European Military Medical Services  2018 a SMART Solution of an EDITORIAL

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EUROPEAN MILITARY EUROPEANMEDICAL MILITARYSERVICES MEDICAL SERVICES 2018

ARMEEN DIE ZUSAMMENARBEIT DER SANITÄTSDIENSTE EUROPÄISCHER ARMEEN ARMEEN DIE ZUSAMMENARBEIT DER SANITÄTSDIENSTE EUROPÄISCHER ARMEEN

Erste Ausgabe für alle Sanitätsdienste europäischer Nationen in englischer Sprache BETA VERLAG & MARKETINGGESELLSCHAFT MBH

Erste Ausgabe für alle Sanitätsdienste europäischer Nationen in englischer Sprache BETA VERLAG & MARKETINGGESELLSCHAFT MBH A SMART solution of an 2 EMERGENCY MEDICAL SYSTEM

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www.aerolite.chEMMS European Military Medical Services  2018 A SMART solution of an EDITORIAL

3 EMERGENCY MEDICAL SYSTEM Content Dear Reader,

Words of Greeting 4 Europe is moving closer together – in

maerkli.ch for the ATF Dingo 2 many respects. Committed to Humanity – This also applies to the European A Look at the Future of the Armed Forces and in particular to the co- European Medical Services 5 operation between the medical services. International collaboration in the field A Step into the Future with of military medicine has been tried and MMCC‘s First Director 9 tested in many foreign operations and has Interview with Brigadier General proven its worth; the focus on EUROPE is Bruno Most, First Director of new. This development will certainly be the „Multinational Medical Co- further intensified in the coming years. ordination Center“ (MMCC) 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 Portraits of the Eight Participating happy to accompany this European process from the very beginning. Medical Services With this special edition of EUROPEAN MILITARY MEDICAL SERVICES we are providing a forum for European collaboration and are reporting Kingdom of Belgium 11 for the first time to this extent on closer European cooperation. We here- by present the establishment of the „European Medical Command“ and Czech Republic 14 report on the medium-term planning of its development. In addition, we provide you with a detailed insight into the medical services of the na- Estonia 18 tions that have been involved from the very start. A large number of people are always involved in the creation of such a Federal Republic of Germany 20 special edition – on their behalf, my thanks go not only to the press and information centre of the Bundeswehr Medical Service for their ever-con- Republic of Hungary 23 structive support, but also to Mr Geschwill for bringing everything together. Grand Douchy of Luxembourg 26 I wish you a stimulating read and look forward to hearing your opinion! Kingdom of the Netherlands 27

Kingdom of Norway 30 Heike Lange Publisher

� Flexible modular system with loading and Index of Advertising

unloading system of patient Published by: Editorial Support: Aerolite AG 2 � Conﬁguration with one or two patient is possible Beta Verlag und Marketing GmbH Presse- und Informationszentrum des Celsiusstraße 43, Sanitätsdienstes der Bundeswehr � Protection according STANAG 4569 GMÖHLING Transportgeräte 53125 Bonn, Germany Kommando Sanitätsdienst der Bundeswehr � Medical devices with retainers GmbH 13 Tel.: +49(228)91937-0 Falckenstein-Kaserne Fax: +49(228)91937-23 Von-Kuhl-Straße 50 � Oxygen system BLÜCHER GmbH 17 E-mail: [email protected] 56070 Koblenz � Electrical system www.beta-publishing.com www.military-medicine.com Advertising: � No tools are needed to change the conﬁguration KARL STORZ SE & Co. KG 19 Peter Geschwill � Heating and cooling compartment Managing Director: Heike Lange WEINMANN Emergency Medical Layout & Produktion: Technology GmbH + Co. KG 21 Portraits of the Medical Services: Sibylle in der Schmitten Brigadier General MC (ret) two-up buchherstellung & design Dr med Lutz Bandekow www.two-up.de General Dynamics European Land Systems Mowag GmbH 32 www.aerolite.ch  2018 European Military Medical Services EMMS WORDS OF GREETING

There therefore exists an essential core competence for a future „European Medical Command“. The strength- ened 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 Security policy reality in Europe has changed both fun- and an enormous task for the armed forces who are op- damentally and permanently – and as a result also the timised during the course of refocusing on national and spectrum of deployment forms and types of operations alliance defence. However, the development of capabili- that need to be dealt with by the German Armed Forces ties required for this can only take place in a synchronised and supported by our medical service. The European manner with the other partners, which we support on the Union has recently responded to these changes with the one hand – thereby enabling them to fulfil their mission „Permanent Structured Cooperation (PESCO)“ initiative, – and on which we are dependent on the other hand in in which Germany is initially responsible for five projects order to achieve our own goals. as the lead nation. One of these projects is the „Euro- pean Medical Command“. The aim here is also to intensify Only close national and international – and in particular multinational cooperation between the medical services European – coordination and a common approach will at the European level in the future. lead to the goal of: Helping the comrades who need us. Because we are, as the motto of our medical service states, As early as 2017, a joint declaration of intent was signed „Committed to humanity!“ 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. Dr. Michael Tempel The aim of the FNC initiative is to strengthen NATO‘s Euro- Lieutenant General MC and pean pillar, for which the German medical service has as- Surgeon General of the Bundeswehr sumed 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.

EMMS European Military Medical Services  2018 COMMITTED TO HUMANITY Committed to Humanity – 5 A Look at the Future of the European Medical Services

Late summer 2022: An unusually prolonged drought both organisations as necessary and therefore provide leads to crop failures throughout the region. The supply the participating nations with the opportunity to make situation of the local population is threatened with col- better use of the scarce resources of medical service ca- lapse. This is affecting a border region which, due to the pabilities. longstanding civil war in the neighbouring country, is having to cope with a large number of refugees and in Through the work of the MMCC, the multinational medi- which state order is eroding. The state‘s inability to cope cal service association required for this task can be put with the crisis and reduce the growing tensions between together. After the nations‘ decision to intervene, ensu- the population and the group of refugees is threatening ring the health care of the troops of the African Union can to upset a fragile balance and thereby trigger a conflagra- make a small but decisive contribution to overcoming the tion that would start largescale migration and destabilise crisis – and in order for Europe‘s interests to be safeguar- a considerable number of nations. The United Nations has ded far beyond European borders – fully in keeping with intervened and the African Union is adopting a common the understanding of security policy. approach to respond to the rapidly evolving crisis. The scenario described here is fictitious, but allows us to The impacts of a major migration movement would affect look into the future of cooperation between European Europe. This is reason enough for the institutions of the medical services. A future that is not fictitious, but a fu- European Union (EU) to deal with this crisis and decide ture that has already begun. on a European commitment. This is carried out by imple- menting the EU‘s wider concept of security – a crisis far The Order of Events: outside Europe whose impact affects key European interests is a task of the EU – for the protection of its citizens. On May 2, 2017, a new chapter in the cooperation of Euro- pean medical services was opened up at the Ehrenbreit- The African Union decides to send in troops to reestablish stein Fortress, a former Prussian fortress above the banks control in the region and therefore create the basis for a of the Rhine in Koblenz with a view of the German Corner. coordinated aid campaign. However, the health care for As a result, the foundation stone for something histori- the planned multinational alliance cannot be guaranteed, cal was laid in a figurative sense in a historical location: as no state considers itself to be in a position to build up the MMCC, which is to develop into the central element health care for the soldiers. The joint approach threatens of the future cooperation structures of the European me- to fail. dical services.

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 Signing of the Declaration of Intent for the future MMCC the people‘s representatives of the nations and no longer, (Source: Bundeswehr/Bannert) as has previously often been the caee, on legal, personnel, material or organisational differences between the medi- In an official ceremony, the inspectors of the medical ser- cal services. Through the MMCC‘s work as an independent vices of a total of eight European nations signed the joint element of voluntary cooperation between nations out- Memorandum of Understanding to intensify the coopera- side the NATO and EU command structure, it can support tion between the participating medical services in order

 2018 European Military Medical Services EMMS COMMITTED TO HUMANITY

6 to create the foundations for the MMCC and its further plemented (known as: Assurance), this also relates to the development. medium- to longterm adaptation of the overall capability disposition of the Alliance, with the aim of improving For the participating nations, this is the next step in a NATO‘s response capability and responsiveness. more intensive cooperation that began almost three years ago within the Framework Nations Concept (FNC) These new demands on the capabilities of the NATO na- initiative under the coordination and initiation of the tions are covered as individual planning targets for each German Armed Forces‘ medical service. Since the end of ally in the NATO defence planning process. The Frame- 2014, medical services of European NATO states, starting work Nations Concept (FNC) serves to better fulfil these with Belgium, the Netherlands, Luxembourg, Norway, Po- NATO planning goals through closer voluntary coopera- land, Slovakia, the Czech Republic, Hungary and Germany tion and systematic, mutual coordination under the mo- – and supplemented by Lithuania in the meantime – have deration of a framework nation in this group. decided to intensify – and above all structure – their cooperation. The idea of structured and coordinated coope- The foundation for the development of the framework ration under the leadership of a larger inspiring nation, nation concept was a NATO initiative formulated by Ger- the framework nation, is the guiding principle of the FNC many as early as 2013. Since then, the concept has gath- initiative, which focuses on European NATO states and ered 15 other nations around Germany as the framework therefore intends to strengthen the European pillar of nation. In addition to widening the circle of participants, NATO. the defence ministers of the 16 FNC nations decided in 2015/2016 to align their cooperation on NATO‘s RAP, to The Framework Nations Concept jointly build up large, deployable troop units and to open it up to European partner nations. NATO has reacted to the serious changes in the security situation since 2014 with the summit resolutions of Wales In the FNC Group, which is moderated by Germany, an ar- in 2014 and Warsaw in 2016, and has taken fundamental chitecture of cooperation has developed which connects decisions on the future direction that place the security the political decisionmaking level of the Ministers of De- and protection of the Allies in the foreground. The core fence with the implementation levels of the ministerial element is NATO‘s Readiness Action Plan (RAP). In additi- planners and armed forces of the participating nations on on to the immediate measures that have already been im- the basis of regular meetings.

CBRN filters

Initial Surgery

Briefing CBRN filters

OP-Lock Med Supply Spec. Diagnostic X-Ray C 4 I

Spec. Diagnostic Laboratory

Corridor Corridor Corridor free space Reception

Patient holding Post-Op ER MPHU

Tech Support

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

EMMS European Military Medical Services  2018 COMMITTED TO HUMANITY

At the end of 2014, the German medical service took over In order to ensure more effective and targetoriented multi- 7 responsibility for the „Medical Support“ cluster. Today, national cooperation of the medical services, the MMCC nine European nations work together on a large number is set up as a multinational planning and coordination of projects. Other nations have decided in favour of ob- element under the leadership of the medical service of server status and might become actively involved in the the German Armed Forces and operated together with cluster in the future. The fields of the cooperation and in- our FNC partners. The main task of the MMCC will be to dividual projects have been jointly identified and cover create the necessary preconditions for the multinational the existing capability gaps. As a result, the small circle medical service support of armed forces across the entire of nations enables faster progress, with the cluster provi- spectrum of tasks. In this way, the MMCC is accelerating ding the coordinative framework for structured coopera- the development that is already taking place of much tion that was previously unavailable. more international cooperation and acting as an interoperability accelerator. One of the visible signs of this successful cooperation was the participation in the largest medical service exercise The setup personnel of the MMCC will be put into service known as NATO VIGOROUS WARRIOR 2017 (VW17) in the on April 1, 2018 in the Rheinkaserne in Koblenz. The task autumn of 2017 at the military training area in Lehnin, consists in the resourcesaving networking of the existing as well as in Rostock-Warnemünde and Holzdorf (Elster). and required providers of expertise and the correspon- During this exercise, a mobile medical service treatment ding coordination of the work. facility from the participating nations was integrated into IONAL the exercise scenario. AT ME IN D T IC L A U L M Examples of this coordinated cooperation are the joint- M M ly developed „Standing Operating Procedures (SOP)“ of this treatment facility, which will benefit all participating CC nations in the future and can serve as a basis for further C O E R O T work. The final evaluation result of the FNC treatment RD N IN CE facility – „capable/minor risks identified“ – exceeded the ATION expectations. The NATO Centre of Excellence for Military Logo of the MMCC (source: Bundeswehr/Dittrich) Medicine (MILMED COE), which has been making a significant contribution to the transformation of the medical Here, a small group of permanently present soldiers will services for many years, was also involved in the success coordinate the targeted exchange of information of a of VW17. The experiences of VW17 will certainly influence very much larger network of medical service experts from future planning. Nevertheless, there is still plenty of work the participating nations and other providers of expertise that needs to be done in order to enable the interac- from NATO, the EU and the nations and therefore create tion of the medical services of German and multinational the preconditions for increasing the interoperability of forces within the framework of a large joint organisation, the medical services. It is already clear that there will need possibly within a symmetrical scenario. 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, Transfer of an injured individual at VW17 networked decentralised working, the office of the future (Source: Bundeswehr/Minh Vu) and Work 4.0 are just a few of the keywords that provide an outlook of the innovations that need to be established.

