Role I is the aid rendered by the army medics and navy corpsman in the field or that given by the battalion aid station that follows the combat units into the field. This is the tourniquet placed on the bleeding extremity. Evacuation is as soon as possible, usually within minutes or hours.
Role II is immediate lifesaving surgical care intended to provide immediate resuscitation and hemorrhage control in the "golden hour" after injury. Evacuation is intended to be within 72 hours. An FST is a Role II facility. We have added capacity by virtue of the air force nursing complement that staffs the medical holding tent and the army medical company that provides primary care.
Role III is a complete field hospital with all surgical specialties, ICU capability and full ancillary services. This is the highest level of care in a combat zone. Kandahar is our Role III facility.
Role IV is definitive medical care outside of combat zone but within a theater of operation. The army hospital at Landstuhl, Germany is Role IV for Middle East operations.
Role V is the medical care available in the continental US or CONUS.
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| Two bed OR at the FST |
These levels of care apply to US or NATO troops. It is a different story for the Afghan nationals. If they are lucky they might get as high as Role III, provided that they are not bumped by coalition casualties. Otherwise they are transferred to a local facility such as the civilian hospital at Kandahar. The care provided is what you might expect of a barely functional healthcare system. Reportedly, the staff goes home at night leaving the patients to themselves, there is minimal janitorial service, the patients eat what their families bring them, and one gets exactly the care for which one pays.
The situation in Qalat is even worse. The staff at the local hospital is essentially a few Jordanian doctors who are expected to pull out soon. Where that will leave the locals is hard to ponder.
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