The Role of the U.S. Army in Health Systems Reconstruction and Development During Counterinsurgency

Health system reconstruction and development in developing countries is difficult under the best of conditions. In counterinsurgency environments, it is even more complex and challenging. U.S. military and civilian organizations involved in Afghan and Iraqi health system reconstruction and development have been criticized for the lack of planning prior to the initiation of conflict, inadequate coordination among involved agencies, and poor strategic planning for comprehensive development. U.S. Army efforts in particular have been criticized for being ad hoc, focused primarily on short-term and high impact projects, and unconnected with host nation ministries of health. As a result, some civilian development theorists have recommended a severely circumscribed role for the U.S. Army in health system reconstruction and development, limited to providing security, supporting military programs, and providing temporary emergency care. Based upon a review of current doctrine, historical experiences, and analysis of the reconstruction and development of the Iraqi and Afghan health systems this thesis recommends that the U.S. Army continue to play a significant role, beyond providing security, in health system reconstruction and development while engaged in counterinsurgency and proposes a series of recommendations to improve Army involvement in the process.