Six medical representatives from the Tanzanian People's Defence Force (TPDF) visited with representatives from Camp Lemonnier and the Combined Joint Task Force - Horn of Africa (CJTF - HOA) in Djibouti, January 31 and February 1, 2011 to engage in discussions on how the U.S. military manages their medical operations in a forward deployed clinic.

The TPDF is increasing their participation in peacekeeping operations and enlarging their role in assisting civilians during natural disasters.

"We are also deploying in the U.N. missions," said Colonel Juma Mwinula, TPDF director of medical services. "In our country, we accept a number of civilians to our [military] medical services."

He added that it is a fragile relationship because if every civilian seeks out military medical treatment in times of need, the capabilities of those facilities would diminish to the point of being ineffective in supporting military operations.

The TPDF requested assistance from the U.S. government to spearhead this concern to increase their caliber of medical care to effectively partner with global colleagues in international operations.

Discussions focused on best practices in handling patient administration, treatment, staffing issues, equipment and supply issues, and human resource organization.
The intent of the exchange was not the actual treatment methods of patients, but rather to discuss the day-to-day management of a medical facility.

"I think it was time well spent," Mwinula said. "We came here to see how a hospital was run, the equipment and the personnel. [U.S. medical personnel] have been very kind to let us see your facilities."

U.S. Navy Commander David Brenner, officer in charge of the Expeditionary Medical Facility at Camp Lemonnier, said that one crucial factor in designing a hospital is understanding your capabilities to effectively treat patients.

"We need to know and make quick decisions on how and where to treat [patients]," Brenner said. "If we make the wrong decisions, hours of delay can really hurt them."

He added that when the TPDF medical staff returns to Tanzania, they need to examine their medical facilities and diagnose what type of care they can provide. That way, the patients can either be treated at that facility or be moved to another that can provide more specialized medical care.

One method to manage these expectations of quality care is to proactively engage in humanitarian missions, Brenner said. The U.S. Navy is undertaking more such missions each year to being medical care to people in need rather than having them travel to the facilities.

"We would not be able to open our doors to all civilians. What we do instead are [veterinary or medical civil affairs projects] where we will go to areas and give specific levels of care," Brenner said.

U.S. Navy Lieutenant Commander Mike Grande, deputy force surgeon for CJTF - HOA, cited several recent humanitarian missions in South America, South Pacific and Caribbean, where the U.S. Navy travelled to thousands of people in need of medical care.

Including missions that provide emergency medical relief, such as after the Haitian earthquake in January 2010, the U.S. Navy provides care in areas such as dermatology, optometry and other basic medical services.

When asked if the Tanzanians found the visit to be helpful, Mwinula replied, "The learning session has been very interesting and we have learned a lot of things, seen a lot of things and it's very encouraging. We are very curious to see if we can make a hospital like yours. Mission is accomplished."