Lansing - A year ago, Brig. Gen. Dean Sienko departed for Iraq on a mission to ensure thousands of soldiers engaged in Iraq would have medical care near the battlefields.

Battling heat and dense sandstorms, Sienko, Ingham County's top doctor, commanded more than 4,000 soldiers in the Army's 804th Medical Brigade in the Middle East for nearly a year.

Their task: Provide hospital, surgical, dental and supply services for soldiers, while managing blood labs and coordinating the logistics of a massive medical undertaking in Iraq.

"We took care of people," said Sienko, 47, medical director of the Ingham County Health Department since 1988. "I think we took very good care of people."

In February, Sienko returned to Ingham County as a three-time military veteran with 22 years of service. In 1991, he served as a medical officer in Saudi Arabia during the Persian Gulf War.

During that conflict, Sienko learned the value of having battle-tested warriors on board.

"It was helpful to have Vietnam veterans around," Sienko said. "They'd been through it before. They knew what it was like psychologically and they knew how to prepare.

"To me, that's half the battle."

Ten years later, Sienko was the senior U.S. medical officer on the ground in Kosovo. In 2002, he became commander of his medical brigade.

When his reserve unit returned to the Middle East in 2003, Sienko embodied the role of the veteran leading and coordinating operations on the ground.

"I am probably one of the most experienced people, given this is my third time out and I've been in a conflict before," said Sienko, an associate professor of epidemiology at MSU.

"You need people like that."

And, Sienko said, the United States needs people who are willing to "strap their boots on and march into a situation like this."

"It is a payback for something I feel fortunate in my life to have - and that is to be an American and live the freedoms and goods that we have," Sienko said.

"That didn't come without sacrifice."

On the ground

In June, Sienko's command realized the extent of that sacrifice when Spc. Paul Nakamura, a 21-year-old from California, was killed in Iraq.

Nakamura was transporting an injured soldier when his ambulance was struck by a rocket.

"It was very hard to write a letter to his family," Sienko said. "What do you say to somebody under those circumstances?"

Sienko faced danger himself in the war zone.

He was flying near the Iraq-Kuwait border when his helicopter malfunctioned. The pilot was forced to put the helicopter down and they signaled for help.

"That time, I had to pull my weapon out and load my ammunition because I didn't know what was going to happen," he said. "If anybody saw us going down, they could try to come over and give us trouble."

About 40 minutes later, a helicopter arrived and picked up Sienko and his colleagues.

In the battlefields, Sienko said soldiers constantly endured enemy threats as well as difficult living conditions.

Summer heat that sometimes surpassed 130 degrees and sandstorms presented obstacles for coalition forces.

Drinking water and using extra care on the roads to avoid sand-related collisions became essential for troops in Iraq dealing with challenges of living in the flat desert.

"We have no ice, so we don't have anything to cool the beverage off," Sienko said. "It is like drinking hot tea.

"As a commander, you need to tell your soldiers to drink it."

Coming home

When Sienko became a general in 2002, he thought it was unlikely that he'd be deployed again.

But when the call came last year, he was ready.

"We are soldiers," Sienko said. "When the commander in chief of the nation calls you to do something, that's what soldiers do. You go out and do your mission."

Still, Sienko said the motivating factor for troops is coming home. Sienko left behind his wife and three children when he went to the Middle East last year.

Sienko, though, said his wife and children are veterans of seeing him go abroad to face conflict.

In the past, his departure was more emotional. This time, he said, "My kids said, 'Well, he's going off again. But he'll be back.'"

While he was gone, Dr. Dennis Jurczak filled in for Sienko at the Ingham County Medical Department. Jurczak, who served in the Army and Navy himself, met Sienko more than 20 years ago in the Michigan National Guard.

"He is bound with energy," Jurczak said. "He is very committed to what he does and his family."

Jurczak added, "It is a pleasure to have him back."

Sienko, now back to work, said he learned organizational skills while leading the medical operation in the Middle East that he can use in Ingham County.

"When you are challenged in a circumstance like this, it makes you grow as a person," Sienko said.

"You bring those experiences and skills back to what I do here in Ingham County."

Steve Eder can be reached at ederstev@msu.edu.