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Ukraine

Capital: KyivArea: 603 . 700 km2Population: 45 . 593 . 000Official Language: UkrainianArmed Forces Personnel: 129 . 950Medical Officers: 2 . 140Military hospitals / institutes / schools: 26 / 1 /
Map
Portrait

Surgeon General
Eduard Khoroshun MD
Colonel MC

Chief of Central Military Medical Directorate
of the Armed Forces
Povitroflotskii Prospect 6
03168 Kyiv
UKRAINE

Vision
The basic ways of medical support system restructuring of
Ukrainian AF will be:
• implementation the organizational-structural transformations
in a health protection measures which will directly
improve medical support in companies, battalions and brigades;
• optimization of military-medical establishments’ quantity
according to the AF needs and improvement of medical
support by territorial principle;
• material and technical basis development for medical service
and supplying it by modern technics and equipment
samples;
• preventive medicine support orientation
in troops by sanitary-and-epidemiologic
supervision strengthening of
their day-to-day service;
• implementation of centralized medical
logistic system and medical service’s
deliverance from excessive and unusable
medical equipment and technics.

Basic Task of the Medical Service
• Medical support of troops combat training;
• Maintenance of high combat and mobilization
readiness of medical personnel
and resources;
• Selection of healthy and fit personnel
for Ukraine Armed Forces;
• Applying medical measures for keeping
and strengthening personnel health;
• Medical support of Ukraine peace -
keeping contingent;
• Maintenance of sanitary and epidemiologic
well being of troops;
• Providing medical care and treatment to different patients
with the right to health care services within military treatment
facilities;
• Providing troops with medical equipment, accumulation
and storage of medical property for special period;
• Training of military medical personnel;
• Providing combat and special training of medical personnel;
• Military-medical training, popularization of hygienic knowledge
and healthy life;
• Scientific solution of medical support issues in peace and
wartime.

Photo


Military Medical Command Structure
Military medicine support management in Ukraine Armed
Forces has: three-level system of administration (Military
Medical Directorate of MoD of Ukraine → Military Medical
Clinical Centres → Military medical facilities, units and subdivisions);
with 3 managerial infrastructures (1 – Treatment
and Prophylactic; 2 – Sanitary and Hygienic; 3 – Medical
Logistic).

Military Medical Service / Military Hospitals
Ukraine has historically had a large and essentially static
armed forces’ medical service. This care is provided through:
• The Main Military Medical Clinical Centre (Kyiv);
• 4 Regional Military Medical Clinical Centres (Vinnitsa,
Odessa, Lviv, Kharkiv);
• Military Medical Clinical Centre for Occupational Pathology;
• 14 Military Hospitals;
• 3 Policlinics with day-inpatient treatment and one Stomatological
Policlinic;
• 6 Military Physician Commissions (1 Central and 5 Regional);
• Blood Support Centre (Kyiv);
• Central Laboratory of Morbid Anatomy (Kyiv).
• 9 Rehabilitation Centres and Sanatoria (2 of them are
State Enterprises);
• 1 Sanatoria Sector within Regional Military Medical Clinical
Centre (Vinnitsa).

The total capacity of these establishments is over 11,000
beds. Over one million active duty service personnel, reservists,
retirees, veterans, civilian employees and dependents
are getting service in these structures. There are five deployable
medical hospitals (forming from MTF of Regional Military
Medical Centres) capable for both ground deployment with
organic vehicles and air movement primarily designed for
using within its own borders.

Photo

Treatment and Prophylactic

At the beginning of 2016 the Curative-prophylactic support
system includes:
• The National Military Medical Clinical Center (Kyiv);
• 4 Regional Military Medical Clinical Centers (Vinnitsa,
Kharkov, Lviv, Odessa);
• Military Medical Clinical Center of Occupational Pathology
of Ukrainian Armed Forces (Irpin);
• 15 Military Hospitals;
• 4 Mobile Hospitals;
• 2 Outpatient Clinics (including one Stomatologic Clinic in
Kyiv);
• 5 Military Medical Examination Commissions (1 Central
and 4 Regional);
• Blood Center (Kyiv);
• Central Laboratory of Morbid Anatomy (Kyiv);
• 3 Rehabilitation Centers and Sanatoria («Puscha-Vodytzya
», «Khmil'nyk», «Truskavets»);
• Sanatoria Sector of Military Medical Clinical Center of Central
Region (Vinnitsa).
• 9 departments of psychological rehabilitation have been
created on the bases of the Military Medical Clinical Centres
and Spa treatment and rehabilitation Centres.

