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When wounded warriors from the U.S. are lowered from the ambulance bus to a team of military providers at Landstuhl Regional Medical Center, seeing a familiar unit patch worn by liaison officers from their command is always a welcomed sight.
It’s been the same for Canadian soldiers seeing the Red Maple Leaf worn by members of the Canadian Armed Forces Casualty Support Team who served at LRMC from 2006 until its closing ceremony March 20. The ceremony coincided with the ending of Canada’s military mission in Afghanistan. The Casualty Support Team served the almost 400 Canadian wounded warriors treated at LRMC.
“Myself, as well as all of the liaison nurses that have preceded me, have been very honored to work with such a high caliber of physicians, nurses and support personnel,” said 1st Lt. Kelsey E.N. Penner, aeromedical evacuation nursing liaison officer at the ceremony.
“We have always received the highest quality of support and have been treated as an integral part of the liaison team at LRMC. We are greatly appreciative of all of the support that we have received here, as well as from organizations such as the 86th Contingency Aeromedical Staging Facility at Ramstein. In addition, the families of those with significant injuries were hosted at the LRMC Fisher House and received tremendous support from the clinical and pastoral staff. Without the outstanding support of LRMC command, medical, and support staff, the Canadian mission in Afghanistan would not have been possible.”
LRMC Commander Col. Judith Lee paid tribute to the important role the Casualty Support Team played in being there for their fellow Canadians.
“There is no greater sight when you’re a casualty than to see someone in your own uniform,” Lee said.
Lee joked saying she hoped she wouldn’t be seeing another CST at LRMC again in the near future, but if future hostilities did require the team here again, she knew the transition would be an easy one.
At its peak, the Casualty Support Team consisted of eight multidisciplinary members, consisting of a commanding officer, nurses (including specialists in aeromedical evacuation), medical technician, chaplain, administrative officer
and clerk, and a technician specializing in IT systems.
The team was responsible for liaison with U.S. medical personnel, facilitation of evacuation back to Canada or back to the combat theatre, and personalized, individual support to casualties and their families while at LRMC.
This was particularly important during the deployment of personnel from French-speaking areas of Canada.
Canadians were one of 55 coalition forces treated at LRMC, and the Maple Leaf became a common sight worn on the distinctive green uniforms worn by Canadian staff, as well as the Canadian flags displayed outside patient rooms of the fellow Soldiers they served.
Canada’s role in the Afghanistan war began in late 2001 after the September attacks on the U.S. In February 2002, the first contingents of regular troops were deployed, and Operation APOLLO was established.
In March 2002, snipers from the 3rd Battalion Princess Patricia’s Canadian Light Infantry fought alongside U.S. Army units as part of Operation ANACONDA, and Canadian troops provided garrison and security support throughout Afghanistan. The Canadian commitment was originally planned to last until October 2003; however, in August 2003, Canadian troops moved to the northern city of Kabul to become the commanding nation of the newly formed International Security Assistance Force.
As hostile operations increased, Canada began to take increased casualties in Afghanistan. A sustainable patient evacuation plan was required, and the U.S. government signed an agreement to provide Aeromedical Evacuation to LRMC. Canadian patients were transported by the U.S. Air Force to LRMC where they received definitive surgical care while awaiting aeromedical evacuation back to Canada through the Canadian Aeromedical Evacuation System.
It was quickly determined that a patient liaison element would be required at LRMC, and medical and nursing staff from the Canadian Forces medical unit located in Geilenkirchen, Germany, were assigned the task. As casualties continued to increase, however, it was quickly determined that this arrangement was not sustainable, and in February 2006 the first Canadian Aeromedical Evacuation Nursing Liaison Officer (AENLO) was deployed to Landstuhl.
In 2006, the Taliban conducted a major offensive in the Kandahar and Helmand provinces, and by the end of the year 36 Canadian Soldiers lost their lives as a result of operations, and 96 Canadian casualties were treated at LRMC. The year 2007 saw a similar number of casualties, and the AENLO and small medical team from Geilenkirchen became overwhelmed. In February 2008, Canadian Expeditionary Force Command deployed the first Casualty Support Team to LRMC with plans to rotate in new personnel every six months.
The team worked out of transient office space at LRMC and nearby Ramstein Air Base. In the spring of 2008, an office trailer was installed by the Canadian government on a space provided by LRMC facilities. The liaison nurses were granted access to U.S. clinical systems instrumental in providing medical reports back to Canada. Additionally, this allowed the nurses to print electronic health records and scan them into Canadian systems. A Canadian Medical Technician was embedded with the 86th Contingency Aeromedical Staging Facility at Ramstein Air Base, and this unit provided outstanding support to outbound Canadian AE missions.
As Canada began withdrawing from Kandahar in 2011, the Casualty Support Team at LRMC was downsized to reflect a decrease in Canadian casualties. In the meantime, CST personnel increased their contribution to LRMC operations, volunteering their time in clinical areas, with the American Red Cross, LRMC Trauma Program, Fisher House, Wounded Warrior Project, and the 86th CASF, all in the hopes of “giving back” to the community for their tremendous support.
The Canadian flag in Kabul was lowered on March 12 and the final Canadian Armed Forces personnel were withdrawn. Although there will no longer be full-time personnel deployed to LRMC, Canada will maintain a presence. The physical infrastructure of the office trailer will be maintained by personnel from the Canadian Operational Support Hub (Europe) located in Cologne, Germany, and medical liaison responsibility will return to the clinic in Geilenkirchen. This arrangement will allow Canada to continue to provide support to patients from various operations throughout the world. The Casualty Support Team will transition to “Caretaker Status” and is able to be reactivated on short notice in response to another large scale operation such as Afghanistan.
