NCOs help AMEDD Flight Paramedic Program get off the ground

By PABLO VILLA
NCO Journal

Medical and technological advances have given modern-day Soldiers who have been injured on the battlefield access to an elite level of immediate trauma care from their fellow Army physicians and combat medics.

But the trek from the battlefield to the next round of care has been a perilous journey — the injured Soldier is typically extricated from harm’s way and into an aircraft, but often without a doctor present and with fewer resources onboard. A 2012 study of 4,600 deaths in Iraq and Afghanistan showed that 87.3 percent of Soldiers died while en route to a military treatment facility.

A recently installed program at the U.S. Army Medical Department Center and School at Joint Base San Antonio-Fort Sam Houston, Texas, aims to bridge that gap. And the program’s NCOs are expected to be a large part of its success.

The program, which began in 2012, is designed to provide flight medics with additional paramedic and critical-care training, and civilian certifications. It meets this end by incorporating high-tech lessons from civilian medical professionals. Though the program is open to E-3s to E-8s, it is NCOs who provide stability and ease the transition from previous flight-medic teachings to the current best practices, said Master Sgt. Michael Cluette, the NCO in charge of the Flight Paramedic Program.

“The flight paramedics who we graduate now will be the future of where aviation medicine goes. So the transition point will be extremely important for those who are graduating here,” Cluette said. “You have to be that mature noncommissioned officer to do that.”

Owning responsibility for battlefield care

The impetus for the Flight Paramedic Program was an Army physician’s nagging feeling.

Lt. Col. (Dr.) Robert Mabry authored a study of service members injured on the battlefield in Iraq and Afghanistan from 2001 to 2011. The study, published in the Journal of Trauma and Acute Care Surgery in 2012, found that of the 4,596 battlefield fatalities analyzed, 87.3 percent died of their injuries before reaching a military treatment facility, or MTF. Of those pre-MTF deaths, 24.3 percent were deemed potentially survivable.

Although battlefield medicine has vastly improved during every war since World War II, Mabry said that 24.3 percent statistic cited in his study — those whose lives might have been saved — kept nagging him.

“That’s where we can make the biggest difference in improving patient outcomes,” he said.

What Mabry found is that no one owns responsibility for battlefield care delivery, meaning that “no single senior military medical leader, directorate, division or command is uniquely focused on battlefield care,” he said. “The diffusion of responsibility is a result of multiple agencies, leaders and units of the service medical departments each claiming bits and pieces with no single entity responsible for patient outcomes forward of the combat hospitals.”

Commanders on the ground own the assets of battlefield care — medics, battalion physicians, physician assistants, flight medics and all the equipment. But they are “neither experts in, nor do they have the resources to train their medical providers for forward medical care,” he said.

What Mabry concluded from his studies and field experience was that the solution to the gap in care cannot be addressed with a “single-bandage” approach.

A solution, he said, would require “evidence-based improvements in tactical combat casualty care guidelines, data-driven research, remediation of gaps in care and updated training and equipment.”

And to supervise those medics, their training, and the medical evacuation equipment and procedures, there would need to be a specially trained and qualified physician in charge of that pre-hospital phase, he said.

Mabry illustrated the power of patient outcome data by tracking a National Guard medevac unit from California whose members were mostly critical-care trained paramedics in their day jobs — working for the California Highway Patrol and other EMS agencies. They deployed to Afghanistan in 2010, taking their civilian EMS model with them, he said.

“I compared their patient outcomes to the standard medevac outcomes and found a 66 percent reduction in mortality using the civilian medic system,” he said.

As a result of that outcome, the Army has revamped its training of flight medics.

Providing a higher level of care

The Flight Paramedic Program began in earnest at Fort Sam Houston in 2012 under the 187th Medical Battalion and through a partnership with the University of Texas Health Science Center at San Antonio.

The flight medic course taken by 68Ws is six months long and is followed by the two-month critical-care course. The critical-care course includes six weeks of embeds with various hospitals throughout San Antonio as well as with San Antonio AirLIFE, which provides Soldiers with a close look at the high-tech application of medicine in the civilian world.

“Your EMT basic course in the civilian world is about 140 hours of training,” said Maj. Matthew Nichols, director of the Flight Paramedic Program. “Paramedic training is 1,000 to 1,200 hours, and you already have to be an EMT basic. So that just goes to show you how advanced [the program’s civilian-inspired] paramedic training is. It’s above and beyond all the extra pharmacology, anatomy, physiology, hemodynamics, all that kind of more in-depth medical training they get in the paramedic course. Then they go on to an eight-week critical-care course, which is two weeks in the classroom of even higher-level, very intense, very fast-paced critical-care transport medicine akin to what ICU nurses do. They get to see how it is applied by professionals in that field. It’s definitely a much higher level above the EMT basic level.”

