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Lessons learned in Irregular Warfare (IW) medicine since 9/11 enhance survivability for all. Gaps in policy and doctrine persist, necessitating a framework to improve medical support for future conflicts.

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Area of Science:

  • Military Medicine
  • Global Health Security
  • Conflict Medicine

Background:

  • Irregular Warfare (IW) involves asymmetric activities in challenging environments with limited medical infrastructure.
  • Providing medical care to U.S. forces, allies, and partner nations in contested areas is complex.
  • Past 24 years of IW have seen advancements in medical care, improving survivability.

Purpose of the Study:

  • Identify global lessons learned since 9/11 to enhance medical support for Irregular Warfare.
  • Address current challenges and future directions in IW medical support.
  • Develop a framework for improving medical care in complex operational environments.

Main Methods:

  • Systematic literature review of peer-reviewed and grey literature from 2000 to present.
  • Data extraction using the Department of Defense (DoD) doctrine, organization, training, materiel, leadership and education, personnel, facilities, and policy (DOTMLPF-P) framework.
  • Analysis of medical functional areas within the context of Irregular Warfare.

Main Results:

  • 1,063 sources analyzed, primarily by civilians, covering 81 countries.
  • Hemorrhage and disease non-battle injury were common issues; noncombatants and service members were key recipients of care.
  • Key themes include interagency synchronization, medical resiliency, Global Health Engagement, doctrine gaps, low-signature operations, host nation capabilities, training needs, ethics, mental health, and technological innovation.

Conclusions:

  • Despite advancements, a lack of clear IW medicine policy and doctrine hinders progress.
  • A DOTMLPF-P framework is proposed to address gaps and guide future medical support solutions.
  • Leveraging IW medicine is crucial for integrated deterrence and preparing for large-scale combat operations.