The total bed capacity of Military Hospitals and Spa treatment
facilities are 6230 beds and 1400 beds.
The curative-prophylactic system is based on territorial principles
(zones of responsibility), with a range of medical treatment
facilities:

1) The National Military Clinical Hospital provides wide
scope of specialized medical care,
2) 4 Regional Military Medical Clinical Centers and Military
Medical Clinical Center of Occupational Pathology of
Ukrainian Armed Forces provide specialized medical care,
3) 15 Military Hospitals provide inpatient medical care.

There are medical services of 4 Commands (“Land-forces”,
“Air forces”, “Airborne forces” and “Navy”) in direct medical
subordination of Central Military Medical Directorate of
Ukrainian Armed Forces.
Motorized, heavy, airborne brigades have medical companies
providing first physician aid and emergency qualified
medical care by surgeons and therapeutics. The first medical
aid, first physician aid which are equal to Role 1 and Role 2
are covered by medical services of companies, battalions
and brigades.

Sanitary and Epidemiologic Service of Ukraine MoD is a
structural part of State Sanitary and Epidemiologic Service
and includes:
• Sanitary and Epidemiologic Governance of Ukraine MOD;
• Sanitary and epidemiologic detachments (regional and
territorial);
• Sanitary and epidemiologic laboratories.
Basic activities of Sanitary, Hygienic and Antiepidemic Support
of Ukraine Armed Forces are:
• State sanitary and epidemiological control;
• Determining priority measures in disease prevention as
well as in healthcare from harmful impact of environmental
factors;
• Analysis, assessment and prediction of servicemen health
indexes in dependence on life activity, environment factors
having harmful impact on their health;
• Preparing proposals on providing sanitary and epidemiologic
well-being of servicemen, on preventing dissemination
of extremely dangerous (as well as quarantine) infectious
diseases;
• Taking control over elimination of reasons and conditions
of onset and spreading of infectious, mass non-infectious
diseases, poisoning and radiolesions;
• State registration of infectious and occupational illnesses
and poisonings.

Medical logistic is provided on the territorial basis. It consists
of the Logistics Department, within the structure of Military
Medical Directorate, the central, regional and territorial
medical stores, the pharmacies of the base and garrison
military hospitals and other military treatment facilities.
Medical equipment for medical subunits and military medical
facilities is purchased on the centralized basis through
the mechanism of tendering of Ukraine Ministry of Defence.
Medications and consumable medical materials (dressing,
syringes, blood transfusion systems etc.) are bought in on
the centralized basis. Military medical facilities receive funds
allocated by authority to buy medicines independently.

The Advantages of National Military Medical Clinical Centre
(MMCC):

• Military medical service administration in the area of responsibility;
• Arranging and providing medical selection, control, hygienic
and antiepidemic protection, psychophysiological training
of servicemen;
• Providing highly- specialized medical care;
• Maintaining permanent readiness of mobile formations;
• Organization and performance of treatment and evacuation
measures.

Photo

Red Star Order National Military Medical Clinical Centre
“Main Military Clinical Hospital” is the oldest and largest
state hospital in Ukraine. It is a historical and legal successor
of the Kiev Military Hospital, which was established by
the Senate Health Office Decree on the 10th of June 1755. It
takes an important position in the wide web of military
health care facilities because it is the most versatile multiclinical,
medical diagnostic and research centre, which
works for the treatment of military personnel, military service
veterans, dependents and employees of the Armed Forces
Ukraine. The centre also provides the medical care for the
service personnel of other force structure, the civilian population
according to the relevant conditions. The Centre table
of organization and equipment consists of: 22 clinics (over
40 departments) Laboratory Diagnostics Clinic, Functional
Diagnostics Department, modern Radiation Therapy Diagnosis
Clinic and 4 Resuscitation Departments. The hospital is
designed for 1000 beds. Every year more than 30 thousand
patients treated in hospital and almost half a million
patients receiving outpatient medical care, over 10 thousand
complicated surgical operations is performed. The hospital is
equipped with modern diagnostic and therapeutic medical
equipment such companies as: “Siemens”, “Shimadzu”,
“General-Electric”, “Kobas Myra”, “Olympus”. Among them:
angiograph (performed stenting), mammography, digital
tomography, 2 MRI, “Kardiomahskan” magneto-cardiographic
laboratory, “Millennium” Ophthalmological multifunctional
system produced by Bousch-Lomb American company,
modern lithotripter – apparatus for the kidneys stones crushing,
ureters without surgery. Almost each department is
equipped with “Logic”, “Aloka” modern ultrasound diagnostic
apparatus, as well as echocardiography is widely used.
The “Teratron-780S” apparatus for radiation treatment of
cancer has been effectively used in many years.
45 research conferences were conducted on the hospital
base annually. Many doctors and nurses have great experience
in medical assistance during peace operations in different
countries of the world: Yugoslavia, Lebanon, Liberia,
Iraq, Serra Leone, Afghanistan.
It constantly involved in medical support of senior state officials
of foreign countries’ visits, military parades, international
exercises, verification etc.

