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Press Release | Jan. 12, 2009

Embedded Training Team strengthens ANA healthcare systems

By None , U.S. Forces - Afghanistan

Press ReleaseUnited States Forces-Afghanistan

January 11, 2009

Release Number 20091101-04

Embedded Training Team strengthens ANA healthcare systems

KABUL, Afghanistan - Located high in the mountains at an elevation of 8,000 feet, the Paktia Regional Military Hospital, where the Combined Security Transition Command-Afghanistan Medical Embedded Training Team has spent the last year, boasts an in-patient capability of 50 beds which will soon to expand to a 100-bed facility.

The hospital serves the Afghan National Army assigned to the region which includes approximately 3,000 troops and several thousand family members. "The mission of the METT is to strengthen ANA healthcare system’s ability to improve healthcare with rapid response by trained, knowledgeable and experienced medical personnel," said Air Force Captain David Barker, Medical Service Corps, METT Facility Manager.

A METT is a multi-discipline unit responsible for the development and training of their Afghan counterparts. The team consists of 15 active duty and Air Force reserve personnel.

"The skills of the ANA nursing staff are at or below those of newly-minted Air Force medical technicians," said Air Force Lieutenant Colonel Joanne R. Ruggeri, chief nurse, medical ETT at Forward Operating Base Lightning. "As the chief nurse mentor for approximately 30 Afghan nurses, my emphasis has been geared toward nursing education."

By even the most casual comparison to western medicine professionals, the ANA medical service could not meet the most rudimentary standards in their delivery of care. This training will assist the ANA in reaching western standards.

A basic nursing course was developed covering the foundational knowledge of nursing geared towards improving patient care. Checklists were developed to ensure a patient’s history and physical exam, lab tests, EKG and all other pertinent orders were completed. The ANA nurses administer and document the amount and type of medication given to each of their patients. "This is a safer practice that has reduced medication errors.

Previously, a patient’s medication was placed at the bedside and the patients self-administered their own meds," said Ruggeri. Wound care management has also seen a significant increase in quality.

Cleaning and infection control measures were unheard of prior to American intervention. The Afghans are now learning how to deliver health care. The professional proficiency of the Afghan nurses has improved tremendously and with their continuing growth, the standard of care continue to improve.


The medical ETT has conducted mass-casualty exercises, including evacuating patients to the next echelon of care in the ANA and coalition systems. The ANA medical staff has successfully managed multiple injuries and casualties resulting from insurgent engagements and motor vehicle accidents.

"We use the medical evacuation system with helicopter flights to Bagram and Kabul major medical trauma centers for higher level of care," said Ruggari. "We have trained them how to safely treat and transport injured patients from outlying medical facilities."

The METT has also supported and strengthened the counterinsurgency strategy with the completion of three humanitarian medical missions in local villages led by special forces. In addition to receiving medical treatment, clothing and food was distributed to local villagers.

"These missions allow the ANA and Afghan National Police to forge lasting relationships with the Afghan civilian population, promoting a governmental and nation-building effort," said Ruggeri. "These missions work to restore the confidence of the local population in the strength and capability of the new Afghan government."

According to Barker, the American METTs are all trained Air Force medics working together to build Afghanistan’s health care system.

"Air Force medical personnel are bringing American ingenuity to rebuild a trained, skilled and knowledgeable ANA professional medical cadre,"

said Barker. "The efforts are turning the rebuilding challenges into a success by building strong partnerships between the Afghan and coalition forces vital to winning the global war on terrorism."


United States Forces Afghanistan’s mission, in coordination with NATO’s International Security Assistance Force, is to conduct operations to defeat terrorist networks and insurgents by developing effective governance and building the Afghan National Security Force. Effective security throughout the Government of the Islamic Republic of Afghanistan facilitates continued regional stability and increases economic development for the people of Afghanistan.

Contact Information - US Forces Afghanistan Public Affairs Office

Tel +93 (0) 799 51 2919 or cell phone 0093 (0) 788 189 049