led by a colonel. U.S. military operations then concluded on 30 June 2015. When the troops left West
Africa, extra measures were taken to ensure protection of the homeland. Redeploying troops were required
to be monitored for 21 days in a controlled environment to ensure that they had not been infected with
the disease. This effort succeeded in ensuring that no U.S. soldiers were responsible for bringing the risk
of Ebola infections to the U.S.
While the U.S. military did successfully contribute to containing the spread of Ebola, due to the overall
delayed international response by the global community and USG, the disease had already spread
exponentially before it was halted. As such, many deaths could have likely been averted with faster
coordinated and decisive response efforts.
In typical crises which require Foreign Humanitarian Assistance, roles and responsibilities are determined
by USAID processes and the UN cluster system. A clearly recognized catastrophic event (such as an
earthquake or hurricane) triggers a necessary USG response. USAID, through the Office of U.S. Foreign
Disaster Assistance (OFDA), will establish a DART, and then request DOD support (such as logistics or
airlift). These mechanisms have been fine-tuned for natural disasters but had not been tested in the case
of a major disease outbreak.
An outbreak of disease does not have the same clear recognition/requirement that triggers a response as a
natural disaster. Even though US ambassadors in the region declared the West Africa Ebola outbreak to
be a foreign disaster, which precipitated the establishment of a DART, this did not immediately translate
to a U.S. military response. There was a substantial delay between the declaration of a disaster and the
commitment of DOD forces.
Most of previous U.S. military medical experience concerned force protection, not infectious disease
control. As such, DOD lacked a complete pre-crisis policy for civil disease response. Amidst the outbreak,
the Chairman of the Joint Chiefs of Staff (CJCS) provided guidance for DOD activities not to involve
direct patient care. Due to the shortfalls in policy, DOD developed draft policies through EXORDs,
eventually limiting its own parameters to four primary lines of efforts – medical training assistance,
engineering support, logistics support, and command and control. However, these parameters were
interpreted differently by different stakeholders on the ground and in Washington.
Initial guidance provided by the White House for the U.S. military response was unclear and there was
confusion about which agency led the USG response. Various agencies began requesting support from
DOD but there was not a mechanism to validate the requests to see how they fit into an overall USG
response plan. This created frustration for the interagency as there was miscommunication about which
DOD capabilities were available for support. Furthermore, once DOD forces were committed, the
Request For Forces (RFF) for the follow-on forces (which were to come from the 101 st ) had to be
generated before the initial troops (from USAFRICOM) had a chance to scope out the situation on the
ground to see what would actually be needed.
The initial confusion about roles and responsibilities in OUA was eventually clarified over