 2018 European Military Medical Services EMMS COMMITTED TO HUMANITY

8 The European Defence Union NATO and the EU. Initially, this is to be carried out with the participation of Italy, the Netherlands, Spain, Roma- In order to further underline the importance of increased nia, Sweden, Slovakia and the observers of Bulgaria, the cooperation between European medical services, here is Czech Republic, France, Lithuania and Luxembourg. a look at the European Union. The duality of two initiatives with similar content (MMCC The EU recently set a milestone in European security po- and EMC) from the medical service perspective can be licy with the official launch of the „PESCO initiative“. At explained by the necessity of responding to current se- the beginning of December 2017, the European Council curity policy developments in both organisations (NATO for Foreign Affairs approved the fundamental document and the EU). First and foremost it is therefore necessary at the level of the Heads of State and Government. All to synchronise the two projects – the MMCC within the the EU Member States, with the exception of the United NATO FNC initiative and the EMC within the EU PESCO Kingdom, Denmark and Malta, have agreed on closer co- initiative – in terms of content, to highlight the interrela- operation in terms of their defence and security policy. tionships and possibilities to the participating nations Permanent Structured Co-operation (PESCO): „Permanent and to avoid any duplication of effort. To this end, the ef- Structured Cooperation“ is the name of the mechanism of forts undertaken in the coming months will be necessary the EU Treaty which is to make this cooperation possible in order to interweave the developments of the European in the future. PESCO initiative in a meaningful way in terms of content with that which already exists – in addition to the consis- The main objective of the initiative is to strengthen co- tent progress on the already planned path to the MMCC. operation agreed on the basis of treaties with respect to projects aimed at strengthening the EU‘s common se- The plans for a central coordinating element of Euro- curity and defence policy. For this purpose, the nations pean medical services are ambitious, require imagination propose projects and implement them under the coordi- and perseverance and are being met today with a certain nation of the EU together with the participating nations. degree of scepticism. But everything that is new needs At the beginning of the initiative, a list of 17 projects is to to be convincing and therefore earn its justification. And be initially approved by the European Council of Foreign this will be achieved. And it is necessary to point out one Affairs in the spring of 2018 and these projects then im- further aspect to the sceptics: What we know today as the plemented by the nations. European Union started with six nations – eight nations have already committed themselves to the establishment As the „Lead Nation“, Germany is responsible for the pro- of the MMCC. jects „Network of Logistic Hubs in Europe and Support to Operations“, „Military Mobility“, „European Union Training The attainable progress is worth all the effort – as the Eu- Mission Competence Centre“ (EU TMCC), „EUFOR Crisis ropean medical services are jointly „Dedicated to humani- Response Operation Core“ (EUFOR CROC) and the „Euro- ty!“ – fully in line with the motto of the medical services of pean Medical Command (EMC)“. the German Federal Armed Forces

The main task of the EMC is to provide and coordinate Alexander Jäckel medical skills and services. Other tasks will be to create Lieutenant Colonel synergies through the harmonisation of common stan- Bundeswehr Medical Service Headquarters dards, the improvement of the rescue chain, personnel Unterabteilung I – 1.5 management and material support for deployments and Von-Kuhl-Straße 50 the bringing together of measures for medical care in 56070 Koblenz

EMMS European Military Medical Services  2018 INTERVIEW A Step into the Future with MMCC‘s First Director 9

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 Medi- cal Coordination Center“ (MMCC).

Interview with Brigadier General Bruno Most

What does your task involve? What has already been achieved and what steps do you see for the near and distant future? During the course of the security policy upheavals of the past few years, in particular the impressions resulting The signing of a letter of intent by eight Surgeon Generals from the Ukrainian conflict and the annexation of the on May 2 last year at Ehrenbreitstein Fortress was a sym- Crimea, NATO has adopted a Framework Nation Concept bolic starting signal for us. Since then, we have been draw- (FNC) in which key questions of operational readiness are ing up the tasks together with a small team which the being further developed by the larger framework nations Centre is to carry out in the future and have identified and with partner states. Among other things, Germany has de- included their expectations in numerous discussions with clared its willingness to perform this guiding function in the participating nations. With the decision of the Surgeon the area of medical assistance. As a result, we have de- General of the Bundeswehr to appoint me as the Director veloped the idea of an „MMCC“, which among other things of the Formation Staff, we have a direct contact person is designed to optimise the setting up and management for the Surgeon Generals of the partner nations for any of medical staff. This project is currently being developed questions. On 1st April 2018, we have moved into our new here in Koblenz. My task as the first Director is to get this location in the Rhine Barracks with the installation staff centre up and running. 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.

 2018 European Military Medical Services EMMS INTERVIEW

10 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 Germany is not only the leading nation for the our staff work. This also means that the staff meetings at „MMCC“ NATO project, but also for the „European Me- our centre are conducted in English as the working lan- dical Command (EMC)“ PESCO project of the EU. What guage. Our products are understandably all in English. is the relationship between the two projects? However, the idea of multinationalisation must not end at the entrance to our new centre. We also have to con- PESCO (Permanent Structured Cooperation) is an expres- sistently multinationalise the entire Medical Service more sion of the EU‘s security policy efforts to be able to meet and more in order to fulfil our role as a leading and frame- challenges with its own forces and concepts. However, work nation. I am expecting impetus for our work in this this does not compete with the idea of the NATO Frame- respect from our subordinate medical service skills units. work Nation Concept, which is intended to strengthen the I have high hopes in particular for English-language trai- European pillar. On the contrary, it is important to recon- ning courses offered by the Bundeswehr Medical Service cile the two initiatives with the same resources. My team Academy. and I see the EU‘s mission as an addition and a further mainstay. As an idea, EMC does not describe a claim to Where do you see the core tasks of the future MMCC? leadership that builds on instructions, but rather an institution that coordinates services and is therefore a service We see ourselves as a working muscle for operational provider for deployments of the EU. This means that we medical service issues – primarily of the European NATO are moving in the same territory that I described earlier nations – but equally for the military staff of the European for the MMCC task. The challenge for me as the Director is Union and as a partner for missions of the United Nations now to harmonise the two projects with one another and (UN). Specifically, we want to coordinate the develop- to win over the various accession countries for this com- ment of medical services capabilities, create products for mon approach in numerous individual discussions. medical services planning for NATO and the EU, harmo- nize medical services deployment planning in various I would like to thank you for the interview, Brigadier General, areas such as NATO, the EU and the UN with one an- and wish you every success in this task! other and also offer services such as management of the wounded and medical logistics for the future. One The interview was conducted by special building block will be products and information Matthias Frank, Lieutenant Colonel in the area of health protection for the operational Press and Information Centre contingents. Together with our partners, we want to of the Bundeswehr Medical Service further develop the internationally acclaimed system of our „Medical Intelligence“.

EMMS European Military Medical Services  2018 Almanc-2017-UB-11 18.01.17 15:17 Seite 33 PORTRAITS OF THE EIGHT PARTICIPATING MEDICAL SERVICES IN MMCC BELGIUM Kingdom of Belgium 11 Kingdom of Belgium

Capital:Capital: ...... Brussels...... Brussels Area:Area: ...... 30 30 526 526 km² km² Population:Population: ...... 11...... 11 303 267 528 910 OfficialOfficial Language: Language: ...... Dutch,...... Dutch, French,French, GermanGerman ArmedArmed Forces Forces Personnel: Personnel:...... 27 ...... 27 594 775 (military) 1 490 (civilians) Medical Officers: ...... 61 Medical Officers:...... 68 Military Hospitals/Institutes: ...... 1/0 Military Hospitals/Institutes:...... 1/0 Missions:Missions: ...... multiple multiple Defence Staff Operational Command of the Medical Component (COMOPSMED) Defence StaffQueen Elisabeth Barracks Surgeon General Medical Component CommanderOperationalRue Command d’Evere 1 of the Medical Geert Laire MD Pierre Neirinckx MD ComponentB-1140 (COMOPSMED) Brussels (Evere) Major General Major General MC BELGIUM Queen Elisabeth Barracks Surgeon General Medical Component Commander Rue d’Evere 1 GeertBasic Laire Task MD of the MilitaryPierre Medical Neirinckx Service MD The Belgian MedicalB-1140 Component Brussels is(Evere) – similar to the Land, Air The main mission of the Belgian Medical Component is to and Naval Components – part of the Intervention Force under Majorensure General the provision MC of medicalMajor support General to all MC defence activi- custody of the BELGIUMAssistant Chief of Staff Operations and Trai- ties assigned to the Land, Air and Navy Component, accor- ning, who is ultimately supervising the overall preparation ding to their level of ambition, both at home and abroad, and and deployment of military operational units and capacities. subsequently to secure adequate medical evacuation from In agreement with the operational ambition, the Medical Basicthe Taskoperational of theatre.the Military Medical withinComponent the Military spans FIVEHospital. Elements One for out Medical of five Intervention has been ServiceOver and above that, the Medical Service is to maintain phy- assignedgeographically the responsibility spread across of the the country production, and ONE storage military and sical and mental integrity of all Defence personnel during distributionhospital in the of capitalmedical city equipment of Brussels. and supplies. Each of (allied) military operations and training exercises and during The Elements for Medical Intervention (EMI 1 to 5) are static The maindaily business,mission of in theorder Belgian to maximize Medical medical Component readiness andis thefacilities other containingEMI is mainly all the oriented personnel towards and material particular resources needs to ensureto guarantee the provision commanders of medical permanently support to having all defence healthy and/ornecessary assets for theof medicaldeployment support, of a Role such 1 or aas Role aeromedical 2 MTF in activitiesdeployable assigned forces to the to achieve Land, Air their and missions. Navy Component, To that effect, evacuation,direct support CBRN of the decontamination, combat units, except or for in the specific specialized aid to the Medical Service medical care providers who are employed within the Military according1. develops to their strategic level healthof ambition, policy; both at home and maritime,Hospital. Onelight out brigade, of five has paratroopers been assigned or the Special responsibi- Forces abroad,2. providesand subsequently territorial garrison to secure health adequate care and specializedmedical Grouplity of operationsthe production, etc. storageAn EMI and is also distribution where theof medical Medical evacuationhospital from care the to operational the Belgian theatre.Defence military and civilian Componentequipment andenvisions, supplies. designs, Each of prepares the other EMIand is trains mainly its personnel; and oriented towards particular needs and/or assets of medical 3. assists in their medical preparedness through medical ownsupport, medical such teams as aeromedical and modules evacuation, up to combatCBRN decontami- readiness Structureselection and fit-for-duty evaluation. fornation, the required or in specific spectrum aid to maritime,of military light activities. brigade, The paratroo- central Military Hospital Queen Astrid (Role 4) on the other Structure The Belgian Medical Component is – similar to the Land, hand, provides a limited lying-in facility as well as an Air and Naval Components – part of the Intervention outpatient clinic in selected medical disciplines, medical Force under custody of the Assistant Chief of Staff Opera- imaging and laboratory services and hosts among others tions and Training, who is ultimately supervising the over- an emergency and disaster medical services system, a all preparation and deployment of military operational burn care unit, a centre for hyperbaric oxygen therapy, a units and capacities. In agreement with the operational physiotherapy and rehabilitation unit, a centre for mental ambition, the Medical Component spans FIVE Elements health care, the military centre for aviation medicine, the for Medical Intervention geographically spread across the centre for medical fitness assessment etc. (see the section country and ONE military hospital in the capital city of ’Military Hospital‘) Brussels. The Component has also a Medical Competence Cen- The Elements for Medical Intervention (EMI 1 to 5) are tre for teaching both medical and combatant (non- static facilities containing all the personnel and material medical) personnel, with the exception of the graduate resources necessary for the deployment of a Role 1 or a and post graduate education of all medical professionals Role 2 MTF in direct support of the combat units, except for (physicians, physiotherapists, veterinarians, nurses etc.) ALMANAC Military Medical Corps Worldwide – Edition 2017 33 the specialized medical care providers who are employed which takes place in civilian universities and medical

 2018 European Military Medical Services EMMS BELGIUM

12 schools. This Centre is collocated with the Military Hospital lic through cost refund. Especially in these three fields of and thus easily allows for increased educational efficiency expertise, the Military Hospital contributes in the context and interchangeability of human resources. of aid to the nation.

