Utilizing a “Crawl, Walk, Run” Training Model to Enhance Field Sanitation Capabilities for Peacekeeping Forces: A Recommendation for the Department of Defense Global Health Engagement Enterprise

Abstract

Introduction: DoD Global Health Engagement (GHE) planners can follow a number of models to effectively plan and execute successful GHE activities. One recommendation that could provide a significant return on investment for the DoD GHE enterprise is to utilize a “Crawl, Walk, Run” training model to build or enhance a specific medical capability for a Partner Nation (PN). Through the African Peacekeeping Rapid Response Partnership (APRRP) program, U.S. military medical subject matter experts serving as instructors for a Field Sanitation Course (FSC) delivered to the Senegalese Armed Forces (SAF), gained first-hand experience of the positive outcomes that resulted from incorporating this training model into the DoD GHE process. Materials and Methods: The SAF completed three APRRP-led, in-person FSC iterations: May 2019 (crawl phase), September 2019 (walk phase), and February 2020 (run phase). Approximately 1 year after the completion of the in-person FSCs, in the midst of the COVID-19 pandemic, USU’s CGHE offered a Field Sanitation Virtual Engagement to augment the FSC, emphasize specific field sanitation topics, and discuss lessons learned with the SAF on the deployment of their Level 2 Hospital. Results: Before deploying their Level 2 Hospital during the COVID-19 pandemic, the SAF conducted a base camp assessment and found multiple ways to apply the knowledge and skills learned through the APRRP FSC to address issues related to waste management, pest control, and personal protective measures to protect against COVID-19. The SAF’s progress in strengthening and institutionalizing their field sanitation capabilities can be seen by their execution of their own variation of the FSC—in preparation for their deployment, the SAF conducted three of their own FSCs, which closely resembled the APRRP-administered course. Conclusions: The “Crawl, Walk, Run” training model demonstrates an excellent teaching method that develops PN instructors so they can train more personnel in the long-term, thus building both capacity and capability. This gives the PN the opportunity to sustainably institutionalize a course, allowing them to continue training it in perpetuity. Implementing this training model flexibly to adapt to the differing needs of each PN and each line of effort would increase the success of DoD GHE activities when training PNs. It would also ensure the PN has the capability to sustainably institutionalize a course and can independently train future cohorts through internal iterations of the course.