That closer look at the civilian side of trauma care is also something that was highlighted in Mabry’s study, which stated that civilian trauma systems evolved after the Vietnam War as a result of Army medics and nurses who returned from the conflict and took on civilian jobs. Mabry said that as a result of this war experience, sick or injured civilians in the United States are transported to a trauma center by an aircraft, accompanied by a critical-care flight paramedic and a critical-care flight nurse, both of whom are highly trained and experienced.

“So the thought is, if a guy who is in a motorcycle accident two hours outside San Antonio is going to get a certain level of care in the back of an aircraft en route to a major hospital in San Antonio, then our Soldiers who have been wounded on the battlefield deserve the same, or as close to the same as we can provide within the Army,” Nichols said.

To accomplish that, Nichols said, the Army is taking the expansive knowledge base available in its hospitals out to the point of injury. Handing flight paramedics the knowledge and training needed to make the proper interventions — and just as importantly, the knowledge to perhaps not intervene — is expected to help decrease mortality numbers.

“A lot of people think that an ambulance driver in the U.S., that’s all they do — they pick up someone and they transport them to the hospital so the doctor can take care of them,” Nichols said. “But, no, those EMTs and those paramedics are conducting care. And the more care they are able to give with their knowledge and their skills, the more likely that that person transported is able to survive their injuries.

“Increasing the level of care provided in back of the aircraft with the critical-care flight paramedic alongside the ECCN (en-route critical care nurse) will help these long transports from point A to point B,” he said. “If anything goes south in that period of time, medically, then you have someone in the back who will be able to treat them better. The aircraft can only go so fast, so you can’t really ask them to go much faster to get them to the hospital. So the paramedic and the nurse in the back of the aircraft are trained to be able to handle those situations and basically mitigate life loss.”

The role of NCOs

The long-term goal of the Flight Paramedic Program is to transition all of the Army’s flight medics to become critical-care paramedics.

Through May 2014, 124 Soldiers have become nationally registered paramedics and 115 have graduated the Army’s critical-care course. Another iteration of the course began in July and is expected to conclude in March. Plans for expansion are being made in 2015. The quickening pace of training goes on despite the expected drawdown of troop levels in Iraq and Afghanistan in order to be prepared for disaster missions at home as well as for any future conflicts.

In the meantime, the transition to a new kind of flight medic training isn’t leaving legacy medics behind.

“I’m one of the legacy F3s (flight medics),” Cluette said. “It isn’t so much that we didn’t know how to use the combat gauze or how to stop a bleeder or put our hands in someone’s chest. What we don’t get as the legacy individuals is a lot of the why-not-to-do-it or why-we-are-doing-it. We know the physiology from Baby Whiskey Land (medic school), we get the anatomy from Baby Whiskey Land, but what we don’t get is when to do it, when not to do it. We just go by the numbers, and the thought process for the legacy [medic] is, ‘When fear gets in your head, training takes over.’ You know just to follow the numbers, because I was trained to do it that way.

“The paramedic, we are now telling them, ‘Yeah, you were trained this way. But I need you to understand why you’re doing it, what you have to do if it doesn’t work and understand why it’s not working in order for you to fix it.’ An EMT might understand he may have to do it, but I may do it way too early or unnecessarily simply because I didn’t get enough of the understanding that what I was currently doing was enough.”

The bridging of the gap when flight medics of the old and new discipline come together will be eased by NCOs, Cluette says.

“NCOs will bolster that leadership to help coach and mentor the F3s when those Soldiers move out and junior Soldiers come in” Cluette said. “They will provide that leadership to help coach and mentor them on how to interact with each other. Because in an aviation company for flight medics it kind of varies, so if I’m a F2 (critical care flight paramedic) and I’m an E-3, and I have a F3 who is an E-5 or an E-6, and I’m having to train them, you have to be mature enough in order to understand that isn’t a leadership, this is a professional mentorship where I have somebody teaching me something that I need to know to help save lives on the battlefield. NCOs can do that.”

The Army News Service contributed to this story.

U.S. Army Africa CSM: NCOs are the ones keeping Soldiers safe on Ebola mission

By MEGHAN PORTILLO
NCO Journal

From designing and building Ebola Treatment Units to providing transportation to health care workers, NCOs have proven to be instrumental in the U.S. military’s support of Operation United Assistance in Liberia, said the command sergeant major of U.S. Army Africa, Command Sgt. Maj. Jeffery Stitzel. But their greatest contribution, he said, has been keeping U.S. Soldiers healthy by enforcing standards and discipline.

