Realism breeds Readiness
Mass casualty exercise
prepares professionals for
real world challenges
Story and photos by U.S. Army Spc. Yancy Mendoza
40th Infantry Division Public Affairs
Task Force Spartan
Video by Ms. Claudia LaMantia
Area Support Group - Kuwait, Public Affairs
August 28, 2023
CAMP ARIFJAN, Kuwait— "The saving of a life is one of the greatest responsibilities one can bear, for it requires not just courage, but compassion and selflessness," said Nelson Mandela, a South African anti-apartheid revolutionary and political leader who became the country's first black president.
Warm air poured over the desert floor seen only by moonlight. One could barely hear the grains of sand as they rushed over a road that extended as far as the eye could see.
Suddenly, at the end of the road twin lights pierced through the darkness from a bus full of soldiers whose day had just begun. Then, two more pairs at the opposite end - a bus and a truck filled with soldiers coming back to base after a long day of work; most of them half asleep. The sound of engines built, from a low hum to a deafening roar as the headlights raced closer together.
Firefighters help victim actors walk to get medical assistance for a mass casualty exercise on Camp Arifjan, Kuwait on August 24, 2023.
Firefighters help victim actors walk to get medical assistance for a mass casualty exercise on Camp Arifjan, Kuwait on August 24, 2023.
"The saving of a life is one of the greatest responsibilities one can bear, for it requires not just courage, but compassion and selflessness."
First responders arrive at the scene of the accident for a mass casualty exercise on Camp Arifjan, Kuwait on August 24, 2023.
First responders arrive at the scene of the accident for a mass casualty exercise on Camp Arifjan, Kuwait on August 24, 2023.
Not a single one knew that tragedy would strike that night.
When the sand settled, faint screams of pain rang through the smoke-filled air. The truck had been thrown onto its side, two soldiers had been flung from the vehicle onto the road and guard railing. Nearby, the two buses were idle, face to face, their front ends caved in from a head-on collision.
A call went out, and immediately hundreds of first responders and medical professionals rose to answer it.
This event was a military training exercise known as a mass casualty, or MASCAL exercise, ran by U.S. Army Area Support Group-Kuwait and the 528th Hospital Center, with support from 3rd Medical Command and Task Force Spartan's 40th Infantry Division on Camp Arifjan, Kuwait, this past August.
"A MASCAL is when the number of causalities exceeds the available medical capability for rapid U.S. Army treatment and evacuation," said Cpt. Jacob Poore, 528th Hospital Center officer in charge of the MASCAL. "The actual number of causalities required before declaring a MASCAL varies from situation to situation depending upon the availability of Army Health System resources."
First responders treat a victim actor in an ambulance to be transported to the U.S. Army 528th Hospital Center on Camp Arifjan, Kuwait, for a Mass Casualty exercise on August 24, 2023.
First responders treat a victim actor in an ambulance to be transported to the U.S. Army 528th Hospital Center on Camp Arifjan, Kuwait, for a Mass Casualty exercise on August 24, 2023.
“This may include airway management, tourniquets, some medications, etc. Once they are at USMH-K (U.S. Military Hospital-Kuwait), patients will be triaged by the emergency medicine staff to direct where that patient needs to go. After that, patients may be stabilized for transport, go to the operating room, or returned to duty based on injuries and our capabilities.”
First responders take a victim actor into an ambulance to be transported to the U.S. Army 528th Hospital Center on Camp Arifjan, Kuwait, for a mass casualty exercise on August 24, 2023.
First responders take a victim actor into an ambulance to be transported to the U.S. Army 528th Hospital Center on Camp Arifjan, Kuwait, for a mass casualty exercise on August 24, 2023.
Medics, fire fighters, military police, and medical doctors have the opportunity to sharpen their skills so that if the day ever comes that the real medical calamity happens, they can be prepared.
The event is extremely comprehensive, starting all the way from the point of incident to the evacuation and high-level treatment of patients in severe condition.
“The patients would receive treatment at the point of injury from first responders,” Poore said.
First responders take a victim actor from an ambulance to the U.S. Army 528th Hospital Center on Camp Arifjan, Kuwait, for a Mass Casualty exercise on August 24, 2023.
First responders take a victim actor from an ambulance to the U.S. Army 528th Hospital Center on Camp Arifjan, Kuwait, for a Mass Casualty exercise on August 24, 2023.
One of the biggest focuses of the exercise was making sure that the event captured the realism of a MASCAL incident.
From weighted human-like dummies in uniform, fake blood, a flipped truck, broken glass, makeup artists for injuries, and even live actors, the MASCAL ensures that first responders get the cutting edge of training. The hyper-realism bridges the gap between theoretical knowledge and practical application of casualty care.
Having live actors is a key component to the event. It emphasizes to exercise players that these aren’t just mannequins to tighten a torniquet around, these are real people.
“The fire department was the first ones to board the bus asking who could walk and who couldn’t, and asking if everyone was okay,” said Spc. Dereck Escobar, a victim actor on the bus accident. “Once we all got off, they helped people who couldn’t walk and told everyone that it was all going to be okay.”
Escobar is a wheeled vehicle mechanic with the 40th Infantry Division Headquarters Support Company, who has experience and exposure to first responders by working in community outreach alongside law enforcement as a civilian in California.
“The importance of keeping injured patients calm and made to feel safe is a big part of making sure the operation goes very smooth,” Escobar said. “When you’re hurt or extremely injured in an accident, it’s a huge feeling of relief when seeing EMT’s (emergency medical technicians), firemen, or even police officers, show up and take care of you and reassure you that you’re going to be fine and that you’re in good hands.”
A medical manikin is used for the Mass Casualty exercise at the U.S. Army 528th Hospital Center on Camp Arifjan, Kuwait, on August 24, 2023.
A medical manikin is used for the Mass Casualty exercise at the U.S. Army 528th Hospital Center on Camp Arifjan, Kuwait, on August 24, 2023.
A victim actor is treated at the U.S. Army 528th Hospital Center for a Mass Casualty exercise on Camp Arifjan, Kuwait, on August 24, 2023.
A victim actor is treated at the U.S. Army 528th Hospital Center for a Mass Casualty exercise on Camp Arifjan, Kuwait, on August 24, 2023.
This kind of training cannot be overstated, especially for first responders, Poore said. It's the responsibility of these few to take the lives of our servicemembers into their own hands - one of the greatest and heaviest responsibilities one can possess.
MASCALS can have a variety of scenarios, whether its enemy drone strikes, natural disasters, vehicle collisions, or other incidents. There are many things in life that are unpredictable and uncertain, but with this innovative and intense training, the Army can be certain that these medical professionals will be ready.
“I received my training through the Army and feel that training was the best I could have possibly received, and for that I am grateful,” Poore said. “The medical community in the Army is small and tight knit. I feel privileged to be a part of it.”
Area Support Group - Kuwait first responders from Camp Arifjan, Kuwait participate in a MASCAL exercise testing their response and readiness. (U.S. Army video by Ms. Claudia LaMantia)
Area Support Group - Kuwait first responders from Camp Arifjan, Kuwait participate in a MASCAL exercise testing their response and readiness. (U.S. Army video by Ms. Claudia LaMantia)
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