2012 Issues   /   October 2012

General: Decision to Delay Afghan Hospital Investigation Not Political

By US Medicine

By Sandra Basu

WASHINGTON — Politics played no role in the timing of a request to investigate corruption and patient neglect at a U.S. funded hospital in Afghanistan, a U.S. general told Congress.

Lt. Gen. William Caldwell IV made an appearance before Congress last month to defend himself against accusations by other high-ranking military officials that he sought to delay an Inspector General investigation at Dawood National Military Hospital until after the 2010 congressional election.

He explained that he sought a short delay in the investigation because he wanted to inform his boss, Gen. David Petraeus, of the need for it, and he wanted to coordinate with Afghanistan officials.


Rep. Jason Chaffetz

“It had everything to do with the necessary and critical coordination and nothing to do with the national elections,” he told a subcommittee of the House Committee on Oversight and Government Reform.

Caldwell served as the former commander of the NATO Training Mission-Afghanistan and now is senior commander of Fort Sam Houston in Texas. His testimony comes as lawmakers are trying to sort out whether the allegations of mismanagement and patient abuse were appropriately handled by senior military officials at the U.S.-funded hospital in Kabul, Afghanistan.

“Witnesses testified that there may have been a deliberate effort to delay an investigation for political reasons,” said Rep. Jason Chaffetz (R-UT), who chaired the hearing. “This was followed by an apparent attempt to prevent information from reaching Congress and the American people.”

This summer, at hearings where Caldwell was not present, other officials told the committee that U.S. and coalition military medical personnel serving as “medical mentors” to the Afghan healthcare providers reported substandard care, mismanagement and patient neglect to their superiors in 2010.

In July, retired Army Col. Gerald Carozza, who served as chief of legal development for the Afghan National Army and Ministry of Defense, told the committee that the conditions at the hospital were, in fact “Auschwitz-like.” An adviser to the Ministry of Defense IG who began inspection of the hospital also saw the abuse, he said.

“What he saw was horrifying. Patients were lying in filth, in some cases starving and with grotesque bed sores. One patient who was on the brink of starving to death, became known to the advisory team as ‘Patient Zero.’ Sadly, despite intense efforts led by the U.S. Medical Advisory Group to save him, ‘Patient Zero’ died,” Carozza said at the July hearing.

Army Col. Mark Fassl, who was Inspector General for the NATO Training Mission Combined Security Transition Command Afghanistan at the time, told the committee that when he emailed the DoD IG for an investigation, Caldwell initially wanted it withdrawn, citing the 2010 midterm elections. Fassl said Caldwell remarked to him “He calls me ‘Bill,’” referring to President Obama calling Caldwell by his nickname.

When the IG request did go forth in November of 2010, it was limited in scope to not include some of the more serious patient-care issues, according to July testimony from then- Col. Schuyler Geller MD, who served as command surgeon in Afghanistan for NATO’s Training Mission.

At the more recent hearing, Caldwell refuted that he mentioned the president calling him “Bill,” in any conversation regarding an investigation at the hospital. He had only brought up the president calling him “Bill” to staff several months earlier, after he gave a briefing to the president and was “impressed” that he knew his nickname, he said.


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