Stitzel was the first NCO on the ground with USARAF’s commander, Maj. Gen. Darryl Williams, when they arrived in Liberia on Sept. 16 to organize the U.S. military’s response to the Ebola crisis. Rather than the traditional adversaries in combat, the main foes these Soldiers are facing can be avoided only by adhering to a strict hygiene regimen, he said.

“The biggest advice I have for any noncommissioned officer deploying here (to Liberia) is to get educated about the disease and really understand it, because it is important,” Stitzel said. “They need to realize how important discipline is. That’s what NCOs do. So when we identify what the training requirements are, … noncommissioned officers are the ones who are going to train those tasks and then enforce those standards in-theater. Discipline is what keeps our Soldiers safe.”

As of Dec. 2, more than 17,256 Ebola cases have been reported and 6,113 individuals have died of the virus in Liberia, Guinea and Sierra Leone, according to information from the Centers for Disease Control and Prevention. Liberia alone has seen 7,650 cases and 3,155 deaths. Four Ebola cases have been reported in the United States — two imported cases, including one death, and two locally acquired cases. A New York doctor who contracted the virus after treating patients in Guinea, as well as two Dallas nurses who treated the individual who died of the virus have since recovered and have been discharged from their hospitals.

The spread of the virus can be stopped only by quickly identifying and isolating infected individuals and those with whom they have had close contact, the CDC states. The virus is not spread by casual contact, and the CDC considers Soldiers deployed to Liberia to be low risk, as they are not in contact with Ebola patients while in-theater. Each Soldier is still meticulously monitored for symptoms including a rise in temperature, vomiting, diarrhea or unexplained bruising or bleeding, and measures have been put into place to immediately recognize any who need to be routed to care. Close monitoring and strict hygiene routines will better protect potentially exposed individuals and everyone around them, Stitzel said.

Discipline is saving lives

Education is the best way for NCOs to set themselves and their Soldiers up for a safe and successful mission in Liberia, said Sgt. Maj. Doug Hall, who was the Operation United Assistance engineering sergeant major in Liberia during the initial weeks of the effort.

U.S. Marines from the Special Purpose Marine Air Ground Task Force Crises Response 14-2, get their temperature checked as they exit a KC-130. All U.S. Soldiers in Liberia are required to have their temperatures taken and logged at least twice each day, as a rise in temperature may be the first sign of infection with the Ebola virus. (Photo by Pfc. Craig Philbrick/U.S. Army)
U.S. Marines from the Special Purpose Marine Air Ground Task Force Crises Response 14-2, get their temperature checked as they exit a KC-130. All U.S. Soldiers in Liberia are required to have their temperatures taken and logged at least twice each day, as a rise in temperature may be the first sign of infection with the Ebola virus. (Photo by Pfc. Craig Philbrick/U.S. Army)

“Pay very close attention to the pre-deployment training,” Hall said. “The training is important. You need to understand the transmission of the disease and how to protect yourself and your Soldiers. And you need to understand what you are coming here to do. You are not coming to treat people, you are coming to either build or provide logistical services. Be mission-focused, and always keep safety in mind.”

U.S. Army Soldiers are in Liberia to provide mission command, logistical, engineering and living support to the organizations that are treating patients and fighting the spread of the virus. Even though they do not have direct contact with Ebola patients, Soldiers are required to lower their risk of exposure by stepping in a shallow container of chlorine bleach solution before entering buildings and by washing their hands frequently with diluted bleach.

Soldiers must also have their temperatures taken and logged at least twice each day, as a rise in temperature to 100.4 degrees may be the first sign of infection. Stitzel said Soldiers can’t get into most buildings without their temperatures being taken. A record is kept of each Soldier’s temperatures every day he or she is in the country, and close monitoring will continue through a 21-day isolation period after a Soldier has left the country. These measures are in place to ensure U.S. Soldiers do not contract the virus, and, in the unlikely event one of them should become infected, to prevent the virus’ further spread by identifying those individuals before they become contagious.

NCOs are the key to enforcing these preventative measures and protecting Soldiers’ health, Stitzel said. From avoiding exposure to the Ebola virus and malaria to lowering the risk of accidents, NCOs save lives by ensuring every Soldier follows protocol.

