European Military Medical Services Journal Special Print 2018

EUROPEAN MILITARY EUROPEAN MEDICAL MILITARY SERVICES

MEDICAL SERVICES 2018

ARMEEN

DIE ZUSAMMENARBEIT DER SANITÄTSDIENSTE EUROPÄISCHER ARMEEN

ARMEEN

DIE ZUSAMMENARBEIT DER SANITÄTSDI EUROPÄISCHER ARMEEN

BETA VERLAG & MARKETINGGESELLSCHAFT MBH

Erste Ausgabe für alle Sanitätsdienste europäischer Nationen in englischer Sprache

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EDITORIAL 3

Content

Dear Reader,

Words of Greeting

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Committed to Humanity – A Look at the Future of the European Medical Services

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A Step into the Future with MMCC‘s First Director Interview with Brigadier General Bruno Most, First Director of the „Multinational Medical Coordination Center“ (MMCC)

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Portraits of the Eight Participating Medical Services Kingdom of Belgium

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Czech Republic

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Estonia

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Federal Republic of Germany

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Republic of Hungary

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Grand Douchy of Luxembourg

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Europe is moving closer together – in many respects.

This also applies to the European Armed Forces and in particular to the cooperation between the medical services.

International collaboration in the field of military medicine has been tried and tested in many foreign operations and has proven its worth; the focus on EUROPE is new. This development will certainly be further intensified in the coming years.

As Beta Verlag, we have seen ourselves as partners of all medical services for almost 40 years with our publications, e.g. the Almanac, which is now available online at www.military-medicine.com, and have been very happy to accompany this European process from the very beginning.

With this special edition of EUROPEAN MILITARY MEDICAL SERVICES we are providing a forum for European collaboration and are reporting for the first time to this extent on closer European cooperation. We hereby present the establishment of the „European Medical Command“ and report on the medium-term planning of its development. In addition, we provide you with a detailed insight into the medical services of the nations that have been involved from the very start.

A large number of people are always involved in the creation of such a special edition – on their behalf, my thanks go not only to the press and information centre of the Bundeswehr Medical Service for their ever-constructive support, but also to Mr Geschwill for bringing everything together.

I wish you a stimulating read and look forward to hearing your opinion!

Kingdom of the Netherlands

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Kingdom of Norway

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Heike Lange

Publisher

Index of Advertising Aerolite AG

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GMÖHLING Transportgeräte GmbH

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BLÜCHER GmbH

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KARL STORZ SE & Co. KG

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Published by: Beta Verlag und Marketing GmbH Celsiusstraße 43, 53125 Bonn, Germany Tel.: +49(228)91937-0 Fax: +49(228)91937-23 E-mail: info@beta-publishing.com www.beta-publishing.com www.military-medicine.com

Editorial Support: Presse- und Informationszentrum des Sanitätsdienstes der Bundeswehr Kommando Sanitätsdienst der Bundeswehr Falckenstein-Kaserne Von-Kuhl-Straße 50 56070 Koblenz Advertising: Peter Geschwill

Managing Director: Heike Lange

WEINMANN Emergency Medical Technology GmbH + Co. KG

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General Dynamics European Land Systems Mowag GmbH

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Portraits of the Medical Services: Brigadier General MC (ret) Dr med Lutz Bandekow

Layout & Produktion: Sibylle in der Schmitten two-up buchherstellung & design www.two-up.de

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WORDS OF GREETING 4

Security policy reality in Europe has changed both fundamentally and permanently – and as a result also the spectrum of deployment forms and types of operations that need to be dealt with by the German Armed Forces and supported by our medical service. The European Union has recently responded to these changes with the „Permanent Structured Cooperation (PESCO)“ initiative, in which Germany is initially responsible for five projects as the lead nation. One of these projects is the „European Medical Command“. The aim here is also to intensify multinational cooperation between the medical services at the European level in the future.

As early as 2017, a joint declaration of intent was signed by the inspectors of eight European medical services to set up the Multinational Medical Coordination Centre as part of the Framework Nations Concept (FNC) initiative.

The aim of the FNC initiative is to strengthen NATO‘s European pillar, for which the German medical service has assumed responsibility. Before this year comes to a close, the initial ability to coordinate the medical services involved will be achieved. This is to be commemorated in the middle of 2018 with a commissioning ceremony.

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There therefore exists an essential core competence for a future „European Medical Command“. The strengthened cooperation between NATO and the EU is now also being implemented at the medical service level in order to make efficient use of the existing resources and avoid any duplication. The medical service of the future must be capable of acting as an independent effector on the one hand – and therefore able to contribute towards a scenario of humanitarian aid or the fight against global epidemics, for example – but on the other hand must also be credibly capable of providing medical care in a scenario of national or alliance defence with larger bodies of deployed troops and a high level of dynamism. Dealing with the entire spectrum is the benchmark of the future and an enormous task for the armed forces who are optimised during the course of refocusing on national and alliance defence. However, the development of capabilities required for this can only take place in a synchronised manner with the other partners, which we support on the one hand – thereby enabling them to fulfil their mission – and on which we are dependent on the other hand in order to achieve our own goals.

Only close national and international – and in particular European – coordination and a common approach will lead to the goal of: Helping the comrades who need us.

Because we are, as the motto of our medical service states, „Committed to humanity!“

Dr. Michael Tempel Lieutenant General MC and Surgeon General of the Bundeswehr

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COMMITTED TO HUMANITY

Committed to Humanity – A Look at the Future of the European Medical Services Late summer 2022: An unusually prolonged drought leads to crop failures throughout the region. The supply situation of the local population is threatened with collapse. This is affecting a border region which, due to the longstanding civil war in the neighbouring country, is having to cope with a large number of refugees and in which state order is eroding. The state‘s inability to cope with the crisis and reduce the growing tensions between the population and the group of refugees is threatening to upset a fragile balance and thereby trigger a conflagration that would start largescale migration and destabilise a considerable number of nations. The United Nations has intervened and the African Union is adopting a common approach to respond to the rapidly evolving crisis.

The impacts of a major migration movement would affect Europe. This is reason enough for the institutions of the European Union (EU) to deal with this crisis and decide on a European commitment. This is carried out by implementing the EU‘s wider concept of security – a crisis far outside Europe whose impact affects key European interests is a task of the EU – for the protection of its citizens.

The African Union decides to send in troops to reestablish control in the region and therefore create the basis for a coordinated aid campaign. However, the health care for the planned multinational alliance cannot be guaranteed, as no state considers itself to be in a position to build up health care for the soldiers. The joint approach threatens to fail.

This is where the Multinational Medical Coordination Centre (MMCC) comes in. The MMCC has been developed as a coordinating element of European medical services and, through its continuous work as an information hub for medical services and a platform for joint further development, has created an opportunity to rapidly bring about multinational cooperation in this respect. The MMCC‘s activities have achieved a degree of interoperability between the medical services involved, which means that the rapid deployment of a multinational medical task force is dependent only on the political will of the people‘s representatives of the nations and no longer, as has previously often been the caee, on legal, personnel, material or organisational differences between the medical services. Through the MMCC‘s work as an independent element of voluntary cooperation between nations outside the NATO and EU command structure, it can support  2018

both organisations as necessary and therefore provide the participating nations with the opportunity to make better use of the scarce resources of medical service capabilities.

Through the work of the MMCC, the multinational medical service association required for this task can be put together. After the nations‘ decision to intervene, ensuring the health care of the troops of the African Union can make a small but decisive contribution to overcoming the crisis – and in order for Europe‘s interests to be safeguarded far beyond European borders – fully in keeping with the understanding of security policy.

The scenario described here is fictitious, but allows us to look into the future of cooperation between European medical services. A future that is not fictitious, but a future that has already begun.

The Order of Events: On May 2, 2017, a new chapter in the cooperation of European medical services was opened up at the Ehrenbreitstein Fortress, a former Prussian fortress above the banks of the Rhine in Koblenz with a view of the German Corner.

As a result, the foundation stone for something historical was laid in a figurative sense in a historical location: the MMCC, which is to develop into the central element of the future cooperation structures of the European medical services.

Signing of the Declaration of Intent for the future MMCC (Source: Bundeswehr/Bannert)

In an official ceremony, the inspectors of the medical services of a total of eight European nations signed the joint Memorandum of Understanding to intensify the cooperation between the participating medical services in order Eu ro p ea n M i li t a r y M ed i c a l S er vi ce s EMMS

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COMMITTED TO HUMANITY 6

to create the foundations for the MMCC and its further development.

For the participating nations, this is the next step in a more intensive cooperation that began almost three years ago within the Framework Nations Concept (FNC) initiative under the coordination and initiation of the German Armed Forces‘ medical service. Since the end of 2014, medical services of European NATO states, starting with Belgium, the Netherlands, Luxembourg, Norway, Poland, Slovakia, the Czech Republic, Hungary and Germany – and supplemented by Lithuania in the meantime – have decided to intensify – and above all structure – their cooperation. The idea of structured and coordinated cooperation under the leadership of a larger inspiring nation, the framework nation, is the guiding principle of the FNC initiative, which focuses on European NATO states and therefore intends to strengthen the European pillar of NATO.

The Framework Nations Concept NATO has reacted to the serious changes in the security situation since 2014 with the summit resolutions of Wales in 2014 and Warsaw in 2016, and has taken fundamental decisions on the future direction that place the security and protection of the Allies in the foreground. The core element is NATO‘s Readiness Action Plan (RAP). In addition to the immediate measures that have already been im-

plemented (known as: Assurance), this also relates to the medium- to longterm adaptation of the overall capability disposition of the Alliance, with the aim of improving NATO‘s response capability and responsiveness.

These new demands on the capabilities of the NATO nations are covered as individual planning targets for each ally in the NATO defence planning process. The Framework Nations Concept (FNC) serves to better fulfil these NATO planning goals through closer voluntary cooperation and systematic, mutual coordination under the moderation of a framework nation in this group.

The foundation for the development of the framework nation concept was a NATO initiative formulated by Germany as early as 2013. Since then, the concept has gathered 15 other nations around Germany as the framework nation. In addition to widening the circle of participants, the defence ministers of the 16 FNC nations decided in 2015/2016 to align their cooperation on NATO‘s RAP, to jointly build up large, deployable troop units and to open it up to European partner nations.

In the FNC Group, which is moderated by Germany, an architecture of cooperation has developed which connects the political decisionmaking level of the Ministers of Defence with the implementation levels of the ministerial planners and armed forces of the participating nations on the basis of regular meetings.

CBRN filters

Initial Surgery Briefing CBRN filters

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Med Supply

Spec. Diagnostic X-Ray

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Corridor

Corridor

Post-Op

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C4I

Spec. Diagnostic Laboratory

Patient holding

free space

Reception

MPHU

Tech Support

Background

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Structural plan of MN Role 2 B in the military training area LEHNIN 2017 (Source: Bundeswehr/PIZ SanDstBw)  2 0 18

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Transfer of an injured individual at VW17 (Source: Bundeswehr/Minh Vu)

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Examples of this coordinated cooperation are the jointly developed „Standing Operating Procedures (SOP)“ of this treatment facility, which will benefit all participating nations in the future and can serve as a basis for further work. The final evaluation result of the FNC treatment facility – „capable/minor risks identified“ – exceeded the expectations. The NATO Centre of Excellence for Military Medicine (MILMED COE), which has been making a significant contribution to the transformation of the medical services for many years, was also involved in the success of VW17. The experiences of VW17 will certainly influence future planning. Nevertheless, there is still plenty of work that needs to be done in order to enable the interaction of the medical services of German and multinational forces within the framework of a large joint organisation, possibly within a symmetrical scenario.

The setup personnel of the MMCC will be put into service on April 1, 2018 in the Rheinkaserne in Koblenz. The task consists in the resourcesaving networking of the existing and required providers of expertise and the corresponding coordination of the work.

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One of the visible signs of this successful cooperation was the participation in the largest medical service exercise known as NATO VIGOROUS WARRIOR 2017 (VW17) in the autumn of 2017 at the military training area in Lehnin, as well as in Rostock-Warnemünde and Holzdorf (Elster).

During this exercise, a mobile medical service treatment facility from the participating nations was integrated into the exercise scenario.

In order to ensure more effective and targetoriented multinational cooperation of the medical services, the MMCC is set up as a multinational planning and coordination element under the leadership of the medical service of the German Armed Forces and operated together with our FNC partners. The main task of the MMCC will be to create the necessary preconditions for the multinational medical service support of armed forces across the entire spectrum of tasks. In this way, the MMCC is accelerating the development that is already taking place of much more international cooperation and acting as an interoperability accelerator.

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At the end of 2014, the German medical service took over responsibility for the „Medical Support“ cluster. Today, nine European nations work together on a large number of projects. Other nations have decided in favour of observer status and might become actively involved in the cluster in the future. The fields of the cooperation and individual projects have been jointly identified and cover the existing capability gaps. As a result, the small circle of nations enables faster progress, with the cluster providing the coordinative framework for structured cooperation that was previously unavailable.

