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Cmdr. Michael G. Swanson, regimental surgeon, Regimental Combat Team 5, discusses plans for an upcoming cooperative medical engagement with Petty Officer 2nd Class Michael G. Bundeson Oct. 2 at the Regimental Aid Station on Camp Ripper, Iraq. Marine Corps medicine has been instrumental in RCT-5's efforts to gain the trust of key Iraqi leaders, allowing more access to the population so civilian-military operations can be more successful.::r::::n::

Photo by Sgt. Trent M. Lowry

Marines crack code for effective civilian medical engagements

6 Oct 2008 | Sgt. Trent M. Lowry

Even though the kinetic efforts in Iraq have become less active with less-frequent small-arms and improvised-explosive-device attacks, the Marines are still at the tip of the spear on another battlefront.

In the ongoing effort to win the hearts and minds of Iraqis in western al-Anbar province, Regimental Combat Team 5 has been engaging the locals with one of their most effective non-kinetic weapons systems: Marine Corps medicine.

“We discovered the value of Marine Corps medicine anecdotally by observing the results that occurred when I went to my first key leader engagement,” said Cmdr. Michael G. Swanson, 47, regimental surgeon, RCT-5, and a resident of Temecula, Calif. “We fell into using medical engagements, and what was an afterthought that met with small success has grown into a fundamental requirement for operations.”

The use of RCT-5’s medical assets has paid dividends for the command, which has been able to take advantage of the position of physicians and corpsmen as medical professionals and caring individuals who have helped the command gain the trust and respect of key leaders –sheikhs, mayors and civic leaders – in the province.

“I can assure the Iraqis that we have their best interests at heart,” said Swanson. “I feel obligated to both of my roles. I adhere to the Hippocratic oath to provide medical care to the Iraqis and earn their confidence, but I can still honor my duty to Marine Corps medicine by using my medical position to support counterinsurgency operations.”

Swanson took a circuitous route to his current position in the military. Enlisting in the Army and expecting ground combat duty, Swanson had never intended to become a doctor.

“I didn’t want to be a medic at all. I wanted to be infantry, but my test scores were too high and the Army hoodwinked me into becoming an infantry field medic,” said Swanson, whose decision to join the Army was motivated by the distinguished, decorated service of his grandfather in World War II and that of his father a generation later.

Swanson made the most of the opportunities the medical field offered.  After leaving the Army as a staff sergeant, Swanson took advantage of a Naval Reserve program and studied nursing and business administration at the University of Northern Colorado in Greeley, Colo. After Officer Indoctrination School in Newport, R.I., he was commissioned an ensign in the Navy.

Swanson got his first experience with treating Iraqis while deployed during Operation Desert Storm, where he and his small-ambulance detachment treated more than 260 enemy prisoners of war in an eight-day period, far more casualties than those suffered by Coalition troops.

He later took advantage of the Health Professionals Scholarship Program to attend medical school at Western University of Health Services in Pomona, Calif., where he earned his Doctor of Osteopathy degree.

After serving tours with two Marine reconnaissance units and then a post as chief of residency at Naval Hospital Camp Lejeune, N.C., Swanson returned to California to work in San Diego for the Navy.  However, Swanson knew his heart was with the Marines, so he worked to get orders to 1st Marine Division, and from there to 5th Marine Regiment.

“My job is to be the advocate for the health and safety of the Marines and sailors, to certify to the commanding officer the health and fitness of his command and to support the Marine Corps mission and objectives as set forth by the commanding officer and his staff,” said Swanson, who developed the above definition to summarize his view that, though there are no medical personnel organic to the Marines, when a sailor in the medical field is assigned to a Marine unit he belongs to Marine Corps medicine.

Being an integral part of Marine Corps medicine is what drives Swanson and his corpsmen. When the RCT-5 commanding officer, Col. Patrick J. Malay, noticed the effects Swanson and other medical personnel could have on engagements with civilians, he had the foresight to integrate the “docs” into the civilian-military operations (CMO), Swanson said.