“Whether it’s in this Ebola environment or anywhere else in Africa, safety is about discipline,” Stitzel said. “It starts with, ‘Do you have your bug spray? Are you taking your malaria pills?’ Malaria is our biggest threat, and it is easily mitigated by discipline. So we come up with different plans. There is a sergeant who looks at everybody and says, “OK, take out your pills and put them in your mouth,’ and then he watches them take it. The commanding general and I do the same thing every morning. He is my battle buddy, and I’m his.”

Great NCO leadership

Stitzel said everywhere he goes in Liberia, he sees exemplary NCOs. Their hands-on style of leadership has contributed greatly to this particular mission, he said.

“There is an Air Force senior master sergeant – Senior Master Sgt. Michael Jordan – who is here with the joint task force port operating team,” Stitzel said. “He has a little over 100 folks working out at the airport, bringing in all the supplies. They take care of all the passengers who come in and all of the equipment that comes in, as we start building out this theater. I watch his airmen and the Soldiers who work for him, and they are doing phenomenal work.

“You go out and see the Seabees out there, and you’ve got a petty officer directing his sailors in two- and three-person teams, getting the land set for us to build these life-support areas. Sgt Maj. Doug Hall went in and helped design and coordinate with the contractors to build the living areas and work areas. These tents and all of these [buildings] that are going up, somebody has to divide up the plan and tell them where to do it, how we are going to do it and set it up. Hall has been the right NCO at the right time to get done what needs to get done.”

In a partnership with the armed forces of Liberia, Hall’s unit was responsible for starting construction of the Ebola Treatment Units, the Monrovian Medical Unit in the country’s capital and the headquarters area.

“We have all of our officers and our engineers – they design, and I am more of a get-out-there-and-make-it-happen person,” Hall said. “It’s been important to get NCO eyes onto what they are designing on paper to develop a product, to get from the conceptual stage to actually building and get the mission done. I think NCOs here have brought that to the plate.”

‘I’m proud to be part of this joint effort’

On Oct. 25, USARAF transferred authority of Operation United Assistance to the 101st Airborne Division. The 101st Airborne Division will continue the work USARAF began: overseeing the joint military operations and providing mission command, logistical, engineering and living support to those fighting to stop the virus.

U.S. Marines and Soldiers enter a U.S. Marine Corps MV-22 aircraft after a site survey of a future Ebola Treatment Unit site near Barclayville, Grand Kru, Liberia. The U.S. Agency for International Development is the lead U.S. government organization for Operation United Assistance. The U.S. Army is supporting the effort by providing mission command, logistics, training and engineering support to contain the Ebola virus outbreak. (Photo by Pfc. Craig Philbrick/U.S. Army)
U.S. Marines and Soldiers enter a U.S. Marine Corps MV-22 aircraft after a site survey of a future Ebola Treatment Unit site near Barclayville, Grand Kru, Liberia. The U.S. Agency for International Development is the lead U.S. government organization for Operation United Assistance. The U.S. Army is supporting the effort by providing mission command, logistics, training and engineering support to contain the Ebola virus outbreak. (Photo by Pfc. Craig Philbrick/U.S. Army)

After witnessing the large-scale joint effort – which includes the U.S. Army, U.S. Navy, U.S. Air Force, U.S. Marine Corps and Liberian military units – of OUA, Stitzel said this deployment will always stand out in his mind.

“I was at the Monrovia Medical Unit today, and right there at the airport you see the joint force working together,” Stitzel said.

U.S. sailors completed the land preparation and built latrine and external structures; U.S. airmen were in charge of building and setting up the structures, and U.S. Army engineers contributed by building the floors at the airport’s now-functional 25-bed hospital.

“To me, personally, I think it’s an amazing opportunity, not only to help out our airmen, but help out in a global situation — helping out wherever we are needed,” said Air Force Master Sgt. Will Villalobos, who helped lead the team working at the airport. “We will always be ready at a moment’s notice. I’m proud, so proud, to be part of this team and to help out the people of Liberia in every way we can.”

Stitzel said NCOs should take pride in this unique mission and in their work alongside so many other organizations assisting the Liberian people. He has been impressed, he said, by the swift and effective cooperation between the United States and Liberian militaries, the U.S. Agency for International Development, the Centers for Disease Control and Prevention, Doctors Without Borders and others.

“I’ve been on a few deployments, and they were all very important missions. But this is definitely going to be one I look back on with pride. We are here in support of USAID, and so I feel very proud to not only be a part of this fight against Ebola but to work with all of the other federal agencies and departments that are here working so well together. It has been a great experience and a blessing to being a part of this mission of helping the people of Liberia.”

