“In Kericho, our enteric disease research and cohort development for potential vaccine testing is the top funded priority for the medical infectious disease research program. We have protocols in place for evaluation of treatment drugs for traveler’s diarrhea. Malaria and HIV fall closely behind enteric diseases and all three are extremely important risks to deployed Service Members. “What we have with AFRICOM [Africa Command] is not a direct-command relationship, but we are within their AOR [area of responsibility], so we maintain data flow to them when we think it would be useful. We support their commanders’ health-related security cooperation efforts on the continent. We do projects such as training of partner countries at their request on topics such as malaria diagnostics training and external quality assurance assistance visits to their labs.”
As with AFRIMS, USAMRU-K’s primary efforts remain infectious disease research, aimed at developing products and information to protect U.S. Service Members.
U.S. Army Medical Research Unit-Europe
USAMRU-E, located at Sembach Kaserne (formerly Sembach Air Base and now an Army installation about 19 miles east of Ramstein Air Base) is the Army’s only behavioral health research asset located with operational units. As such, USAMRU-E is able to send researchers into the field quickly to conduct both randomized trials and survey-based epidemiological studies on emerging behavioral health and resilience issues faced by U.S. service members. Initially a forward-deployed research unit, established in 1977 to investigate the high prevalence of drug use in the post-Vietnam Army, the unit now conducts operational behavioral health research. It is the smallest of the overseas commands, with roughly 18 personnel evenly divided between uniformed military, Department of the Army civilians, and contractors.
“I think our size has more to do with the type of research and studies that we do. While the other overseas commands have multisite trials requiring more laboratory capability, USAMRU-E’s research occurs in the field with a given unit, typically a brigade, and generally involves survey-based research leading to validated training and policy recommendations pertaining to behavioral health, so we don’t need as large of a team for our line of research,” noted USAMRU-E Commander Lt. Col. Jeffrey Thomas, a research psychologist with a Ph.D. in applied social psychology.
“Our customers and participants are all operational units and Soldiers. We have fielded human dimension research teams where the soldiers are – Iraq, Afghanistan, Kosovo – to look at human dimension issues, stressors, and their effects. We have a capability that is somewhat unique, not only within WRAIR, but within the DoD in working with operational units where they are, in order to advance programmatic behavioral health research.”
After more than 35 years in Heidelberg, USAMRU-E was relocated in 2013, along with all U.S. Army medical operations in Germany, to new facilities in southwestern Germany in the Rheinland Pfalz region. The only WRAIR overseas operation located on a U.S. military base – and in one of the world’s most advanced nations – USAMRU-E’s small contingent nonetheless maintains a significant multination collaboration.
“We have a very nice international presence, taking part in NATO panels, working with Partnership for Peace [former Soviet Bloc] countries, and helping to advance research among partners on behavioral health and deployment support for soldiers across NATO. And we’ve been very active in consulting with and exchanging behavioral health support ideas and processes with our host nation partner, the Bundeswehr in Germany. We also currently have an active collaborative agreement with the U.K. to examine differences and similarities between U.S. and U.K. soldiers on mental health issues following deployment to Iraq and Afghanistan.” Thomas said. “We not only have a history of success in Europe, but there are also clear benefits being located in Germany which is at the crossroads of three combatant commands – European Command, Africa Command, and support for the overseas contingency operations in Central Command.” With the expansion of AFRICOM, USAMRU-E has a mental health advisory mission in Africa and recently sent a behavioral health team to Djibouti to conduct a study in the Horn of Africa. “We’ve also supported a few military-to-military requests with some eastern Africa countries of interest to the U.S.,” he added. “Those requests focused on building Army resilience training programs and what they can apply to their own forces.”
“We’ve done quite a bit of research on combat soldier reintegration. During World War II, soldiers returning home on ships took up to a month; now they can be home in 12 hours. So part of reintegration has been identifying soldier expectations. In the past, soldiers often were warned of the psychological problems they might have, primarily from an illness perspective, but having reintegration problems when you first get back is common, such as reacting to a car backfiring in a parking lot.”
With the drawdown in Afghanistan, reduction and consolidation of forces in Europe, and budget constraints, funding continues to ebb and flow, driven by the needs of soldiers returning from Southwest Asia with PTSD and adjustment problems. “As the problems have manifested, the Army has made more money available to find solutions, and I suspect those efforts will continue in the post-combat era. As long as we continue to answer questions about how to help soldiers, the funding will be there,” Thomas said, adding that the nature of combat-related mental health concerns has changed with better understanding, new technologies, and faster response and transport.
“We’ve done quite a bit of research on combat soldier reintegration. During World War II, soldiers returning home on ships took up to a month; now they can be home in 12 hours. So part of reintegration has been identifying soldier expectations. In the past, soldiers often were warned of the psychological problems they might have, primarily from an illness perspective, but having reintegration problems when you first get back is common, such as reacting to a car backfiring in a parking lot.