Building Healthcare for the Iraqi Military & Police

1. Building Healthcare for the Iraqi Military & Police Presentation to the 2006 Tri-Service Symposium 14 July 2006

2. Agenda • Operational Perspective • Situation • Staffing • General Lessons Learned • Pass to Captain Evors

3. Operational Perspective • J7 Engineer for Multi-National Security Transition Command – Iraq (MNSTC-I) • Responsible for approximately $3B construction program supporting Iraqi military and police • Projects all over the country • Work executed primarily by Air Force Center for Environmental Excellence (AFCEE) and Gulf Region Division (GRD), US Army Corps of Engineers • Almost all work design-build • Included work to develop Iraqi ministries capability to do construction/facilities maintenance • Period from May 2005 to December 2005

4. Situation • Starting to finish facilities originally planned for a much smaller force structure (11 Brigades vs. 10 Divisions) • Construction starting on work for larger force • Improvised Explosive Devices (IEDs) continued to be a problem, though some sites had regular indirect fire incidents • Planning for future expansion/growth in the Ministry of Interior program • Working closely with the Iraqi Security Ministries to assist them in acquiring resources and capability to build for themselves

5. Staffing • J7 a split of Individual Augmentees (IAs) and unit fills from the Army Reserve (Training Divisions) • IAs from the Air Force and Navy were degreed engineers, but Army Reserve were combat engineers (some had engineering degrees) • Contracting agencies (Air Force Center for Environmental Excellence (AFCEE) and Gulf Region Division, US Army Corps of Engineers (GRD)) had staff present in my office to support the MNSTC-I program • Healthcare expertise resident in the MNSTC-I Health Affairs Directorate

6. Lessons Learned • Infrastructure construction is a time-consuming process • Force generation plans change faster than we as engineers can react • Best use of resources to go ahead and build, then adapt to the new mission • Local materials and construction technologies are best • U.S. agencies tried to introduce technologies we perceived to be faster and cheaper • Iraqi construction workforce had never dealt with them before • Cost actually higher and took longer than concrete and brick • We need to respect their way of construction and understand the limitations of the workforce

7. Lessons Learned (cont.) • Using local materials also creates employment outside of our jobsite • Using cost contracting vehicles provided the flexibility to deal with the changing security environment and keep the work moving • Larger projects with a defined security perimeter had fewer security issues than those in the middle of towns • In town, it was critical to get coalition forces, local Iraqi police and Iraqi military units involved to assist in ensuring the contractor can work • As I was leaving, we were starting to have more embedded coalition teams with the police and military units to facilitate this process

8. Lessons Learned (cont.) • Having QA eyes on the project was crucial to success • Both AFCEE and GRD had local Iraqi engineers working for them or their Title II contractor • Have to work security issues closely to make sure that local engineer can get onto the jobsite to do his work and avoid being targeted by insurgents • Organic movement/convoy team allowed us to visit the sites and obtain first hand knowledge of the work • A surprising number of adult Iraqis cannot read – impacts how we train operators of sewer/water plants and other complex systems on the bases we’re building

9. Construction Standards • They DO exist in Iraq!! • Ministry of Construction and Housing is the repository • MNSTC-I and our agencies used the International Building Code where Iraqi standards were silent • Must be enforced by a vigorous QA/QC program • Sometimes difficult for US military and civilian personnel to realize we’re operating to a different standard than what we see as “normal”