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Logo of the MMCC (source: Bundeswehr/Dittrich)

Here, a small group of permanently present soldiers will coordinate the targeted exchange of information of a very much larger network of medical service experts from the participating nations and other providers of expertise from NATO, the EU and the nations and therefore create the preconditions for increasing the interoperability of the medical services. It is already clear that there will need to be new ways of working together for this purpose, as the experts are often already fully involved in this in their nations or multinational organisations. Nevertheless, in order to be able to use their knowledge for the joint further development of European medical services, new forms of collaborative decentralised cooperation need to be developed and established. Although this requires a rethink on the part of all those involved, as aspects of work organisation – some of which have been practised for decades – will give way to new approaches, it is nevertheless necessary in the assessment of all those involved in order to overcome the upcoming challenges with the greatest possible multinational participation. Digitisation, networked decentralised working, the office of the future and Work 4.0 are just a few of the keywords that provide an outlook of the innovations that need to be established.

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The European Defence Union In order to further underline the importance of increased cooperation between European medical services, here is a look at the European Union.

The EU recently set a milestone in European security policy with the official launch of the „PESCO initiative“. At the beginning of December 2017, the European Council for Foreign Affairs approved the fundamental document at the level of the Heads of State and Government. All the EU Member States, with the exception of the United Kingdom, Denmark and Malta, have agreed on closer cooperation in terms of their defence and security policy.

Permanent Structured Co-operation (PESCO): „Permanent Structured Cooperation“ is the name of the mechanism of the EU Treaty which is to make this cooperation possible in the future.

The main objective of the initiative is to strengthen cooperation agreed on the basis of treaties with respect to projects aimed at strengthening the EU‘s common security and defence policy. For this purpose, the nations propose projects and implement them under the coordination of the EU together with the participating nations.

At the beginning of the initiative, a list of 17 projects is to be initially approved by the European Council of Foreign Affairs in the spring of 2018 and these projects then implemented by the nations.

As the „Lead Nation“, Germany is responsible for the projects „Network of Logistic Hubs in Europe and Support to Operations“, „Military Mobility“, „European Union Training Mission Competence Centre“ (EU TMCC), „EUFOR Crisis Response Operation Core“ (EUFOR CROC) and the „European Medical Command (EMC)“.

The main task of the EMC is to provide and coordinate medical skills and services. Other tasks will be to create synergies through the harmonisation of common standards, the improvement of the rescue chain, personnel management and material support for deployments and the bringing together of measures for medical care in

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NATO and the EU. Initially, this is to be carried out with the participation of Italy, the Netherlands, Spain, Romania, Sweden, Slovakia and the observers of Bulgaria, the Czech Republic, France, Lithuania and Luxembourg.

The duality of two initiatives with similar content (MMCC and EMC) from the medical service perspective can be explained by the necessity of responding to current security policy developments in both organisations (NATO and the EU). First and foremost it is therefore necessary to synchronise the two projects – the MMCC within the NATO FNC initiative and the EMC within the EU PESCO initiative – in terms of content, to highlight the interrelationships and possibilities to the participating nations and to avoid any duplication of effort. To this end, the efforts undertaken in the coming months will be necessary in order to interweave the developments of the European PESCO initiative in a meaningful way in terms of content with that which already exists – in addition to the consistent progress on the already planned path to the MMCC. The plans for a central coordinating element of European medical services are ambitious, require imagination and perseverance and are being met today with a certain degree of scepticism. But everything that is new needs to be convincing and therefore earn its justification. And this will be achieved. And it is necessary to point out one further aspect to the sceptics: What we know today as the European Union started with six nations – eight nations have already committed themselves to the establishment of the MMCC. The attainable progress is worth all the effort – as the European medical services are jointly „Dedicated to humanity!“ – fully in line with the motto of the medical services of the German Federal Armed Forces Alexander Jäckel Lieutenant Colonel Bundeswehr Medical Service Headquarters Unterabteilung I – 1.5 Von-Kuhl-Straße 50 56070 Koblenz

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INTERVIEW

A Step into the Future with MMCC‘s First Director In December last year, the Surgeon General of the Bundeswehr, announced to the nations participating in the project that Brigadier General (Medical Corps) Bruno Most is to be the first Director of the „Multinational Medical Coordination Center“ (MMCC).

Interview with Brigadier General Bruno Most

What does your task involve?

During the course of the security policy upheavals of the past few years, in particular the impressions resulting from the Ukrainian conflict and the annexation of the Crimea, NATO has adopted a Framework Nation Concept (FNC) in which key questions of operational readiness are being further developed by the larger framework nations with partner states. Among other things, Germany has declared its willingness to perform this guiding function in the area of medical assistance. As a result, we have developed the idea of an „MMCC“, which among other things is designed to optimise the setting up and management of medical staff. This project is currently being developed here in Koblenz. My task as the first Director is to get this centre up and running.

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What has already been achieved and what steps do you see for the near and distant future?

The signing of a letter of intent by eight Surgeon Generals on May 2 last year at Ehrenbreitstein Fortress was a symbolic starting signal for us. Since then, we have been drawing up the tasks together with a small team which the Centre is to carry out in the future and have identified and included their expectations in numerous discussions with the participating nations. With the decision of the Surgeon General of the Bundeswehr to appoint me as the Director of the Formation Staff, we have a direct contact person for the Surgeon Generals of the partner nations for any questions. On 1st April 2018, we have moved into our new location in the Rhine Barracks with the installation staff and will be visibly demonstrating in May with an „Initial Operating Capability Ceremony“ that we have the initial capabilities to do our work. Our two Liaison Officers from the Netherlands and Norway, who are actively involved in the MMCC Task Force, are playing a major role in this.

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How is the cooperation with the Liaison Officers developing?

With their arrival, our two Liaison Officers have indicated that in addition to their classical liaison work, they consider the core of their task to be their involvement in the MMCC project. In the coming year, I hope that other nations will follow this path and advance our project, either by being present in Koblenz or by participating in it from their respective national workplaces.

What form does the daily interaction take?

„Thinktank“ for designing the MMCC

My colleagues and I are increasingly internationalizing our staff work. This also means that the staff meetings at our centre are conducted in English as the working language. Our products are understandably all in English.

However, the idea of multinationalisation must not end at the entrance to our new centre. We also have to consistently multinationalise the entire Medical Service more and more in order to fulfil our role as a leading and framework nation. I am expecting impetus for our work in this respect from our subordinate medical service skills units.

I have high hopes in particular for English-language training courses offered by the Bundeswehr Medical Service Academy.

Germany is not only the leading nation for the „MMCC“ NATO project, but also for the „European Medical Command (EMC)“ PESCO project of the EU. What is the relationship between the two projects?

Where do you see the core tasks of the future MMCC? We see ourselves as a working muscle for operational medical service issues – primarily of the European NATO nations – but equally for the military staff of the European Union and as a partner for missions of the United Nations (UN). Specifically, we want to coordinate the development of medical services capabilities, create products for medical services planning for NATO and the EU, harmonize medical services deployment planning in various areas such as NATO, the EU and the UN with one another and also offer services such as management of the wounded and medical logistics for the future. One special building block will be products and information in the area of health protection for the operational contingents. Together with our partners, we want to further develop the internationally acclaimed system of our „Medical Intelligence“.

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PESCO (Permanent Structured Cooperation) is an expression of the EU‘s security policy efforts to be able to meet challenges with its own forces and concepts. However, this does not compete with the idea of the NATO Framework Nation Concept, which is intended to strengthen the European pillar. On the contrary, it is important to reconcile the two initiatives with the same resources. My team and I see the EU‘s mission as an addition and a further mainstay. As an idea, EMC does not describe a claim to leadership that builds on instructions, but rather an institution that coordinates services and is therefore a service provider for deployments of the EU. This means that we are moving in the same territory that I described earlier for the MMCC task. The challenge for me as the Director is now to harmonise the two projects with one another and to win over the various accession countries for this common approach in numerous individual discussions.

I would like to thank you for the interview, Brigadier General, and wish you every success in this task!

The interview was conducted by Matthias Frank, Lieutenant Colonel Press and Information Centre of the Bundeswehr Medical Service

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PORTRAITS OF THE EIGHT PARTICIPATING MEDICAL SERVICES IN MMCC BELGIUM

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Kingdom of Belgium Capital: .......................................... Brussels Capital:........................................................Brussels Area:............................................................30 526 km² Area: .............................................. 30 526 km² Population: ..................................................11 267 910 Population: .................................... 11 303 528 Official Language:........................................Dutch, French, Official Language: ........................... Dutch, French, German German Armed Forces Personnel:..............................27 775 (military) Armed Forces Personnel: ................. 27 594 1 490 (civilians) Medical Officers: ............................. 61 Medical Officers:..........................................68 Military Hospitals/Institutes: ........... 1/0 Military Hospitals/Institutes:.......................1/0 Missions: ........................................ multiple Missions:.....................................................multiple

Surgeon General Geert Laire MD Major General

Defence Staff Operational Command of the Medical Component (COMOPSMED) Defence Staff Queen Elisabeth Barracks Rue d’Evere 1 of the Medical Medical Component Commander Operational Command B-1140 Brussels (Evere) Pierre Neirinckx MD Component (COMOPSMED) BELGIUM Major General MC

Queen Elisabeth Barracks Rue d’Evere 1 Medical Component Commander Surgeon General Basic Task Medical Service The Belgian Medical Component is – similar to the Land, Air B-1140 Brussels (Evere) Pierre Neirinckx MD Geert Laire MDof the Military and Naval Components – part of the Intervention Force under The main mission of the Belgian Medical Component is to Major General Major General MC of medical Assistant Chief of Staff Operations and Traiensure the provision support to allMC defence activi- custody of the BELGIUM ties assigned to the Land, Air and Navy Component, according to their level of ambition, both at home and abroad, and subsequently to secure adequate medical evacuation from the operational theatre.

Over and above that, the Medical Service is to maintain physical and mental integrity of all Defence personnel during (allied) military operations and training exercises and during The main mission of Medical Component is daily business, in the orderBelgian to maximize medical readiness and to ensure the provision of medical support tohaving all defence to guarantee commanders permanently healthy deployable forces to achieve their missions.

To that effect, activities assigned to the Land, Air and Navy Component, the Medical Service according to their level health of ambition, 1. develops strategic policy; both at home and abroad, and subsequently to secure medical 2. provides territorial garrison healthadequate care and specialized hospital the Belgian theatre.

Defence military and civilian evacuation fromcare thetooperational personnel; and 3. assists in their medical preparedness through medical selection and fit-for-duty evaluation.

Basic Task of the Military Medical Service

Structure

Structure The Belgian Medical Component is – similar to the Land, Air and Naval Components – part of the Intervention Force under custody of the Assistant Chief of Staff Operations and Training, who is ultimately supervising the overall preparation and deployment of military operational units and capacities. In agreement with the operational ambition, the Medical Component spans FIVE Elements for Medical Intervention geographically spread across the country and ONE military hospital in the capital city of Brussels.

The Elements for Medical Intervention (EMI 1 to 5) are static facilities containing all the personnel and material resources necessary for the deployment of a Role 1 or a Role 2ALMANAC MTF in direct support of the combat units, except for Military Medical Corps Worldwide – Edition 2017 the specialized medical care providers who are employed  2018

ning, who is ultimately supervising the overall preparation and deployment of military operational units and capacities.

In agreement with the operational ambition, the Medical within the Military Hospital.

One of five has been Component spans FIVE Elements forout Medical Intervention assigned the responsibility of the thecountry production, storage and geographically spread across and ONE military hospital in the cityequipment of Brussels.and supplies. Each of distribution of capital medical The Elements for Medical Intervention (EMI 1 to 5) are static the other containing EMI is mainly oriented towards particular needs facilities all the personnel and material resources and/or assets of medical support, asRole aeromedical necessary for the deployment of a Rolesuch 1 or a 2 MTF in direct support of thedecontamination, combat units, except specialized evacuation, CBRN orfor inthe specific aid to medical care providers who are employed within the Military maritime, light brigade, paratroopers or Special Forces Hospital. One out of five has been assigned the responsibiGroup etc. storage An EMIand is also where the Medical lity of operations the production, distribution of medical equipment and supplies.designs, Each of prepares the other EMI mainlyits Component envisions, andistrains oriented towards particular needs and/or assets of medical own medical and modules up to combat readiness support, suchteams as aeromedical evacuation, CBRN decontamifornation, the required spectrum of military activities.

The central or in specific aid to maritime, light brigade, paratroo-

Military Hospital Queen Astrid (Role 4) on the other hand, provides a limited lying-in facility as well as an outpatient clinic in selected medical disciplines, medical imaging and laboratory services and hosts among others an emergency and disaster medical services system, a burn care unit, a centre for hyperbaric oxygen therapy, a physiotherapy and rehabilitation unit, a centre for mental health care, the military centre for aviation medicine, the centre for medical fitness assessment etc. (see the section ’Military Hospital‘) The Component has also a Medical Competence Centre for teaching both medical and combatant (nonmedical) personnel, with the exception of the graduate and post graduate education of all medical professionals (physicians, physiotherapists, veterinarians, nurses etc.)

