From October 2013 until June 2014, Brigadier General Dr. Bernd Mattiesen, German Medical Service was the last Medical Advisor at HQ ISAF in Kabul in the rank of a flag officer. His tour of duty was impressed by the declining strength of the Force and a more civilian attitude of the task.
The UN - Resolution 1386 might be seen as the initial ignition for the establishment of the ISAF mission in Afghanistan. The then given task was to assist the legal government of Afghanistan (later “GIROA”: Government of the Islamic Republic of Afghanistan) and provide security over the country. In the first years of the mission ISAF was restricted to ... more
Report: Lt Col N T Tarmey RAMC, Maj C L Park RAMC, Lt Col M Fox RAMC, Lt Col T Lowes RAMC, Surg Cdr A Mellor Royal Navy, Col P F Mahoney L/RAMC
The aim of this article is to share our recent experience of deployed military anaesthesia with the international community. In the United Kingdom Defence Medical Services (UK-DMS) we have recently completed a major revision of our Clinical Guidelines for Operations (CGOs). These guidelines aim to provide practical, concise guidance for deployed ... more
Article: Herron, JBT; Hay-David, AGC; Gilliam, AD; Hodgetts, TJ.
Since the London Bombings on 07/07/2005, terror attacks have made a resurgence in Great Britain: with 122 terrorism related attacks and 42 deaths in 2017 (1), and, a tactical shift towards the targeting of civilians in marauding terrorist attacks or vehicle based attacks (2). When a terrorist incident occurs, the police cannot guarantee the safety of any ... more
This paper discusses the emerging concept of Continuous Improvement in Healthcare Support to Operations (CIHSO) recently introduced within NATO. It starts by summarising the developments in NATO policy regarding clinical governance and how this has evolved into CIHSO before examining the operational aspects of CIHSO within the Plan-Refine-Execute (PRE) ... more
The University of Pécs Medical School in Hungary developed the cooperation between military and civilian medicine as an ongoing issue. The Medical University provided much-needed theoretical backup to practice oriented military medicine. The university supported basic/introductionary training courses for young doctors enrolled into the compulsory national ... more
Article: EUROPEAN MILITARY MEDICAL SERVICES (EMMS) 2019
We are pleased to present to you the announced 2nd edition of the EUROPEAN MILITARY MEDICAL SERVICES.
After the publication of the first edition last year, we received a lot of positive feedback for our decision to accompany the allied European Military Medical Services in their efforts to come closer together. This has further spurred us on, and now you can follow the current developments. ... more
In 2007, the Canadian Armed Forces established a working group to consider new and innovative approaches to mental health training and education in the CAF, and was given the task of developing, delivering and evaluating mental health education across the spectrum of Canadian Forces audiences, including Canadian Forces members’ families. ... more
This article reflects on the Canadian Forces Health Services Group initiative on attraction and retention of military medical health care personnel.
The ability to attract high quality people and subsequently retain experienced military practitioners remains the primary aim of this strategic plan. ... more
What have we Learnt from Operation HERRICK in Afghanistan?
Medical Force Protection (Med FP) measures are important in mitigating morbidity and mortality in deployed forces. Historically, Disease Non Battle Injury (DNBI) accounts for significantly more morbidity than traumatic injury. However, how successful have we been in implementing such measures in Afghanistan? The author who conceived and undertook 3 Med FP ... more
Organophosphate-type nerve agents (e. g. tabun, sarin, soman, cyclosarin, VX) are among the most toxic synthetic compounds known so far. Organophosphate intoxication causes an excess of the neurotransmitter acetylcholine by inhibition of the acetylcholinesterase that normally reduce the activity of acetylcholine. The following study gives an insight in the ... more
Article: Peter Zimmermann, Christian Fischer, Thomas Thiel, Christina Alliger-Horn
From the German Armed Forces Centre for Military Mental Health (Psychotrauma Centre) of the Bundeswehr Hospital Berlin
Participating in a military operation abroad is for many soldiers an experience that will shape their lives. During the months spent outside Germany, soldiers gain many different impressions, for example as a result of the close bonds that form in the camps – not least with soldiers from other nations – but also through contact with the local culture ... more
This article is designed to provide a short summary for medical personnel with limited military experience to understand how the medical staff function works within a military headquarters. It places planning military health services support in the context of wider planning for military operations. It starts by examining the Contemporary Operating ... more
Report: Diana Elisa Gomes Correia, José João Baltazar Mendes
The epidemiological association between PD and DM results from a direct causal relationship in which the complications of DM act as modifiers of the expression of PD and vice versa. The aim of this study is to investigate the influence of DM2 in the development of PD in a Portuguese
