With the emergence of new security equations following the Cold War, there has been a growing need to provide the highest levels of protection for military units operating in various conflict zones. This trend has been further reinforced by the development of offensive technologies aimed at undermining the confidence of these units and preventing them from carrying out their assigned tasks. Even before this development, which has been gradually confirmed since the early 1990s, safety in the broad sense of the word was one of the fundamental components of military work and one of its basic functions.
Moreover, the increasing confidence of military personnel supports health and logistical coverage and constitutes a positive factor at the psychological level when the military situation requires direct or indirect comprehensive confrontations. Advanced medical care and rescue measures are considered a key element of the comprehensive logistical mechanism and its practical applications, given the role of health services, unlike other moving entities within the same combat environment. War has proved that medical support is one of the necessities for maintaining combat efficiency and morale among individuals participating in battles.The purpose of field medical care is to save the wounded and maintain the morale of individuals by stopping bleeding, and relieving pain so that the fighter can return to the front lines after receiving medical care.
Differences between military and civilian doctors:
Civilian doctors graduate and work in civilian hospitals, the Ministry of Health, and private clinics, while military doctors hold military ranks after graduation and work in military hospitals.
Civilian doctors have complete freedom to advance in their profession by obtaining numerous certificates from foreign countries and the ability to travel at any time and work anywhere, unlike military doctors who are bound by the rules of the military institution throughout their service.
Civilian doctors are evaluated based on their experience and reputation in their speciality, while military doctors are evaluated based on the rank they have obtained as a result of their professional development.
This raises the question: What are the other non-medical qualifications that military doctors should possess?
Military doctors require other qualifications in addition to their civilian medical qualifications as they need to be able to treat patients in the field with very limited equipment.
While no army has the resources to train someone to become a fully qualified doctor, the military can provide a doctor with the necessary additional training to qualify them for specific tasks during combat and military service in general.
Such training should include familiarizing the new doctor with military formations and basic tactics so that they can make appropriate decisions regarding the situation and move first-aid stations at the battalion level, as well as field ambulances, field hospitals, and other medical means while understanding how all these things fit into the military structure.
Furthermore, military doctors have to know the means of evacuating injured soldiers from combat zones and the problems associated with them.
Moreover, military patients and casualties of battles require surgical operations, not just ordinary medical treatment like that provided to patients in civilian life, thus military doctors must have a surgical experience that exceeds the experience they gain from practising medicine in the civilian field.
Soldiers may fight in the jungle or desert areas and become infected with unfamiliar diseases from unfamiliar countries, this requires that military doctors take short courses on medicine in tropical areas.
It may also be necessary to train doctors in the art of leadership in a military college before they can lead a medical unit, whether in the barracks or combat zones.
Tasks of medical services in modern armies
The treatment approaches for injuries in modern armies generally focus on the following:
Contributing to maintaining the basic health of military personnel and providing medical support to those who are entitled to treatment, whether military or civilian, in the fields of preventive medicine, diagnosis, treatment, hospital services and medical tests.
Promoting health education within the military.
Monitoring the environmental situation and working on its protection within military units.
Monitoring epidemics within the armed forces, studying related preventive programs and implementing and monitoring them in coordination with the relevant departments under the Ministry of Health.
Supervising food analysis in laboratories.
Adopting regulatory measures to provide health support for the units belonging to the three armies, administrations, and joint services, in accordance with their specificities.
Preparing medical intervention plans during disasters and military operations and taking the necessary measures to implement them.
Training individuals and field medical units in the field of health support for the military during disasters and military operations.
Preparing programs related to the procurement of medical equipment and pharmaceuticals, providing health supplies within the armed forces, and monitoring the maintenance of medical equipment.
Ensuring the preparation of individuals in medical and semi-medical specialities, including organizing scientific and military medical conferences.
The medical service corps in any army is responsible for caring for the wounded and patients until full recovery. Therefore, educating all members of the armed forces about the principles of first aid is essential, thus this education must be an integral part of the training curricula for recruits, regardless of their speciality.
Soldiers must be aware of the danger of anyone suffering from nervous shock due to burns or severe bleeding. Therefore, every soldier must carry a first aid kit, and in isolated areas, they should have a bottle of painkillers with them. They should be able to bandage a wound, splint a limb, or perform resuscitation when necessary.
Advanced Field Medical Care
Military medicine serves as the medical arm of modern armies, providing direct medical assistance to military personnel in the field during national emergencies.
The field military medical leadership is responsible for providing combat health services to support the tactical element of the forces, in addition to providing technical education and training for members of the Medical Service Corps.