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schools. This Centre is collocated with the Military Hospital and thus easily allows for increased educational efficiency and interchangeability of human resources.

lic through cost refund. Especially in these three fields of expertise, the Military Hospital contributes in the context of aid to the nation.

Finally, the Staff of the Operational Command of the Medical Component (COMOPSMED), situated on the same campus as the Defence Staff in Evere, nearby Brussels, is responsible for the organization and implementation of the military garrison and operational health care portfolio to the beneficiary Defence personnel.

Since, as a consequence, the Military Hospital is not a genuine general hospital, multilateral collaboration with civilian partners have become of utmost importance. In this way, the Military Hospital holds several partnerships with university hospitals in the neighbourhood and even provides to one of these, part of its infrastructure. Besides, where necessary, Defence personnel will be referred to the civilian health care services and can get their costs reimbursed.

Military Hospital The mission of the Military Hospital Queen Astrid is three fold: (1) to hold medical capabilities in stand by and to preserve and train medical skills, necessary to support operations, in theatre as well as on the national territory; (2) to contribute to the medical readiness of the deployable forces; (3) finally, with all non-deployed capacities, to participate in the Defence aid to the nation.

One of the main service objectives to achieve this mission is providing specialist medical care tailored to the military duty. The Military Hospital is not a distinct hospital in the traditional sense, but manages a number of specialized health care services in specific domains of military interest. That is why its activities are primarily focused on pre-hospital emergency care and disaster medicine,

Secondly, the Military Hospital holds an important role as a medical training facility to maintain skills and competencies tailored to military operational medicine and serves as a reach back capability for the deployed medical forces. Moreover, the hospital is a key player when it comes to scientific research and development of innovative technology and treat ment in certain niche activities that are of military concern such as infectious diseases, septic surgery, wound healing etc. The laboratory for molecular and cellular technology works closely together with several national and international (academic) partners and concentrates on the development of skin substitutes, on safety improvement of skin and keratinocyte grafts, on the molecular epidemiology of resistant micro-organisms and on bacteriophages therapy. The laboratory for clinical biology, on the other hand, has been recognized as a national centre of reference for zoonotic diseases (Coxiella burnetii, Rickettsia and Anaplasma).

Number of the Medical Service Personnel

Military Hospital �Koningin Astrid“

burn care, traumatology, orthopedic surgery and rehabilitation, travel medicine, hyperbaric medicine, mental health care and crisis psychology. These hospital facilities are merely dedicated for the treatment of beneficiary active military and civilian Defence personnel. However, the burn care centre, being a national centre of excellence, the centre for hyperbaric oxygen therapy and the emergency medical services, both integrated in the Capitals emergency and disaster relief system, are open to the pubEM M S Eu ropea n M ilitar y M edical S er vices

The Belgian Medical Component numbers approximately 1500 service members, of which 61 are medical officers (almost 65 % qualified general physicians and emergency physicians), 18 qualified physiotherapists, 5 dental officers, 9 veterinary doctors and 25 pharmacists. An aggressive recruitment campaign will result during the coming years in a significant increase of this Medical Technical Corps with about 67 employees. Beside these medical technicians, another 60 officers constitute the Medical Support Corps of the Component. Moreover, 10 occupational medicine and 8 medical advisors serve within the Well-being staff department of the Belgian Armed Forces Command.

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BELGIUM Field Deployments The Belgian medical evacuation chain concept starts with thorough self-aid and buddy-aid at the combatant level (combat life saver and aidman) all the way through EMT support, followed by emergency nursing and physician medical care, ending up, as needed, in initial surgical care (light forward surgical teams) and definitive surgery in variable compositions of MTF modules.

Flying the upcoming light transport helicopter NH-90 might soon result in new challenges for the flight surgeons when it comes to optimizing the tactical aeromedical evacuation policy.

State-of-the-art retrieval of the sick and wounded soldiers from the operational theatre completes this process of care. To that purpose, the Belgian Medical Component operates a dedicated strategic aeromedical evacuation program in close collaboration with the European Aviation Transport Command (EATC). Specialized assets include certified aeromedical crews and various types of patient transport units.

According to the political guidance, the mission of the Belgian Medical Component is to participate to joint medical support inthe framework of EU, NATO or UN operations by filling either advisory orinternational staff positions either delivering Role 1, Role 2B and Role 2E capabilities conform and tailored to the activities, operations and level of ambition of the other components or independently on its own.

Missions Belgian military medical teams contribute to several EU-, NATO- and UN-led operations worldwide providing medical support to Belgian contingents and multinational forces. Medical Component personnel are currently deployed with units serving in Afghanistan (RSM), Iraq (OVP), Jordan (ODF), Mali (EUTM), the Central African Republic (EUTM), the Baltic States (EAPM and EFP), Refugee Relief Operations in the Mediterranean Sea (EUNAVFORMED), and on various locations in the Democratic Republic of Congo. Previous overseas missions have included i.a. Lebanon (UNIFIL), ISAF-theatres in Afghanistan and the Indian Ocean / Somalia Coast (ATALANTA). Since the terrorist attacks of 22 March 2016, Belgian military medical personal participates in Homeland Ops. Moreover the medical component contributes to stand-by operations such as EUBG and NRF/VJTF.

097_67_EN_Anzeige_Wehrmedizin_185x90 | KOKO:RI design | 20.11.2017  2018

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CZECH

CZECH CZECH CZECH

Czech CzechRepublic Republic CzechRepublic Republic Czech

Capital:........................................................Prague Area:............................................................78 866 km² Capital: .......................................... Prague Capital:........................................................Prague Capital:........................................................Prague Population: ..................................................10 553 800 Area:............................................................78 866 km² Area: ..............................................

78 866 km² Area:............................................................78 866 km² Population: ..................................................10 553 800 Official Language:........................................Czech Population: .................................... 10 553 800 Population: ..................................................10 553 800 Official Language:........................................Czech Armed Forces Personnel:..............................29 512 Official Language: ........................... Czech Official Language:........................................Czech Armed Forces Personnel:..............................29 512 Armed ForcesPersonnel: Personnel:..............................29 512 Armed Forces ................. 31 248 Medical Officers:..........................................454 Medical Officers:..........................................454 Medical Officers:..........................................454 Medical Officers: ............................. 454 Military Hospitals/Institutes:.......................3/3 Military Hospitals/Institutes:.......................3/3 Military Hospitals/Institutes:.......................3/3 Military Hospitals/Institutes: ........... 3/3 Missions:.....................................................multiple Missions:.....................................................multiple Missions:.....................................................multiple Missions: ........................................ multiple

Surgeon General Surgeon General Surgeon General Surgeon General Zoltan Bubenik Zoltan Bubenik MDMD Zoltan Bubenik MD Zoltan Bubenik MD Brigadier General Brigadier General Brigadier General Brigadier General

Military Medical Agency Military Medical Agency Military Medical Agency Military Medical Agency Buzulucká 897 Buzulucká 897 Buzulucká 897 Buzulucká 897 KRALOVE 500 HRADEC KRALOVE 500 02 02 HRADEC 500 02HRADEC HRADEC KRALOVE 500 02 CZECH REPUBLICKRALOVE CZECH REPUBLIC CZECH REPUBLIC CZECH REPUBLIC

Basic Task of the Military Medical Service

The Military Medical Agency is responsible for medical comThe Military Medical Agency is responsible for medical com- comThe Military Medical Agency is responsible for medical mand and control, health care quality, medical development ofmand Public Health, Ministry ofauthorities Interior, and other authorities and control, health care quality, medical development To guarantee the soldiers of the Armed Forces of the Czech and cooperation with other regarding force health Republic (AFCR) outstanding medical support in operations mand and control, health care quality, medical development To guarantee the soldiers of the Armed Forces of the Czech and cooperation with other authorities regarding force health Republic outstanding medical support in operations operations and organisations, i.e.

Red Cross.

The Director of the Miliprotection, medical supply activities, medical assistance and and to(AFCR) ensure both the physical and mental welfare. and cooperation with other authorities regarding force health Republic (AFCR) outstanding medical support in protection, medical supply activities, medical assistance and and and to ensure both physical andmental mentalwelfare. welfare. crisis management. tary Medical Department is subordinated to theassistance Director protection, medical supply activities, medical and to ensure both thethe physical and The medical care is based on prevention and treatment pro- crisis management. crisis management.

Division of MoD to whom he directly To guarantee the care soldiers ofthey the Forces oftreatment thereceive Czech The Support Military Medical Department, which is within the MoDrehowever if get injured, they will theof the Thecedures, medical is based onArmed prevention and proThe medical care is based on prevention and treatment proSupport Division structure, is responsible medical standard care.

The Military Medical Department, which isfor within the straMoD Republic (AFCR) outstanding medical opera-the ports. cedures, however if they get injured,support they willinreceive The Medical Department, which is within cedures, however if they get injured, they will receive the Support tegy Military and policy, medical concepts and medical legality.

It the is MoD Division structure, is responsible for medical strastandard care. tions and care. to ensure both the physical and mental welSupport Division structure, is responsible for medical standard also responsible for cooperation with the Department of Structure tegy and policy, medical concepts and medical legality. It is straprimary health care within Armed Forces of of the It is fare. The medical care is based on prevention treatOrganization Management ofconcepts MoD,the Ministry Public Health, The Surgeon General is double-hatted as theand CHOD MedicalThe tegy and policy, medical and medical legality. also responsible for cooperation with theof Department Structure Ministry of Interior, and other authorities and organisations, Advisor and the Director of the Military Medical Agency.

He is is mostly bywith Regional Medical of ment procedures, however if they get injured, theyMedical will Czech alsoRepublic responsible for cooperation the Department Structure Organization Management ofcovered MoD, Ministry of Public Health, The Surgeon General is double-hatted as the CHOD i.e. RedofCross.

Theand Director of Military Medical Depart-Health, subordinated toisthe Director of the as Support Division of Ministry Interior, other authorities and organisations, Advisor and the Director of the Military Medical Agency.

HeMoD is Treatment Organization Management ofthe MoD, Ministry of Public The Surgeon General double-hatted the CHOD Medical Centres (7) and Battalion Aid Stations (17).

Rereceive the standard care. ment subordinated to theof Director of the Support Division to whom he reports.

The Surgeon General i.e.

RedisCross.

The Director theauthorities Military Medical Departsubordinated to directly the Director of the Support Division of as MoD Ministry of Interior, and other and organisations, Advisor and the Director of the Military Medical Agency.

Hethe is gional Medical Treatment provide the initial care of MoD to whom he directly reports. highestherepresentative of theThe Czech Military Medicalas Service ment subordinated theCentres Director of the Support Division to whom reports.

Surgeon General the i.e. is Red Cross. ThetoDirector of the Military Medical Departsubordinated to directly the Director of the Support Division of MoD isest the Director of the Military Medical Agency, which hasfor the military personnel and other related beneficiaries of MoD to whom he directly reports. high representative of the Czech Military Medical Service ment is subordinated to thethe Director of theofSupport Division to whom he departments directly reports.

Thedealing Surgeon General as the The primary health care within Armed Forces the Czech three directly with medical service is the Director of the Military Medical Agency, which has and ensure the primary contact members of the armed of MoD to whom he directly reports. highest command representative of the Czech Military Medical Service Republic mostlycare covered Regional Medical and control: Medical Services Department, The primaryishealth withinbythe Armed Forces ofTreatment the Czech three departments directly dealing with medical service is the Director of the Military Medical Agency, which has Centres (7)the andmedical Battalionservice.

Aid Stations Regional Medical Pharmacy and Medical Materiel and Veterinary Service forces with The(17).

Role 1 medical units The Surgeon General is double-hatted as the CHOD MeRepublic is mostly covered by Regional Medical Treatment command and control: Medical Services Department, Treatment Centres provide the initial care for the military perDepartment and Operational Psychology Department.

The primary health care within the Armed Forces of the Czech three departments directly dealing with medical service integral part of theMedical military dical Pharmacy Advisor and Director of the Medical Centres (7)aid andstations Battalionas Aidan Stations (17).

Regional and the Medical Materiel andMilitary Veterinary Service - battalion Republic is mostly covered by Regional Medical Treatment command and control: Medical Services Department, Treatment Centres provide the initial care forarea the military perDepartment and Operational Psychology perform tasks mainly within the of medical Agency.

He is subordinated to the DirectorDepartment. of the Support units,

Basic Task of the Military Service Basic Task of the Military Service To guarantee the soldiersMedical ofMedical the Armed Forces of the Czech

Basic Task of the Military Medical Service

Structure

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Regional Medical Treatment Center

Regional Medical Treatment Center Regional Medical Treatment Center

Centres (7) and Battalion Aid Stations (17). Regional Medical Pharmacy and Medical Materiel and Veterinary Service medical support forthe military training, exercises Division of MoD to whom hePsychology directly reports.

