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ADF Health September 2001 - Volume 2 Number 2

Health Service profile

Combined Health Element, Peace Monitoring Group, Bougainville

The Peace Monitoring Group (PMG) in Bougainville is a multinational entity, with personnel from Australia, New Zealand, Fiji, and Vanuatu. The Combined Health Element (CHE) provides Level 3 health support to the PMG and has been operational since December 1997.

This health support is based on the concept of a light-scale tented surgical facility, namely the Field Surgical Troop (light) structure that is integral to the Army's Health Support Battalions. Health capabilities of the CHE are tailored to the geographical isolation of the PMG in Bougainville and lack of civilian health infrastructure, a legacy of the civil unrest over the last 10 years.

CHE staff are sourced from all three ADF Services. A tour of duty is generally four months, although two-month rotations allow flexibility for filling some positions. Medical specialists, however, rotate through every two weeks. Unlike the ADF commitment to the UN Military Hospital in East Timor, CHE staffing is not based on health unit contingents but on individuals nominated by their units.

In the three and a half years since deployment, CHE has conducted about 240 resuscitations, 800 surgical procedures, admitted 1300 inpatients, and supported 100 forward aeromedical retrievals. The PMG mandate allows for humanitarian assistance where life or limb is at risk. Of the 800 surgical procedures, 725 operations were performed on Bougainvilleans. An average of 90% of admissions and 90% of forward aeromedical evacuations were also for the local population.

The illness of main concern for PMG members is malaria. Army Malaria Institute statistics from the start of the PMG operation to 1 July 2001 attribute 51 malaria cases to operational service in Bougainville.

The PMG is planning a smaller establishment structure, which will reshape the health support required. The CHE is preparing to change from a Level 3 surgical capability to a Level 1 health facility by the end of August 2001.

Activities of CHE include medical education presentations by staff and medical specialists, resuscitation training and CHE drills. Teamwork, confirmation of standard operating procedures, and maintenance of clinical skills is promoted by such events. Opportunities to participate in PMG sporting competitions add to the teambuilding within CHE.