Finally, the Staff of the Operational Command of the Since, as a consequence, the Military Hospital is not a Medical Component (COMOPSMED), situated on the same genuine general hospital, multilateral collaboration with campus as the Defence Staff in Evere, nearby Brussels, is civilian partners have become of utmost importance. In responsible for the organization and implementation of this way, the Military Hospital holds several partnerships the military garrison and operational health care portfolio with university hospitals in the neighbourhood and even to the beneficiary Defence personnel. provides to one of these, part of its infrastructure. Be- sides, where necessary, Defence personnel will be refer- Military Hospital red to the civilian health care services and can get their costs reimbursed. The mission of the Military Hospital Queen Astrid is three fold: (1) to hold medical capabilities in stand by and to Secondly, the Military Hospital holds an important role preserve and train medical skills, necessary to support as a medical training facility to maintain skills and com- operations, in theatre as well as on the national territo- petencies tailored to military operational medicine and ry; (2) to contribute to the medical readiness of the de- serves as a reach back capability for the deployed medi- ployable forces; (3) finally, with all non-deployed capa- cal forces. Moreover, the hospital is a key player when it cities, to participate in the Defence aid to the nation. comes to scientific research and development of innova- tive technology and treat ment in certain niche activities One of the main service objectives to achieve this mission that are of military concern such as infectious diseases, is providing specialist medical care tailored to the mili- septic surgery, wound healing etc. The laboratory for mo- tary duty. The Military Hospital is not a distinct hospital in lecular and cellular technology works closely together the traditional sense, but manages a number of special- with several national and international (academic) part- ized health care services in specific domains of military ners and concentrates on the development of skin sub- interest. That is why its activities are primarily focused stitutes, on safety improvement of skin and keratinocy- on pre-hospital emergency care and disaster medicine, te 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

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 co- Military Hospital ”Koningin Astrid“ ming years in a significant increase of this Medical Techni- cal Corps with about 67 employees. Beside these medical burn care, traumatology, orthopedic surgery and reha- technicians, another 60 officers constitute the Medical bilitation, travel medicine, hyperbaric medicine, mental Support Corps of the Component. Moreover, 10 occu- health care and crisis psychology. These hospital facilities pational medicine and 8 medical advisors serve with- are merely dedicated for the treatment of beneficiary ac- in the Well-being staff department of the Belgian Armed tive military and civilian Defence personnel. However, the Forces Command. 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 pub-

EMMS European Military Medical Services  2018 BELGIUM

Field Deployments According to the political guidance, the mission of the 13 Belgian Medical Component is to participate to joint The Belgian medical evacuation chain concept starts with medical support inthe framework of EU, NATO or UN thorough self-aid and buddy-aid at the combatant level operations by filling either advisory orinternational staff (combat life saver and aidman) all the way through EMT positions either delivering Role 1, Role 2B and Role 2E support, followed by emergency nursing and physician capabilities conform and tailored to the activities, opera- medical care, ending up, as needed, in initial surgical care tions and level of ambition of the other components or (light forward surgical teams) and definitive surgery in va- independently on its own. riable compositions of MTF modules. Missions Flying the upcoming light transport helicopter NH-90 might soon result in new challenges for the flight sur- Belgian military medical teams contribute to several geons when it comes to optimizing the tactical aerome- EU-, NATO- and UN-led operations worldwide providing dical evacuation policy. medical support to Belgian contingents and multinational forces. Medical Component personnel are currently State-of-the-art retrieval of the sick and wounded sol- deployed with units serving in Afghanistan (RSM), Iraq diers from the operational theatre completes this process (OVP), Jordan (ODF), Mali (EUTM), the Central African Re- of care. To that purpose, the Belgian Medical Component public (EUTM), the Baltic States (EAPM and EFP), Refugee operates a dedicated strategic aeromedical evacuation Relief Operations in the Mediterranean Sea (EUNAVFOR- program in close collaboration with the European Avia- MED), and on various locations in the Democratic Repub- tion Transport Command (EATC). Specialized assets in- lic of Congo. Previous overseas missions have included clude certified aeromedical crews and various types of i.a. Lebanon (UNIFIL), ISAF-theatres in Afghanistan and patient transport units. 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.

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Almanc-2017-UB-11Almanc-2017-UB-11 18.01.17 18.01.17 15:19 15:19 Seite Seite 82 82 CZECH CZECH CZECHCZECH CzechCzech Republic Republic CzechCzech Republic Republic Capital:...... Prague ...... 78 866 km² Area:Capital:Capital:Capital: ...... Prague...... Prague Prague Population:Area:Area: Area:...... 78...... 10...... 78 78 866 866553 866 km² km² 800 km² OfficialPopulation:Population: Population:Language: ...... 10...... 10...... Czech 10 553 553 553 800 800 800 ArmedOfficialOfficial ForcesOfficial Language: Language: Personnel:Language: ...... Czech...... Czech...... 29 Czech 512 ...... 29 512 MedicalArmedArmedArmed ForcesOfficers: Forces Forces Personnel: Personnel:...... 454 Personnel:...... 29 ...... 31 248 512 Medical Officers:...... 454 MilitaryMedicalMedical Hospitals/Institutes: Officers: Officers: ...... 454...... 3/3 454 Military Hospitals/Institutes:...... 3/3 MilitaryMilitary Hospitals/Institutes: Hospitals/Institutes:...... 3/3 ...... 3/3 Missions:Missions:...... multiple...... multiple Missions:Missions: ...... multiple multiple

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Basic Task of the Military Medical Service The Military Medical Agency is responsible for medical com- BasicBasic TaskTo guaranteeTask of theof the theMilitary Militarysoldiers Medical of Medical the Armed Service Service Forces of the Czech TheThemand Military Military and control,Medical Medical health Agency Agency care is responsiblequality, is responsible medical for medical development for medical com- com- of Public Health, Ministry of Interior, and other authorities BasicTo guaranteeTo guaranteeTaskRepublic the of (AFCR) the soldiers the soldiers outstanding Military of ofthe the Armed medical Armed Medical Forces Forcessupport of in the operations CzechCzech mandmandand cooperationand and control, control, with health healthother care authorities care quality, quality, medicalregarding medical development force development health ServiceRepublicRepublicand (AFCR) to (AFCR) ensure outstanding outstanding both the physical medical medical and support support mental welfare.inin operations andandandprotection, organisations, cooperation cooperation medical with i.e.with supply other Red other authorities activities,Cross. authorities The medical regarding Director regarding assistance force of the health force and Mili health- and toand ensure to ensure both both the the physical physical and and mental mental welfare. welfare. taryprotection,protection,crisis Medical management. medical Department medical supply supply activities,is subordinated activities, medical medical assistanceto the assistance Director and and The medical care is based on prevention and treatment pro- crisis management. crisis management. 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The to Director the Director of the of theMilitary Support Medical Division Depart- is the Director of the Military Medical Agency, which hasfor the military personnel and other related beneficiaries Structureto whomhighest he representative directly reports. of the TheCzech Surgeon Military GeneralMedical Service as the ofment MoD tois whomsubordinated he directly to reports. the Director of the Support Division is thethree Director departments of the Military directly Medical dealing Agency,with medical which service has The primary health care within the Armed Forces of the Czech highest representative of the Czech Military Medical Service andof ensure MoD to the whom primary he directly contact reports. members of the armed threecommand departments and control:directly dealing Medical with Services medical Department, service TheRepublic primary is health mostly care covered within by the Regional Armed ForcesMedical of Treatment the Czech Centres (7) and Battalion Aid Stations (17). 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Service Structure Ministry of Defence Military Medical Military Medical Service is the Director of theMinister Military of Defence Service Structure Medical Agency,Deputy which MoD has three departmentsChief directlyof the General Staff State Secretary Military HospitalsMinistry of Defence Military Medical dealing with Deputymedical MoD service command and control:ChiefMinister of the ofGeneral Defence Me Staff- State Secretary Service Structure Department Support Division HQ HQ Personnel Division dical Servicesof Organisation Department, Management PharmacyMedical Department and MedicalGrand Mate Forces - There areAir Forces three military hospitals in the Armed Forces of riel and VeterinaryDeputy MoDDepartment Service DepartmentSupport Division and ChiefOperational of theHQ General Staff the CzechHQ Republic. AlthoughPersonnelState Division Secretary the primary target group of of Organisation Management Medical Department Grand Forces Air Forces Central Military Military Medicine Agency Brigades, Battalions Brigades, Air Bases University of Defence Psychology Department.Hospital Prague The Military(Surgeon General) Medical Agency is patients are the members of the Armed Forces of the Czech Faculty of Military Support Division Health Sciences responsibleDepartment forCentral medical Military commandMilitary Medicine Agency and control,Brigades, HQhealth Battalions14 x Republic,Brigades, AirHQ theBases2 x militaryUniversity hospitalsPersonnel of Defence Division provide medical care for Role 1 Role 1 of Organisation ManagementHospitalMilitary Prague Hospital Medical(Surgeon Department General) Grand Forces Air Forces Faculty of Military care quality, medicalOlomouc development and cooperation with civilian population in the Bechyngiveně region. Therefore, almost 14 x 2 x Health Sciences Role 1 Role 1 Hradec Králové other authoritiesMilitary Hospitalregarding force health protection, me- 90% of the patients in the military hospitals are civilians. 6 th Field Hospital AE / Medical Rescue Center Military Veterinary Institute Prague Central MilitaryOlomoucMilitary Hospital Military Medicine Agency Brigades, Battalions Brigades, Air Bases UniversityBechyně of Defence Brno dical supplyHospital activities, Prague medical(Surgeon General)assistance and crisis ma- The hospitals have two sourcesProstějov of funding: reimburse- HradecFaculty Králové of Military 7 th Field Hospital Medical Material Center Military Canine Center Přáslavice Military Hospital 6 th Field Hospital AE / Medical14 x Rescue Center Military Veterinary2 x Institute PragueHealth Sciences nagement. Aviation Medicine ment from the health insuranceVyškov companies as well as Brno Role 1 Role 1 Prostějov Military HospitalInstitute Prague Žatec

Hospital Support Company Military Medical Institute Bio Defence Department Regional Medical Treatment Center Olomouc 7 th Field Hospital Medical Material Center fundingMilitary from Canine Centerthe MinistryPřáslavice ofBechyn Defence.ě Military hospitals Vyškov The Military AviationMedical Medicine Department, which is within the assess the health status of soldiersHradec Králové in active duty and ap- Institute Prague Žatec

Hospital Support Company Military Medical Institute Bio Defence Department Regional Medical Treatment Center MoD SupportMilitary HospitalDivision structure,6 th Fieldis Hospitalresponsible AEfor / Medical me Rescue- CenterplicantsMilitary (recruits) Veterinary Institute to join the PragueArmed Forces of the Czech Brno Prostějov ALMANAC Military Medical Corps Worldwide – Edition 2017 dical strategy82 and policy, medical7 th Field concepts Hospital and medicalMedical Material CenterRepublic.Military They Canine play Center a key rolePř áslavicein providing a medical trai- legality. It Aviationis also Medicine responsible for cooperation with the De- ning to military medical personnel.Vyškov Institute Prague Žatec

Hospital Support Company Military Medical Institute ALMANACBio DefenceMilitary Department MedicalRegional Medical Treatment Center Corps Worldwide – Edition 2017 partment82 of Organization Management of MoD, Ministry