The Sur- training, Ministry of Defence Treatment Centres provide initialMilitary care for the military perMedical Department and Operational Department.

Minister of Defence Service Structure and missions abroad. geon General as the high est representative of the Czech Ministry of Defence Military Medical Military Medical Service is the Director of the Military Minister of Defence Service Structure State Secretary MoD Chief of the General Staff Medical Agency,Deputywhich has three departments directly Military Hospitals Ministry of Defence Military Medical Minister Defence Service Structure State Secretary MoD Chief of the of General Staff dealing withDeputy medical service command and control: MeSupport Division Department HQ HQ Personnel Division Grand Forces Air Forces of Organisation Management dical Services Department, Pharmacy and Medical MateThere are three military hospitals in the Armed Forces of Medical Department Support Division Department Service Department and Chief HQ Republic. Although Secretary PersonnelState Division riel and Veterinary Operational the Czech the primary target group of Deputy MoD of theHQGeneral Staff Grand Forces Air Forces of Organisation Management Medical Department Brigades, Battalions Brigades, Air Bases University of Defence Central Military Military Medicine Agency Psychology Department.

The Military Medical Agency is patients are the members of the Armed Forces of the Czech Hospital Prague (Surgeon General) Faculty of Military Health Sciences Support Division and control, responsible for medical command health Republic, militaryUniversity hospitals provide medical care for 14 x 2x Department HQ HQthe Personnel Brigades, Battalions Brigades, Air Bases of DefenceDivision Central Military Military Medicine Agency Role 1 Role 1 Grand Forces Air Forces of Organisation Management Medical Department Military Hospital Hospital Prague (Surgeon General) Faculty of Military care quality, medical development and cooperation with civilian population in the given region.

Therefore, almost Olomouc Bechyně Health Sciences 14 x 2x Hradec Králové 1 Role 1 patients in the military hospitals are civilians. other authorities regarding force health protection,Roleme90% of the Military Hospital Prague 6 th Field Hospital / Medical Rescue Center Military Veterinary Institute Military Hospital Olomouc Brigades,AEBattalions Brigades, Air Bases University Bechyněof Defence Central Military Military Medicine Agency Brno Prostějov dical supply activities, medical assistance and crisis maThe hospitals have twoHradec sources of funding: reimburseHospital Prague (Surgeon General) Králové Faculty of Military Přáslavice 7 th Field Hospital Medical Material Center Military Canine Center Health Sciences Prague 6 th Field Hospital AE / Medical Rescue Center Military Veterinary Institute Hospital nagement. MilitaryAviation ment from 2 the health insurance companies as well as 14 x x Vyškov Brno Medicine Prostějov Role 1 Role 1 Institute Prague Military Hospital Žatec Hospital Support Company Military Medical Institute Bio Defence Department funding from the Ministry of Defence.

Military hospitals Přáslavice 7 th Field Hospital Medical Material Center Military Canine Center Olomouc Bechyně Vyškov Aviation Medicine Hradec Králové The Military Medical Department, which is within the assess the health status ofŽatec soldiers in active duty and apInstitute Prague Hospital Support Company Military Medical Institute Bio Defence Department Prague 6 th Field Hospital AE / Medical Rescue Center Military Veterinary Institute Military Hospital MoD Support Division structure, is responsible for meplicants (recruits) to join the Armed Forces of the Czech Brno Prostějov ALMANAC Military Medical Corps Worldwide – Edition 2017 82 dical strategy and policy, medical concepts and medical Republic.Military They play in providing a medical traiPřáslavice 7 th Field Hospital Medical Material Center Canine Centera key role Vyškov Medicine legality. It Aviation isInstitute also responsible for cooperation with the Dening to military medical personnel.

Prague Military Medical Corps ŽatecWorldwide – Edition 2017 Hospital Support Company Military Medical Institute ALMANAC Bio Defence Department 82 partment of Organization Management of MoD, Ministry  2 0 18

ALMANAC Military Medical Corps Worldwide – Edition 2017

CZECH The Military University Hospital Prague is a training, educational and professional medical facility of the Armed Forces of the Czech Republic, which provides comprehensive health care at the level of teaching hospitals. The number of treated patients, as outpatients, and hospitalized is gradually increasing (around 1,1 million outpatients and 25 thousand hospitalized patients yearly).

The Military University Hospital Prague provides a nearly complete range of medical services except paediatrics, obstetrics, cardiac surgery, and treatment of burns. It focuses mainly on acute surgical conditions and internal profile, the care of polytrauma, including brain and spinal cord injuries.

The Military University Hospital Prague is continuously developing modern, especially minimally invasive, medical procedures in various fields.

The hospital has currently 10 clinics, 20 specialized departments and 674 beds. The hospital has been also involved in the care of war veterans. The quality and safety of care in the Military University Hospital is in accordance with international principles and the hospital has been accredited by a Czech auditing body.

The Military Hospital in Brno consists of following wards: Department of Internal Medicine with ICU and Oncological short-stay ward, Surgical and Orthopaedic department with ICU, Neurological department with ICU, Psychiatric department, Ophthalmology department, and ENT department include a total of 212 beds for acute care patients. Clinics radiology, Clinical Laboratories, Psychology, Rehabilitation and physiotherapy, Dermatology, Stomatology, Anaesthesiology and resuscitation, Pharmacy and Medical Technology, Medical assessment board and Department of Occupational Diseases belong to the out-

patient clinics. The hospital is well equipped with modern technology and reflects contemporary trends in medicine.

The Military Hospital in Olomouc is the oldest military hospital in the territory of the Czech Republic (established in 1748).The Military Hospital in Olomouc offers an identical range of medical services as the Military Hospital in Brno. It has currently 273 beds. The hospital is equipped with Light Speed VCT, which is one of the latest innovations in CT technology. It has other top equipment for laparoscopy, arthroscopy, endoscopy, EEG, EMG etc. Since 2006, the hospital has become involved in the regional emergency medical system.

Military Institutes The Institute of the Aviation Medicine Prague (the IAM) is a diagnostic, therapeutic, advisory and training facility with a nationwide competence for both civilian and military personnel, with the possibility of providing a whole range of highly specific services exploitable by other patients and even healthy persons.

The IAM performs the both initial and regular medical examinations of flight personnel, air traffic control personnel and the people involved in rescue operations (e.g. divers, fight – fighters, rescuers, paramedics and police officers) and therapeutical and advisory activities relating to the military and aviation personnel, paratroopers, divers and air traffic controllers.

The above-mentioned services are primarily aimed at making a speedy diagnosis, after-treatment, assessment of an examinee´s ability to execute his/her job and giving recommendations on preventive as well as therapeutic measures. These services are provided by skilled staff, mainly to outpatients, but also by means of a short-term hospitalization with frequently used methods requiring sophisticated equipment that is not in use in other clinical branches (hypobaric chambers, simulators etc.).

The Military Health Institute in Prague is a specialised medical facility responsible for anti-epidemic and hygienic support within the Czech military, laboratory and expertise activities (both in the Czech territory and Czech military foreign deployments), radiation protection, biological protection, vaccination of troops of the Armed Forces of the Czech Republic and operation of the Serum Bank of ACR. The Institute includes the Preventive Care Department in Ceske Budejovice and the Biological Defence Department in Techonin.

The Military Hospital in Olomouc  2018

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CZECH 16

The Department at Techonin is a specialized medical institution of the Czech Armed Forces ensuring complete biological defence primarily in favour of the Czech troops.

There are following primary objectives: • Isolation of bacilli carriers of dangerous diseases and prevention of spreading of contagious diseases to the rest of population; • Identification of the sort of contamination, determination of diagnosis, suggestion and taking necessary measures - especially in issues of prevention; • Treatment of affected persons; • Biological defence research.

MEDEVAC Capabilities Patient transport (ground medical evacuation) can be provided by protected transport vehicles of the medical service. That are eight-wheeled Pandur II armoured personnel carriers and, medical version of Iveco LMV (Light Multirole Vehicle). Medical version replaces older Soviet-era OT-64 SKOT. All the types of vehicles have the same capacity - four casualties.

For STRATEVAC medically adjusted Airbus A-319 CJ or CASA C-295 is used. The specialized equipment, the Patient Transport Unit (PTU), can be quickly installed for the transport of the intensive care patients. The aircraft interior can be adjusted to accommodate up to six lying patients (two PTUs for seriously injured and four beds for slightly or moderately wounded).

AIR TACEVAC can be performed by FW assets (CASA C-295).

Currently there are no capabilities to provide AIR FORWARD MEDEVAC. To achieve this capability is expected by 2020.

The Biological Defence Department in Techonin

The Biological Defence Department includes the Specialised Infection Hospital for persons affected with dangerous or exotic infections under biosafety level 3 & 4 conditions equipped with laboratories for diagnostics of selected biological agents. It also offers isolation-quarantine capabilities for examination of the troops returning from military missions abroad.

The Department serves as a training and education facility both for military and civilian specialists from the Czech Republic and within the NATO (Centre of Excellence).

The Department is part of the Integrated Rescue System of the Czech Republic, and, at the same time, it is involved in the NATO biological defence system.

Number of the Medical Service Personnel Qualified physicians: 239 11 Qualified dentists: Pharmacists: 19 29 Veterinary surgeons: Assisting / nursing personnel: 321 Medics / drivers: 172 Other allied health professionals: 39 EM M S Eu ropea n M ilitar y M edical S er vices

Field Deployments Treatment chain for wounded soldiers commences at the self-aid or body-aid and continues with the enhanced first aid delivered by a combat life saver at the point of injury.

Role 1 MTF encompasses provision of the first emergency medical care.

Role 2/Role 2E MTF accomplishes clinical enhancement if necessary. Final clinical treatment and rehabilitation is provided in Role 4 MTFs in the Czech Republic.

The Medical Service of the Czech Armed Forces has currently the capability to deploy MTFs up to Role 2E – (field hospitals).

The Military Medical Service has two field hospitals available. Each field hospital is composed of several tents and containers, containing emergency, surgery with two operation rooms, ICU, ward, dentistry, laboratory, X-Ray, ultrasound, CT, pharmacy and sterilization.

The Military Medical Service personnel have been participating in all major foreign activities. The fact that the Czech military medical personnel are being included in the NATO, UN or EU-led missions reflects their considerable credibility.

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CZECH Field hospitals personnel were involved e.g. in the missions in Albania, Turkey, Afghanistan or Iraq, medical teams were deployed in several peace keeping operations.

Since 2003 the Czech medical teams have been embedded in the UK, Dutch, German and NATO Field Hospitals.

At present the Czech military medical service is developing a medical module (based on Multinational Medical Task Force) which will be ready to provide medical support to V4 EUBG 2019/2.

Civilian Military Cooperation The Military Hospitals are fully integrated in the civilian healthcare system.

state sponsored emergency medical services and acts as an important part of the Integrated Rescue System of the Czech Republic. Currently The Armed Forces of the Czech Republic have been fully covering the Air Rescue Service in the regions of South Bohemia, Karlovy Vary and Plzen.

17

The Institute of Aviation Medicine in Prague serves the military and civilian flight personnel and air traffic control service.

The Biological Defence Centre in Techonin serves as a training and education facility both for military and civilian specialists from the Czech Republic and within NATO (CBRN Centre of Excellence).

The department is also a part of the Integrated Rescue System of the Czech Republic, and at the same time, it is involved in the NATO biological defence system.

Air Rescue Service and Emergency Medicine Department Pilsen-Line has become an integral part of the

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oF combat injurieS today are cauSed by improviSed exploSive deviceS.

The greatest risk faced by armed forces in today’s missions is the effect of improvised explosive devices (IeDs). Triggered IeDs produce primary and secondary fragments such as debris, sand, elements of the environment, of vehicle interiors, and of personal equipment against which the human body requires efficient protection.

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ESTONIA ESTONIA ESTONIA

Estonia

Republic of Estonia Republic of Estonia

Capital:........................................................Tallinn Capital: .......................................... Tallinn Capital:........................................................Tallinn Area:............................................................45 228 km² Area: ..............................................

45 228 km² Area:............................................................45 228 km² Population: ..................................................1 340 602 Population: .................................... 1 340 602 Population: ..................................................1 340 602 Official Language:........................................Estonian Official Language: ........................... Estonian Official Language:........................................Estonian Armed Forces Personnel:..............................5 000 Armed ForcesPersonnel: Personnel:..............................5 000 Armed Forces ................. 5 000 Medical Officers:..........................................19 Medical Officers:..........................................19 Medical Officers: ............................. 19 Military Hospitals/Institutes:.......................0/0 Military Hospitals/Institutes:.......................0/0 Military Hospitals/Institutes: ........... 0/0 Missions:.....................................................1 Missions:.....................................................1 Missions: ........................................ 1

Surgeon General Lieutenant Colonel Surgeon General Targo Lusti Targo Lusti Targo Lusti Major Lieutenant Colonel Major

Basic Task of the Military Medical Service

Estonian Defence Forces HQ Estonian Defence Forces HQ HQ Estonian Defence Forces J4J4Medical Medical Service Service J4 Medical Service Juhkentali 58 58 Juhkentali Juhkentali 58 15007Tallinn Tallinn 15007 15007 Tallinn ESTONIA ESTONIA ESTONIA Training

EDF has currently two main training centres for medical perTo Task support Estonian Defence Forces (EDF) personnel in Training Basic Task the Military Medical Basic ofof the Military Medical Service Training One in National Defence College iscentres providing healthcare related issues, mainly primary care for militaryin sonnel.

