PACAF AVIAN INFLUENZA WORKSHOP FOR LAO MILITARY

UNCLAS VIENTIANE 000061

SIPDIS

SENSITIVE
SIPDIS

DEPARTMENT FOR EAP/MLS (BESTIC)
DEPARTMENT FOR AIAG (PATTERSON, SUMMERS)
DEPARTMENT FOR OES/STC
DEPARTMENT FOR OES/IHA
DOD FOR OSD-POLICY (STERN, SHUBERT)
DOD FOR DSCA (JUDKINS)
PACOM FOR J52 (LACY)
PACOM FOR J45 (NICHOLLS)
PACOM FOR PACAF/SGZ (CINCO, OH, PALMER)
PACOM FOR POLAD
MARFORPAC FOR (NOREN)

E.O. 12958: N/A
TAGS: KFLU LA MOPS PREL TBIO MASS
SUBJECT: PACAF AVIAN INFLUENZA WORKSHOP FOR LAO MILITARY
TRAINERS

REF: A. 07 VIENTIANE 0092

B. 07 VIENTIANE 0625

C. 07 VIENTIANE 0790


1. (U) SUMMARY: U.S. Pacific Air Force (PACAF) medical
specialists helped organize and funded a five-day "train the
trainers" workshop on avian influenza (AI) rapid response for
Lao medical personnel. More than seventy specialists --
including 35 from the Ministry of National Defense (MND) --
attended the workshop which was coordinated on the Lao side
by the National Avian and Human Influenza Coordinating Office
(NAHICO) and MND's Medical Department. The workshop followed
World Health Organization (WHO) and the U.S. Centers for
Disease Control (CDC) training materials. Attendees broke
into working groups for a table-top exercise (TTX) based on
an increasingly serious AI outbreak scenario. As was true
for the first PACOM-NAHICO-MND AI workshop held last August
(ref b),this program was special because it brought Lao
military medical specialists together with their civilian
counterparts to discuss how the two sides would work together
in a situation requiring rapid response to a serious AI
outbreak. Presentations by Embassy and PACOM specialists
conveyed our desired message: that the role of the military
in these efforts will be critical. End summary.

BACKGROUND
--------------

2. (U) AI was identified during January 2007 talks, at the
beginning of our expanded military-military cooperation, as
an area acceptable to the Government of Laos (GOL) and MND
for PACOM training (ref a). The Marine Forces of the Pacific
(MARFORPAC) and PACAF cooperated on the first two-day very
successful AI Subject Matter Expert Exchange (SMEE) in August

2007. More than 120 officials attended that SMEE including
more than 70 from the Lao military (ref b). NAHICO and its
director, Dr. Bounlay Phommasack, played a key role in
organizing that program. Support from the Director General
of MND's Medical Department, COL Dr. Bounteun Bandavong, was
another key element ensuring success. NAHICO, which falls
under the authority of the Prime Minister's Office, has the
mandate to coordinate all AI preparations for the GOL.


3. (U) PACAF Office of International Health Affairs
(PACAF/SGZ) COL John Cinco and MAJ Wesley Palmer returned to
Vientiane in December 2007 to discuss with NAHICO and the MND
Medical Department details for this second AI program, which
had been previewed for GOL officials during our October 2007
Bilateral Defense Talks (ref c). This five-day AI/Pandemic
Influenza (PI) Rapid Response Training of Trainers was based
on a training course developed by the WHO and U.S. CDC and
has been presented by PACAF/SGZ in a number of neighboring
countries. The target audience was to include both MND
medical and non-medical personnel who may be called upon to
respond to control a pandemic outbreak.

THE WORKSHOP
--------------

4. (U) NAHICO and MND's Medical Department invited more than
60 participants, with the majority representing MND.
Military personnel, from both the Lao People's Army (LPA) and
Air Force, came from MND's Medical Department, MND's Disease
Prevention Institute, the Office of the Chief of Staff, MND's
Transportation Department, MND's Agriculture Production
Department, the Military Commander's Officer of the Vientiane
Capital District, the LPA Newspaper, LPA Television, three
military/public security hospitals, and five regional
military units. Other attendees came from the Prime
Minister's Office; the Ministries of Public Health,

Agriculture and Forestry, Public Security, Energy, Public
Works and Transportation, Information and Culture, and
Foreign Affairs; as well as the Central Laboratory for
Epidemiology (CLE),the Center for Information, Education,
and Health (CIEH),and the Immigration Department and Water
Bureau from the Vientiane Capital District.