Modern armies have focused on establishing military schools for health sciences to help train their members, improve their efficiency and performance, and achieve the highest possible level of self-sufficiency while ensuring the utilization of available training programs, capabilities, and competencies whenever possible.
The training opportunities are provided to all members, especially trainers, and the distribution of training opportunities is fair and based on the needs and focus on developing the required skills while considering time and effort.
These goals can be achieved and have been implemented through the following programs:
Development of the Training Authority Efficiency Program.
Clinical Competence Program.
Officer Development Program in Training Curriculum Development.
Trainer Development Program in Medical Terminologies.
Clinical Competence Program Practical Training.
Trainer Development Program in Chemical Defence.
The Preparation of preparatory courses for leadership exercises to gain experience.
Furthermore, it is vital to nominate individuals for administrative courses, as well as for practical nursing and automated systems courses, to acquire the latest skills.
The Medical Battalion
Based on the above, the medical battalion must employ its evacuation and medical units to support manoeuvre brigades that provide most of the combat health service support elements.
Medical evacuation units receive injured cases and sort them before providing emergency medical care until they are evacuated to a larger healthcare facility.
These units perform medical evacuation for patients, injured and wounded from military medical units to mobile field hospitals or any other fixed medical facility.
The units also provide medical treatment and evacuation according to location, to ensure that no soldier is evacuated before receiving treatment.
Through its medical statistics section, the battalion provides second-class medical supplies and maintains medical equipment to support all medical units in the area of operations.
Military Medical Support Organization
When organizing medical support in the field, treatment methods developed over the years should be taken into consideration, along with advancements in medicine and treatment methods.
The first principle of those methods adopted by most modern armies is to treat the wounded in medical centres close to the combat areas as much as possible so that the wounded can return to their units after recovery, or be safely transported to the interior using approved evacuation routes according to the severity of the injury.
The second principle, known as “surgery within six hours,” has been proven worldwide and is based on the fact that injuries requiring surgery, which represent the majority of field injuries, have a better chance of recovery if treated within six hours of occurrence.
Furthermore, it has also been generally proven that patients who undergo major surgeries cannot be safely moved for a period ranging from 7 to 10 days.
In this context, we must mention two principles: The first principle requires surgeons to work in advanced combat zones, which makes it difficult to obtain the necessary equipment in front-line areas.
The second principle allows for surgery in areas farthest from the front line, where conditions are more favourable for surgeons, and the unit does not have to move around a lot according to the needs of the battle.
These circumstances required the development of a solution, so as a compromise “medical support lines” were established, the first of which is linked to the unit and is based on the field medical aid centre managed by a doctor with the rank of officer, with the help of a few assistants.
The second medical support line runs between military formations, while the third line includes field hospitals at the army level, to be established in the areas where the army operates, but behind the rear areas of the units.
While the fourth line includes all state hospitals and military medical bases.
War hospitals
Modern army units design and produce shelters and tents for use in potential battlefields as mobile field hospitals, depending on the weather conditions and climate factors, and have succeeded in manufacturing rooms and tents that function as mobile field hospitals that can be expanded and extended according to need and situation development.
Turning a shelter into a successful field hospital requires basic elements and advanced means to provide the required isolation between rooms, and to ensure excellent and permanent conditions of cooling, ventilation, heating, and sometimes maintaining constant temperature levels.
However, achieving those requirements effectively can sometimes pose additional challenges in certain environments such as tropical, desert, or in locations where temperatures vary between day and night.
Based on the multiple-purpose characteristics of tents, one tent can accommodate up to three hundred patients after expansion.
Field hospitals, regardless of their independent form, size, or scope, must include all high-tech medical equipment, especially those that allow for surgical procedures or placing the patient under observation or in an intensive care unit, and therein lies the qualitative difference between evacuation and rescue means, such as helicopters, boats, ambulances, and field hospitals.
Advanced ambulance vehicles
Modern armies have adopted high standards in equipping ambulances dedicated to transporting casualties during military operations, such as adopting an armour ratio according to the standards of armoured troop carriers, although this is often done at the expense of vehicle space.
Furthermore, these vehicles must be equipped with anti-mines protection, and perhaps for these reasons among others, some ground forces have resorted to converting outdated tanks into a type of ambulance vehicle due to their high protection characteristics.
Thus, it is clear that there must be a wide range of complementary services to medical equipment, as there are multiple mechanisms that complement each other, to provide forms of transport and support for health purposes that are suitable for modern combat and security scenarios.
In recognition of this aspect and its increasing importance, the armed forces are working to provide their own security and avoid adverse consequences.●
» By: Dr. Moeen Ahmad Mahmoud (Military and Strategic Researcher)