injuries suffered in a vehicle accident. The team of American and Emirati health care personnel oversaw her rapid treatment and stabilization.

Increasing Survivability

It’s widely accepted in the medical community that providing immediate medical aid, followed by transport to a higher level of care within the first “golden hour,” will increase survivability from potentially fatal injuries.

Due to logistical challenges of moving across large geographic distances and difficult terrain, often called the “tyranny of distance,” achieving a golden hour standard can be difficult, if not impossible.

Reducing that travel time by creating a Level 1 trauma system in the UAE is especially beneficial for U.S. and allied service members assigned to austere locations in the Central Command region.

“The TBRM effort will be a force multiplier for the U.S., UAE and all partner nations conducting operations within the Middle East region,” Teneza said. “In addition, the trauma center will provide a future world-class training platform for DoD trauma, burn and rehabilitative medicine specialists.”

The mission of the TBRM team, which consists of physicians, nurses and health administrators from the Army, Navy and Air Force, falls under the authority of the U.S. Army Security Assistance Training Management Organization out of Fort Bragg, North Carolina.

The organization reports to the U.S. Army Security Assistance Command at Redstone Arsenal, Alabama, and fulfills training requirements from Foreign Military Sales cases that Security Assistance Command manages.

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Lt. Col. Joey Kamerath, M.D., the team’s rehabilitative medicine director, briefs fellow medical officers and staff at a hospital in Abu Dhabi, United Arab Emirates.
(Credit: Courtesy Photo)

Current TBRM team members are part of the initial cadre of executive and operational personnel permanently assigned for either a one- or two-year overseas tour.

Once reaching full operational capability, the TBRM will have a fully staffed leadership team of 11 personnel along with rotational forces that will bring surgical capabilities, an anesthesiologist, and operating room nurse and technician to the capabilities of the TBRM within the SSMC.

Rehab Is Key

While trauma and burn care are the team’s strategic priority missions, Army Lt. Col. Joey Kamerath, the TBRM team’s rehabilitative medicine director and a physician, knows an important part of their legacy will be to help build a viable, collaborative rehabilitation program within the UAE military medical community.

Kamerath and Deputy Director Army Maj. Meghan McHenry have traveled across the UAE, forging relationships with military and civilian leaders in the medical community and encouraging collaborative rehabilitation care within the UAE medical system. McHenry also has been instrumental in providing operational-level rehabilitation training to the UAE medical staff.

“From a rehabilitation perspective, we are working between the public and private health care institutions, as well as local and international professional organizations, to further develop the rehabilitation system of care,” Kamerath said. “Our mission is to partner for an effective, accredited and sustainable destination rehabilitation health care network in the UAE.”

Unique Opportunity

During these difficult times in the global medical community, TBRM team members have the unique opportunity to build trust and strengthen the relationship between the U.S. and its Emirati partners, while amplifying and building upon the medical capabilities within the community of care in the UAE.

Ultimately, wounded U.S. and partner forces on the battlefields of tomorrow can and will receive critical trauma and stabilization care within the region, reaping the benefits of this medical partnership for years to come.