“I look at it as taking our capabilities and using them to support the commanding officer to help the full spectrum of the operation, with medicine as just a part of shaping the success of the mission,” Swanson said.

At the heart of what Marine Corps medicine affects during CMOs is the cooperative medical engagement (CME). The medical personnel meet with Iraqi physicians and learn what the needs of the people are. Then the Marines and docs provide the specific assistance requested, so the people of al-Anbar province get the help that is of most value to them.

“We have perfected a system out here,” Swanson said. “We turn tactical CMOs – one-time medical engagements that bring medical support to the Iraqis, but aren’t specifically directed at their needs – and turn them into operational CMOs, which ensure gains in stability in the area by meeting the needs of the Iraqi Security Forces and the civilians.”

For instance, one sheikh who was a leader in the Haditha area had trouble communicating with Marines, even through interpreters who were always having to repeat themselves loudly. The sheikh had severe hearing loss, and after Swanson examined him and arranged for a Coalition audiologist to see the sheikh, a hearing aid was presented to the sheikh. As gratitude for the improvement in his quality of life, the sheikh opened communications and the Marines were able to gain broader access to the area.

“Another thing we’ve created is the concept of the rural health engagement,” Swanson said. “We take Iraqi physicians from the cities to the rural area, and bring aid out to the Iraqis in the region.

“We’re careful, though, to let the rural people know that they’re receiving aid through the advocacy of their physicians and key leaders and from the efforts of the Civil Affairs Teams.”

Marine Corps medicine wasn’t always as integral to the overall mission. There was a time not so long ago when the main responsibility for medical personnel was emergency first aid for battlefield casualties.

“When I first got to Iraq, I was exposed only to front-line medicine,” said Petty Officer 2nd Class Michael G. Bundeson, 27, assistant leading petty officer, Regimental Aid Station, RCT-5, who is serving his fifth deployment to Iraq and has experienced the gamut of operational tempos here. “When we were taking casualties, our goal was to prolong life long enough to get them back to the rear for surgery and further medical care. We lost a lot of Marines, but we (corpsmen) worked hard to save the Marines.”

Bundeson’s first deployment was with 3rd Battalion, 5th Marine Regiment, during Operation Iraqi Freedom I, the offensive effort at the beginning of the war. Since then, Bundeson has served with 2nd Bn., 4th Marines; 1st Bn., 1st Marines; and RCT-5’s Personal Security Detachment, in addition to his current duties at the RAS. He’s taken two bullets and several pieces of shrapnel in performing his duties of treating Marine injuries.

Now, Bundeson sees the gains that have been earned by the blood of Coalition forces and Iraqi Security Forces. Swanson said Bundeson is one of the corpsmen that makes the current mission work.

“I can definitely see the progress in this country; it’s a lot quieter now, but I’m always vigilant,” said Bundeson, a Roseburg, Ore., native who recently passed his 10-year mark in the Navy. “This is a good feeling, that the Marines are doing all this.

“We’re making progress.  The Iraqis are not afraid of us and see that we’re here to help. We’re earning their support and respect.”

The progress hasn’t always been easy.  There are still people in remote areas of Iraq who don’t fully trust Coalition forces yet. After talking to key leaders in Nazrah, one such town with animosity toward Marines, Swanson and the Marines were able to negotiate setting up a rural health engagement.

“Not only were we effective, we were successful in gaining their confidence enough that they allowed male doctors to examine female patients,” Swanson said. “(That) was the first time I’ve seen that happen.  We’ve become valued and trusted when we show them that we are concerned with their needs.”

“It’s like a bank account – you keep putting in the deposit, in this case trust is the currency, and it will continue to grow,” Bundeson said. “If you lose that trust, that’s making a withdrawal, and you’ve got to keep putting more deposits in to get that trust back.”

While the battle is not yet won, the visible successes are promising to Swanson.

“When RCT-5’s medical assets have been involved with CME’s, we’ve created sustainable efforts that continue to grow,” Swanson said. “It has set us apart from other units and has allowed us to have more far-reaching and permanent effects on the center of gravity, but we’ve just scratched the surface of what we can do.”


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