EDF has currently two main training forcourses medical perTo support Estonian Defence Forces (EDF) personnel Service personnel, incl. medical examination through medical board. for medical leaders and clinicians, including reservists and

sonnel.

One in National Defence College is providing courses healthcare related issues, mainly primary care for military EDF has currently two main training centres for medical medical students in Universities. The other training centre is Eligible beneficiaries are: conscripts, active duty service for medical leaders and clinicians, including reservists and personnel, incl. medical examination through medical board.

To support Estonian Forces personnel Oneonintraining National is providing more focused of Defence conscriptsCollege to paramedics and members, reserveDefence component (only (EDF) once activated) andinin- personnel. medical students in Universities. The other training centre is Eligible beneficiaries are: conscripts, active duty service refreshing knowledge of theclinicians, deploying units. jured formed duty serviceprimary members. healthcare relatedactive issues, mainly care for military courses formedical medical leaders and including remore focused on training of conscripts to paramedics and members, reserve component (only once activated) and inpersonnel, incl. medical examination through medical servists and medical students inofUniversities.

The other refreshing medical knowledge the deploying units. juredOther formed active dutycreation service members. tasks include of medical support plans and Field Deployments board.resources Eligiblefor beneficiaries are: conscripts, active duty training centre is more focused on training of conscripts deployable and other operational units, devel- Main focus is supporting of EDF ongoing deployments in Other tasks include creation ofmedical medical support and toMali, Field Deployments service members, reserve component (only once activaparamedics refreshing medical knowledge of the oping and providing military training andplans providing CAR, Iraq and and Kosovo where EDF medical service proviinput for related legislation, guidelines etc. des Rolefocus 1units. andisground MEDEVAC support to its own units. resources forhealth deployable and other units, devel- deploying Main supporting of EDF ongoing deployments in ted) and injured formed active duty operational service members. medical hasKosovo an excellent withservice its EU provioping and providing military medical training and providing EDF Mali, CAR, service Iraq and wherecooperation EDF medical and partners.MEDEVAC support to its own units. inputStructure for health related legislation, guidelines etc. desNATO Rolecoalition 1 and ground OtherSG’s tasksoffice include creation of medical support plans Role and 1 Field operates on joint level. There are eleven EDF medical service has an excellent cooperation with its EU Deployments medical organic to military units and in addition one Civil-Military Cooperation resources forcentres deployable and other operational units, deand NATO coalition partners.

Structure Health Centre which provides most specialist outpatient ser- Higher level care, including rehabilitation services are SG’s office operates onmilitary joint level.

There are eleven Role 1 Main focus is supporting of EDF ongoing deployments veloping and providing medical training and provices and performs as a healthcare board to assess medical provided on civilian bases. Universal health insurance grants medical centres organic to military units and in addition Civil-Military Cooperation viding input forservice. health related legislation, guidelines etc.one ineasy Mali, CAR, to Iraq and Kosovo where EDF medical service fitness for access all healthcare providers.

In addition to its cliHealth Centre which provides most specialist outpatient ser- nical Higher level care, including rehabilitation services are counterparts, medical service has a very close provides Role 1 andEDF ground MEDEVAC support to its co own vicesThere and performs as a healthcare to assess providedwith on Ministry civilian of bases. healthInstitute insurance are no military hospitals inboard Estonia, but all medical military operation SocialUniversal Affairs, National for grants units.

EDF medical has providers. an excellent cooperation fitness for service. easy access to allservice healthcare In addition to its cliStructure doctors and nurses are highly encouraged to practice in civi- Health Development, Tartu University and Medical Colleges. with its EU and NATO coalition partners. is responsible for military medical training of physician lian medical facilities. Such activities are considered mutu- EDF nical counterparts, EDF medical service has a very close coand nurses during their pre-diploma curriculum in Universially beneficial and by in legislative There are no military hospitals Estonia, but allRole military operation with Ministry of Social Affairs, National Institute for SG’s office operates onregulated joint level.

There areacts. eleven 1 ties. doctors and nurses are highly encouraged to practice in civiHealth Development, Tartu University and Medical Colleges. medical centres organic to military units and in addition Medical Service Personnel lian medical facilities.

Such activities are considered mutu- Civil-Military EDF is responsibleCooperation for military medical training of physician one Health Centre which provides specialist outpaPhysicians (including dentists, most healthcare administration ally beneficial and regulated by legislative acts. and nurses during their pre-diploma curriculum in Universitraining): (17 activeasduty/18 officials board and contracted) tient and services and35 performs a healthcare to as- Higher ties. level care, including rehabilitation services are Pharmacists: 2 (active duty) sess medical fitness for service. provided on civilian bases. Universal health insurance Medical Service Personnel Nurses: 75 (68 active duty/7 officials and contracted) Physicians (including dentists, healthcare administration grants easy access to all healthcare providers. In addition and training): 35 (17 active duty/18 officials and There are no military hospitals in Estonia, but allcontracted) military to its clinical counterparts, EDF medical service has a very Pharmacists: 2 (active duty) doctors and nurses are highly encouraged to practice in close cooperation with Ministry of Social Affairs, National Nurses: 75 (68 active duty/7 officials and contracted) civilian medical facilities. Such activities are considered Institute for Health Development, Tartu University and mutually beneficial and regulated by legislative acts.

Medical Colleges. EDF is responsible for military medical training of physician and nurses during their pre-diploma curriculum in Universities.

Medical Service Personnel

Physicians (including dentists, healthcare administration and training): 35 (17 active duty/18 officials and contracted) Pharmacists: 2 (active duty) Nurses: 75 (68 active 92 duty/7 officials and contracted) EM M S Eu ropea n M ilitar y M edical S er vices

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ALMANAC Military Medical Corps Worldwide – Edition 2017  2 0 18

ALMANAC Military Medical Corps Worldwide – Edition 2017

AN 43 2.2 02/2018/A-E

Proud to Support Saving Lives

KARL STORZ SE & Co. KG, Dr.-Karl-Storz-StraĂ&#x;e 34, 78532 Tuttlingen/Germany, www.karlstorz.com

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GERMANY GERMANY (JOINT MEDICAL SERVICE)

GERMANY (JOINT MEDICAL SERVICE)

Federal Republic of Germany

(Joint Medical Service) Federal Republic (JointMedical Medical Service) Federal Republic of of Germany Germany (Joint Service) Capital: .......................................... Berlin Capital:........................................................Berlin Capital:........................................................Berlin Area: ..............................................

357 121 km² Area:............................................................357 121 km² km² Area:............................................................357 Population: .................................... 82 000 000 Population: ..................................................82 000 000 Population: ..................................................82 000 000 Official Language:........................................German Official Language: ........................... German Official Language:........................................German Armed Forces Personnel:..............................185 000 Armed Forces Personnel: ................. 185 000 Armed Forces Personnel:..............................185 000 Medical Officers:..........................................3 500 Medical Officers: ............................. 3 500 Medical Officers:..........................................3 500 Military Hospitals/Institutes:.......................5/7 Military Hospitals/Institutes:.......................5/7 Hospitals/Institutes: ........... 5/7 Military Missions:.....................................................multiple Missions: ........................................ multiple Missions:.....................................................multiple

Surgeon General Surgeon General Dr medGeneral Michael Tempel Surgeon Drmed medMichael Michael Tempel Lieutenant General MC Dr Tempel

Lieutenant LieutenantGeneral GeneralMC MC

Basic Task of the Military Medical Service

The core task of the Bundeswehr Joint Medical Service is to Basic Task of the Military Medical Service protect, sustain and restore the health of service personnel.

The core task of the Bundeswehr Joint Medical Service is to This is of particular relevance in the case of deployments protect, sustain and restore the health of service personnel. abroad, where service personnel is exposed to exceptional This health is of particular relevance in the of deployments hazards (that they do not facecase at home).

The work of abroad, where personnel isJoint exposed to exceptional the Bundeswehr Medical Service is based on the guiThe core task ofservice theJoint Bundeswehr Medical Service health hazards (that they do not face at home).

The work of ding principle that ill, injured or wounded personnel on opeis to protect, sustain and restore the health of service the Bundeswehr Medical Service is based onof the guirations are to Joint be given medical care, the outcome which personnel.

Thisthat istoof in theThis case of medical standards in Germany. applies dingcorresponds principle ill,particular injured or relevance wounded personnel on opeacross entire spectrum ofcare, medical care and services. deployments where personnel is exrations are the to abroad, be given medicalservice the outcome of which Through its and resources, the also procorresponds tostaff medical standards inMedical Germany.

This applies posed to exceptional health hazards (that Service they do not vides medical care to military personnel in Germany. across the entire spectrum of medical care and services.

Basic Task of the Military Medical Service

Bundeswehr Medical Medical Service Bundeswehr ServiceHeadquarters Headquarters Bundeswehr Medical Service Headquarters Von-Kuhl-Strasse 50 Von-Kuhl-Strasse 50 56070 Koblenz Von-Kuhl-Strasse 50 56070 Koblenz GERMANY 56070 Koblenz GERMANY GERMANY continued focus on tasks that require a medical licence are essential determinants of the Bundeswehr Joint Medical continued focus on tasks that require a medical licence are Service. control over the medical services of all branches exercises

essential determinants of the Bundeswehr Joint Medical

of Service. the German Armed Forces.

In order to achieve these goals and maintain personnel sustainability, the Bundeswehr Joint Medical Service comprises order to achieve the these goalsmilitary and maintain personnel of approximately 14.650 and 2.700 civilian HeaIntotal also commands Bundeswehr Medical Servicesustainability, the Bundeswehr Joint Medical Service comprises posts.

Headquarters located in Koblenz, which at field army lea total of approximately 14.650 military and 2.700 civilian vel is Surgeon the highest military command The General is themedical commanding generalinofGermany. the Gerposts. man Joint Medical Service and, in medical matters, exercises

over theGeneral medicalisservices of all branches of theofGerThe Surgeon the structures commanding the GerAllcontrol command and control ofgeneral the Bundesman Armed Forces. man Joint Medical Service and, in medical matters, exercises wehr Medical Service are organized at the Bundeswehr control over the medical services of all branches of the GerHe also commands the Bundeswehrfocusing Medical Service HeadMedical Service Headquarters, on a processman Armed Forces. quarters located in Koblenz, which at field army level is the oriented organisation rather than on customary staff highest military medical command in Germany.

He also In commands the branch, Bundeswehr Medical Service Headbranches. the training for example, staff from quarters located in Koblenz, which at field army level is the personnel management work alongside staff from operahighest military medical command in Germany. tions and readiness.

face at home). The work of the Bundeswehr Joint MeThrough its staff and resources, the Medical Service also proStructure dical based on thepersonnel guiding principle that ill, videsService medicaliscare to military in Germany.

Consistent orientation towards mission-related tasks, the injured or wounded personnel on operations are to streamlining of command and control structures and the Structure be given medical care, the outcome of which corresConsistent orientation towards ponds to medical standards in mission-related Germany. This tasks, appliesthe streamlining of command and control structures and the across the entire spectrum of medical care and services.

Through its staff and resources, the Medical Service also provides medical care to military personnel in Ger- A feature unique to the Medical Service is its responsibility for the organisation and management of Strategic many.

Aeromedical Evacuation (StratAirMedEvac) operations. This responsibility includes stationing, military seStructure curity, alerts and mobilisation.

Consistent orientation towards mission-related tasks, the streamlining of command and control structures and the At division level, two commands and the Bundeswehr continued focus on tasks that require a medical licence Medical Academy are subordinate to the Bundeswehr are essential determinants of the Bundeswehr Joint Medical Service Headquarters.

Medical Service.

The Operational Medical Support Command in In order to achieve these goals and maintain personnel Weißenfels is responsible for and coordinates the deploysustainability, the Bundeswehr Joint Medical Service ment of medical personnel, air and ground assets, and comprises a total of approximately 14.650 military and material. Medical regiments and medical logistic centres are its main assets for fulfilling this task.

2.700 civilian posts.

The Surgeon General is the commanding general of the 102 German Joint Medical Service and, in medical matters, EM M S Eu ropea n M ilitar y M edical S er vices

102

Regional medical facilities have been placed ALMANAC Militarytreatment Medical Corps Worldwide – Edition 2017 under the authority of the Regional Medical Support  2 0 18

ALMANAC Military Medical Corps Worldwide – Edition 2017

GERMANY Command in Diez. Medical care for active-duty personnel is provided by major medical clinics, which also offer specialty services, and medical clinics.

