Management Assistance Report: Medical Personnel Assigned to Protective Movement Details at U.S. Embassy Baghdad, Iraq, Lack Access to Needed Medications

During an audit that is currently underway involving the management and oversight of security services provided to U.S. Embassy Baghdad, Iraq, for the Department of State’s (Department) Bureau of Diplomatic Security (DS), the Office of Inspector General (OIG) discovered that paramedics assigned to protective movement security teams do not possess the medications needed to render aid to severely injured personnel. Specifically, the medications required but not available are Ketamine, Diazepam, Midazolam, Morphine, and Oxycodone. These medications are used to help manage pain resulting from severe injury and have not been available for more than a year.

In September 2016, the Bureau of Administration, Office of Logistics Management, Office of Acquisitions Management (A/LM/AQM), on behalf of DS, awarded the Worldwide Protective Services (WPS) II contract Task Order 2 to Triple Canopy, Inc. to provide protective movement security services for U.S. Embassy Baghdad. To carry out its responsibilities, Triple Canopy hired paramedics to accompany the protective movements. The paramedics were expected to carry with them specific controlled medications when accompanying a security movement. In accordance with contractual provisions, the Department’s Office of Medical Services, Office of Operational Medicine (MED/OM), was required to review and clear the medications in April 2017. However, as of June 20, 2018, Triple Canopy has not obtained these medications, in part, because the Government of Iraq will not allow security contractors to import controlled medications into Iraq. According to DS officials, they have worked with Triple Canopy to obtain the Government of Iraq’s permission to import the medications but have not been successful.

Despite the impasse with the Government of Iraq, DS expressed its belief that the contract requires Triple Canopy to obtain the medications. However, the Foreign Affairs Handbook (FAH) also states that “where necessary, [DS] and/or post will facilitate importation of medication.” OIG concludes that this is a circumstance in which such facilitation is “necessary.”

OIG made one recommendation in this report. Specifically, OIG recommended that DS, in conjunction with A/LM/AQM, assess the issues preventing the importation of the required medications and take appropriate action to facilitate the acquisition of those medications necessary to support the efforts of paramedics assigned to protective movement details at U.S. Embassy Baghdad. In response to a draft of this report, DS concurred and stated that it had taken steps to implement the recommendation. Specifically, DS reached an agreement with the Bureau of Administration, Logistics Management Diplomatic Pouch and Mail to ship the controlled medications. Barring any issues, DS expects the first shipment of medicines to be sent to Baghdad in July 2018. On the basis of the actions taken by DS, OIG considers the recommendation resolved, but the recommendation will remain open until OIG receives documentation demonstrating that Triple Canopy paramedics have received the required medicines. DS’s response to a draft of this report is reprinted in Appendix A.