population. Patients are followed in the Armed Forces Hospital by the ... more
From the CAF perspective, a stratified risk matrix was formulated by the Directorate of Medical Policy/Medical Standards, which balanced an acceptable level of risk to the health and safety of CAF personnel, whilst taking into consideration the potential unavailability of an appropriate level of medical care required, due to operational situation. The ... more
Report: S. M. Eagan Chamberlin, MPH PhD (United States of America)
Moral Dilemmas, the Physician-Soldier & the Problem of Dual Loyalty
Being a physician-soldier can be an ethically and morally complicated job. While the moral obligations of physicians are usually oriented towards the health and well being of their individual patients, military health professionals may encounter situations in which ethical tensions arise between their responsibilities to individual patients and those ... more
This article will discuss and review the role of the Nurse Practitioner (NP) within a Role One, deployed Defence health facility,build on international evidence whilst supporting the utilisation of NPs in the RAAF Health Service and subsequently more widely in the greater Australian Defence Force (ADF). This article will provide somepractical evidence ... more
Report: H. Frickmann1, D. Sturm2, E.-J. Finke (GERMANY)
As experience from the most recent crisis regions in the Middle East (Gaza, Lebanon, Iraq, Syria), in Central Africa (including the Democratic Republic of the Congo and Mali) or in Afghanistan very clearly prove, asymmetric warfare will determine the nature of military conflicts in future. The Medical Service must be prepared for this development too. In ... more
In the previous NATO Trauma Registry publication of the MCI Forum in 2012, the author summarized the history of the initiative. Now the project has been delivered to the second phase with more involvement of the project participating nations. Allied Command Transformation (ACT) and NATO Centre of Excellence for Military Medicine (MILMED COE) have been ... more
Article: W. HUSSAIN, A. M.KHAN, M. Z. ALI, A. RASHID, A. IKRAM (PAKISTAN)
African Trypanosomiasis is a serious public health problem in certain regions of Africa. Many cases remain undiagnosed due to lack of diagnostic facilities. The disease is curable; fatal if untreated. We report a middle aged African individual with nonspecific symptoms diagnosed as a case of African Trypanosomiasis. ... more
Hypobaric and hyperbaric changes can trigger extreme states of pain in the human body. This article focuses on the phenomenon of barodontalgia, describing its pathophysiology and providing suggestions for preventative measures and approaches to treatment based on patient cases.
The article highlights the issue from a strategic point of view and does not go into details of its operational and tactical aspects. MCIF readers get a short introduction, background and the main requirements for a comprehensive approach to integration of military and civilian medical capabilities, using competence as a driving factor, within one organization, under military management.
The authors intend to generate discussions that can contribute to development of recommendations how to approach integration of civilian and military medical capabilities within one organization. These recommendations will inevitably go beyond national aspects of integration efforts, defining the appropriate level of interaction between the political, ... more
In the MCIF issue 1/2010 an article was published called “Multinational Approach in Medical support to NATO Operations”. In this article the author, Col Dr Fazekas, explains the need for multinational cooperation and the definition of standards for Multinational Medical Units to ensure minimum quality requirements. This need resulted in the development of the AMedP-27, the NATO Medical Evaluation Manual and the promulgation of its covering STANAG 2650 in 2010.
In a following article from the same author, Col Dr Fazekas describes the design and conduct of the pilot Medical Evaluation (MEDEVAL) Course. In the meantime two medical exercises were evaluated, the MEDEVAL course had evolved tremendously and the preparation for four major international evaluation and certification projects were ongoing. The magnitude of ... more
Report: J. PERALBA, J. COUCEIRO DE MIGUEL, V.N. GAVILÁN (SPAIN)
War and combat has served for centuries as an engine for research, progress and as an experimental ground to test theories and hypothesis. Some advances and conclusions were the result of just observations or casual events and others the result of specific scientific research geared for war or just applications of scientific knowledge in other fields of the combat arena. This has also been the case in the medical field.
At the 2002 NATO Summit still under the impression of the terror attacks in the United States, decisive capability gaps were
shown to exist within NATO. Among other issues, warnings were raised about the lack in capability for the near-real-time (NRT)
detection of disease outbreaks and the determination of whether these outbreaks are to be attributed to the use of biological
weaponry or to natural causes. Since 2003, under the lead of NATO Allied Command Transformation (ACT), existing capabilities
and systems of NATO partners have therefore been identified and examined as to their suitability for operational use in NATO