Croatia, Republic of
Dr Boris Zdilar
Basic Task of the Military Medical Service
The tasks of medical service in CAF are: force health protection in general (combining physicians, specialists, dentists and veterinarians), medical care of servicemen, medical examinations (especially of pilots, divers and SOF servicemen) and medical support for all kind of military activities including deployed missions.
The Military Medical Service is organized as a part of logistic & medical support system following decisions delivered through national strategic defence documents. In addition, Croatia has so-called “integrated” National Medical Healthcare System; except Role 1 capability covered by military medical service, higher levels of requested capability are provided by civilian healthcare system.
Comprehensive medical support in CAF is organized and harmonized as unique functional system based on the principles of Medical Support in CAF, essential doctrine document, delivered in accordance with relevant national regulations and NATO reference publications. Structural organization is presented through four levels, as follows.
MOD level – The Medical Service Department is responsible for planning process and for coordination of comprehensive activities related to integration of civilian and military medical capabilities in order to fulfil national target capabilities.
GS level – MEDAD with his Staff Officers has central authority for implementation national target capabilities related to medical support area and provides all necessary plans, guidelines, directives and others medical-relative documents to subject units.
Component level – The Support Command has authority to provide logistic and medical support on the second level and its main medical support provider is The Military Medical Centre.
Unit level – The structure of logistic units includes medical platoons, Role 1 capability, responsible to provide medical support in Guardian Brigades of Armed Force, as well as in Naval and Air Force Bases.
Military Medical Centre
Due to fact that Croatia has no military hospitals, the Military Medical Centre is a main military medical facility in CAF, responsible for primary healthcare, preventive medicine protection, veterinarian healthcare, specific healthcare and occupational medicine provided by specialized medical experts. Its organizational structure integrates Primary Healthcare Department, Veterinary Department, Preventive Medicine Department, Role 2 Command and two institutes: Aerospace Medicine Institute and Naval Medicine Institute.
The Aerospace Medicine Institute, located in Zagreb (Picture 1), provides medical examinations for the military and civilian aviation staff and the Naval Medicine Institute, located in Split (Picture 2), provides medical examinations for maritime staff and special force divers. Both institutes have Occupational Medicine Departments, capable to provide medical examinations for servicemen who participate in military operations and missions abroad (NATO, UN, EU, etc.). In coordination with Air Force, the Aerospace Medical Institute organizes Aeromedical Evacuation Course one or two times per year. Finally, the Naval Medicine Institute organizes a Hyperbaric and Diving Medicine Courseand is capable to provide HBOT using own stationary hyperbaric chambers, full equipped and supported by hyperbaric expert medical teams.
Medical Service Personnel
Professional medical service personnel consist of MD, dentists, veterinarians, pharmacists, nurses and medical technicians. In civilian hospitals and institutes we have various specialized military medical experts of occupational medicine, epidemiology, ENT, ophthalmology, physical medicine, surgery, orthopaedics, gynaecology, psychiatry, internal medicine and dermatology, including aerospace and hyperbaric medicine.
Specialized training for military medical personnel, as well as for non-medical personnel, is provided by Military Medical Training Facility within the Centre of Logistic Doctrine and Training. The facility is developed and specialized primary for “first responders” training, known as Combat Lifesavers (CLS) - soldiers who are capable to care casualties during combat situation in “Platinum 10 Minutes”. Therefore, a two-weeks-long CLS Course is developed as part of pre-deployment training process, needed for selected participants in ISAF operation.
Currently, the facility provides Basic Life Support Course for military medical personnel, as well as “train the trainers” and ATLS courses, in order to maintain and improve skills and medical practice of the personnel, including selection of instructors required for training process (Picture 3.). In accordance with long-term planning process, BATLS Course will be developed and organized within the facility.
The medical platoons at Role 1 level provide medical support for units in coordination with Regional Military Medical Clinics which are responsible for providing primary health care to servicemen in barracks, training fields, naval and air force bases. Their medical personnel is involved in medical preparation for the units such as training soldiers in first aid and field hygiene, as well as training in evacuation of casualties from battlefield.
For the purpose of medical evacuation, we use ground wheeled vehicles (ambulance) and armoured evacuation vehicles “Patria” (Picture 4.) and HAGA. The Air Force provides Forward AE capability using rotary wing assets (Picture 5.).
In accordance with long-term planning process, Role 2 Command has been established as a part of Mil Med Centre in order to develop Role 2 LM MTF required for mission deployed medical support.
In CAF, all candidates for military operations and missions abroad must be volunteers, medical personnel as well. Pre-deployment training process goes through the above mentioned military medical courses, including three-weeks-long medical practice at emergency departments in civilian hospitals and clinical centres.
Qualified deployable medical personnel have gained a lot of experience participating in following operations and missions abroad:
2003 – on-going ISAF/RS
2008 – 2013 UNDOF
2010 Nordic EU BG
2012-2016 EU BG
Civil-Military Cooperation is based on the Memorandum of Mutual Cooperation signed by Ministry of Health and Ministry of Defence Republic of Croatia in accordance with the national concept of “integrated” healthcare system. The memorandum enables involving military medical system into Croatian Medical CIS – “CEZIH” providing a direct approach to all necessary services and capacities of the national healthcare system. Furthermore, all military medical personnel have opportunity to be educated in civilian clinical centres and hospitals as medical care specialists.
For the purpose of emergency air medical transport, the military system provides rotary wing assets with flight crew and military medical teams for HEMS to the civiilan health-care system (in accordance with the special memorandum).
During possible crisis situations on the national level, the military medical system will be included into national crisis response forces led by The Crisis HQ of Ministry of Health.