Spc. Kristal Calderon, an information technology support specialist with the 35th Signal Brigade (Theater Tactical) at Fort Gordon, Ga., practices carefully donning and removing personal protective equipment during pre-deployment training at the brigade’s logistical warehouse at Fort Gordon. The training was mandatory for the Soldiers who deployed to Liberia in late October to add their communications equipment and expertise to the fight against the Ebola outbreak in West Africa. (Photo by Capt. Lindsay D. Roman/U.S. Army)
Spc. Kristal Calderon, an information technology support specialist with the 35th Signal Brigade (Theater Tactical) at Fort Gordon, Ga., practices carefully donning and removing personal protective equipment during pre-deployment training at the brigade’s logistical warehouse at Fort Gordon. The training was mandatory for the Soldiers who deployed to Liberia in late October to add their communications equipment and expertise to the fight against the Ebola outbreak in West Africa. (Photo by Capt. Lindsay D. Roman/U.S. Army)

Amputee rises to challenge, earns airborne wings

By SGT. 1ST CLASS RAYMOND J. PIPER
USAMU Public Affairs

A U.S. Army Marksmanship Unit NCO became the first Soldier with a lower-leg amputation to successfully earn his Airborne wings.

Sgt. Joseph Mille, a member of the USAMU Paralympic Team, graduated Nov. 14, from the Basic Airborne Course at Fort Benning, Ga.

Sgt. Joseph Mille, a U.S. Army Marksmanship Unit shooter/instructor, graduated Nov. 14, 2014, from the Basic Airborne Course at Fort Benning, Ga. (U.S. Army photo by Sgt. 1st Class Raymond J. Piper)
Sgt. Joseph Mille, a U.S. Army Marksmanship Unit shooter/instructor, graduated Nov. 14, 2014, from the Basic Airborne Course at Fort Benning, Ga. (U.S. Army photo by Sgt. 1st Class Raymond J. Piper)

“The primary difficulty was finding a way for Sgt. Mille to conduct a proper parachute landing fall on his prosthetic (right side) without causing injury to himself,” said Marine Sgt. Daniel Lecour, 3rd Platoon airborne instructor, Company B, 1st Battalion, 507th Parachute Infantry Regiment. “We were able to speak with a prior Black Hat (airborne instructor) who had a similar amputation, and were able to develop an effective method for Sgt. Mille to conduct a PLF (parachute landing fall).”

Mille explained that, in a normal landing, the impact is absorbed through the balls of the feet, calves, thighs, buttocks and back. For his right side, the impact is absorbed through the foot, buttocks and back.

“Once we figured that out, it was smooth sailing,” he added.

The three-week course trains students to properly conduct parachute operations. The first week, known as Ground Week, focuses on building the individual airborne skills. The individual skills learned during Ground Week are refined during Tower Week, and team skills or the “mass exit” concept is added to the training. During the third week, known as Jump Week, students must successfully complete five parachute jumps at 1,250 feet from a C-130 or C-141 aircraft.

“My first jump was interesting. It wasn’t like the movies, but I knew what to expect from the landing,” Mille said.

Lecour said that having Mille in the course was no different from having any other non-commissioned officer attend.

“Aside from his right side PLF, you could not tell he was an amputee,” Lecour said. “He pulled duties at the company, participated in Airborne physical readiness training, and successfully completed all the company 3.2-mile runs.”

Mille encourages other amputees to try it.

“You’ll get plenty of opportunities before you jump out of plane to make sure you’re good to go, so it’s not like ‘here’s your parachute, OK, go.'”

Earlier this year, Mille graduated from the Army Sniper School and has now set his sights on Ranger School and becoming a part of the 75th Ranger Regiment.

“It’s what I originally wanted to do when I joined the Army, but there were no contracts [for Army Rangers] when I enlisted. I’m going to try it out now,” Mille said.

Sgt. Joseph Mille, a U.S. Army Marksmanship Unit shooter/instructor, graduated Nov. 14, 2014, from the Basic Airborne Course at Fort Benning, Ga. Members of his class salute as the national anthem plays before their Airborne wings are presented during their graduation ceremony. (U.S. Army photo by Sgt. 1st Class Raymond J. Piper)
Sgt. Joseph Mille, a U.S. Army Marksmanship Unit shooter/instructor, graduated Nov. 14, 2014, from the Basic Airborne Course at Fort Benning, Ga. Members of his class salute as the national anthem plays before their Airborne wings are presented during their graduation ceremony. (U.S. Army photo by Sgt. 1st Class Raymond J. Piper)

ARCENT NCOs building relationships with officers, other branches and other countries

By MICHAEL L. LEWIS
NCO Journal

Though there are hot spots throughout the globe, U.S. Central Command’s area of responsibility — the Middle East — has been the locale for several spots that, during the past 13 years, have been hotter than most. Supporting the land forces in the region is U.S. Army Central, commonly known as ARCENT, whose headquarters at Shaw Air Force Base, S.C., includes NCOs who are expected to be strategic thinkers capable of working alongside officers, be subject-matter experts able to deploy temporarily when needed downrange and be able to build relationships with members of other U.S. military branches and the militaries of other countries. It’s a tough job description, but one for which ARCENT’s NCOs say they routinely rise to the occasion.