The Bundeswehr Medical Academy is the centre of competence for military medical research, development and training and is located in Munich.

Five Bundeswehr Hospitals located in Koblenz, Ulm, Berlin, Hamburg and Westerstede are directly subordinated to the Bundeswehr Medical Service Headquarters as well as the Central Institutes of the Bundeswehr Medical Service at Kiel and Munich and Supervisory Centres for Public Law Tasks of the Bundeswehr Medical Service North (Kiel), West (Koblenz), East (Potsdam) and South (Munich).

In the future the Bundeswehr Joint Medical Service will have five regiments, elements of which will be stationed at or close to Bundeswehr hospitals in order to strengthen the training and exercise system and to increase options

for the mutual support between field units and Bundeswehr hospitals.

21

Three Medical Regiments are stationed in Weißenfels/ Berlin, Rennerod/Koblenz and Dornstadt.

The Medical Service Rapid Reaction Regiment in Leer combines all airmobile and airborne medical capabilities of the Bundeswehr Joint Medical Service to ensure that medical care and support are made available to troops on deployments abroad within a very short period of time.

During longer deployments, rapid response forces are relieved by stabilization forces.

Basic training of medical trainee soldiers and predeployment training of medical personnel are provided by the Medical Training Regiment in Feldkirchen.

All hospitals are operated by the Bundeswehr and provide medical care not only for service personnel but also for civilian patients.

Solutions for military medical corps Call: +49 40 88 18 96 – 0, E-Mail: info@weinmann-emt.com

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 2018

NATO and the armies of its member states place their trust in our products for use under extreme conditions.

Eu ro p ea n M i li t a r y M ed i c a l S er vi ce s EMMS Photograph: Military medical corps of the German Federal Armed Forces

GERMANY 22

Institutes, Research and Public Health Veterinary and pharmaceutical laboratory diagnostics including potable water and food examination are provided by Central Institutes of the Bundeswehr Medical Service at Kiel and Munich.

Medical research in the field of detecting and preventing of CBRN-Threats is conducted in the laboratories of the institutes affiliated with the Medical Service Academy in Munich. The Bundeswehr Institutes of Microbiology, of Pharmacology and Toxicology, and of Radiobiology are also stationed in Munich. The Bundeswehr Institute of Preventive Medicine will be established in Andernach and will provide research and operational assets for injury protection, health protection and surveillance capabilities.

Further elements of the force health protection program of the Bundeswehr Joint Medical Service are established at the Supervisory Centres for Public Law Tasks of the Bundeswehr Medical Service North (Kiel) / East (Potsdam) / West (Koblenz) / South (Munich) acting in preventive medicine, veterinary service, pharmacy and food safety in an interdisciplinary approach.

Field Deployments First aid through self and buddy aid forms the start of the medical evacuation chain. Initial emergency medical care is rendered at Mobile Aid Stations (Role 1). Trained medical specialists perform on-site triage, shock and pain management as well as haemostatic measures. They also ensure the clearance of the respiratory tract and artificial ventilation.

In relation to the kind and severity of their injuries Casualties are generally transported back to Germany in specially equipped Bundeswehr aircrafts within the framework of StratAirMedEvac. Special equipment includes Patient Transport Units (PTU) for the movement of intensive care patients. Six PTU can be installed in Airbus A-310 aircraft operated by the Deutsche Luftwaffe (German Air Force, see Luftwaffe).

The main elements at Role 4 level are the Bundeswehr Hospitals in Germany. If necessary, civilian hospitals and rehabilitation centres are also used. These facilities provide for the further treatment of patients who have been evacuated from the area of deployment. As a rule, strategic air medical evacuation aircraft land in the reserved military zone of Cologne- Bonn airport. From there, patients are transferred to the Bundeswehr hospitals.

Current missions: 1999 – KFOR / Kosovo 2002 – RS / Afghanistan 2005 – UNMISS / South Sudan 2006 – UNIFIL / Lebanon 2007 – UNAMID / Sudan 2009 – ATALANTA / Horn of Africa 2010 – EUTM / Somalia 2012 – EUCAP Nestor / Somalia 2013 – EUTM / Mali 2013 – MINUSMA / Mali 2013 – MINURSO / West Sahara 2013 – AF TUR / Turkey 2015 -- EU NAVFOR MED / Mediterranean Sea 2015 – Training Support Mission / Iraq

Complementary emergency diagnostic services and treatment are provided at Mobile Surgical Hospitals (Role 2).

These are able to deal with acute injuries and disorders and the relevant surgeons and anaesthetists. A Mobile Surgical Hospital consists of mobile containers. Tents are used in some cases. The size and facilities of a centre are adapted to the requirements of each deployment.

Field Hospitals (Role 3) provide in-patient and out-patient specialist medical care. They have extended surgical, intensive care and specialist diagnostic and treatment facilities and, if necessary, can stabilise casualties for direct evacuation back to Germany.

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Tegucigalpa Ministry of National Defence Colonia Florence HONDURAS Ministry of National Defence Tegucigalpa Colonia Florence HONDURAS Tegucigalpa

José Luís Hernández Canales Surgeon Colonel MCGeneral

José LuísSurgeon Hernández Canales General Colonel José MC Luís Hernández Canales

HONDURAS

Colonel MC

HUNGARY

Republic Hungary Republic ofofHungary

23

Republic of Hungary Republic of Hungary

Capital:........................................................Budapest Capital: .......................................... Budapest Capital:........................................................Budapest Area:............................................................93 030 km² Capital:........................................................Budapest Area: ..............................................

93 030 km² Area:............................................................93 030000 km² Population: ..................................................9 944 Area:............................................................93 030 km² Population: ..................................................9 944 000 Population: ....................................

9 944 000 Population: ..................................................9 944 000 Official Language:........................................Magyar Official Language:........................................Magyar Official Language: ...........................

Magyar Official Language:........................................Magyar Armed Forces Personnel:..............................26 500 Armed Forces Personnel:..............................26 500 500 Armed Forces Personnel:..............................26 Armed Forces Personnel: ................. 26 500 Medical Officers:..........................................n/a Medical Officers:..........................................n/a Medical Officers:..........................................n/a Medical Hospitals/Institutes:.......................8/3 Officers: ............................. n/a Military Military Hospitals/Institutes:.......................8/3 Military Hospitals/Institutes:.......................8/3 Military Hospitals/Institutes: ........... 8/3 Missions:.....................................................multiple Missions:.....................................................multiple Missions:.....................................................multiple Missions: ........................................ multiple

Surgeon General Surgeon General Surgeon General Surgeon General Dr István Kopcsó István Kopcsó István Kopcsó DrDrDr István Kopcsó Brigadier General

Brigadier General Brigadier BrigadierGeneral General

Basic Task of the Military Medical Service

Ministry of Defence Ministry of Defence Ministry of Defence Ministry of Defence Balaton u. 7-11 Balaton u.

7-11 Balaton u.

7-11 Balaton u. 7-11 1055 Budapest 1055 Budapest 1055 Budapest 1055 Budapest HUNGARY HUNGARY HUNGARY HUNGARY Structure

Basic Task of the Military Medical Service Structure The Directorate of Medical Force Health Protection and MediIn order to unify the Hungarian Military Medicine, the Military

Basic of Authorities’ the Medical Service TheTask Directorate of Military Medical Force Health Protection and MediInStructure order to unify the Hungarian Military Medicine, the Defence Military cal responsibility includes professional control Hospital – State Health Centre and the Hungarian

The Directorate of Medical Health Protection and MediIn Forces order– to unify the Hungarian Military Medicine, the Military Basic Taskandof the Military oversight of Force aptitude andMedical occupational fitness tests for Dr. Radó György Military Medical Centre wasDefence integracal Authorities’ responsibility includes professional control Hospital State Health Centre and the Hungarian personnel of the and Ministry of Defence and the Hungarian ted,Dr. and newly established structure ofthe element, Huncal Authorities’ responsibility includes professional control Hospital –a State Health Centre andCentre Hungarian Defence and oversight of aptitude occupational fitness tests for Forces Radó György Military Medical was the integraService Defence Other responsibilities include executing garian Defence Forces Military Hospital started itsthe work onintegraof theForces.

Ministry ofoccupational Defence andfitness the Hungarian and aDr. newly established structure of element, Hunand personnel oversight of aptitude and tests for theted, Forces Radó György Military Medical Centre was

public epidemic safety tasks for the the MoD 15th November 2011.

This military medical rationalization, Defenceof Forces.

Otherservice responsibilities include executing garian Defence Forces Military Hospital started its work on personnel the health Ministry of and Defence and the Hungarian ted, and a newly established structure of element, the HunThe Directorate Medical Force Health Protection and and of HDF personnel, exercising authorized oversight of public on the one hand, was part of themedical efforts ofrationalization, the Minister of public health service and epidemic safety tasks for the MoD 15th November 2011.

This military Defence Forces.

Other responsibilities include executing the garian Defence Forces Military Hospital started its work on health and epidemiologicalincludes issues in the Hungarian Defence Defence, on the other hand, plays an important role in the Medical Authorities’ responsibility professional andhealth HDF personnel, exercising authorized oversight ofthe public the one hand, was partThis of the effortsmedical of the Minister of public service and epidemic safety tasks MoD on15th November 2011.

Forces, operating the HDF Public Health andfor Epidemiological organization process that wasmilitary started in the publicrationalization, health in and epidemiological issuesand in the Hungarian Defence Defence, on the other hand, plays an important role in the control oversight of aptitude fitand health HDFand personnel, exercising authorized oversight of public the one hand, was part of the efforts of the Minister of Service and performing complexoccupational hygiene-related duties in on2011.

Forces, operating the Directorate HDF Publiccoordinates Health andprofessional Epidemiological organization process that was started in the public health in the HDF. The psycholoJoining together organizational and coordination tasks as in the ness tests for personnel of the Ministry of Defence and health and epidemiological issues in the Hungarian Defence Defence, on thethe other hand, plays an important role Service and performing complex hygiene-related duties in 2011. gical work thePublic HDF, conducts accreditation procedures for organization well as the medical support, the started Military Hospital which health is Forces, operating the in HDF Health and Epidemiological process that was in the public in the Hungarian Defence Forces.

Other responsibilities inthe HDF. The Directorate professional psycholoJoining the organizational and coordination tasks as further vocationalcoordinates training at the units, provides psychologinowtogether directly subordinated to the Chief of Defence Staff fulfils Service and performing complex hygiene-related duties in 2011. workcal intraining the forassiswell the as the medical support, the Military Hospital which is cludegical executing theHDF, public healthaccreditation service and epidemic forconducts personnel nominated for procedures missions, and responsibilities in the field of military medicine arising the HDF. The Directorate coordinates professional psycholoJoining together the organizational and coordination tasks as further vocational training at the units, provides psychologinow directly subordinated to the Chief of Defence Staff fulfils ting them during their sustained operations and re-adaptafrom NATO and international agreements, planning and exersafety tasks for the MoD and HDF personnel, exercising gicalcal work intion. the conducts accreditation procedures for inthe well as control the medical support, the Military Hospital which is training forHDF, personnel nominated fortests missions, and assisresponsibilities the field of of military medicine arising It carries out aptitude and assessment cising overinthe execution complex medical tasks in authorized oversight ofof public health and epidemioloprocedures second for those against collective peacekeeping humanitarian tingvocational them during their sustained operations andappealing re-adaptafrom NATO anddefence, international agreements, planning andoperaexerfurther training at theinstance units, provides psychologinow directly subordinated to theand Chief of Defence Staff fulfils aptitude and review decisions of first instance. tion. carries out aptitude tests and assessment in cising control over the execution of complex medical tasks inarising gical issuesIt in the Hungarian Defence operating cal training for personnel nominated forForces, missions, and assisthetions. responsibilities in the field of military medicine procedures of second instance for those appealing against collective defence, peacekeepingagreements, and humanitarian operatingHDF them during their sustained operations and re-adaptafrom NATO and international planning and exerthe Public Health and Epidemiological Service and aptitude and review decisions of first instance. tions. tion.

It carries out aptitude tests and assessment in cising control over the execution of complex medical tasks in performing complex hygiene-related duties in the HDF. 2017 ALMANAC Medical – Edition procedures of secondMilitary instance for Corps thoseWorldwide appealing against collective defence, peacekeeping and humanitarian127 operaThe Directorate coordinates professional psychological aptitude and review decisions of first instance. tions. workALMANAC in the HDF, conducts procedures for Military Medicalaccreditation Corps Worldwide – Edition 2017 127 further vocational training at the units, provides psycho- tant role in the organization process that was started in logical training forMedical personnel missions, ALMANAC Military Corpsnominated Worldwide for – Edition 2017 the public health in 2011.