5. (U) The U.S. side included PACAF/SGZ personnel led by Lt
Col John Oh as well as specialists from 13th Air Force,
Tripler Army Medical Center, and the Air Force Institute for
Occupational Health (AFIOH),all of whom were active as
speakers and/or "facilitators" for the six working groups
during the workshop. In addition, Embassy Infectious Disease
Control (IDC) Specialist Dr. Andrew Corwin, an Embassy IDC
local employee specialist, and an Embassy-based USDA/APHIS
specialist joined personnel from NAHICO, MND, and the
Ministry of Public Health in making presentations and acting
as facilitators. Special presentations were also delivered
by personnel from WHO, including on WHO's Containment
Strategy, and WHO and UNICEF on Risk Communication.


6. (U) Workshop topics included the Lao National Human
Pandemic Influenza Plan; Ethical Conduct in an Outbreak
Investigation; AI Protection and the Role of the Military;
Case Management of Suspected AI Cases; Pharmaceutical and
Non-Pharmaceutical Interventions to Control a Pandemic;
Laboratory Diagnostics, Specimen Collection, and Biosafety
Issues; and Case Investigation of Human AI; among others.
Separate sessions were held on Animal Husbandry for Animal
Health Practitioners. The attendees were each issued
Protective Personal Equipment (PPE) sets, watched a
demonstration on their use, and practiced putting them on
correctly.

THE TABLE-TOP EXERCISE (TTX)
--------------

7. (U) This workshop used a TTX set on Palawan Island in the
Philippines where AI outbreaks were, according to the
scenario, beginning to occur. Exercises started with making
recommendations to the National Crisis Management Center on
setting up a Rapid Response Team, on declaring an isolation
zone, and on transportation, logistics, medical and monetary
assistance, public communication, and related issues. The
six working groups were presented with a total of six
increasingly serious situation reports spreading over the
21-day scenario and asked to examine what the military's role
would be in responding to the escalating pandemic. The
participants took their roles seriously and engaged in
detailed discussions of the situations they faced. Each
working group was supported by as many as three facilitators
to help them move through the TTX. The facilitators included
visiting U.S. team members, and specialists from the Embassy,
NAHICO, and the Ministry of Public Health. Working group
reports back to the plenary and question-and-answer
opportunities demonstrated differing options adopted by the
different groups. However the common element was to ensure
all involved ended the program understanding the important
role the military has to play in helping manage a major
pandemic event - whether AI or any other major problem which
may affect Laos in the future.

MND's Plan
--------------

8. (U) MND's Medical Department was very supportive of this
program. Director General COL Dr. Bounteun joined the
Ambassador and NAHICO Director Dr. Bounlay for the opening
ceremony and remained for the entire first day to help ensure
all of the MND participants were clear about his personal

interest. COL Dr. Bounteun also returned for the closing to
hand out certificates to all participants including the
facilitators and presenters. Throughout, COL Dr. Bounteun
and his senior deputies sent very positive messages about the
importance they were attaching to this event.


9. (U) More importantly, the military attendees met
separately mid-week and drafted their own plan for
"Prevention and Control Planning of Avian Influenza (AI) in
Line of Lao Military During the Year 2008-2010." The plan
established the composition of the military team for dealing
with a pandemic outbreak at both the ministry and grassroots
levels, listed tasks the military needs to do to prepare for
meeting the AI threat, and decided on required training for a
military rapid response. (Copies of the Embassy's
translation of the military plan are being e-mailed to AIAG
and EAP/MLS. The PACAF team members also have copies.)

COMMENT
--------------

10. (SBU) We are struck by how far we have progressed in
training for the Lao military in a very short time. This is
the second major AI program PACOM has supported in six
months, and PACAF/SGZ also undertook a medical
donation/nursing training/demonstration cleft palate surgery
program in late September for Vientiane hospitals. We are
even more satisfied that the military medical personnel
attending this workshop sat down and committed to paper a
serious plan to implement training to prepare for an AI
pandemic. This was designed to be a "train the trainers"
program, and the military plan provides the military
personnel attending this workshop the basis necessary to
return to their units to undertake or participate in further
training. Our responsibility is to find ways to support this
process. The Embassy expresses strong appreciation for
PACAF/SGZ support and looks forward to continued cooperation.



Huso