Level III preventive medicine in a counterinsurgency environment

As the Department of Defense moves forward to secure Baghdad, military forces are being strategically dispersed in very austere environments. These forces live and work side-by-side with their Iraqi counterparts in an effort to clear, hold, and reconstruct the city block by block, and further separate the insurgents from the general population. Level II preventive medicine (PM) personnel directly support these forces and keep them in the fight by reducing acute illness and disease and nonbattle injuries. Level III PM is performing the traditional PM mission of reducing both acute and chronic illness while conducting Deployment Occupational Environmental Health Surveillance and supporting Level II PM. However, the doctrinal basis of Level III allocation and priorities of core competencies have shifted. Are we meeting the need? This article attempts to answer the question based on experience as a Level III PM detachment commander in Baghdad, and provide recommendations for change across the spectrum of the Army's structure of doctrine, organizations, training, materiel, leadership, education, personnel, and facilities.