127 and assisting them during their sustained operations and re-adaptation. It carries out aptitude tests and as- Joining together the organizational and coordination sessment in procedures of second instance for those ap- tasks as well as the medical support, the Military Hospipealing against aptitude and review decisions of first in- tal which is now directly subordinated to the Chief of Destance. fence Staff fulfils the responsibilities in the field of military medicine arising from NATO and international agreements, planning and exercising control over the exeStructure cution of complex medical tasks in collective defence, In order to unify the Hungarian Military Medicine, the Mili- peacekeeping and humanitarian operations. tary Hospital – State Health Centre and the Hungarian Defence Forces Dr. Radó György Military Medical Centre was In addition, the relationship between the military and integrated, and a newly established structure of element, civilian medicine has changed. One of the results of the the Hungarian Defence Forces Military Hospital started its above mentioned integration was that the personnel of work on 15th November 2011. This military medical ratio- the Military Hospital have been increased with 400 peonalization, on the one hand, was part of the efforts of the ple and the health care system has been widened as well.

Minister of Defence, on the other hand, plays an impor- On the other hand, special military medical tasks have

 2018

Eu ro p ea n M i li t a r y M ed i c a l S er vi ce s EMMS

HUNGARY 24

become the part of the newly established structure of element.

Being a priority hospital, it has become one of the key health care institutions in Hungary that specializes in all medical disciplines except for paediatrics. Basically, the core mission of the institute is the treatment of the Hungarian military personnel as well as the claimants of the Military Hospital – State Health Centre’s predecessor institutes, so the Military Hospital offers outpatient and in-patient care for the personnel of the Ministry of Justice and Law Enforcement, the HDF and State Railway and their family members, while it also carries out special aptitude tests for the HDF and provides medical support for the HDF missions. The hospital plays a significant role in providing treatment for the civil population on a regional basis.

Besides maintaining the appropriate defence capabilities of Hungary, the health care of the Hungarian population is in the focus that the Military Hospital wishes to solve with the Semmelweis Plan. The Semmelweis Plan is the reform of the Hungarian healthcare system, as a result of which Hungary has been divided into 8 regions since 30 November 2011. Each region provides healthcare services for 1-1.6 million people, and a centre responsible for the organization of local healthcare services was established in every region. The Military Hospital has been chosen by the medical government as one of the hospitals which is responsible for one region. The doctors of the Military Hospital administer a range of special treatments. One of the strengths in the special character of the institution is the comprehensive traumatology, neurotraumatology and burns therapy, which is a priority in the HDF and also in disaster medicine. As one of the most important emergency care centres in Hungary, the Military Hospital plays a key role in providing treatment for acute cardiac arrests and strokes. In addition to outpatient and inpatient therapy, the institute conducts high-level educational activity and scientific research. The chronic and rehabilitation therapy is provided at five extramural institutions around the country.

Institute of Aviation Medicine, Military Fitness and Research – Kecskemét The Institute is responsible for conducting activity in the field of aviation medicine, military aptitude tests, outpatient surgery hours, single-day surgery and scientific research projects. It performs aviation aptitude tests for civilian pilots, pilot candidates, ground crews (techniEM M S Eu ropea n M ilitar y M edical S er vices

cians, air controllers), paratroops, divers and hang-gliders.

The Institute provides single-day surgery and outpatient surgery hours for the claim ant service personnel and their relatives. The Aviation Medicine Research Section conducts scientific research in close cooperation with the Aviation and Space mMedicine Department of the Szeged University of Science.

The Scientific Institute – Budapest The Institute conducts basic and applied research into chemical, biological, radiological and nuclear (CBRN) weapons and medical CBRN protection in the field of biomedical science. It applies and broadens the specialist knowledge and develops the applied research methods.

The HDF MMC Scientific Institute is in charge of surveying the patterns related to the use of drugs and psychotropic chemicals and also of conducting regular screenings for the HDF service personnel. As a prioritized field of research, it has recently launched ma project on developing a DNA-based personal identification system which will ensure exact identification of victims.

Medical Training Base – Budapest The training and certification programs conducted at the base cover the planning and implementation of basic-level and advanced (MOS) medical training programs for the professional and contract personnel as well as for the civil servants. Furthermore, the Base is responsible for running medical training and certification courses for the HDF troops declared for crisis management and peacekeeping operations, and certifying the medical specialists of the HDF. The medical training courses are aimed at providing basic and MOS training for the personnel and providing the personnel preparing for some special MOS (rescue divers, EOD troops) with special medical training.

The base offers special trainingm to the professional and  2 0 18

HUNGARY contract personnel specializing in medical MOS as well as medical training for the units and staff officers nominated for NATO- and EU-led response and stand-by forces and missions abroad.

Field Deployments

Mercedes G-270 is a military all-terrain motor vehicle designed for transporting casualties. The bandaging container provides mobility and infrastructure for treatment administered in accordance with the medical care techniques (protocols) meeting the standards of ROLE-1 and ROLE-2 NATO-compatible medical organizations.

25

The BTR-80 armoured vehicles are an all-terrain military vehicles designed for evacuation of casualties from the battlefield.

6TH DIMIMED

INTERNATIONAL CONFERENCE ON DISASTER AND MILITARY MEDICINE NOVEMBER 13-14, 2018

 2018

Eu ro p ea n M i li t a r y M ed i c a l S er vi ce s EMMS

www.dimimed-duesseldorf.de

Medical Support Units Group LUXEMBOURG

Role 2 LM

Grand Douchy of Luxembourg Grand Douchy of Luxembourg Capital: .......................................... Luxembourg Capital: ....................................Luxembourg Area: ..............................................

2 586 km² Area: ........................................2 586 km² Population: .................................... 502 066 Population: ..............................502 066 Luxembourgish, Official Language: ...........................

Official Language: ....................Luxembourgish, German, French German, French Armed Forces Personnel: ..........900 Armed Forces Personnel: ................. 900

Surgeon General Surgeon General Cyrille Dupont Cyrille Dupont MDMD Major Major MCMC

Service Médicale Centre Militaire Service Médicale Centre Militaire B.P.166 B.P.166 9202 Diekirch 9202 Diekirch LUXEMBOURG LUXEMBOURG

Basic Task of the Medical Service

comprehensive, i.e. it must cover preventative as well as curative both in Dental terms of care of individual and of of comThe Medical Service is responsible for the medical care of The Chiefcare, Military Officer is in charge the army personnel on active service. This is understood to be munity medical care.

Basic Task of the Medical Service

The Medical Service is responsible for the medical care of army personnel on active service. This is understood to 152 be comprehensive, i.e. it must cover preventative as well as curative care, both in terms of care of individual and of community medical care.

The Medical Service is required to be operational both in its permanent form at the Military Hospital and when on national or international deployments.

The Medical Service carries out medical examinations of candidates applying for a career in the Armed Forces, as well as annual medical examinations for Army personnel on active service. The Medical Service is responsible for the medical training of its Para-medics and other personnel, as well as of other Army personnel.

Dental Section.

The Chief Military Military Psychologist is in –charge of the ALMANAC Medical Corps Worldwide Edition 2017 Psychology Section.

The Chief Military Pharmacist is in charge of the Pharmaceutical Section.

The Physiotherapy Section is managed by a graduate in physiotherapy.

Qualified non-commissioned nursing officers are responsible for providing “nursing care”, organise the preparation of medical units for exercises or other missions, carry out medical training and manage the medical facilities of the Medical Service.

Structure

Non-medical non-commissioned officers manage the administration of all non-medical aspects of the Medical Service.

The Medical Service is divided into Sections: • Medical Section • Dental Section • Psychology Section • Pharmaceutical Section • Physiotherapy Section

Soldiers who have trained voluntarily as Paramedics are available to assist in the reception of patients into Medical Service units, to support military activities on the ground and they also take part in the life of the unit.

Medical Service Staff

Soldiers who have volunteered as secretarial auxiliaries assist in managing the secretarial services and administration of the unit.

The Chief Military Medical Officer commands the Medical Service. He is responsible both for relations between the Medical Service and Army Staff Headquarters and he maintains contact with military and civilian, medical services, both national and international.

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Almanc-2017-UB-11 18.01.17 15:22 Seite 174

NETHERLANDS THE NETHERLANDS

Kingdom of the Netherlands Kingdom of the Netherlands

Capital: .......................................... Amsterdam Capital:........................................................Den Haag Area: ..............................................

41 543 km² Area:............................................................41 543 km² Population: .................................... 17.000.000 Population: ..................................................16 768 736 Official Language:........................................Dutch Official Language: ........................... Dutch Armed ForcesPersonnel: Personnel:..............................37 400 Armed Forces ................. 41 900 Medical Officers:..........................................280 Medical Officers: ............................. 280 Military Hospitals/Institutes:.......................2/6 Military Hospitals/Institutes: ........... 2/6 Missions:.....................................................multiple Missions: ........................................ multiple

Surgeon General General Surgeon Johan de Graaf MD MPH DMCC Remco Willem Blom Brigadier General MC Commandeur (Rear Admiral)

Basic Task of the Military Medical Service

• To

provide operational medical care at Role 1 to 4,

evacuation, and preventive medicine in the Basic(aero)medical Task of the Military Medical field.

Service • To provide in individual healthcare including dental care and physiotherapy for NLD military personnel.

• To •provide operational medical care for at NLD Rolemilitary 1 to per4, To provide in occupational healthcare sonnel. (aero)medical evacuation, and preventive medicine in To educate military healthcare professionals. the•field.

• To monitor the overall quality of military healthcare.

• To •provide inthe individual healthcare including To advise NLD military and political leaders indental military matters. for NLD military personnel. care healthcare and physiotherapy • To provide in occupational healthcare for NLD military Structure personnel.

Centrally positioned healthcare elements Organization • To Defence provideHealthcare rehabilitation care for NLD military personConsisting of ten centrally organized health service providers nel. and a staff. The organization has a personnel strength of • To about educate and train healthcare professionals.

1 200 men andmilitary women and provide health services for the branches of the forces inimprove the Netherlands and abroad.

• To all monitor and continuously the overall quaservices include for example first line healthcare, dental lityThe of military healthcare. care, central hospital capability, blood provision, clinical • To specialist advise theteams NLD military and political leaders in milifor deployment, medical logistics, and initial education for medical personnel. tary healthcare matters.

The Commander of the Defence Healthcare Organization is also the Surgeon General.

Structure

The Inspector of Military Healthcare NLD Armed Forces (IMG)

has apositioned staff of 5 andhealthcare is responsible for independent inspecCentrally elements tions of health related matters.

Defence Healthcare Organization

Command Medical Services Each branch of the Armed Servicesconsists has it’s of own The Defence Healthcare Organisation tenmedical censervice:

trally organised healthcare providers and a staff. The organisation employs approximately 1350 men and women The NLD Royal Army has medical personnel incorporated within thehealthcare manoeuvre services units. Each a dedicated and provides forbrigade all thehas branches of medical company with additional Role 1 assets assigned. In the forces in the Netherlands abroad.

The companies. services total there are 3 brigades withand 3 brigade medical include line healthcare, dental care, central Onefirst of these companies is air assault with an hospital additional field dressing station incorporated.

Above brigade there capability, rehabilitation, blood provision, clinical level speciais a medical battalion incorporated within the operational list teams for deployment, medical logistics, and initial education for medical personnel. The commander of the Defence Healthcare Organisation is also the Dutch Sur174 geon General.  2018

Ministry of Defence Ministry of Defence P.O. BOX P.O. BOX90004 90004 MPC55A 55A MPC 3509 AA Utrecht 3509 AA Utrecht THE NETHERLANDS THE NETHERLANDS support command Army. The medical battalion consists of 4

The operational Role 1medical and 2 companies. assets are This decentralised interservice operational battalion has the possibility to deploy 8 Role 2 facilities for and under full command of ARMY, AIR FORCE,sustained NAVY and operations or can combine this capability for a high level MARECHAUSSEE (MILITARY POLICE).

threat operation not only for the Army but for Airforce or NAVY as well, including afloat. The battalion also has centralizedNLD RoleArmed 1 capabilities for Inspector general support: aid posts,HealthmediThe Forces of Military cal transport and holding. At company and battalion level care (IMG) there are medical staffs that can be used as such and there The IMGahas a small staff and responsible forSurgeon. indepenis also separate medical staff is headed by a Staff The Army medical services have a total strength approximadent inspections of healthcare related matters, assets and tely 1063 service members.

personnel. They report independently to the Ministry of Health, Welfare and Sports.

The NLD Royal Air Force has aviation medical capabilities for

aeromedevac tasks, holding and general capabilities for Role 1 support of Air Force deployable units. There is a limited SAR capability for domestic tasks (in cooperation with the Navy). At the HQ Air Force level is a separate medical staff headed byNetherlands a Staff Surgeon.

The has Air Force medical servicesinThe Royal Army medical personnel have a totalwithin strengththeir of approximately 140 AirMobile service members. corporated 3 brigades (11 Bde, 43

Operational Medical Services

Armoured Bde and Light Bde). Each brigade has a dediThe NLD Royal Navy13has maritime medical capabilities for their medical vessels, company including awith Roleassigned 2 facility Role aboard an amphicated 1 assets.

