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Medical Logistics Operations on the Korean Peninsula During Key Resolve 2010

One of the U.S. Army Medical Materiel Center, Korea’s missions is to ensure the medical logistics readiness of U.S. Forces Korea for transition to hostilities. This capability was tested using four medical logistics scenarios.

Anyone who has been around the Army Medical Department has probably heard, “Have no fear; USAMMA [U.S. Army Medical Materiel Agency] will wave its magic wand and medical supplies will be there when you need them.” However, as former Secretary of Defense Donald Rumsfeld said, “You go to war with the army you have, not the army you might want.” During Key Resolve 2010 (KR10), the U.S. Army Medical Materiel Center, Korea (USAMMC–K) exercised four scenarios to ensure that the medical logistics the warfighters have in Korea is the medical logistics they want.

Reorganization in Korea

Supporting the warfighter in often austere and usually joint operations provides unique opportunities to shape medical logistics organizations for mission success. The most significant transformation within the last 3 years was the activation of USAMMC–K to replace the deactivated 16th Medical Logistics (MEDLOG) Battalion.

For 6 decades, a medical logistics organization at Camp Carroll, Korea, has supported the Korean peninsula and parts of the U.S. Pacific Command (PACOM) area of responsibility. In 2007, the 16th MEDLOG Battalion was slated for deactivation, creating a critical gap in medical logistics.

Over many months of intense discussions, collaborative efforts among PACOM; U.S. Forces Korea (USFK); the Office of the Surgeon General; the Defense Logistics Agency (DLA), which is the Executive Agent for Medical Materiel; the Army Medical Research and Materiel Command; the 18th Medical Command (now the 65th Medical Brigade); and the Army medical logistics community resulted in the establishment of USAMMC–K as a provisional organization. In October 2008, USAMMC–K assumed the missions of the 16th MEDLOG Battalion and the Theater Lead Agent for Medical Materiel-Korea (TLAMM–K).

USAMMC–K was officially activated in October 2009. The organization is a direct reporting unit under the Army Medical Research and Materiel Command but is under the operational control of the 65th Medical Brigade, which was activated in October 2008 as a subordinate command of the Eighth U.S. Army.

During the same time period, another medical logistics transformation was occurring in Japan. In 2009, the Air Force’s 18th Medical Group in Okinawa was designated as the Theater Lead Agent for Medical Materiel-PACOM (TLAMM–P). The unit began by supporting Okinawa-based units and achieved initial operating capability in October 2010. When TLAMM–P reaches full operational capability, it will be able to provide backup medical logistics support to TLAMM–K.

USAMMC–K is an amalgamated organization consisting of—

  • USAMMC–K military personnel.
  • USAMMC–K Department of the Army civilians.
  • Borrowed military manpower from the Headquarters and Headquarters Company, 65th Medical Brigade, and the Headquarters and Headquarters Detachment, 168th Multifunctional Medical Battalion, and the 563d Medical Logistics Company.
  • Korean Augmentee to U.S. Army soldiers.
  • Korean national employees.
  • Korean Service Corps personnel.
  • A DLA planner.
  • The 19th Sustainment Command (Expeditionary) liaison officer.

Despite the mix of personnel, USAMMC–K has jelled extremely well as a world-class organization,
as was displayed during KR10.


Planning for KR10

In 2009, the USFK surgeon and 65th Medical Brigade commander informed the USAMMC–K commander of his intent to exercise medical logistics capabilities extensively during the upcoming exercise. Medical logistics officers throughout the peninsula developed four medical logistics scenarios designed to challenge the multiple echelons of medical logistics support required during a transition-to-hostilities operation. The scenarios exercised class VIII (medical materiel) electronic ordering and distribution in realistic situations.

The objectives were as follows:
  • Assess medical supply electronic-ordering strengths and challenges.
  • Validate the operational “in support of” relationship with the Republic of Korea (ROK) forces.
  • Exercise the forward distribution team mission of USAMMC–K and the 563d Medical Logistics Company.
  • Exercise the TLAMM–P in support of the TLAMM–K concept.
  • Assess Defense Distribution Depot Korea (DDDK) support capabilities

Scenario 1: Army-Centric Class VIII Support

The concept of the Army-centric operation was to provide class VIII to a task force with a medical company that became the class VIII supply support activity (SSA). The supported units then reconfigured their DMLSS (Defense Medical Logistics Standard Support) Customer Assistance Module (DCAM) to submit orders to the SSA using a combat service support very small aperture terminal (CSS VSAT), and the SSA submitted the requirement to USAMMC–K using a CSS VSAT.

Multiple issues arose during the electronic ordering of medical supplies, preventing USAMMC–K from exercising the process fully. The supported units attended several training sessions conducted by Medical Communications for Combat Casualty Care and USAMMC–K personnel to help with reconfiguring their DCAM systems. Unfortunately, the DCAM reconfiguration could not be accomplished because of hardware, software, and network issues. The solution was for each unit to order separately, using DCAM over the existing local area network to USAMMC–K and the SSA’s Department of Defense activity address code as a supplemental address for delivery to the SSA.

Movement of supplies began at USAMMC–K with the palletization and preparation for rotary-wing delivery of class VIII. The CH–47 Chinook helicopter picked up the cargo at Camp Carroll and moved the shipment to Area I. The delivery was made late that afternoon to a landing zone where a forward distribution team, consisting of 563d Medical Logistics Company and 560th Medical Company (Ground Ambulance) Soldiers, received the class VIII supplies. The team transported the supplies to the SSA and then separated the supplies for each customer.

