Cablegate: (U) Policy Change Needed for Medevac of Non-Us

This record is a partial extract of the original cable. The full text of the original cable is not available.




E.O. 12958: N/A

(U) Sensitive But Unclassified; protect accordingly.


2. (SBU) SUMMARY: Soldiers from Coalition countries
medevaced from Iraq through Kuwait are typically stranded in
Kuwait days longer than Americans in similar condition,
before being flown onward for better/longer-term care. The
same thing happened in the case of UN personnel wounded in
the terrorist attack on the UN HQs in Baghdad. This
dissimilar treatment has already fueled negative perceptions
on the part of victims' embassies and UN staff in Kuwait,
some of it misdirected at this Embassy and US forces deployed
here. Far more seriously, it could lead to unfair criticism
of Kuwait, which would be a supreme irony given that many
wounded have been brought here without the permission or even
the knowledge of the GOK. There are many complications, and
we understand that CENTCOM, USUN and others have devoted a
great deal of effort to streamlining the process.
Nonetheless, we believe the situation still needs improvement
that can only come from decisions at the political level in
Washington. We offer specific recommendations in the spirit
of pushing for a sustainable solution. END SUMMARY.

3. (SBU) Discussion of the Problem: This problem first came
to the attention of US Embassy Kuwait last month, after the
Baghdad UN HQ bombing. Patients were flown to Kuwait for
treatment at the 47th Combat Support Hospital (47CSH) and
onward movement for further care that is unavailable here.
Those who happened to be American citizens were flown on to
Germany (Landstuhl) almost immediately, while those of other
nationalities remained in Kuwait pending the lengthy and
complex approval procedure required per normal regulations
applicable worldwide. In the meantime, the patients received
dedicated professional care, and eventually they were moved
out -- apparently, in some cases without all the necessary
approvals. A similar case occurred later in August involving
four Georgian soldiers burned in Iraq. (One of the Georgians
was transferred to a Kuwaiti hospital for a time. Septel
will address the need for more systematic coordination with
the GOK regarding use of Kuwaiti medical facilities.)

4. (SBU) Our understanding of regulations governing air
transport of "non-eligible personnel" such as Coalition
soldiers or UN staff, is as follows:

1) Determination is made that MEDEVAC of non-eligible
personnel is necessary because:
a. Immediate threat to life, limb, or eyesight
b. Suitable commercial air not available and suitable
treatment not available
c. MEDEVAC is in the US National Interest
(Diplomatic post forwards request to DoS for determination)

2) Approval of evacuation requires all of the following:
a. Nation to which the patient belongs (call it Country X)
must consent (this is a CENTCOM responsibility to obtain, it
1- If military casualty - this is done at USCENTCOM HQ in
2- If civilian - is likely a diplomatic matter; State
Department or USUN to solve, along with Country X
b. Country in which the treatment is to take place must
consent; USEUCOM seeks the approval
from German Foreign Ministry if going to Landstuhl (US
military are covered by SOFA with
1- Other nation's military - must be approved by Germany
2- Civilian - requires approval by Germany, with enough info
to issue a temporary visa
c. EUCOM sends the approval to the Joint Patient Movement
Regulating Center (JPMRC) in Qatar which informs the Medical
Regulating Office (MRO) at Camp Doha, Kuwait
d. Transportation is arranged concurrently
e. Care plan for patient is arranged with Germany or home
country of patient
f. SECDEF-level approval required to move a foreign citizen
on U.S. MIL AIR (this rule was apparently not applied when
the US MEDEVACed the UN patients)
g. SECSTATE must certify that moving the foreign citizen on
U.S. MIL AIR is in the National interest (required by DoD
Directive 4515.13R)

5. (SBU) ACTION REQUESTED: We ask the State Department to
coordinate inter-agency response addressing this issue to
eliminate the negative perception of unequal and inhumane
treatment of wounded personnel from coalition partners.
We urge maximum consideration be given to concluding prior
blanket arrangements with all coalition partners, including
Kuwait, and Germany as the most likely recipient country for
MEDEVACs from the AOR.

6. (U) Baghdad minimize considered.

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