EMMS European Military Medical Services  2018

82 ALMANAC Military Medical Corps Worldwide – Edition 2017 CZECH

The Military University Hospital Prague is a training, patient clinics. The hospital is well equipped with modern 15 educational and professional medical facility of the technology and reflects contemporary trends in medicine. Armed Forces of the Czech Republic, which provides comprehensive health care at the level of teaching The Military Hospital in Olomouc is the oldest hospitals. The number of treated patients, as outpatients, military hospital in the territory of the Czech Republic and hospitalized is gradually increasing (around 1,1 (established in 1748).The Military Hospital in Olomouc million outpatients and 25 thousand hospitalized patients offers an identical range of medical services as the Mili- yearly). tary Hospital in Brno. It has currently 273 beds. The hospital is equipped with Light Speed VCT, which is one The Military University Hospital Prague provides a nearly of the latest innovations in CT technology. It has other complete range of medical services except paediatrics, top equipment for laparoscopy, arthroscopy, endosco- obstetrics, cardiac surgery, and treatment of burns. It fo- py, EEG, EMG etc. Since 2006, the hospital has become cuses mainly on acute surgical conditions and internal involved in the regional emergency medical system. profile, the care of polytrauma, including brain and spinal cord injuries. Military Institutes The Military University Hospital Prague is continuously developing modern, especially minimally invasive, medi- The Institute of the Aviation Medicine Prague (the cal procedures in various fields. IAM) is a diagnostic, therapeutic, advisory and training facility with a nationwide competence for both civilian The hospital has currently 10 clinics, 20 specialized de- and military personnel, with the possibility of providing partments and 674 beds. The hospital has been also in- a whole range of highly specific services exploitable by volved in the care of war veterans. The quality and safety other patients and even healthy persons. of care in the Military University Hospital is in accordance with international principles and the hospital has been The IAM performs the both initial and regular medical accredited by a Czech auditing body. examinations of flight personnel, air traffic control -per sonnel and the people involved in rescue operations (e.g. The Military Hospital in Brno consists of following divers, fight – fighters, rescuers, paramedics and police wards: Department of Internal Medicine with ICU and officers) and therapeutical and advisory activities relating Oncological short-stay ward, Surgical and Orthopaedic to the military and aviation personnel, paratroopers, di- department with ICU, Neurological department with ICU, vers and air traffic controllers. Psychiatric department, Ophthalmology department, and ENT department include a total of 212 beds for The above-mentioned services are primarily aimed at ma- acute care patients. Clinics radiology, Clini- king a speedy diagnosis, after-treatment, assessment of cal Laboratories, Psychology, Rehabilitation and phy- an examinee´s ability to execute his/her job and giving siotherapy, Dermatology, Stomatology, Anaesthe- recommendations on preventive as well as therapeutic siology and resuscitation, Pharmacy and Medical measures. These services are provided by skilled staff, Technology, Medical assessment board and Depart- mainly to outpatients, but also by means of a short-term ment of Occupational Diseases belong to the out- 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 specia- lised 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 European Military Medical Services EMMS CZECH

16 The Department at Techonin is a specialized medical in- MEDEVAC Capabilities stitution of the Czech Armed Forces ensuring complete biological defence primarily in favour of the Czech troops. Patient transport (ground medical evacuation) can be There are following primary objectives: provided by protected transport vehicles of the medical • Isolation of bacilli carriers of dangerous diseases service. That are eight-wheeled Pandur II armoured per- and prevention of spreading of contagious diseases sonnel carriers and, medical version of Iveco LMV (Light to the rest of population; Multirole Vehicle). Medical version replaces older Sovi- • Identification of the sort of contamination, et-era OT-64 SKOT. All the types of vehicles have the same determination of diagnosis, suggestion and taking capacity - four casualties. necessary measures - especially in issues of prevention; For STRATEVAC medically adjusted Airbus A-319 CJ or • Treatment of affected persons; CASA C-295 is used. The specialized equipment, the Pa- • Biological defence research. tient 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 FOR- WARD MEDEVAC. To achieve this capability is expected by 2020.

Field Deployments The Biological Defence Department in Techonin Treatment chain for wounded soldiers commences at the The Biological Defence Department includes the Spe- self-aid or body-aid and continues with the enhanced first cialised Infection Hospital for persons affected with dan- aid delivered by a combat life saver at the point of injury. gerous or exotic infections under biosafety level 3 & 4 Role 1 MTF encompasses provision of the first emergency conditions equipped with laboratories for diagnostics of medical care. oF combat injurieS selected biological agents. It also offers isolation-quarantine capabilities for examination of the troops returning Role 2/Role 2E MTF accomplishes clinical enhancement 83 % today are cauSed by from military missions abroad. if necessary. Final clinical treatment and rehabilitation is The Department serves as a training and education facili- provided in Role 4 MTFs in the Czech Republic. improviSed exploSive deviceS. ty both for military and civilian specialists from the Czech The Medical Service of the Czech Armed Forces has cur- Republic and within the NATO (Centre of Excellence). rently the capability to deploy MTFs up to Role 2E – (field The greatest risk faced by armed forces in today’s missions is the effect of improvised explosive hospitals). 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 The Department is part of the Integrated Rescue System human body requires efficient protection. of the Czech Republic, and, at the same time, it is involved The Military Medical Service has two field hospitals avai- in the NATO biological defence system. lable. Each field hospital is composed of several tents and containers, containing emergency, surgery with two ope- Fragment protective clothing: Number of the Medical Service ration rooms, ICU, ward, dentistry, laboratory, X-Ray, ul- Personnel trasound, CT, pharmacy and sterilization. ® The Military Medical Service personnel have been parti- Qualified physicians: 239 cipating in all major foreign activities. The fact that the Saratoga Fpc Qualified dentists: 11 Czech military medical personnel are being included in Pharmacists: 19 the NATO, UN or EU-led missions reflects their consider- Veterinary surgeons: 29 able credibility. Assisting / nursing personnel: 321 Medics / drivers: 172 For more information please contact us at: Other allied health professionals: 39 highest body protection in one system. The new generation of Blücher Gmbh phone: +49 211 92 44 0 SArATOGA® FPc significantly enhances protection from the Mettmanner Straße 25 email: [email protected] EMMS European Military Medical Services  2018 resulting explosion effects. 40699 erkrath | Germany www.bluecher.com

251770 Anz FPC_RZ_171117.indd 1 17.11.17 13:11 CZECH

Field hospitals personnel were involved e.g. in the mis- state sponsored emergency medical services and acts as 17 sions in Albania, Turkey, Afghanistan or Iraq, medical an important part of the Integrated Rescue System of the teams were deployed in several peace keeping opera- Czech Republic. Currently The Armed Forces of the Czech tions. Republic have been fully covering the Air Rescue Service in the regions of South Bohemia, Karlovy Vary and Plzen. Since 2003 the Czech medical teams have been embed- ded in the UK, Dutch, German and NATO Field Hospitals. The Institute of Aviation Medicine in Prague serves the military and civilian flight personnel and air traffic control At present the Czech military medical service is develo- service. ping a medical module (based on Multinational Medical The Biological Defence Centre in Techonin serves as Task Force) which will be ready to provide medical sup- a training and education facility both for military and port to V4 EUBG 2019/2. civilian specialists from the Czech Republic and within NATO (CBRN Centre of Excellence). Civilian Military Cooperation The department is also a part of the Integrated Rescue The Military Hospitals are fully integrated in the civilian System of the Czech Republic, and at the same time, it is healthcare system. involved in the NATO biological defence system.

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

oF combat injurieS 83 % 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.

Fragment protective clothing: Saratoga® Fpc

For more information please contact us at:

highest body protection in one system. The new generation of Blücher Gmbh phone: +49 211 92 44 0 SArATOGA® FPc significantly enhances protection from the Mettmanner Straße 25 email: [email protected] resulting explosion2018 effects. European40699 erkrath Military | Germany Medical www.bluecher.comServices EMMS

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ESTONIAESTONIA ESTONIA Estonia Republic of Estonia Republic of Estonia

Capital:Capital:...... Tallinn ...... Tallinn Capital:...... Tallinn Area:...... 45 228 km² Area:Area: ...... 45 45 228 228 km² km² Population:...... 1 340 602 Population:Population: ...... 1...... 1 340 340 602 602 OfficialOfficialOfficial Language: Language: Language:...... Estonian ...... Estonian...... Estonian ArmedArmedArmed Forces Forces Forces Personnel: Personnel: Personnel:...... 5...... 5 ...... 5 000 000 MedicalMedicalMedical Officers: O fficers:Officers:...... 19 ...... 19...... 19 MilitaryMilitaryMilitary Hospitals/Institutes: Hospitals/Institutes: Hospitals/Institutes:...... 0/0...... 0/0 ...... 0/0 Missions:Missions:Missions:...... 1 ...... 1 1 Estonian Defence Forces HQ Estonian Defence Forces HQ J4 MedicalEstonian Service Defence Forces HQ J4J4 Medical Medical Service Service LieutenantSurgeon General Colonel JuhkentaliJuhkentali 5858 Surgeon General Juhkentali 58 TargoTargo Lusti Lusti 1500715007 Tallinn Tallinn TargoMajor Lusti ESTONIA15007 Tallinn MajorLieutenant Colonel ESTONIAESTONIA

Basic Task of the Military Medical Service Training BasicBasicTo TaskTask support of of theEstonian the Military Military Defence Medical Forces Medical Service(EDF) personnel in TrainingEDFTraining has currently two main training centres for medical per- ServiceTo supporthealthcare Estonian related issues, Defence mainly Forces primary(EDF) care personnel for military in sonnel.EDF has One currently in National two Defence main training College is centres providing for courses medical per- healthcarepersonnel, related incl. medicalissues, examination mainly primary through care medical for military board. EDFforsonnel. medicalhas currently One leaders in National two and mainclinicians, Defence training including College centres reservistsis providing for medical and courses personnel,Eligible incl. beneficiaries medical examination are: conscripts, through active medical duty service board. medicalfor medical students leaders in Universities. and clinicians, The other including training reservistscentre is and To supportmembers, Estonian reserve Defence component Forces (only (EDF)once activated) personnel and in in - personnel.more focused One on in training National of conscriptsDefence College to paramedics is providing and Eligible beneficiaries are: conscripts, active duty service medical students in Universities. The other training centre is healthcarejured formed related active issues, duty mainly service primary members. care for military coursesrefreshing for medical medical knowledge leaders andof the clinicians, deploying units.including re- members, reserve component (only once activated) and in- more focused on training of conscripts to paramedics and personnel, incl. medical examination through medical servists and medical students in Universities. The other juredOther formed tasks active include duty creation service of members. medical support plans and Fieldrefreshing Deployments medical knowledge of the deploying units. board.resources Eligible for beneficiaries deployable and are: other conscripts, operational active units, develduty - trainingMain focus centre is supportingis more focused of EDF on ongoing training deployments of conscripts in serviceOtheroping tasksmembers, and include providing reserve creation military component of medical medical training(only support once and plansprovidingactiva and- toMali, paramedicsField CAR, Deployments Iraq and Kosovorefreshing where medical EDF medical knowledge service provi- of the ted)resources andinput injured for for health deployable formed related active andlegislation, other duty operationalservice guidelines members. etc. units, devel- deployingdesMain Role focus 1 units. and is ground supporting MEDEVAC of EDFsupport ongoing to its own deployments units. in oping and providing military medical training and providing EDFMali, medical CAR, serviceIraq and has Kosovo an excellent where cooperation EDF medical with service its EU provi- inputStructure for health related legislation, guidelines etc. anddes NATO Role coalition 1 and groundpartners. MEDEVAC support to its own units. OtherSG’s tasks office include operates creation on joint of medical level. There support are eleven plans Roleand 1 FieldEDF medical Deployments service has an excellent cooperation with its EU resourcesStructuremedical for centresdeployable organic and to militaryother operational units and in additionunits, de one- Civil-Militaryand NATO coalition Cooperation partners. Health Centre which provides most specialist outpatient ser- Higher level care, including rehabilitation services are velopingSG’s office and operates providing on military joint level. medical There training are eleven and proRole- 1 Main focus is supporting of EDF ongoing deployments vices and performs as a healthcare board to assess medical provided on civilian bases. Universal health insurance grants AN 43 2.2 02/2018/A-E vidingmedicalfitness input centres for for service. health organic related to military legislation, units and guidelines in addition etc. one ineasy Mali,Civil-Military access CAR, toIraq all healthcareand Cooperation Kosovo providers. where EDF In addition medical to itsservice cli- Health Centre which provides most specialist outpatient ser- Higher level care, including rehabilitation services are providesnical counterparts, Role 1 and EDF ground medical MEDEVAC service has support a very closeto its coown- vicesThere and performsare no military as a healthcarehospitals in board Estonia, to assessbut all militarymedical operation provided with on Ministrycivilian ofbases. Social Universal Affairs, National health Institute insurance for grants units. EDF medical service has an excellent cooperation Structurefitnessdoctors for service. and nurses are highly encouraged to practice in civi- Healtheasy accessDevelopment, to all healthcare Tartu University providers. and Medical In addition Colleges. to its cli- lian medical facilities. Such activities are considered mutu- withEDFnical its is responsible EUcounterparts, and NATO for militarycoalitionEDF medical medical partners. service training has of physiciana very close co- SG’Theres officeally are beneficial no operates military and regulated onhospitals joint level. by in legislative Estonia,There are acts. but eleven all military Role 1 andoperation nurses during with Ministry their pre-diploma of Social Affairs,curriculum National in Universi- Institute for ties. medicaldoctors centresand nurses organic are highly to military encouraged units and to practice in addition in civi- Health Development, Tartu University and Medical Colleges. Proud to Support Saving Lives lian medicalMedical Service facilities. Personnel Such activities are considered mutu- Civil-MilitaryEDF is responsible Cooperation for military medical training of physician one Health Centre which provides most specialist outpa- ally beneficialPhysicians and (including regulated dentists, by legislative healthcare acts. administration and nurses during their pre-diploma curriculum in Universi- and training): 35 (17 active duty/18 officials and contracted) tient services and performs as a healthcare board to as- Higherties. level care, including rehabilitation services are sess medicalPharmacists: fitness 2 (active for service. duty) provided on civilian bases. Universal health insurance MedicalNurses: Service 75 (68 Personnel active duty/7 officials and contracted) Physicians (including dentists, healthcare administration grants easy access to all healthcare providers. In addition Thereand training): are no military 35 (17 activehospitals duty/18 in Estonia, officials but and all contracted)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 Medical Service Personnel curriculum in Universities.

