gullThe goal is to help as many people as possible without saturating or blocking the channel.”
The importance of strengthened collaboration between civil and military actors and the improvement of medical skills are also crucial elements.
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During this exercise, the medical component therefore deployed three types of medical installations on the ground. These are two advanced care stations called Role 1where first aid is provided, from a field hospital Role 2 Basicspecialized in war surgery, and a new innovative structure, the Role 2 Forward. The latter, designed to be quickly transported and installed, makes it possible to offer surgical care directly near the front line.
The importance of the information channel
Currently in the testing phase, this structure helps improve resource availability and should soon be deployed in the field.
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“Each patient must follow the medical chain correctly, and the information must arrive without delay or error. When we are told of the arrival of a patient, it is essential that we are immediately informed of their condition. The information channel is fundamental. What we do on the ground must be documented and transmitted, like a medical file. Everything is based on pragmatic choices. The objective is to help as many people as possible without saturating or blocking the chain. traffic jam in the transmission or management of care could slow down the critical care of another patient, confides Doctor Boghaert, military doctor and head of Role 1 during the exercise, that is to say the advanced medical post responsible for forward medicine. We mainly focus on pre-hospital medicine, where every second counts. And here, everyone speaks the same language, it must go quickly, but above all be efficient”.
Lieutenant-Colonel De Smet, responsible for the Green Light exercise, highlights the evolution of threats on the modern battlefield.
“Lessons learned from the conflict in Ukraine show that war is now dominated by the massive use of drones. These devices represent a constant threat, targeting not only medical infrastructure, but also means of evacuation and healthcare personnel.
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There is a kind of drone war, with a constant threat and targeted attacks, so all of this is included in our scenarios. This leads to an increased risk of casualties and significantly lengthens evacuation times. The objective is therefore to prepare our staff to work under pressure, with very tight evacuation deadlines, or even delayed due to tactical constraints. They must therefore be able to provide the best possible care, even in extreme conditions.“. All in a context where Arizona should properly arm SkyGuardian drones.
Training is calibrated to reflect on-the-ground realities
In Ukraine, field experience also highlighted a brutal reality: in the face of constant attrition, it is crucial to get soldiers back into fighting condition as quickly as possible. “The pressure is enormous to send the wounded back to the front, while taking into account their vital stateexplains Doctor Boghaert. We are talking here about war medicine where every minute counts, and where the balance between recovery and operational necessity is constantly evaluated.“.
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The most common injuries are those caused by artillery, shrapnel, drone or missile strikes. “We often see patients thrown by an explosion, hitting obstacles or being burned. It is on these types of injuries that our training scenarios focus, explains the doctor. Drawing on returns from the Eastern Front and other recent conflicts, such as in Israel, training is calibrated to reflect the most likely realities.”.
Faced with these multiple challenges, the ability to care for a large number of injured people simultaneously therefore becomes crucial. “We must adapt our training to varied environments, explains it Lieutenant Colonel De Smet, abandoning traditional tents for locations such as buildings, basements or even trenches”.
Medical training also includes scenarios simulating communications outages, power outages, and even cyberattacks, in order to prepare personnel to intervene in realistic tactical conditions. “These elements strengthen our capacity to adapt to increasingly complex crisis situations. I think we can go even further in the tactical aspect. We could integrate several medical teams in even more advanced scenarios, combining complex tactical elements This would allow more units to be involved while perfecting our medical scenarios.
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The Medical Component is recruiting at all levels
Doctor Boghaert specifies that in terms of medical resources, the capacities deployed are almost equivalent to those available in Belgium. “The objective is to get as close as possible to the level of care that a patient could receive in Belgium, even if we know that in a war situation, there are tactical or strategic imperatives which can influence our choices“. He insists that the objective remains to provide the best possible care, which requires constant training, suitable equipment and efficient logistics.
“We already have a structure in place, trained and functional. But if, after that, we encounter blockages, it will not work,” he adds. He emphasizes the importance of being able to manage an influx of patients. “If reception capacity is not adequate, this will pose priority management dilemmas”. The system must be able to accommodate a constant flow of wounded, and it is this capacity that is taking concrete shape.
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However, the Medical Component faces a major challenge: lack of staff. “We need doctors, including emergency doctors, anesthetists and specialist surgeons, but also qualified nurses in various fields, specifies Lieutenant-Colonel De Smet. These human resources are crucial to maintaining our operational capacity and effectively responding to needs on the ground.”.
Doctor Boghaert discusses the difficulties linked to reconciling personal and professional life: “Many of these roles require availability which affects the family. My biggest challenge is learning to say no. I love what I do, but we also have to understand that we are individuals with limits”.
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He points out that the training of military doctors takes a considerable time and that attrition is particularly marked during this period. “Training a military doctor is a long and demanding process, and the shortage of human resources further accentuates this problem, he emphasizes. But it is clear that we are seriously lacking operational doctors. Recruitment needs are high, particularly for certain key positions. The pressure generated by this lack is significant, and we observe a phenomenon of attrition, where people hesitate to commit to very demanding roles, which require great flexibility, an ability to adapt and constant management of the stress”.