Regional Medical Facilities
The level of the primary and first medical care, Role 1 and
Role 2 within the armed forces is covered by Regional Military
Medical facilities of companies, battalions and brigades.
The Role 1 medical units – battalion aid stations as an integral
part of the military units, mainly perform tasks within the
area of medical training and medical support to military exercises.

Specializations of other Regional MMCC:
• MMCC of Western Region – neurosurgery, gastroenterology
and emergency medicine;
• MMCC of Central Region – cardio surgery, gastroenterology,
pilot medical examination, special trainings for aircraft
personnel;
• MMCC of Northern Region – traumatology and orthopaedics;
• MMCC of Southern Region – ophthalmology;
• MMCC of Occupational Pathology of Servicemen UAF –
alternative medicine, occupationally caused diseases
treatment.

Number of the Medical Service Personnel
The total strength of Ukraine medical service is 14658 personnel
(≈ 60 % are civilians).

Training
The system of military-medical education has been legally
established in Ukraine. The system functions in full accordance
with the current the State legislation standardized
credentials and privileges. It is closely integrated into the
State system of medical education as its specific and organic
component.

PhotoThe structure of military medical personnel.

The Ukraine Military Medical Academy (UMMA) is an independent
training, research, methodical and information centre
of military-medical service.

Photo

The main tasks of UMMA fall into six categories:
1. Postgraduate medical education. It is realized through 2-
3-year internship combining with primary specialization.
The latter includes many basic specialties: general practice,
general surgery, internal medicine, anaesthesiology,
stomatology, pharmacy, epidemiology, hygiene, etc. This
stage of physician training is normally completed with a
State certification, which is equivalent to the license in the
Western system of medical education.
2. Selected training on 2-3-year magisterial course for talented
graduates. This course is a combination of clinical training
and research, and if the candidate passes the complex
examinations successfully, he will receive a magister
diploma and a medical specialist certificate.
3. Postgraduate (each 5 years) advanced training courses
lasting 1-3 months, with a 1-month pre-course exercise,
followed by an examination. These course was set up to
confirm existing or to get higher a physician qualification
degree. Therefore, it is mandatory for each medical doctor.
4. Secondary or narrow specialization in one of the 106 military-
medical specialties (ophthalmology, urology, neurosurgery,
cardiology, etc.). To obtain a certificate in any of
these specialties, the candidate should pass through special
advanced course (10 months for a surgeon and up to
6 months for an internist and a preventive medicine
specia list) and a certifying examination, which is held at
the UMMA, the Main Military Clinical Hospital or one of the
medical departments of the operative commands.
5. Adjunct research (3-year study, a pre-admission and a
post-admission profile examination, preparation of a thesis).
This program is completed by defending a thesis at a
specialized scientific council of authorized institutes, universities
or academies, and a candidate of the medical
sciences degree (PhD) is obtained.
6. Courses for Doctor of Medicine are open to candidates of
the medical sciences who have at least five years served
as a physician or researcher. After completion of a 3-year
research program, the scholar has to defend his doctoral
thesis at an authorized specialized council.

Photo

The main research establishments are: the UMMA which
includes Research Institute of Military Medicine (RIMM); and
the MMMCH. Scientists at the UMMA are working on the
organization of medical support to the Armed Forces, medical
radiology and toxicology, improvement of the treatment
of patients and wounded, and pedagogic and educational
issues. The RIMM is the main executor of research on occupational
medicine, the organizational structure and management
of the medical service betterment, armament and military
engineering medical evaluation, fundamental research
of human psychophysiology at extreme condition and other
issues. The RIMM consists of 4 departments and 2 laboratories.
The MMMCH units and clinics serve as a base for UMMA
for the training of military physicians and research on the
organization of outpatient and hospital medical care, the
improvement of the quality of medical care and medical examination,
etc.

International Cooperation / Missions /
Field Deployments

International cooperation plays an important role in the realization
of the reform of the Ukraine Military Medical Service.
The primary topics for cooperation are:
a) studies of the experience of the military-medical support
system in NATO nations and in other leading western
countries in the following areas:
• optimization of the management structure of the medical
services;
• re-structuring of the military-medical service and optimization
of the organization structure of medical facilities;
• rational use of medical resources;
• quality control of medical care;
• introduction of new technologies in curative-diagnostic
process;
• improvement of the training of military medical personnel;
• practical use of military medical standards;
b) international research cooperation in:
• scientific support for the reform of the military health
system;
• joint research on military pathology and its influence
on troops combat readiness;
• joint development of the military medical doctrine;
• study of the incidence rates, prevention and control of
militarily relevant infectious diseases;
• development of countermeasures against biological
terrorism;
c) international humanitarian medical aid to Ukraine (medical
equipment, pharmaceuticals diagnostic means).