Physicians (including dentists, healthcare administration and training): 35 (17 active duty/18 officials and contracted) Pharmacists: 2 (active duty) Nurses: 75 (68 active ALMANAC Military Medical Corps Worldwide – Edition 2017 duty/792 officials and contracted)

EMMS European Military Medical Services  2018 KARL STORZ SE & Co. KG, Dr.-Karl-Storz-Straße 34, 78532 Tuttlingen/Germany, www.karlstorz.com

92 ALMANAC Military Medical Corps Worldwide – Edition 2017 AN 43 2.2 02/2018/A-E

Proud to Support Saving Lives

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GERMANY GERMANY (JOINT MEDICAL SERVICE) GERMANY (JOINT MEDICAL SERVICE) Federal Republic of Germany (JointFederal FederalMedical Service)Republic Republic ofof Germany (Joint (Joint Medical Medical Service) Service)

Capital:Capital:...... Berlin ...... Berlin Berlin Area:Area:...... 357 ...... 357 357 121 121 121 km² km²km² Population:Population:...... 82 ...... 82...... 82 000 000 000 000 000 OfficialOfficial Language: Language: Language:...... German ...... German...... German ArmedArmed Forces Forces Forces Personnel: Personnel: Personnel:...... 185...... 185 ...... 185 000 000 000 MedicalMedicalMedical Officers: Officers: Officers:...... 3 ...... 3...... 3 500 500 500 MilitaryMilitaryMilitary Hospitals/Institutes: Hospitals/Institutes: Hospitals/Institutes:...... 5/7...... 5/7 ...... 5/7 Missions:...... multiple Missions:...... multiple ...... multiple

BundeswehrBundeswehr MedicalMedical Service Service Headquarters Headquarters Von-Kuhl-StrasseBundeswehr Medical 50 Service Headquarters SurgeonSurgeon General General Von-Kuhl-Strasse 50 SurgeonDr med General Michael Tempel 56070Von-Kuhl-Strasse Koblenz 50 DrDr medLieutenant med Michael Michael General TempelTempel MC 56070GERMANY56070 Koblenz Koblenz LieutenantLieutenant General General MC MC GERMANYGERMANY

Basic Task of the Military Medical Service continued focus on tasks that require a medical licence are BasicThe Task core taskof the of the Military Bundeswehr Medical Joint MedicalService Service is to essentialcontinued determinants focus on tasks of the that Bundeswehr require a medical Joint Medical licence are protect, sustain and restore the health of service personnel. Service. BasicThe core Task task of of the the Bundeswehr Military Joint Medical Medical Service is to exercisesessential control determinants over the medical of the Bundeswehrservices of all Jointbranches Medical This is of particular relevance in the case of deployments of the German Armed Forces. Serviceprotect,abroad, sustain where and service restore personnel the health is exposed of service to exceptional personnel. In Service. order to achieve these goals and maintain personnel sus- This healthis of particular hazards (that relevance they do notin the face case at home). of deployments The work of tainability, the Bundeswehr Joint Medical Service comprises Theabroad, corethe Bundeswehrwheretask of service the Joint Bundeswehr personnel Medical Service is Joint exposed isMedical based to exceptional on Service the gui- HeaIn totalalso order ofcommands approximatelyto achieve thethese 14.650 Bundeswehr goals military and maintain and Medical 2.700 personnel civilianService sus- health hazards (that they do not face at home). The work of tainability, the Bundeswehr Joint Medical Service comprises is to dingprotect, principle sustain that ill,and injured restore or wounded the health personnel of service on ope- Headquartersposts. located in Koblenz, which at field army le- the Bundeswehrrations are to Jointbe given Medical medical Service care, theis based outcome on ofthe which gui- a total of approximately 14.650 military and 2.700 civilian personnel.dingcorresponds principle This that is to of medicalill, particular injured standards or relevancewounded in Germany. personnelin the This case applieson ofope- velTheposts. is Surgeonthe highest General military is the medical commanding command general in of Germany. the Ger- deploymentsrationsacross are theto abroad,be entire given spectrum wheremedical ofservice care, medical the personnel outcome care and services.ofis whichex- man Joint Medical Service and, in medical matters, exercises posedcorrespondsThrough to exceptional its to staff medical and health resources, standards hazards the in Medical Germany. (that Servicethey This do also applies not pro- AllcontrolThe command Surgeon over the Generaland medical control is services the commandingstructures of all branches of general the of theBundes of Ger- the -Ger- vides medical care to military personnel in Germany. man Armed Forces. faceacross at home). the entire The spectrum work of ofthe medical Bundeswehr care and Joint services. Me- wehrman Medical Joint Medical Service Service are organized and, in medical at the matters,Bundeswehr exercises Through its staff and resources, the Medical Service also pro- control over the medical services of all branches of the Ger- Structure He also commands the Bundeswehr Medical Service Head- dicalvides Service medical is care based to military on the personnel guiding principlein Germany. that ill, Medicalman Armed Service Forces. Headquarters, focusing on a process- injuredConsistent or wounded orientation personnel towards on mission-related operations tasks,are to the orientedquarters organisationlocated in Koblenz, rather which than at fieldon armycustomary level is thestaff streamlining of command and control structures and the highest military medical command in Germany. beStructure given medical care, the outcome of which corres- branches.He also Incommands the training the branch,Bundeswehr for example, Medical Servicestaff from Head- pondsConsistent to medical orientation standards towards in mission-relatedGermany. This tasks,applies the personnelquarters managementlocated in Koblenz, work alongside which at field staff army from level opera is- the streamlining of command and control structures and the highest military medical command in Germany. across the entire spectrum of medical care and services. tions and readiness. Solutions for military medical corps Through its staff and resources, the Medical Service Call: +49 40 88 18 96 – 0, E-Mail: [email protected] also provides medical care to military personnel in Ger- A feature unique to the Medical Service is its responsibi- many. lity for the organisation and management of Strategic

Aeromedical Evacuation (StratAirMedEvac) opera- 2 2 MEDUMAT Standard MEDUMAT Standard Structure tions. This responsibility includes stationing, military se- emergency ventilator 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 MEDUMAT Transport MEDUMAT Transport are essential determinants of the Bundeswehr Joint Medical Service Headquarters. emergency and transport ventilator Medical Service. The Operational Medical Support Command in In order to achieve these goals and maintain personnel Weißenfels is responsible for and coordinates the deploy- sustainability, 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 ACCUVAC Pro 2.700 civilian posts. are its main assets for fulfilling this task. suction device

The Surgeon General is the commanding general of the Regional medical treatment facilities have been placed NATO 102 ALMANAC Military Medical Corps Worldwide – Edition 2017 German Joint Medical Service and, in medical matters, under the authority of the Regional Medical Support and the armies of its member states EMMS European Military Medical Services  2018 place their trust in our products for use under extreme conditions. Photograph: Military medical corps of the German Federal Armed Forces 102 ALMANAC Military Medical Corps Worldwide – Edition 2017

17-266_Anzeige_Militär_EN_210x145_V2.indd 8 16.11.17 13:50 GERMANY

Command in Diez. Medical care for active-duty person- for the mutual support between field units and Bundes- 21 nel is provided by major medical clinics, which also offer wehr hospitals. specialty services, and medical clinics. Three Medical Regiments are stationed in Weißenfels/ The Bundeswehr Medical Academy is the centre of com- Berlin, Rennerod/Koblenz and Dornstadt. petence for military medical research, development and training and is located in Munich. The Medical Service Rapid Reaction Regiment in Leer combines all airmobile and airborne medical capabilities Five Bundeswehr Hospitals located in Koblenz, Ulm, of the Bundeswehr Joint Medical Service to ensure that Berlin, Hamburg and Westerstede are directly subordi- medical care and support are made available to troops on nated to the Bundeswehr Medical Service Headquarters deployments abroad within a very short period of time. as well as the Central Institutes of the Bundeswehr Me- During longer deployments, rapid response forces are re- dical Service at Kiel and Munich and Supervisory Centres lieved by stabilization forces. for Public Law Tasks of the Bundeswehr Medical Service North (Kiel), West (Koblenz), East (Potsdam) and South Basic training of medical trainee soldiers and predeploy- (Munich). ment training of medical personnel are provided by the Medical Training Regiment in Feldkirchen. In the future the Bundeswehr Joint Medical Service will have five regiments, elements of which will be stationed All hospitals are operated by the Bundeswehr and pro- at or close to Bundeswehr hospitals in order to strengthen vide medical care not only for service personnel but also the training and exercise system and to increase options for civilian patients.

Solutions for military medical corps Call: +49 40 88 18 96 – 0, E-Mail: [email protected]

2 2 MEDUMAT Standard MEDUMAT Standard emergency ventilator

MEDUMAT Transport MEDUMAT Transport emergency and transport ventilator

ACCUVAC Pro suction device

NATO and the armies of its member states  2018 place their trust in our European Military Medical Services EMMS products for use under extreme conditions. Photograph: Military medical corps of the German Federal Armed Forces

17-266_Anzeige_Militär_EN_210x145_V2.indd 8 16.11.17 13:50 GERMANY

22 Institutes, Research and Public Health In relation to the kind and severity of their injuries Casual- ties are generally transported back to Germany in spe- Veterinary and pharmaceutical laboratory diagnostics cially equipped Bundeswehr aircrafts within the frame- including potable water and food examination are pro- work of StratAirMedEvac. Special equipment includes vided by Central Institutes of the Bundeswehr Medical Patient Transport Units (PTU) for the movement of in- Service at Kiel and Munich. tensive care patients. Six PTU can be installed in Airbus A-310 aircraft operated by the Deutsche Luftwaffe (Ger- Medical research in the field of detecting and preventing man Air Force, see Luftwaffe). of CBRN-Threats is conducted in the laboratories of the institutes affiliated with the Medical Service Academy in The main elements at Role 4 level are the Bundeswehr Munich. The Bundeswehr Institutes of Microbiology, Hospitals in Germany. If necessary, civilian hospitals and of Pharmacology and Toxicology, and of Radiobiology rehabilitation centres are also used. These facilities pro- are also stationed in Munich. The Bundeswehr Institute vide for the further treatment of patients who have been of Preventive Medicine will be established in Andernach evacuated from the area of deployment. As a rule, strate- and will provide research and operational assets for in- gic air medical evacuation aircraft land in the reserved mi- jury protection, health protection and surveillance capa- litary zone of Cologne- Bonn airport. From there, patients bilities. are transferred to the Bundeswehr hospitals.