The following day, part of the class VIII shipment received was slated to be moved by front-line ambulance backhaul to a supported unit. However, because of severe road conditions, this movement was delayed for several days until ice was cleared from the roads.

The success of this mission can be attributed in large part to the reconnaissance missions and planning of the 563d Medical Logistics Company forward distribution team and the 560th Medical Company. The 2d Combat Aviation Brigade flight crew also did an outstanding job of ensuring that the mission was completed despite delays caused by the weather.

Scenario 2: Combined Support to ROK Forces

The concept of this scenario was to provide emergency class VIII combined support to the ROK Army in order to support Korean hospital operations. ROK Army ground assets picked up class VIII at Camp Carroll and moved the supplies to a supported hospital.

The mutual logistics support agreement was used to authorize the transfer of supplies from USAMMC-K to the ROK Army. The supply request flowed from the ROK unit through the Combined Forces Coordination Center and the Joint Medical Operations Center to USAMMC–K. All communication was accomplished via email, telephone, and “click-to-meet” video teleconference.

Although all supplies were notional, each box was packed and marked as if it were the actual class VIII materiel. The temperature-sensative items were packed to standard, and a joint inventory was conducted of all items. This process, although very simple, had never been exercised as far back as anyone could recall. The scenario was a success because it was well executed and expanded the possibility for future scenarios.

A notable discovery was that the Republic of Korea and the United States use different catalog numbers to identify individual items. Both parties agreed to research corresponding catalog numbers for their 100 high-demand items to facilitate future ordering.

The ROK Army medical logistics community performed commendably in their coordinating efforts, which ensured mission success.

Scenario 3: TLAMM–P Support to TLAMM–K

In this scenario, the 18th Medical Group, based at Kadena Air Base in Okinawa, served as the TLAMM–P and supported the Joint Special Operations Task Force-Philippines and the III Marine Expeditionary Force. In this scenario, a Marine unit in Korea requested emergency resupply. USAMMC–K could not provide support with current stocks on hand; the TLAMM–P was able to support the requirement with its on-hand stock through an aeromedevac flight backhaul.

The Defense Supply Center Philadelphia medical logistics planner at USAMMC–K and the USAMMC–K support operations officer visited the 18th Medical Group in February 2010 to assist with a TLAMM–P planning conference. These relationships proved to be invaluable in executing the operation.

Because of systems incompatibility, the medical electronic ordering was accomplished by email. In order to effectively support future requirements, USAMMC–K must establish an account with the TLAMM–P once it reaches full operational capacity.

The class VIII shipment was flown from the TLAMM–P to Korea by fixed-wing aircraft from the 18th Medical Group in Okinawa and then transported to the port by 2d Combat Aviation Brigade rotary-wing assets. As the TLAMM–P has not reached full operational capability, the authorized medical allowance list containers used to simulate class VIII movement were empty. The 18th Medical Group and the aeromedevac crew ensured that the authorized medical allowance list containers were loaded onto the C–130 airplane and transported to Osan Air Base. The 3d Combat Aviation Brigade coordinated jointly with the Marines and the ROK Navy to guarantee delivery to a ROK Navy port.

A clear lesson learned from this scenario was that medical and logistics units understand the importance of working jointly and are even beginning to embrace mutual support relationships.

By finding a way to get the class VIII onto the airplane, the 18th Medical Group and the aeromedevac crew showed their “can do” mindset. The participation and “Oorah!” attitude of the III Marine Expeditionary Force staff in Okinawa also contributed immensely to the success of this scenario.

Scenario 4: Joint Support to the U.S. Navy
This scenario focused on a joint operation between USAMMC–K, DDDK, and Navy personnel from the USS Blue Ridge. A Navy ship at port requested emergency medical supplies through USAMMC–K, and USAMMC–K coordinated the delivery.

Before enacting the scenario, the Navy established an account with USAMMC–K to facilitate the class VIII ordering process. The Navy used Non-Secure Internet Protocol Router email to submit orders for class VIII to USAMMC–K because the onboard system and Theater Enterprise-Wide Logistics System do not interface.

After receiving the order, USAMMC–K selected, packaged, and prepared the requested medical supplies for shipment. It also coordinated with DDDK and the 563d Medical Logistics Company to distribute the supplies and with the ROK Navy to obtain access to their port for the delivery. On the ship, the 563d Medical Logistics Company and the Navy conducted a joint inventory of the medical supplies and then transferred them to the Navy .

On the road ahead, USAMMC–K must develop critical items list requirements, work with the ROK to improve medical logistics collaboration, refine operation plans and exercises, and demonstrate the importance of medical logistics support operations to the USFK leaders. To project requirements and identify shortfalls in the supply pipeline, USAMMC–K will work with USFK and DLA to ensure that appropriate mitigation actions are taken. These scenarios have reinforced the fact that USAMMC–K must work with USFK, the ROK and DLA to coordinate medical logistics planning in peacetime in order to facilitate success during war.

Major William Tudor is a medical logistics management intern at the U.S. Army Medical Materiel Agency at Fort Detrick, Maryland. In previous assignments, he was the support operations officer for U.S. Army Medical Materiel Center-Korea (USAMMC–K) and commander of the 563d Medical Logistics Company in South Korea. He is a graduate of the Medical Logistics Course and the Combined Logistics Captains Career Course.

Sara Schubert is the troop support planner for the Defense Logistics Agency Troop Support Medical Directorate at USAMMC–K. She holds a bachelor’s degree in biomedical engineering from Rensseleaer Polytechnic Institute.

The authors thank Lieutenant Colonel Shon-Neil W. Severns, commander of USAMMC–K, and Major Marco Ocha, USAMMC–K pharmacy consultant, for their contributions to this article.

 
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