When the Botswana Defense Force sets out to build a medevac and aeromedical evacuation capability within its forces, it looked to the U.S. military, which has become the world's expert in evacuating wounded troops from the battlefield.



U.S. soldiers, airmen, Marines and sailors brought their medical know-how to the Southern Accord 12 exercise under way at Thebephatshwa Air Base, Botswana, sharing with their host-nation counterparts everything from initial battlefield medicine to medevac and aeromedevac techniques.



The training culminated yesterday with a mass casualty exercise, in which the BDF medics watched their U.S. trainers provide immediate, lifesaving care to simulated casualties, then moved them through progressive, escalating levels of care.



The "casualties," Marine Corps reservists from the 4th Marine Division's Company D, Antiterrorism Battalion, had been wounded during a mock ambush. Their battle buddies, applying lessons the Marines here are sharing with their BDF counterparts, provided immediate combat lifesaver care at the point of injury before a BDF ambulance transported them to the forward surgical hospital.



Navy Petty Officer 2nd Class Christopher Miller, one of two Navy corpsmen participating in Southern Accord, spent six days teaching basic combat lifesaver training to BDF infantry troops. Miller taught them techniques such as how to make and use tourniquets and how to apply pressure dressings for chest wounds.



"They seemed to be eating up the knowledge very quickly," Miller said, ultimately racing against each other to see how quickly they could apply a tourniquet and pull a casualty to safety.



Once the casualties reached the forward surgical hospital, Army Captain Ray Abordo, commander of the Army Reserve's 909th Forward Surgical Team, explained the step-by-step process used to triage the casualties, provide advanced trauma life support, and identify those who required care at the combat support hospital.



"This is the first demonstration of casualty evacuation from point of injury to the collection point, then to the forward surgical team, and then to the combat support hospital," said Army Lieutenant Colonel Kyle Remick, commander of the medical task force for the exercise, as he watched the two staffs tend to patients.



The BDF then took the lead in applying the aeromedevac training they received here to load the "casualties" aboard a C-130 aircraft for evacuation.



Medlite 12, a U.S. Air Forces Africa exercise conducted this year during Southern Accord, focused on teaching the Botswanan medics not only to load patients for aeromedical evacuation, but also to treat them during the flight.



"You can have aircraft, but if you don't know how to care for patients in the air, it's not enough to conduct aeromedevac missions," said Air Force Lieutenant Colonel June Oldman, a flight nurse assigned to the National Guard Bureau in Washington. "We are teaching them the proper techniques, and by applying these, it can make an amazing difference in lowering mortality rates."



That capability, she said, would improve the BDF's ability to support peacekeeping missions and other possible contingencies on the continent.



Most of the Medlite instructors were members of the North Carolina Air National Guard, which partners with Botswana's military through the National Guard Bureau's State Partnership Program.



Oldman called the arrangement a win-win situation that enables the Guardsmen to hone their readiness skills while serving as mentors, and for the BDF medics who are eager to learn.



Air Force Master Sergeant Christopher Choate, chief flight evaluator for the North Carolina Guard's 156th Air Evacuation Squadron, praised the speed in which the Botswanan combat medics grasped the week-and-a-half-long instruction. "After just that short time, they are taking over 100 percent, which is amazing," he said.



Air Force Staff Sergeant Sara Baker called it a testament to the medical training the BDF is providing its medics. "It's clear that they've had great training and brought it to the table," she said. "They have just blown us away."



BDF Marine Lance Corporal Oarabile Lesefedi, a paramedic who received the training, said he was amazed to see how the U.S. forces essentially transformed a military aircraft into a flying ambulance.



"This a big benefit, because it means that patients can be extracted more quickly and be moved in a way that is fast, very reliable and can take a lot of patients," he said. "If we are able to adapt these techniques, it can save lives."



Remick, the medical task force commander, said lessons being shared during Southern Accord and Medlite will go a long way toward helping the BDF build similar capabilities within its own force.



"This is a very exciting proposition to see how it will develop," he said. "There is a lot of exciting potential in this country."



The BDF graduated its first class of medics in 2009, and has instituted combat lifesaver and intermediate lifesaver certification programs, said Botswana Defense Force Lieutenant Colonel (Dr.) Aubrey Kadiwa. However, it has no equivalent of a battalion aid station or forward surgical team, and the military as well as civilian trauma-care systems are still evolving.



Kadiwa, a BSF doctor for the past seven years, emphasized that traditional military training alone isn't enough to make the evolving BDF medical corps combat-ready.



"What you learn in medical school when you train as a doctor doesn't reflect what actually happens on the battlefield," he said.



Kadiwa welcomed the opportunity to train with U.S. military medics, many with combat deployments under their belts, during Southern Accord.



"What the Americans have learned in Afghanistan and Iraq is very different [from traditional medical] modalities. It's not text book," he said. "So there is a true benefit for us, being able to learn what they have learned."