Further elements of the force health protection program of the Bundeswehr Joint Medical Service are established Current missions: at the Supervisory Centres for Public Law Tasks of the Bundeswehr Medical Service North (Kiel) / East (Potsdam) 1999 – KFOR / Kosovo / West (Koblenz) / South (Munich) acting in preventive 2002 – RS / Afghanistan medicine, veterinary service, pharmacy and food safety in 2005 – UNMISS / South Sudan an interdisciplinary approach. 2006 – UNIFIL / Lebanon 2007 – UNAMID / Sudan Field Deployments 2009 – ATALANTA / Horn of Africa 2010 – EUTM / Somalia First aid through self and buddy aid forms the start of 2012 – EUCAP Nestor / Somalia the medical evacuation chain. Initial emergency medical 2013 – EUTM / Mali care is rendered at Mobile Aid Stations (Role 1). Trained 2013 – MINUSMA / Mali medical specialists perform on-site triage, shock and pain 2013 – MINURSO / West Sahara management as well as haemostatic measures. They also 2013 – AF TUR / Turkey ensure the clearance of the respiratory tract and artificial 2015 -- EU NAVFOR MED / Mediterranean Sea ventilation. 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.

EMMS European Military Medical Services  2018 Almanc-2017-UB-11 18.01.17 15:21 Seite 127

Almanc-2017-UB-11 18.01.17 15:21 Seite 127 HONDURAS / HUNGARY

Almanc-2017-UB-11 18.01.17 15:21 Seite 127 Republic of Honduras HONDURAS / HUNGARY

HONDURAS / HUNGARY Capital:...... Tegucigalpa Area:...... 112Republic of Honduras 090 km² Population:...... 8 500 000 Capital:...... TegucigalpaRepublic of Honduras Official Language:...... Spanish Area:...... 112 090 km² ArmedPopulation: ForcesCapital: Personnel:...... 8...... Tegucigalpa...... 20 500 000 000 Official Language:Area:...... 112...... Spanish 090 km² Armed ForcesPopulation: Personnel:...... 8...... 20 000 500 000 Official Language:...... Spanish Armed Forces Personnel:...... 20 000 Ministry of National Defence Surgeon General Colonia Florence José Luís Hernández Canales MinistryTegucigalpa of National Defence Surgeon General ColoniaHONDURAS Florence Colonel MC Ministry of National Defence José Luís Hernández Canales Tegucigalpa Surgeon General Colonia Florence Colonel JoséMC Luís Hernández Canales HONDURASTegucigalpa HUNGARY Colonel MC HONDURAS

23 RepublicRepublic of of Hungary Hungary Republic of Hungary Republic of Hungary Capital:...... Budapest Capital:Capital: ...... Budapest...... Budapest Area:...... 93Capital:...... Budapest 030 km² Area:Area: ...... 93 93 030 030 km² km² Population:...... 9Area:...... 93 944 000 030 km² Population:Population: ...... 9...... 9 944 944 000 000 Official Language:Population:...... Magyar...... 9 944 000 OfficialOfficial Language: Language: ...... Magyar...... Magyar Armed ForcesOfficial Personnel: Language:...... 26...... Magyar 500 ArmedArmed Forces ForcesArmed Personnel: Personnel: Forces Personnel:...... 26 ...... 26 26 500 500 500 Medical Officers:...... n/a MedicalMedical O fficers:Officers:Medical Officers:...... n/a...... n/a n/a Military Hospitals/Institutes:...... 8/3 MilitaryMilitary H ospitals/Institutes:Hospitals/Institutes:Military Hospitals/Institutes:...... 8/3 ...... 8/3 8/3 Missions:Missions:...... multipleMissions:...... multiple...... multiple Missions: ...... multiple

Ministry of Defence MinistryMinistryMinistry of Defenceof of Defence Defence SurgeonSurgeonSurgeon General General BalatonBalatonBalaton u. u. 7-11 7-11 u. 7-11 Surgeon GeneralDr István Kopcsó Balaton1055 Budapest u. 7-11 Dr István Kopcsó 1055 Budapest DrDr István István KopcsóBrigadier Kopcsó General 10551055 HUNGARYBudapest Budapest BrigadierBrigadierBrigadier General GeneralGeneral HUNGARYHUNGARYHUNGARY Basic Task of the Military Medical Service Structure Basic TaskThe Directorateof the Military of Medical Medical Force Health Service Protection and Medi-StructureIn order to unify the Hungarian Military Medicine, the Military BasicThe Task Directorate calof Authorities’the of MilitaryMedical responsibility Force Medical Health includes ProtectionService professional and Medi- controlInStructure orderHospital to unify – State the HungarianHealth Centre Military and theMedicine, Hungarian the Defence Military BasicThe Directoratecal Authorities’Taskand of of oversight Medicalresponsibilitythe Militaryof Forceaptitude includes Health and Medical occupational Protection professional fitnessand control Medi- tests forHospitalIn Forcesorder – toDr.State unify Radó Health Györgythe Hungarian Centre Military and Medical Military the Hungarian Centre Medicine, was Defence integra- the Military Servicecal Authorities’and oversightpersonnel responsibility of aptitude of the and Ministry includes occupational of Defence professional fitness and the tests control Hungarian for ForcesHospitalted, Dr. and Radó – a Statenewly György establishedHealth Military Centre structureMedical and Centreof the element, Hungarian was theintegra- Hun- Defence and personneloversightDefence of aptitude the Forces. Ministry andOther of occupational responsibilities Defence and fitness include the Hungarian testsexecuting for theted,Forces garianand a Dr. newlyDefence Radó established ForcesGyörgy Military Military structure Hospital Medical of element,started Centre its the work was Hun- on integra- personnelDefence of Forces.public the health MinistryOther serviceresponsibilities of and Defence epidemic include and safety the executing tasks Hungarian for the MoDgarianted,15th andDefence November a newly Forces 2011. established Military This military Hospital structure medical started of rationalization, element, its work on the Hun- The Directorateand ofHDF Medical personnel, Force exercising Health authorized Protection oversight and of public on the one hand, was part of the efforts of the Minister of Defencepublic Forces. health Otherservice responsibilities and epidemic safety include tasks executing for the MoD the 15thgarian November Defence 2011. Forces This Militarymilitary medicalHospital rationalization, started its work on Medicaland Authorities’HDF personnel,health and responsibility epidemiologicalexercising authorized includes issues inoversight theprofessional Hungarian of public Defence on theDefence, one hand, on the was other part hand, of the plays efforts an important of the Minister role in the of public healthForces, service operating and epidemic the HDF Public safety Health tasks and for Epidemiological the MoD 15thorganization November process 2011. that This was military started in medical the public rationalization, health in health and epidemiological issues in the Hungarian Defence Defence, on the other hand, plays an important role in the controland HDF and personnel, oversightService and exercising of performing aptitude authorized complex and occupational hygiene-relatedoversight of publicfit duties- in on2011. the one hand, was part of the efforts of the Minister of Forces, operating the HDF Public Health and Epidemiological organization process that was started in the public health in nesshealth tests and for epidemiologicalthe personnel HDF. The Directorate of theissues Ministry coordinates in the ofHungarian professionalDefence Defence and psycholo- Defence,Joining together on the the other organizational hand, plays and coordinationan important tasks role as in the Service andgical performing work in the complexHDF, conducts hygiene-related accreditation dutiesprocedures in for2011.well as the medical support, the Military Hospital which is theForces, Hungarianthe HDF.operating The Defence Directorate the HDF Forces. Public coordinates Other Health professionalresponsibilities and Epidemiological psycholo- in- Joiningorganization together processthe organizational that was and started coordination in the public tasks ashealth in Service and furtherperforming vocational complex training hygiene-related at the units, provides duties psychologi- in 2011.now directly subordinated to the Chief of Defence Staff fulfils cludegical executing workcal in training the HDF, public for conducts personnel health accreditation nominated service andfor proceduresmissions, epidemic and for assis-well theas theresponsibilities medical support, in the fieldthe Militaryof military Hospital medicine which arising is the HDF. The Directorate coordinates professional psycholo- Joining together the organizational and coordination tasks as safetyfurther tasks vocational forting the them MoD trainingduring and their at HDF the sustained units, personnel, provides operations exercising psychologi- and re-adapta- now fromdirectly NATO subordinated and international to the agreements, Chief of Defence planning Staff and fulfils exer- gicalcal work training intion. the for HDF, personnel It carries conducts outnominated aptitudeaccreditation for testsmissions, andprocedures and assessment assis- for inthewell responsibilitiescising as controlthe medical over in the the support, execution field of theofmilitary complex Military medicine medical Hospital tasksarising whichin is authorizedfurtherting vocational them oversightprocedures during training their of of publicsustainedsecond at the instancehealth units, operations providesforand those epidemioloand appealing psychologi- re-adapta- -againstfromnowcollective NATO directly and defence, internationalsubordinated peacekeeping agreements, to the and Chief humanitarian planning of Defence and opera- exer- Staff fulfils gicalcal training tion.issues It infor carriesaptitude the personnel Hungarian outand review aptitude nominated decisionsDefence tests for of Forces, andmissions,first instance. assessment operating and assis- in cisingthetions. responsibilitiescontrol over the execution in the field of complex of military medical medicine tasks in arising theting HDF proceduresthem Public during ofHealth theirsecond sustainedand instance Epidemiological foroperations those appealing andService re-adapta- against and collectivefrom NATO defence, and international peacekeeping agreements, and humanitarian planning opera- and exer- aptitude and review decisions of first instance. tions. performingtion. It carries complex out hygiene-related aptitude tests duties and assessmentin the HDF. in cising control over the execution of complex medical tasks in procedures ofALMANAC secondMilitary instance Medical for Corpsthose Worldwide appealing – Edition against 2017 collective defence, peacekeeping and humanitarian127 opera- The Directorate coordinates professional psychological aptitude and review decisions of first instance. tions. work in the HDF, conducts accreditation procedures for ALMANAC Military Medical 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 for personnel nominated for missions, the public health in 2011. ALMANAC Military Medical Corps Worldwide – Edition 2017 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 Hospi- pealing against aptitude and review decisions of first in- tal which is now directly subordinated to the Chief of De- stance. fence Staff fulfils the responsibilities in the field of military medicine arising from NATO and international agree- Structure ments, planning and exercising control over the execution 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 De- fence 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 peo- nalization, 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 European Military Medical Services 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 Jus- tice 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 re- cians, air controllers), paratroops, divers and hang-gliders. gional basis. The Institute provides single-day surgery and outpatient surgery hours for the claim ant service personnel and Besides maintaining the appropriate defence capabilities their relatives. The Aviation Medicine Research Section of Hungary, the health care of the Hungarian population conducts scientific research in close cooperation with is in the focus that the Military Hospital wishes to solve the Aviation and Space mMedicine Department of the with the Semmelweis Plan. The Semmelweis Plan is the Szeged University of Science. reform of the Hungarian healthcare system, as a result of which Hungary has been divided into 8 regions since 30 The Scientific Institute – Budapest November 2011. Each region provides healthcare services for 1-1.6 million people, and a centre responsible for the The Institute conducts basic and applied research into organization of local healthcare services was established chemical, biological, radiological and nuclear (CBRN) in every region. The Military Hospital has been chosen by weapons and medical CBRN protection in the field of TH the medical government as one of the hospitals which biomedical science. It applies and broadens the specialist 6 DIMIMED is responsible for one region. The doctors of the Military knowledge and develops the applied research methods. Hospital administer a range of special treatments. One of The HDF MMC Scientific Institute is in charge of surveying INTERNATIONAL CONFERENCE ON DISASTER the strengths in the special character of the institution the patterns related to the use of drugs and psychotropic is the comprehensive traumatology, neurotraumatology chemicals and also of conducting regular screenings for AND MILITARY MEDICINE and burns therapy, which is a priority in the HDF and also the HDF service personnel. As a prioritized field of re- in disaster medicine. As one of the most important emer- search, it has recently launched ma project on developing NOVEMBER 13-14, 2018 gency care centres in Hungary, the Military Hospital plays a DNA-based personal identification system which will a key role in providing treatment for acute cardiac arrests ensure exact identification of victims. and strokes. In addition to outpatient and inpatient therapy, the institute conducts high-level educational ac- Medical Training Base – Budapest tivity and scientific research. The chronic and rehabilitation therapy is provided at five extramural institutions The training and certification programs conducted at the around the country. base cover the planning and implementation of basic-level and advanced (MOS) medical training programs for Institute of Aviation Medicine, the professional and contract personnel as well as for the Military Fitness and Research – civil servants. Furthermore, the Base is responsible for running medical training and certification courses for the Kecskemét HDF troops declared for crisis management and peacekeeping operations, and certifying the medical specialists The Institute is responsible for conducting activity in the of the HDF. The medical training courses are aimed at field of aviation medicine, military aptitude tests, outpa- providing basic and MOS training for the personnel and tient surgery hours, single-day surgery and scientific re- providing the personnel preparing for some special MOS search projects. It performs aviation aptitude tests for (rescue divers, EOD troops) with special medical training. civilian pilots, pilot candidates, ground crews (techni- The base offers special trainingm to the professional and

EMMS European Military Medical Services  2018 www.dimimed-duesseldorf.de HUNGARY contract personnel specializing in medical MOS as well as Mercedes G-270 is a military all-terrain motor vehi- 25 medical training for the units and staff officers nominated cle designed for transporting casualties. The bandaging for NATO- and EU-led response and stand-by forces and container provides mobility and infrastructure for treat- missions abroad. ment administered in accordance with the medical care techniques (protocols) meeting the standards of ROLE-1 Field Deployments and ROLE-2 NATO-compatible medical organizations.