There bious transport ship.

Furthermore, NLD Royal are a total of 3 support brigades with 3 brigadethe medical comMarines have available Role 1 capabilities for amphibious panies.

All Role 2 assets are centralised in a single service operations. At HQ Navy level there is a separate medical staff headed by a Staff Theunder Navy medical have the a management unitSurgeon. residing Army services command, total strengthBattalion off approximately 120MedBn). service members.

400 Medical (SSM 400 Above brigade level, SSMRoyal 400 Marechaussee MedBn is incorporated withinhas thea sepaArmy’s The NLD (military police) rate medicalsupport staff 5 personnel by aSSM Staff400 Surgeon. operational commandheaded brigade.

MedBn They have dedicated medical personnel to support miliconsists of no 5 interservice medical companies.

This battatary police (operations). lion has the possibility to deploy 4+4 Role 2 facilities for sustained operations or can combine this capability for a Military Hospitals The threat-level Central Military Hospital (CMH) is located Utrecht andfor high operation not only for theinArmy but has approx. 30 regular beds. All regular in-patient and outAir Forcespecialisations or Navy as well (including Rolethe2 military AFLOAT). patient are available within hos-All medical can provide augmentHospital medical pital or units obtainable from thepersonnel collocatedto University Utrecht.

TheMedcell, Central Military in conjunction withmedithe task forces, PECC’s,Hospital etc. There is a separate university hospital also provide a (sheltered) Disaster Hospical staff at Army HQ, headed by the Army Staff Surgeon.

The Army medical services have a total strength of approximately 1100Military service members.

ALMANAC Medical Corps Worldwide – Edition 2017 Eu ro p ea n M i li t a r y M ed i c a l S er vi ce s EMMS

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NETHERLANDS 28

The Royal Netherlands Air Force has aviation medical capabilities for AEROMEDEVAC and STRATEVAC tasks, holding capabilities for Air Force deployable units. There is casualty station capacity within their casualty staging units (CSU) and they have search and rescue (SAR) assets for domestic tasks (in cooperation with the Navy). There is a separate medical staff at Air Force HQ, headed by the Air Force Staff Surgeon. The Air Force medical services have a total strength of approximately 140 service members.

The Royal Netherlands Navy has maritime medical capabilities for their vessels (Role 1 and ART). Role 2 capability can be stationed on the prepared facilities of the 3 Dutch Joint Support ships. The Role 2 facilities will be manned and equipped by SSM Role 2 of the SSM 400 MedBn and surgical capacity from the Defence Healthcare Organisation.

tion with the university hospital, also provides a (sheltered) major incident hospital with a capability of 200 beds.

This major incident hospital also has quarantine facilities available. This hospital is a unique capability within the Netherlands and can be operational within 30 minutes.

This hospital concept has proven its worth over many years for disaster relief and major incidents.

The Military Rehabilitation Centre The Military Rehabilitation Centre is located in Doorn and has capacity for 80 inpatients and a number of outpatients. The centre also receives civilian patients and has state of the art training facilities at its disposal. It also has its own orthopaedic workshop.

Institutes

Furthermore, the Dutch Marine Corps has Role 1 capabilities for amphibious operations available and can rely on landbased Role 2 support from SSM 400 MedBn. There is a separate medical staff at Navy HQ, headed by the Navy Staff Surgeon. The Navy medical services have a total strength of approximately 120 service members.

Expert Centre of Expertise for Military Health Tasked with: • Knowledge management on health related issues; • Providing advice on specific subjects as food and water hygiene, radiation, micro-biology, pharmacy, disease control, public health, etc.; • Coordination of medical testing and research.

The Royal Netherlands Marechaussee (military police) has a separate medical staff, headed by the Marechaussee Staff Surgeon. They have some dedicated medical personnel to support military police operations but will be mainly supported by the commands they are deployed with.

Knowledge Centre for Medical Service.

Tasked with: • Medical skills lab training at group level; • Support of medical training in the field; • Support of requirement and procurement of medical equipment.

Military Hospitals

Centre for Man and Aviation Tasked with: • Aeromedical and psychological examinations; • Testing and training of air men; • Research in the field of human factors.

Diving Medical Centre Tasked with: • Medical examinations of diving personnel; • Testing, education and training of diving personnel; • Treatment of decompression sickness; • Research in the field of diving medicine.

Central Military Hospital The Central Military Hospital is located in Utrecht and has approximately 30 regular beds. All regular inpatient and outpatient specialisations are available within the military hospital or obtainable from the collocated University Hospital Utrecht. The Central Military Hospital, in conjuncEM M S Eu ropea n M ilitar y M edical S er vices

Sports and Training Medical Centre Tasked with: • Individual medical examinations; • Applied research in the field of physical exercise; • Providing advice regarding the physical stress of soldiers in the field.

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NETHERLANDS Defence Medical Training Institute All military medical personnel attend the IDGO for initial military medical education and training. This institute is focussed on the military application of healthcare.

Institute for Defence and Partnership Hospitals The Dutch Armed Forces have a unique concept to generate surgical capacity from the civilian market. By formally partnering with civilian hospitals, the Armed Forces pay for additional personnel at civilian hospitals. During periodical placements, they train civilian personnel with a military reserve status and utilise pre-planning and contracts in order to use these teams for missions and training purposes.

A small staff residing directly under the Defence Healthcare Organisation ensures ‘just in time’ and ‘just enough’ surgical and medical specialists for exercises, missions and operations.

2007-2011 KFOR: Role 3 specialist team; 2012 Kunduz: Role 1 and contribution with a

Role 2 medical team; 2012-2014 Afghanistan Kunduz: Role 1 and contri butions with a Role 2 medical team; 2013-2014 BMDTF (Patriot) Turkey: Role 1 MTF; 2014- ongoing MINUSMA Mali: Role 1 MTF and Aero Medevac; 2015 MH-17: deployment of Role 1 MTF,

Role 2 MTF and identification teams; 2016- ongoing 1 (NLD)CBMI: training support mission

IRAQ mission, R1 MTF; 2016- ongoing Enhanced Forward Presence (eFP)

Baltic States: integrated Role 1 assets; 2016- ongoing Ocean Shield, European border patrol:

integrated Role 1 assets; Ongoing Numerous ongoing missions with a

small tailor made medical footprint In addition, medical services support various exercises throughout the world.

Number of Medical Service Personnel The total strength of NLD medical service members is approximately 2800 men and women, consisting of approximately 950 civilian and 1860 military personnel.

Qualified physicians approx. 220 Medical officers (non physicians) approx. 200 Qualified dentists approx. 50 Pharmacists approx. 10 Qualified physiotherapists approx. 60 Nurses (non commissioned officers) approx. 600 Medical assistants and medical supporting personnel (soldiers/corporals) approx. 400

Field Deployments Recent deployments include: 2003 Central Afghanistan Kabul:

Role 2 deployment; 2004-2005 SFIR Iraq: Role 1 and Role 2 deployment;

North Afghanistan Pol-E-Khomri:

Role 2 deployment; 2006 NRF 5 Pakistan: Role 2 for humanitarian assistance; 2006 Exercise RECAMP Cameroon Africa:

medical assistance programme; ISAF South Afghanistan Uruzgan: 2006-2010

Role 1 and Role 2 deployment; ISAF South Afghanistan: Aeromedevac 2006-2010

and holding capabilities; 2006-2011 ISAF South Afghanistan Kandahar:

Role 3 specialist team;  2018

International Cooperation The Dutch armed forces are very internationally orientated and have several cooperations with other nations, including international healthcare elements. The main effort is focussed on further cooperation and synchronisation with all NATO-countries and specifically with Germany, Belgium, Luxemburg, United Kingdom, Canada, Norway and the United States of America.

Civil-Military Cooperation The NLD Military Medical Service highly depend on support by the civilian healthcare organisations. Specialist teams are recruited and deployed by a specific military agency and specialist medical personnel support military medical education and training as reserve officers and reserve non commissioned officers. The interaction with the civilian sector will increase even more as we strive to ensure the required medical quality. This will be achieved by embedding military medical personnel in civilian healthcare organisations for periodical training.

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NORWAY NORWAY

NORWAY

Kingdom of Norway Kingdom Kingdomof ofNorway Norway

Capital: .......................................... Oslo Capital:........................................................Oslo Capital:........................................................Oslo Area: ..............................................

385 170 km² Area:............................................................385 170 km² Area:............................................................385 170 km² Population: .................................... 5 267 146 Population: ...................................................5 Population: ...................................................5 236 826 826 Official Language:........................................Norwegian Official Language: ........................... Norwegian Official Language:........................................Norwegian Armed Forces Personnel:..............................24 450 Armed Forces Personnel: ................. 25 000 Armed Forces Personnel:..............................24 450 Homeguard: .................................................45 000 Medical Officers: ............................. 250 000 Homeguard: .................................................45 Medical Officers:..........................................48 Military Officers:..........................................48 Hospitals/Institutes: ........... 0/4 Medical Military Hospitals/Institutes:.......................0/4 Missions: ........................................ multiple Military Hospitals/Institutes:.......................0/4 Missions:.....................................................multiple Missions:.....................................................multiple Surgeon General

Surgeon General

Dr Jan Sommerfelt-Pettersen Surgeon General Dr Rear Jan Sommerfelt-Pettersen Sommerfelt-Pettersen Admiral MC Dr Jan Rear Admiral AdmiralMC MC

Armed Forces Medical Service

Armed Forces Medical Service 2058 Sessvollmoen Armed Forces Medical Service 2058 Sessvollmoen NORWAY 2058 Sessvollmoen NORWAY NORWAY

Basic Task of the Military Medical Service

The NAFMS provides medical policy and guidelines for all militarymedical medical activity activity across four service branches The vision of the Norwegian Armed Forces Medical Services military across the the fourand service branches The NAFMS provides medical policy guidelines for all Basic Task of the Military Medical Service (Army, Navy, Air Force and Home Guard).

(NAFMS) is: (Army, Navy, Air Force and Home Guard).

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(NAFMS) is: nerates specialized medical capacities for use in support in(Army, support of land and airHome operations as needed.

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These capacities The vision of the Norwegian Armed Forces Medical Ser- ofcapacities in support of landnational sea andcapacities air operations as needed.

“Ad Militiae support, or provide in a tri-service set-These basicValetudinem” task of the Norwegian Armed Forces Medical Serviaim to either reinforce service branch medical support, or vices The (NAFMS) is: capacities aim to either reinforce service branch medical One example is strategic medical evacuation.

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The requirements.

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Thea high MTF system modular.

Services (NAFMS) maintainoverseas. and restore the deployment.

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The NAFMS develops national cal Policy andatismilitary the senior medicalconcepts, advisor todoctrines the Chief of size medical, dental and veterinary services in support of all serThe NAFMS is commanded by the Surgeon General, who has Defence.

Structure provides a number of other specialized medical, and procedures.

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Basic Task of the Military Medical Service

the overall responsibility for Norwegian Armed Forces Medi-

for use at home and for deployment overseas. It provides cal Policy and is the senior medical advisor to the Chief of medical Defence.evacuation and force health protection for the Norwegian Defence at home and overseas. The NAFMS is commanded by the Surgeon General, who has the overall responsibility for Norwegian Armed Forces Medical Policy and is the senior medical advisor to the Chief of Defence.

The NAFMS provides medical policy and guidelines for all

vice branches at home and overseas.

dental and veterinary services in support of all service branches at home and overseas.

Structure The NAFMS is commanded by the Surgeon General, who has the overall responsibility for Norwegian Armed Forces Medical Policy and is the senior medical advisor to the Chief of Defence.

Structure

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ALMANAC Military Medical Corps Worldwide – Edition 2017  2 0 18

ALMANAC Military Medical Corps Worldwide – Edition 2017

NORWAY 31

Field Deployments Role 2 Medical Treatment Facilities In the last decade NAFMS has deployed MTF to Afghanistan (2003 – 2004 and 2005 – 2006) and to Chad (2009 – 2010). The NAFMS can deploy an MTF with capacity up to up to Role 2 Enhanced. An MTF may be deployed as an autonomous unit with integral logistics and C2, or it may be deployed in collaboration with a partner nation to augment an existing MTF in a given theatre of operations.

The MTF is modular and up to Role 2 basic infrastructure independent.

Main Missions (medical units) Korea Egypt/ Gaza Congo Peru Lebanon Saudi–Arabia Iraq/Kuwait

 2018

1951 – 1954 1956 – 1963 1960 – 1963 1970 1978 – 1998 1991 1991 – 1992

Somalia Bosnia-Herzegovina FYROM Sudan Afghanistan MERO 2 Afghanistan Chad Mali Iraq Iraq

1992 – 1994 1992 – 1998 1993 – 1994 2005 2003 – 2006 – 2012 2009 – 2010 2014 – 2015 2017 –

Eu ro p ea n M i li t a r y M ed i c a l S er vi ce s EMMS

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