 

Covering all the angles

Sgt. 1st Class James Garton, an explosive ordnance disposal NCO with U.S. Army Central, observes a Tajikistan engineer wire explosives for an electric demolition during the ARCENT-sponsored International Mine Action Standard EOD level-one course in Tajikistan on June 5, 2014. (Photo by Sgt. Tracy R. Myers)
Sgt. 1st Class James Garton, an explosive ordnance disposal NCO with U.S. Army Central, observes a Tajikistan engineer wire explosives for an electric demolition during the ARCENT-sponsored International Mine Action Standard EOD level-one course in Tajikistan on June 5, 2014. (Photo by Sgt. Tracy R. Myers)

NCOs at ARCENT are quick to dispel the myth that NCOs assigned there don’t have much to do. Noncommissioned officers are constantly going in and out of theater to supplement units downrange, said Master Sgt. James C. Brown of ARCENT’s G-4 logistics directorate.

“I think the misconception out there is based on the fact that a lot of people don’t know what ARCENT does,” Brown said. “They don’t know that ARCENT really controls everything out there Army-wise in the AOR. So when they hear people are coming to ARCENT [headquarters], they think we’re ‘taking a knee.’”

“In this unit, you work,” said Master Sgt. Amel Brooks of ARCENT’s inspector general’s office. “If you take your average inspector general office in the U.S. Army, this office has a bigger footprint than them, including the ones at Fort Jackson (S.C.), Fort Bragg (N.C.) or Fort Stewart (Ga.), because, not only do we cover down on this headquarters, we have the United Arab Emirates, Bahrain, Qatar, Kuwait — all that is under us. So we get it coming in from all those different angles.”

“Then there’s the fact that this is a three-star headquarters,” Brown said. “A lot of people ask, ‘How much work [is an NCO] really going to be doing at a three-star headquarters?’ But just about everybody here is on a deployable status and TCSes (temporary change of station) downrange. Some deploy more than others, depending on MOS shortages or shortages of personnel with a skill set that is needed downrange.”

Besides helping their U.S. Army colleagues, ARCENT NCOs are also key participants in one of the command’s hallmark missions: building relationships with nations in the region.

“We do a lot of partnerships,” said Sgt. 1st Class Nick Salcido of ARCENT’s public affairs office. ”We have 20 countries in our AOR, 18 of which we have regular participation in. Partnership is a big part of ARCENT; it’s a large part of what we do.”

“In May, our office visited with the Kuwaiti inspector general to build a relationship and partnership,” said Master Sgt. William Cintron of ARCENT’s inspector general office. “They wanted to learn from us, because they really don’t have established inspectors general like the U.S. Army does. They only do inspections — they don’t do assistance or investigations — and the way they do inspections isn’t like how we do them. So they really wanted to learn from us how we did them, how to do the follow-up and how to correct the deficiencies. That’s a good example of the kinds of partnering we do.”

 

A part of something bigger

Cpl. Sara Manning, a military police officer with the 450th Military Police Company, 304th MP Battalion, 290th MP Brigade, U.S. Army Reserve, tests the balance of a Kuwaiti soldier serving with the 94th Al-Yarmouk Mechanized Brigade during an ARCENT-supported training exercise at Camp Arifjan, Kuwait, on Oct. 29, 2013. (Photo by Sgt. Jennifer Spradlin)
Cpl. Sara Manning, a military police officer with the 450th Military Police Company, 304th MP Battalion, 290th MP Brigade, U.S. Army Reserve, tests the balance of a Kuwaiti soldier serving with the 94th Al-Yarmouk Mechanized Brigade during an ARCENT-supported training exercise at Camp Arifjan, Kuwait, on Oct. 29, 2013. (Photo by Sgt. Jennifer Spradlin)

The relationships NCOs help develop are the building blocks of the larger strategy the U.S. Army is employing with other countries throughout the globe, said Command Sgt. Maj. Christopher Greca, the senior enlisted leader of ARCENT’s higher headquarters, U.S. Central Command, headquartered at MacDill Air Force Base, Fla.

