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Honoring the last MASH.

PFC. Kevin Henderson turned his back to the crowd and began to walk. The damp grass colored the tips of his brown leather boots chocolate. The sun, off to his right, did its best to break through the low-lying clouds.

As Pfc. Henderson, a radiologist, continued his measured gait across the field, he realized he would be the last person to carry the colors of the last mobile Army surgical hospital.

Behind him, Col. Angel Lugo and Command Sgt. Maj. Michael Mendoza fitted the unit's battle streamers to new colors that would denote the 212th Combat Support Hospital.

A MASH once had a place in the Army. Having an organization specialized in providing life- and limb-saving surgery as close as possible to the front line was an efficient method of increasing a Soldier's chances of surviving the fight, Col. Lugo said.

But as times and tactics changed, the MASH, with its confining structure, had to go.

For the past six years the 212th MASH in Miesau, Germany, was unofficially known as the "Last MASH Standing." The unit's doctors, nurses and medical staff lived with gentle jibes about their namesake, the 4077th MASH of the hit 1970s television series.

And while it was usually humorous to be likened to people like Hawkeye, B.J. and Hot Lips Hoolihan, everyone assigned to the 212th over the years knew there was a big difference between providing entertainment and giving life-saving care to Soldiers in combat, Col. Lugo added.

"You mention the word MASH and, because of the TV series, people across America associate it with a field hospital whose staff saved lives on the battlefield," Col. Lugo said. "We'll miss that connection, and I hope the American public doesn't forget what we do, now that we have a new name. We are professionals on the battlefield, and we'll be saving lives for many years to come. What I want Soldiers to know is that if on some future battlefield they are wounded and make it to us, they are going to live."

The 212th's conversion is but a small part of the reshuffling of people and materiel across the Army Medical Command. As the Army modularizes, so, too, do the combat medical units that will provide Army medicine in the field. A new acronym joined the Army lexicon--MRI, or medical re-engineering initiative.

Many units since World War I have carried the title of combat surgical hospital, but MRI has made today's CSH smaller, lighter and more compact than the previous versions. The 212th, for example, is designed around an 84-bed inpatient capacity that can expand up to 248 beds with the assignment of reserve-component units from the United States.

The core setup is a 44-bed arrangement that, as part of an early-entry force, can accept wounded Soldiers within 72 hours of arrival in theater. The operating room can be available within six or seven hours.

It comes in an air-transportable, "three-in-one," hard-sided trailer. The sides unfold to become the ceiling sections for a room large enough to allow two surgical teams to operate at the same time. The CSH has two surgical units, as well as a laboratory, digital X-ray equipment and intensive-care units. The staff includes a new mix of health-care professionals, too, Col. Lugo said.

In their new configuration, the 212th staff can provide medical support just as readily to Soldiers in combat as to civilians in a humanitarian-relief setting.

"This is the specialty-care ward," said wardmaster Staff Sgt. Tammie Haynes during a tour of the facility for unit family members. "This addition to the hospital gives us the ability to provide labor and delivery services, pediatrics and mental-health care. In Pakistan, we had to create a ward like this, but now it's part of our standard setup."

Staff Sgt. Haynes was referring to the last mission of the MASH. Just a year before its conversion, the 212th was in Pakistan following that country's 7.6-magnitude earthquake. It was there that U.S. medical officials recognized a serious mismatch of resources and requirements, Col. Lugo said.

Thousands of people living in the harsh Northern Pakistan mountains had died in the initial quake and its aftershocks. Rocks and rubble crushed entire villages. In the quake's aftermath, the Pakistani people needed more than the strictly surgical capabilities of a MASH.

Planners and logisticians built a package around the 212th's core capabilities. Human Resources Command; Army Medical Command; the U.S. Army Medical Materiel Agency; U.S. Army, Europe; V Corps; and the Europe Regional Medical Command (which oversees the delivery of medical care in Europe), all pitched in to help the 30th Medical Brigade and its subordinate, the 212th MASH, prepare for the mission.

Doctors, nurses and support staff were called on from three Army hospitals in Germany. Even the 67th CSH, in the process of standing down in Europe, provided Soldiers to go "downrange." In its three-month deployment, Task Force 212 treated more than 20,000 Pakistanis.

In its new configuration, the next mission for the 212th will be easier, Col. Lugo said. The conversion to a CSH brings the unit back from zero readiness in February 2006, to a higher level of readiness. Additionally, the unit received new equipment and nearly a 98 percent resupply of "everything we need to answer a call 'downrange,'" Col. Lugo said.

"In late September 2006 we had a team from U.S. Army Materiel Management Agency deliver more than $5 million worth of supplies, surgical sets and other equipment to get us ready for our new mission. And the USAMMA team stayed on to train our staff," Col. Lugo added.

The unit received the newest medical equipment the Army had to offer, said Maj. James Tuten, chief of plans and operations for USAMMA's Force Sustainment Directorate.

Radiology specialists like Pfc. Henderson will use a digital radiography machine that uses electrons instead of X-ray film. The time saved by not having to process film used in older radiography equipment can mean the difference between life and death. This is especially true during the "golden hour," the period of time a wounded Soldier has to survive on his or her own after being wounded.

Another aspect of the 212th's conversion comes from the fact that the equipment fielding, personnel actions and required training all took place with the unit's parent, the 30th Med. Bde., deployed to Iraq, Col. Lugo said. Reserve-component Soldiers from around the United States and Europe filled out a provisional unit from Heidelberg. They guided the conversion, even as many of them were on yearlong assignments in a foreign land without their families.

"You know, we can change the unit all we want, but the heart of the 212th MASH is now the heart of the 212th CSH," said Col. Terry D. Carroll, commander of the 30th Med. Bde. Rear element. "It's the men and women who serve. I know they'll do us proud."

Mr. Phil Tegtmeier works at the Europe Regional Medical Command Public Affairs Office.
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Title Annotation:mobile Army surgical hospital
Author:Tegtmeier, Phil
Publication:Soldiers Magazine
Geographic Code:4EUGE
Date:Jun 1, 2007
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