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 European Military Medical Services EMMS www.dimimed-duesseldorf.de Almanc-2017-UB-11 18.01.17 15:22 Seite 152

LITHUANIA / LUXEMBOURG

2. Air Forces Medical Support Unit Air Forces MSU : • Role 1 functions, • 24/7 search and rescue team work; • aeromedical evacution with fixed-wing aircraft.

3. Naval Forces Medical Support Unit Naval Forces MSU: • Role 1 functions; • support on ships: • divers medical care: • hyperbaric therapy.

Role 3 and Role 4 medical support is provided at Lithuanian civilian hospitals.

Role 2 LM

LUXEMBOURGMedical Support Units Group Role 2 LM Grand Douchy of Luxembourg Grand Douchy of Luxembourg Capital: ...... Luxembourg Area:Capital: ...... Luxembourg 2 586 km² Population:Area: ...... 2 ...... 586 km² 502 066 OfficialPopulation: Language:...... 502 ...... 066 Luxembourgish, Official Language: ...... Luxembourgish, German, German, French French Armed Forces Personnel: ...... 900 Armed Forces Personnel: ...... 900

Service Médicale Centre Militaire Service Médicale Centre Militaire SurgeonSurgeon General General B.P.166 B.P.166 CyrilleCyrille Dupont Dupont MD MD 9202 Diekirch 9202 Diekirch MajorMajor MC MC LUXEMBOURG LUXEMBOURG

Basic Task of the Medical Service comprehensive, i.e. it must cover preventative as well as The Medical Service is responsible for the medical care of Thecurative Chief care, Military both in Dentalterms of careOfficer of individual is in charge and of ofcom- the Basicarmy Task personnel of theon active Medical service. This Service is understood to be munity medical care. Dental Section. The Medical Service is responsible for the medical care of army personnel on active service. This is understood to The Chief Military Psychologist is in charge of the 152 ALMANAC Military Medical Corps Worldwide – Edition 2017 be comprehensive, i.e. it must cover preventative as well Psychology Section. as curative care, both in terms of care of individual and of community medical care. The Chief Military Pharmacist is in charge of the Pharmaceutical Section. The Medical Service is required to be operational both in its permanent form at the Military Hospital and when on The Physiotherapy Section is managed by a graduate in national or international deployments. physiotherapy.

The Medical Service carries out medical examinations of Qualified non-commissioned nursing officers are candidates applying for a career in the Armed Forces, as responsible for providing “nursing care”, organise the well as annual medical examinations for Army personnel preparation of medical units for exercises or other on active service. The Medical Service is responsible for missions, carry out medical training and manage the the medical training of its Para-medics and other person- medical facilities of the Medical Service. nel, as well as of other Army personnel. Non-medical non-commissioned officers manage the Structure administration of all non-medical aspects of the Medical Service. The Medical Service is divided into Sections: • Medical Section Soldiers who have trained voluntarily as Paramedics • Dental Section are available to assist in the reception of patients into • Psychology Section Medical Service units, to support military activities on the • Pharmaceutical Section ground and they also take part in the life of the unit. • Physiotherapy Section Soldiers who have volunteered as secretarial auxiliaries Medical Service Staff assist in managing the secretarial services and administration of the unit. The Chief Military Medical Officer commands the Medi- cal 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.

EMMS European Military Medical Services  2018 Almanc-2017-UB-11 18.01.17 15:22 Seite 174

NETHERLANDS THE NETHERLANDS Kingdom of the Netherlands 27 Kingdom of the Netherlands

Capital:Capital: ...... Den...... Amsterdam Haag Area:Area: ...... 41 41 543 543 km² km² Population:Population: ...... 16...... 17.000.000 768 736 OfficialOfficial Language: Language: ...... Dutch...... Dutch ArmedArmed Forces Forces Personnel: Personnel:...... 37 ...... 41 900 400 MedicalMedical O fficers:Officers: ...... 280...... 280 MilitaryMilitary H ospitals/Institutes:Hospitals/Institutes:...... 2/6 ...... 2/6 Missions:Missions: ...... multiple multiple Ministry of Defence Ministry of Defence P.O.P.O. BOX BOX 90004 90004 SurgeonSurgeon General MPCMPC 55A 55A Johan de Graaf MD MPH DMCC 3509 AA Utrecht Remco Willem Blom 3509 AA Utrecht Brigadier General MC THE NETHERLANDS Commandeur (Rear Admiral) THE NETHERLANDS

Basic Task of the Military Medical Service • To provide operational medical care at Role 1 to 4, support command Army. The medical battalion consists of 4 Basic(aero)medical Task of the evacuation, Military and preventive Medical medicine in the Theinterservice operational operational Role 1 medical and 2 companies.assets are Thisdecentralised battalion field. has the possibility to deploy 8 Role 2 facilities for sustained Service and under full command of ARMY, AIR FORCE, NAVY and • To provide in individual healthcare including dental care MARECHAUSSEEoperations or can (MILITARY combine thisPOLICE). capability for a high level and physiotherapy for NLD military personnel. threat operation not only for the Army but for Airforce or • To •provide To provide operational in occupational medical healthcare care forat NLDRole military 1 to per-4, NAVY as well, including afloat. The battalion also has centra- (aero)medicalsonnel. evacuation, and preventive medicine in Thelized NLD Role Armed1 capabilities Forces for Inspectorgeneral support: of Military aid posts, Health- medi- the• field. To educate military healthcare professionals. carecal transport(IMG) and holding. At company and battalion level • To monitor the overall quality of military healthcare. there are medical staffs that can be used as such and there • To •provide To advise in the individual NLD military healthcare and political including leaders indental military Theis also IMG a has separate a small medical staff staffand headedis responsible by a Staff for Surgeon. indepen- care healthcareand physiotherapy matters. for NLD military personnel. dentThe inspectionsArmy medical of services healthcare have arelated total strength matters, approxima- assets and • To provide in occupational healthcare for NLD military personnel.tely 1063 service They reportmembers. independently to the Ministry of Structure personnel.Centrally positioned healthcare elements Health,The NLD Welfare Royal Air and Force Sports.has aviation medical capabilities for • To Defenceprovide Healthcare rehabilitation Organization care for NLD military person- aeromedevac tasks, holding and general capabilities for Role nel.Consisting of ten centrally organized health service providers 1 support of Air Force deployable units. There is a limited and a staff. The organization has a personnel strength of OperationalSAR capability for domesticMedical tasks Services (in cooperation with the • To abouteducate 1 200 and men train and military women andhealthcare provide healthprofessionals. services for Navy). At the HQ Air Force level is a separate medical staff • To allmonitor the branches and continuously of the forces in improve the Netherlands the overall and abroad.qua- Theheaded Royal by Netherlands a Staff Surgeon. Army The hasAir Force medical medical personnel services in- lityThe of militaryservices includehealthcare. for example first line healthcare, dental corporatedhave a total within strength their of approximately 3 brigades (11140 AirMobileservice members. Bde, 43 care, central hospital capability, blood provision, clinical • To specialistadvise the teams NLD military for deployment, and political medical leaders logistics, in mili and- ArmouredThe NLD Royal Bde andNavy 13has Light maritime Bde). Eachmedical brigade capabilities has a dedi- for taryinitial healthcare education matters. for medical personnel. catedtheir medicalvessels, companyincluding a with Role assigned 2 facility Roleaboard 1 assets. an amphi- There The Commander of the Defence Healthcare Organization is arebious a total transport of 3 supportbrigades ship. with Furthermore, 3 brigade the medical NLD Royal com- also the Surgeon General. Marines have available Role 1 capabilities for amphibious Structure panies.operations. All Role At HQ 2 assetsNavy level are there centralised is a separate in a singlemedical service staff The Inspector of Military Healthcare NLD Armed Forces (IMG) managementheaded by a Staff unit Surgeon. residing The under Navy medical Army servicescommand, have thea Centrallyhas a positionedstaff of 5 and healthcare is responsible elements for independent inspec- 400total Medical strength Battalion off approximately (SSM 400 120 MedBn). service members. Above brigade tions of health related matters. Defence Healthcare Organization level,The NLDSSM Royal 400 MarechausseeMedBn is incorporated (military police) withinhas the a sepa-Army’s Command Medical Services operationalrate medical support staff 5 personnel command headed brigade. by aSSM Staff 400 Surgeon. MedBn The DefenceEach branch Healthcare of the ArmedOrganisation Services consists has it’s of own ten medical cen- consistsThey have of no5 interservice dedicated medical medical personnel companies. to support This mili-batta- service: tary police (operations). trally organised healthcare providers and a staff. The or- lion has the possibility to deploy 4+4 Role 2 facilities for ganisationThe NLD employs Royal Armyapproximatelyhas medical 1350 personnel men and incorporated women sustainedMilitary Hospitals operations or can combine this capability for a and provideswithin the healthcare manoeuvre servicesunits. Each for brigade all the has branches a dedicated of highThe threat-levelCentral Military operation Hospital (CMH)not only is located for the in Army Utrecht but and for medical company with additional Role 1 assets assigned. In has approx. 30 regular beds. All regular in-patient and out- the forcestotal there in the are 3Netherlands brigades with and 3 brigade abroad. medical The companies.services Airpatient Force specialisations or Navy as well are available(including within Role the 2 militaryAFLOAT). hos- All includeOne first of these line companieshealthcare, is dental air assault care, withcentral an additionalhospital medicalpital or unitsobtainable can provide from the personnel collocated to University augment Hospital medical capability,field dressing rehabilitation, station incorporated. blood provision, Above clinicalbrigade levelspecia- there taskUtrecht. forces, The Medcell, Central Military PECC’s, Hospital etc. There in conjunction is a separate with medi the - is a medical battalion incorporated within the operational university hospital also provide a (sheltered) Disaster Hospi- list teams for deployment, medical logistics, and initial cal staff at Army HQ, headed by the Army Staff Surgeon. education for medical personnel. The commander of the The Army medical services have a total strength of approx- Defence Healthcare Organisation is also the Dutch Sur- imately 1100 service members. 174 ALMANAC Military Medical Corps Worldwide – Edition 2017 geon General.