“What I would underline is the multinational approach,” he said. “How do you build coalitions so that people internal to the areas of responsibility solve their problems? Operationally, I had been to both Iraq and Afghanistan, and I thought I understood the AOR. But, frankly, I didn’t understand — every place in that AOR is slightly different. How can we assist as a nation through DIME — through the diplomatic, informational, military and economic elements of U.S. power?”

NCOs also need to understand how the various pieces of the U.S. military contribute in the region, and the Army’s place in that mix, Greca said.

“As our Army goes to 450,000 Soldiers, we can’t do it alone,” he said. “It’s been pretty eye-opening [getting to know the component commands]. As I formerly understood CENTCOM, I didn’t understand the NAVCENT (U.S. Naval Forces Central Command) piece, and I didn’t understand the AFCENT (U.S. Air Forces Central Command) piece. Certainly, I understood that there are airplanes and ships out there. But to truly understand how, day-in and day-out, they are supporting the commander’s intent and providing support internal to the AOR has been eye-opening. I just had no idea.”

Neither did many of the NCOs who relocated to Shaw when ARCENT moved there from its former home of Fort McPherson, Ga., which was closed as part of the 2005 Base Realignment and Closure process. Shaw, already the location of AFCENT’s headquarters, was seen as a natural place for ARCENT to call home, too. But the co-location of the two commands resulted in a culture clash at first, Brooks recalled.

“When we first got here, we had a big cookout at one of the hangars, and it was Air Force sitting on one side and Army sitting on the other — completely separate,” he said. “But, hey, we’re supposed to be here together. So one of our Soldiers went above and beyond. He helped develop a Shaw Air Force Base soccer team — an Army and Air Force joint team. That sergeant first class took initiative and helped build that joint relationship, showing the Air Force what we do and letting the Air Force show us what they do.”

That interaction is exactly what Greca envisions as the ideal throughout the larger joint command.

“You can sometimes get wrapped up in the little world, the little place, the little cubicle, the little team that you’re exposed to, and not appreciate what’s going on on the outside,” he said. “If our NCOs pay a little bit more attention and truly talk with our joint brothers and sisters on our right and left flank, it would give them an appreciation for the other services and our role and how we fit into the team,” he said.

That appreciation includes learning the different duties and responsibilities of NCOs in the two service branches that call Shaw home, Salcido said.

“In the Army, it is better to be multifunctional rather than to be so niche, because we often have to cover down on so many different kinds of positions,” he said. “In the Air Force, you have to test in your job in order to advance to the next rank. So you tend to have individuals who are very knowledgeable about their particular career field, rather than being a jack-of-all-trades, which is to our benefit in the Army.”

Being knowledgeable in areas outside of one’s primary military occupational specialty helps keep NCOs relevant, said Master Sgt. Christopher Pair of ARCENT’s G-6 signal directorate.

“I’m a 25W (telecommunications chief) now, but I need to know the 25B job, which is computers; I need to know the 25Z job, which is (video teleconferences); I need to know the 25L job, which is cable installer. I’ve got to know all their jobs. So it is different [than in the Air Force].”

But the exposure to other U.S. military branches and the militaries of other countries is providing invaluable insight into a wide-angle view of the world, which can benefit NCOs throughout their careers, Brooks said.

“Being in a line unit, you see the small picture. But you have to look at the big picture,” he said. “If, when I leave here, I go on to be a first sergeant, I will be getting my team leaders, my squad leaders, my platoon sergeants to see the bigger picture. I think that will help them better train their Soldiers, because they’ll understand the bigger picture.”

“Other units, it’s all about the micro. Here, it’s about the macro, the overall picture,” Pair said. “That’s what I’ll definitely take back and tell others: Stop looking at the micro and start looking at the big picture, because the big picture is going to directly affect the smaller picture. With the big picture in mind, you can prepare a lot better for whatever comes your way.”

 

Not typical NCO duties

Sgt. Edgar Sanchez (center), an EOD NCO, and 1st Lt. Mitchell Amoriello, an EOD operations officer with the 75th Ordnance Disposal Company, 79th Ordnance Disposal Battalion, 71st Ordnance Group, conduct a practical exercise with a Tajikistan engineer during the International Mine Action Standard EOD level-one course in Tajikistan on June 3, 2014. (Photo by Sgt. Tracy R. Myers)
Sgt. Edgar Sanchez (center), an EOD NCO, and 1st Lt. Mitchell Amoriello, an EOD operations officer with the 75th Ordnance Disposal Company, 79th Ordnance Disposal Battalion, 71st Ordnance Group, conduct a practical exercise with a Tajikistan engineer during the International Mine Action Standard EOD level-one course in Tajikistan on June 3, 2014. (Photo by Sgt. Tracy R. Myers)

Perhaps the biggest difference of NCOs’ work at ARCENT headquarters versus elsewhere in the Army is the interaction they have with officers, Brooks said.

