Medical Train-the-Trainer Program Expands to More Partner Nations

Medical Train-the-Trainer Program Expands to More Partner Nations

By Dialogo
November 14, 2015


Historical data shows that 90% of combat wound fatalities die on the battlefield before reaching a military treatment facility, so first responder care at the point of injury is literally a matter of life and death.

Tactical Combat Casualty Care (TCCC), according to the Field Medical Training Batallion’s Combat Lifesaver/Tactical Combat Casualty Care Student Handbook, is an attempt to better prepare medical and non-medical personnel for the unique factors associated with combat trauma casualties. It originated as a U.S. Special Operations research project, but is currently used throughout the U.S. Military and various partner nations.

For its part, the Tactical Combat Casualty Care Life Saver (TCLS) Course is a customized version of TCCC developed to provide students more advanced and relevant combat medic skills for their specific duties in a remote terrain with difficult access.

In 2012, Diálogo
told the story of a collaborative train-the-trainer program
that had recently graduated a new group of combat medics in El Salvador. They received the TCLS trainingfrom Peruvian instructors who had received the training themselves from a U.S. Southern Command (SOUTHCOM) cadre as part of a 2011 cooperative initiative with Peru.

SOUTHCOM’s Command Surgeon’s Office originated the program after seeing a need to have more able combat medics for Troops deploying to Peru’s Valley of the Apurímac, Ene, and Mantaro Rivers Valley (VRAEM), where the Military is combatting the remnants of the terrorist drug-trafficking organization Shining Path.

The program has been so successful that it has not only become a requirement for all Peruvian Military members deploying to the VRAEM, but also kept growing and spreading to other partner nations since then, including Peru, El Salvador, and Uruguay.

In fact, some of the Salvadoran graduates from 2012 were selected to join some of their Peruvian instructors to multi-laterally train members of the Uruguayan Military who are scheduled to deploy to diverse peacekeeping missions around the world.

Four Peruvian instructors, two Salvadorans, and two U.S. combat medics from the Special Operations Forces accompanied by a member of SOUTHCOM’s Command Surgeon’s Office comprised the TCLS staff that deployed to the Uruguayan National Peace Operations School (ENOPU, for its Spanish acronym) during the first four weeks in September.

There, they collaborated with 27 Uruguayans identified to serve as TCLS instructors. After the first iteration of training, 45 additional Uruguayans and two Brazilians ranging in rank from Soldier to Lieutenant reported to training with the purpose of learning from the newly minted Uruguayan TCLS instructors, who came from both medical and non-medical backgrounds. The third iteration saw another 45 Service Members receive training from a now very competent cadre of TCLS instructors.

Colonel Carlos Frachelle, ENOPU’s director, told Diálogo
that they requested this medical training in order to augment Uruguay’s enduring medical capacity and better train the approximately 1,500-person contingent who deploys to and from the different UN peace keeping missions in the Democratic Republic of the Congo, Haiti, Liberia, Kashmir, the Ivory Coast, and the Multinational Force of Observers in the Sinai Peninsula.

“Uruguay has a long tradition in peace missions, but within a context where the environment and threats in our mission areas are constantly evolving, so we too must evolve our techniques and training in order to remain current. TCLS is the perfect framework for what we intend to achieve. The training is very important to us; it will allow our Troop to not only provide better care and help to those who need, but also to increase their confidence in doing so,” he said.

Col. Frachelle said that having the course taught by Peruvian, Salvadoran, and U.S. personnel is an added value because they not only speak the same language, but also represent the presence of partner nation armies. “We value their presence. For us it’s a privilege and an honor to host them in our country and benefit from their high professionalism. They speak our language and in the case of Peru, represent a partner with whom we comprised a joint battalion in Haiti. As for the Salvadoran personnel, it means working together with them once again. A few months ago, a medical team from our Military Hospital trained with them when the Ebola outbreak took place in Africa.”

The program represents a new way of looking at Train-the-Trainer events. Rather than conducting one iteration of training and leaving a given country to develop the rest of their program, this training walks the new instructors through a couple of iterations of training until they demonstrate they can manage on their own.

“Building capacity is not done overnight,” said the program director, Lieutenant Colonel Michael Coote of SOUTHCOM’s Surgeon General’s Office. “But it can be done when: 1. U.S. trainers have confidence in our partners’ abilities to perform the tasks well, 2. Our partners invest themselves in the process, and 3. We provide them with the tools to be successful.” According to Lt. Col. Coote, “By supporting our partners, we empower allies with whom we will work side-by-side.’

Since the first course was taught in Peru in 2011, approximately 2,500 more military service members from Peru, El Salvador, Brazil, Panama, and now Uruguay have become trained in and trainers for the TCLS course, with a customized version of the course adapted for the needs of each class. They will keep paying it forward to future generations of trainers to come, attesting to the strength of what true collaboration among partner nations can achieve.