Ukraine cooperates with other nations on the following
issues:
• participation in joint exercises of multinational forces;
• participation in medical support of peacekeeping and
humanitarian missions of UN and NATO;
• arranging training of Ukrainian military physicians in NATO
training courses and in military medical facilities worldwide
(Germany, Poland, Republic of Lithuania, Russian
Federation, USA);
• participation of UAF medical representatives in international
scientific seminars, symposiums, conferences for
scientific and practical information exchange in working
groups specific studying topics of military health care;
• organizing bilateral and multilateral meetings of official
representatives from other countries to exchange experience
in medical support of troops (forces) and international
peacekeeping contingents, to discuss issues on
mutual compatibility of medical care standards.
In 1991–2011 more than 300 medical officers of Ukraine
Armed Forces participated in peacekeeping missions in Liberia,
Lebanon, Iraq, Sierra Leone, Kosovo. 12 servicemen served
as peacekeeping personnel in military contingents of
other countries. Role 1 and Role 2 Medical Treatment Facilities
have been developed and successfully function in the
medical support system according to NATO standards:
Photo • Military unit aid station of national contingent in Kosovo
(Republic Serbia);
• Military unit aid station of Ukrainian peacekeeping contingent
(as a part of 56 separate helicopter group of UN Mission)
is functioning in Liberia;
• Military unit aid station of Ukrainian peacekeeping contingent
(as a part of separate helicopter group 18 of UN Mission)
is functioning for stabilization in Congo Republic.
However, the capabilities of role 3 level are based only on
human resources – 6 doctors-peacekeepers as a part of ISAF
in Islamic Republic Afghanistan. They are deployed within
the Lithuanian PRT for reconstruction of the Afghani province
Ghor (2 surgeons and 1 anaesthesiologist) and within the
Polish PTR in the Afghani province of Ghazni (1 surgeon,
1 anaesthesiologist, 1 therapist).
Medical care for Ukrainian peace-keepers in NATO or UN op -
erations is performed by medical personnel of medical subdivisions
(first-aid stations) that are the structural elements
of the Ukrainian national contingents, (which is equal to
Role 1 NATO standards) in other cases medical
care (Role 1) can be given in the nearest medical subdivisions in
another participating countries. Role 1 medical care in medical
subdivisions is performed according with the medical
personnel qualification and medical equipment
and contains the measures of the first, premedical and first
medical aid and stomatological aid.


The servicemen, after receiving medical aid in medical sub -
divisions of level Role 1 depending on severity of wound/of
illness, are head for the Role 2 and 3 military field curative
establishments in the theatre of military operation by a
senior chief command using territorial principle.
In case of the protracted treatment necessity and high-spe -
cialized medical aid necessity the servicemen are evacuated
to Military Medical Clinical Centres of MOD (Level 3 and 4).
During 2013 year 44 medical positions is staffed as follows:
annually (- 6 military physicians in peacekeeping contingents
of other countries (Lithuania, Poland) in Islamic Republic
of Afghanistan; - 4 positions of national contingent in
Kosovo, Republic of Serbia;) twice a year (- 10 positions in
56 separate helicopter detachment (in UN mission in Liberia);
- 9 positions in 18 separate helicopter detachment (in
UN stabilization mission in Democratic Republic of Congo
since February 2012)).

Photo Photo Photo Photo

One MEDEVAC aircraft An-26 “Vita” (2 medical teams included,
unit is manned at 100% in peace time and selfsustain
ing for 5 days without host nation support) is ready
in 30 days to deploy from home station. It is implicated in
EU multinational combat tactical group “Baltiys’ka”.

Photo

Civil-Military Cooperation
Medical treatment establishments of MOD are partially integrated
in the national public health system providing emergency
medical care to the civilians and medical support in
disaster situations. Moreover, Military Hospitals and Medical
Rehabilitation and Sanatorium Treatment Centres provide a
paid high-specialized medical service and rehabilitation to
the civilians. In wartime the capabilities of the civilian health
system are incorporated into the military medical service.
The Ukraine Military Medical Academy serves as a retraining
and education facility both for military and civilian specialist,
even from other countries.

Other Special Aspects
The quarterly scientific and practical journal – “Military Medicine
of Ukraine” and annual scientific digest – “Problems of
Military Health Care” were founded by Ukraine Military Medical
Academy in 2000. There are Herald and Annual Scientific
Digest “Modern aspects of military medicine” published by
the Main Military Medical Clinical Centre.