“The the role of the NCO in your average line unit? Your role here is much more broad than there,” he said. “NCOs have a huge role here. Sometimes, you’re doing the work of a field-grade officer, sometimes that of a senior NCO. You’re never going to just stay in the NCO’s lane here.”

To be successful means understanding your unique role within the organization and cultivating a culture of trust, Greca said.

“When you talk about a shared understanding, everybody understands the environment that he or she is working in,” he said. “You build cohesive teams based on mutual trust, and that trust goes up and down; it’s not only trusting subordinates, it’s the subordinates trusting their leaders.”

“It’s about understanding that you’re on a staff, understanding the staff’s functions, and being productive in that,” Brown said. “It’s easy to become complacent here, so you should make yourself relevant. Insert yourself into what is going on.”

Being a valuable asset to a staff requires NCOs to become more of a strategic thinker than they may be used to, Greca said.

“We need our NCOs — we even need our junior Soldiers — to think,” he said. “There was a time when the expectation was you just acted. There was this battle drill concept where, without thought, you just reacted. But in today’s environment, the environment requires leaders and Soldiers to think.

“[The Army] talks about discipline and initiative internal to mission command, and that discipline piece gives a military solution to a problem set that a service member is exposed to,” Greca said. “So he or she has to be able to think. The environment is complex, and if you don’t have those service members out there putting a deliberate decision-making process against a problem, the results are — well, we just can’t have that happening.”

“In school, we learn about the military decision-making process,” Brooks said. “Here, you’re doing the military decision-making process, and you have to know your role in that process.”

That means taking into consideration a multitude of variables, Greca said.

“How can you be value-added for that commissioned officer?” he said “They often talk about noncommissioned officers as the executors — the commanders specify the task, and we ensure those tasks are accomplished to a high level. Regardless of where you’re at, I think that remains constant, however the tasks change. Maybe you’ve got a greater emphasis on force protection, because you’re in a deployed environment and you have to secure a piece of tactical infrastructure on which your organization is sitting. How do you ensure that your personnel recovery [standard operating procedures] are solidified? How do you ensure there’s no needless loss of life internal to those environments, where there are a lot of moving pieces? Equipping — how do you ensure our Soldiers have the best equipment on hand to be prepared for their particular mission?

“Then, you certainly have professional development,” Greca said. “Every day, we’re charged with ensuring the professional development of our enlisted formation is done correctly. How do we ensure they are best positioned, not only for them personally but for the good of the Army? We’re doing a multitude of things, and you have to prioritize the tasks the commander gives you — what’s important at that time and place? That means you have to really understand the environment in which you’re working and your commander.”

An NCO must find a way to balance their staff duties with their normal NCO duties, Salcido said.

“In a lot of the operations and planning scenarios, we’re doing a lot of the work of the field-grade officers. We’re pretty interchangeable in that way. And that’s where part of the challenge comes being an NCO. Ensuring sergeant’s time training takes place is a challenge, because some in a field-grade officer-heavy environment don’t see the value in that. Just making sure some of those things happen for the junior Soldiers — prepping them for boards, doing mock boards before the real board — that stuff becomes more of a challenge than it might be in another unit.”

Though the headquarters environment is officer-heavy, ARCENT officers quickly come to appreciate the value of NCOs — if they haven’t before — through the work of the NCOs on staff there.

“In our office, the officers really listen to the NCOs. We NCOs have a huge say-so,” Brooks said. “Our officers will come to us and will ask us questions. During sergeants time training, our officers are welcome to come, and they learn things there, too.”

“The officers will definitely seek you out,” said Sgt. 1st Class Jared Oberman of ARCENT’s G-33 current operations division. “They’ve definitely expected a lot from me, and I would like to say that I’ve been able to pull through and show them what an NCO is capable of doing, because they sure as heck haven’t stopped giving me stuff to do.”

Greca said that is indicative of the ever-growing confidence officers have in NCOs.

“I think the trust has risen and continues to rise,” he said. “I think part of that is because the capabilities of our NCO Corps and our enlisted Soldiers have increased. They’ve been given more responsibility, and they’ve excelled in taking that responsibility and have run with it. I think what we have proven to our commissioned officers is that we’re capable, agile and adaptive, and given the requirements, we will achieve the mission.”