Local program helps troops wounded in action recover

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By Deirdre Cox Baker | Saturday, May 24, 2008 12:59 AM CDT | () comments

Certified hand therapist Warren Wright stretches Sgt. Ralph McCallum’s right hand during a therapy session May 19. McCallum was wounded by a roadside bomb in southern Iraq and is recovering with the help of a new program called the Community Based Health Care Organization, which is based at Arsenal Island. (Kevin E. Schmidt/Quad-City Times) Buy this Photo

It was June 2007 and Army National Guard Sgt. Ralph McCallum was riding in the gunner position atop a convoy’s scout truck as it traveled through southern Iraq.

A roadside bomb hidden behind a lamppost suddenly detonated, knocking McCallum off the peak of the Humvee and inside the vehicle, which soon caught on fire.

Rescuers pulled him from the burning Humvee, but he came away with deep lacerations on the left side of his head as well as his left forearm, and the radial tendon in his right hand was sliced. Three soldiers inside the fortified vehicle suffered concussions.

McCallum — a junior at Augustana College in Rock Island before he was deployed to Iraq as a member of the Illinois National Guard — was transported to an air base in Germany and then to Fort Bragg, N.C.

He recuperated in North Carolina for three months before learning about the U.S. Army’s Community Based Health Care Organization, or CBHCO, at the Rock Island Arsenal. He jumped at the chance to return to the Quad-Cities and continue to mend.

CBHCO is a specialized recovery program that represents a “radical, new” approach to health care as it relates to warfare, said Lt. Bryan Huebsch, the executive officer in charge. It started in 2004 in Madison, Wis., and moved to the Arsenal in 2006. It features intense, interdisciplinary team care 24 hours a day, seven days a week for about 200 soldiers who are recovering from injuries and wounds.

It is considered the best such regional program in the United States and is serving as a model for similar efforts across America, officials say.

“We created this program and we continue to massage it, not only for the warriors who come through, but for ways we can expand it and make it better for others in America,” said Capt. Martin Munoz, the program commander.

Active, wounded warriors

The Army’s CBHCO is designed for active-duty soldiers who may be hospitalized or receiving medical care several thousand miles from their actual homes, families and support groups.

The United States is divided into 10 regions to administer the program, and Iowa and Illinois are grouped with Minnesota, Wisconsin, Indiana and Michigan.

McCallum and other soldiers receiving care locally stay and work in the Quad-Cities and go to medical appointments as necessary. The sergeant has had four surgeries on his hand and is undergoing physical rehabilitation in Davenport. He faces a possible fifth procedure on the hand.

The injury leaves him with a constant sharp tingle in his right index finger, “like I was stabbing myself with a pen or pencil,” he said. It takes him more time to button shirts and lace up shoes with his left hand, and he’s still not able to do pushups. To stay in the infantry, McCallum has to pass physical tests that include doing push-ups. He’s also lost some hearing in both ears, but he hopes that will return in the next two years.

Now 23, McCallum grew up in a military family in Springfield, Ill. He visited Augustana College after completing high school, loved the campus and ended up playing football there for coach Jim Barnes.

He enlisted in the Illinois National Guard in late 2003 and volunteered to go to Iraq when he learned a good friend was headed there, too. That was the end of his college football days.

McCallum is now enrolled in night classes at Western Illinois University and should earn his degree in another year. He hopes to eventually attend law school and specialize in real estate law.

Team organization

The Army employs doctors as primary-care managers, and nurses and physician’s assistants as case managers for the wounded soldiers, Huebsch said. Platoon sergeants are placed on a soldier’s care team along with a chaplain and a social worker.

More than half of all active soldiers are not in the regular Army, said Lt. Col. Paul Graham, a nurse and case manager in the program. The idea of bringing the wounded home to manage, streamline and expedite their care is a very new idea for the military, he pointed out.

Previously, soldiers were more or less left on their own to cope, and that proved difficult, especially for those with depression, brain injuries or post-traumatic stress disorder, officials said.

Lessons learned in previous wars helped form the after-care program, Graham said, noting that while a certain percentage of the soldiers cannot carry on in the military, 75 percent do return to duty.

That leaves about 25 percent who do not, and case managers such as Graham connect eligible soldiers with the Veterans Administration, which provides care to former members of the military.

“These soldiers did all what they were asked to do,” he said. “Now we need to step forward and help.”

Best practices

The key to the success of the Arsenal’s after-care program is active platoon sergeants who consistently keep in touch with each soldier who is enrolled.

“That’s what makes us so effective,” Huebsch said. “The platoon sergeants can sense a soldier’s problems and attitudes every day.”

The largest percentage of medical problems presented are in orthopedics, Graham said. A substantial number of participants have a traumatic brain injury, or TBI, and some have other types of neurological and psychological issues.

The TBI issue can be complicated, and that is why the program’s team approach works so well, Graham said. Several area specialists can be arranged to help, depending on what is needed.

“Musters” are an example of program’s best practices that spread around the U.S., Huebsch said. These are organized four times a year, with each including about 50 wounded soldiers and their families, plus senior enlisted advisers. The soldiers stay together for a week and learn about benefits and the options they have for the future.

On the next muster in June, Munoz said, they will explore forming a family focus group for the soldiers. Spouses will study a curriculum on the topic and decide if it would improve the program and help warriors in transition.

Results of surveys on what soldiers think of the CBHCO program have been positive, Huebsch said.

In fact, the program changed McCallum’s mind about the military community and his commitment that runs into 2009.

“I know now that the Army will take care of me, and I have decided to re-enlist and hopefully help mentor other wounded men and women,” he said.

Deirdre Cox Baker can be contacted at (563) 383-2492 or dbaker@qctimes.com.