 2018 European Military Medical Services EMMS NETHERLANDS

28 The Royal Netherlands Air Force has aviation medical tion with the university hospital, also provides a (shel- capabilities for AEROMEDEVAC and STRATEVAC tasks, tered) major incident hospital with a capability of 200 beds. holding capabilities for Air Force deployable units. There This major incident hospital also has quarantine facilities is casualty station capacity within their casualty staging available. This hospital is a unique capability within the units (CSU) and they have search and rescue (SAR) assets Netherlands and can be operational within 30 minutes. for domestic tasks (in cooperation with the Navy). There is This hospital concept has proven its worth over many a separate medical staff at Air Force HQ, headed by the Air years for disaster relief and major incidents. Force Staff Surgeon. The Air Force medical services have a total strength of approximately 140 service members. The Military Rehabilitation Centre The Military Rehabilitation Centre is located in Doorn and The Royal Netherlands Navy has maritime medical ca- has capacity for 80 inpatients and a number of outpa- pabilities for their vessels (Role 1 and ART). Role 2 capa- tients. The centre also receives civilian patients and has bility can be stationed on the prepared facilities of the state of the art training facilities at its disposal. It also has 3 Dutch Joint Support ships. The Role 2 facilities will be its own orthopaedic workshop. manned and equipped by SSM Role 2 of the SSM 400 MedBn and surgical capacity from the Defence Health- Institutes care Organisation. Expert Centre of Expertise for Military Health Furthermore, the Dutch Marine Corps has Role 1 capa- Tasked with: bilities for amphibious operations available and can • Knowledge management on health related issues; rely on landbased Role 2 support from SSM 400 MedBn. • Providing advice on specific subjects as food and water There is a separate medical staff at Navy HQ, headed by hygiene, radiation, micro-biology, pharmacy, disease the Navy Staff Surgeon. The Navy medical services have control, public health, etc.; a total strength of approximately 120 service members. • Coordination of medical testing and research.

The Royal Netherlands Marechaussee (military police) Knowledge Centre for Medical Service. has a separate medical staff, headed by the Marechaus- Tasked with: see Staff Surgeon. They have some dedicated medical • Medical skills lab training at group level; personnel to support military police operations but will • Support of medical training in the field; be mainly supported by the commands they are deploy- • Support of requirement and procurement of medical ed with. 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.

Sports and Training Medical Centre Tasked with: Central Military Hospital • Individual medical examinations; The Central Military Hospital is located in Utrecht and has • Applied research in the field of physical exercise; approximately 30 regular beds. All regular inpatient and • Providing advice regarding the physical stress of outpatient specialisations are available within the mili- soldiers in the field. tary hospital or obtainable from the collocated University Hospital Utrecht. The Central Military Hospital, in conjunc-

EMMS European Military Medical Services  2018 NETHERLANDS

Defence Medical Training Institute 2007-2011 KFOR: Role 3 specialist team; 29 All military medical personnel attend the IDGO for initial 2012 Kunduz: Role 1 and contribution with a military medical education and training. This institute is Role 2 medical team; focussed on the military application of healthcare. 2012-2014 Afghanistan Kunduz: Role 1 and contri- butions with a Role 2 medical team; Institute for Defence and Partnership Hospitals 2013-2014 BMDTF (Patriot) Turkey: Role 1 MTF; The Dutch Armed Forces have a unique concept to gene- 2014- ongoing MINUSMA Mali: Role 1 MTF and rate surgical capacity from the civilian market. By formally Aero Medevac; partnering with civilian hospitals, the Armed Forces pay 2015 MH-17: deployment of Role 1 MTF, for additional personnel at civilian hospitals. During pe- Role 2 MTF and identification teams; riodical placements, they train civilian personnel with a 2016- ongoing 1 (NLD)CBMI: training support mission military reserve status and utilise pre-planning and con- IRAQ mission, R1 MTF; tracts in order to use these teams for missions and trai- 2016- ongoing Enhanced Forward Presence (eFP) ning purposes. Baltic States: integrated Role 1 assets; 2016- ongoing Ocean Shield, European border patrol: A small staff residing directly under the Defence Health- integrated Role 1 assets; care Organisation ensures ‘just in time’ and ‘just enough’ Ongoing Numerous ongoing missions with a surgical and medical specialists for exercises, missions small tailor made medical footprint and operations. In addition, medical services support various exercises throughout the world. Number of Medical Service Personnel The total strength of NLD medical service members International Cooperation is approximately 2800 men and women, consisting of The Dutch armed forces are very internationally orien- approximately 950 civilian and 1860 military personnel. tated and have several cooperations with other nations, Qualified physicians approx. 220 including international healthcare elements. The main Medical officers (non physicians) approx. 200 effort is focussed on further cooperation and synchroni- Qualified dentists approx. 50 sation with all NATO-countries and specifically with Ger- Pharmacists approx. 10 many, Belgium, Luxemburg, United Kingdom, Canada, Qualified physiotherapists approx. 60 Norway and the United States of America. Nurses (non commissioned officers) approx. 600 Medical assistants and medical supporting personnel Civil-Military Cooperation (soldiers/corporals) approx. 400 The NLD Military Medical Service highly depend on sup- Field Deployments port by the civilian healthcare organisations. Specialist teams are recruited and deployed by a specific military Recent deployments include: agency and specialist medical personnel support mili- 2003 Central Afghanistan Kabul: tary medical education and training as reserve officers Role 2 deployment; and reserve non commissioned officers. The interaction 2004-2005 SFIR Iraq: Role 1 and Role 2 deployment; with the civilian sector will increase even more as we North Afghanistan Pol-E-Khomri: strive to ensure the required medical quality. This will be Role 2 deployment; achieved by embedding military medical personnel in 2006 NRF 5 Pakistan: Role 2 for humanitarian civilian healthcare organisations for periodical training. assistance; 2006 Exercise RECAMP Cameroon Africa: medical assistance programme; 2006-2010 ISAF South Afghanistan Uruzgan: Role 1 and Role 2 deployment; 2006-2010 ISAF South Afghanistan: Aeromedevac and holding capabilities; 2006-2011 ISAF South Afghanistan Kandahar: Role 3 specialist team;

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NORWAY NORWAY NORWAY Kingdom of Norway KingdomKingdom of of Norway Norway

Capital:Capital:...... Oslo ...... Oslo...... Oslo Area:Area:...... 385 ...... 385 385 170 170 km² km²km² Population:Population:...... 5 ...... 5...... 5 267 236236 146 826826 OfficialOfficial Language: Language: Language:...... Norwegian ...... Norwegian...... Norwegian ArmedArmed Forces Forces Forces Personnel: Personnel: Personnel:...... 24...... 24 ...... 25 000 450 Homeguard:MedicalHomeguard: Officers:...... 45...... 45 ...... 250 000 MedicalMilitaryMedical Officers: Hospitals/Institutes: Officers:...... 48...... 48 ...... 0/4 Military Hospitals/Institutes:...... 0/4 MilitaryMissions: Hospitals/Institutes: ...... 0/4 multiple Missions:...... multiple Missions:...... multiple

Armed Forces Medical Service SurgeonSurgeon General General Armed Forces Medical Service SurgeonDr Jan Sommerfelt-PettersenGeneral 2058Armed Sessvollmoen Forces Medical Service Dr RearJan Sommerfelt-Pettersen Sommerfelt-PettersenAdmiral MC 2058NORWAY2058 Sessvollmoen Sessvollmoen Rear Admiral MCMC NORWAYNORWAY

Basic Task of the Military Medical Service The NAFMS provides medical policy and guidelines for all The vision of the Norwegian Armed Forces Medical Services military medical activity across the four service branches BasicBasic TaskTask of of the the Military Military Medical Medical Service militaryThe NAFMS medical provides activity medical across the policy four and service guidelines branches for all (NAFMS) is: (Army,(Army, Navy, Navy, AirAir ForceForce and and Home Home Guard). Guard). The NAFMS ge- ServiceThe vision of the Norwegian Armed Forces Medical Services Themilitary NAFMS medical generates activity specialized across medical the fourcapacities service for branchesuse (NAFMS)“Ad Militiae is: Valetudinem” neratesin(Army, support specialized Navy, of land Air seaForce medical and and air Home capacitiesoperations Guard). foras needed.use in support These The vision of the Norwegian Armed Forces Medical Ser- ofcapacities landThe NAFMS sea and aim generates air to operations either specialized reinforce as needed. service medical branchThese capacities capacities medical for use “Ad Militiae Valetudinem” in support of land sea and air operations as needed. These vices The(NAFMS) basic taskis: of the Norwegian Armed Forces Medical Servi- aimsupport, to either or provide reinforce national service capacities branch medicalin a tri-service support, set- or ces (NAFMS) is to protect, maintain and restore the health of ting.capacities One example aim tois strategic either reinforce medical evacuation. service branch Another medical The basicNorwegian task militaryof the Norwegian service personnel. Armed Forces Medical Servi- provideexamplesupport, national is ora Role provide capacities 2 enhanced national in medical a tri-servicecapacities treatment setting.in a facilitytri-service One for ex- set- ”Adces Militiae (NAFMS)NAFMS develops Valetudinem“ is to protect, national maintain military and medical restore concepts, the health doc of- ampleuseting. in is supportOne strategic example of the medical serviceis strategic evacuation.branches medical or available Another evacuation. for example over- Another Norwegiantrines and military procedures. service It personnel.generates medical treatment facili- is seasaexample Role deployment. 2 enhanced is a Role The 2 medical MTFenhanced system treatment medicalcomponents facilitytreatment are modular.for facilityuse in for ties for use at home and for deployment overseas. It provides This provides a high degree of flexibility in capacity and size TheNAFMS basic develops task of thenational Norwegian military Armed medical Forces concepts, Medical doc - supportuse in ofsupport the service of the branches service branches or available or available for overseas for over- trinesmedical and procedures. evacuation andIt generates force health medical protection treatment for the facili- Nor- dependingseas deployment. upon mission The requirements.MTF system components are modular. wegian Defence at home and overseas. The NAFMS further provides a number of other specialized Servicesties for use(NAFMS) at home is andto protect, for deployment maintain overseas. and restore It provides the deployment.This provides The a highMTF degreesystem of components flexibility in capacityare modular. and size healthThe of NAFMS Norwegian is commanded military by service the Surgeon personnel. General, NAFMS who has Thismedical, provides dental a highand veterinary degree ofservices flexibility in support in capacity of all ser- and medicalthe overall evacuation responsibility and force for healthNorwegian protection Armed Forces for the Medi- Nor- vicedepending branches upon at home mission and overseas. requirements. developswegiancal PolicyDefence national and at is militaryhome the senior and medical overseas. medical concepts, advisor to doctrinesthe Chief of sizeThe depending NAFMS further upon providesmission requirements.a number of other The specializedNAFMS andThe procedures. NAFMSDefence. is commanded It generates by medical the Surgeon treatment General, facilities who has furtherStructuremedical, provides dental a and number veterinary of other services specialized in support medical, of all ser- the overall responsibility for Norwegian Armed Forces Medi- vice branches at home and overseas. for use at home and for deployment overseas. It provides dental and veterinary services in support of all service cal Policy and is the senior medical advisor to the Chief of medicalDefence. evacuation and force health protection for the branchesStructure at home and overseas. Norwegian Defence at home and overseas. The NAFMS is commanded by the Surgeon General, who has the overall The NAFMS is commanded by the Surgeon General, who responsibility for Norwegian Armed Forces Medical Policy has the overall responsibility for Norwegian Armed Forces and is the senior medical advisor to the Chief of Defence. Medical Policy and is the senior medical advisor to the The NAFMS provides medical policy and guidelines for all Chief of Defence.

Structure

180 ALMANAC Military Medical Corps Worldwide – Edition 2017

EMMS European Military Medical Services  2018

180 ALMANAC Military Medical Corps Worldwide – Edition 2017 NORWAY

Field Deployments

Role 2 Medical Treatment Facilities In the last decade NAFMS has deployed MTF to Afgha- nistan (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. Somalia 1992 – 1994 Main Missions (medical units) Bosnia-Herzegovina 1992 – 1998 Korea 1951 – 1954 FYROM 1993 – 1994 Egypt/ Gaza 1956 – 1963 Sudan 2005 Congo 1960 – 1963 Afghanistan 2003 – Peru 1970 MERO 2 Afghanistan 2006 – 2012 Lebanon 1978 – 1998 Chad 2009 – 2010 Saudi–Arabia 1991 Mali 2014 – Iraq/Kuwait 1991 – 1992 Iraq 2015 Iraq 2017 –

 2018 European Military Medical Services EMMS 20171107_210x297_EMMS.indd 1 Best protectionandmobilityforabroadmissionspectrum EAGLE Family Defense Solutions fortheFuture

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