Germany (Army), Federal Republic of
Dr med Dirk-Friedrich Klagges
Surgeon General of the Army
Prötzeler Chaussee 25
The Army Medical Corps
In the year 2000 the personnel of all medical corps of the branches of the armed forces were combined into the Bundeswehr Joint Medical Service. The only personnel who were left in the individual branches of the armed forces were those who have to enter into a close long-term relationship with the troops to be cared for in order to ensure their medical care.
Accordingly, the mechanised forces of the Army in the form of two divisions with three brigades each receive medical care on all levels during basic operations and when on assignment by forces Joint Medical Service. The mechanised divisions are supplemented by forces of the Rapid Response Forces Division (RRFD). This division controls an Airborne Brigade with two parachute assault regiments, three helicopterunits and the Special Forces Command (SFC). It brings together the skills of the Army, which are required for a rapid response, air mobility and for the execution of special and specialised operations. Owing to this special requirements profile, the RRFD has its own airborne and air-mobile medical forces on medical Role 1 level which ensures qualified initial general and emergency medical care during training, exercises and when on assignment.
Specialised Service Command Structure
The Surgeon General of the Army Commands the Army Medical Corps on behalf of the Army Chief of Staff and the Surgeon General of the Bundeswehr as a specialized service. At the same time he represents the interests of the Army with respect to the General of the Bundeswehr and vice versa.
The Surgeon General of the Army is located in the German Army Headquarters and advises the Army Commanders directly on medical service matters and those relating to the Medical Services of the Army. All Corps and Division Surgeons, the Flight Surgeon of the Army, the Army Medical Services Branch in the Army Concepts and Capabilities Development Centre and the Senior Medical Officer in the Army Training Command are technically assigned to him.
Medical Service in Headquarter Staffs
Medical service command and advisory elements (corps, division, brigade surgeons as well as Senior Medical Officers) are provided in the subordinate command authorities, as well as at the division and brigade level. They advise the respective commanders on all medical support matters and are responsible for the planning, control, coordination and monitoring of the measures for ensuring the deployment readiness and support services of the Medical Corps. As Senior Medical Officers they lead the medical service of the unit, which is technically assigned, to them during deployment. The Division and BrigadeSurgeons have an important interface function with the points of contact at theBundeswehr Joint Medical Service. This ensures that the specific interest and needs of the Army and theBundeswehr Joint Medical Service are mutually agreed and coordinated.
Medical Service of the Rapid Response Forces Division
The Medical Service of the RRFD is technically assigned to the Division Surgeon, who has a medical service staffdivision available to him for this purpose within the RRFD staff unit. The Special Operations and Specialied Forces of the Army are located in this division. The potential deployments of the RRFD are characterised in particular by a high degree of mobility, air mobility, a high level of threat, the bridging of large distances with an appropriate distance to their own troops, surprise, speed and secrecy.
The specific characteristics of Army Special Operations and Specialised Forces training, exercise and deployment are taken into account in medical services support, so that in the two paratroop regiments of the Airborne Brigade and in the SFC their own medical personnel are organically deployed to support the troops.
The two independent Airborne Medical Companies of the Paratroop Regiments are disciplinary and technically assigned to a Medical Staff Officer. They each have an airborne patient treatment platoon, two airborne rescueplatoons and their own Patient Evacuation Coordination Cell (PECC). The ability to parachute jump is an essential precondition in order to be able to follow without restriction the parachute regiments, which are to be supported in all deployment types/options. For this reason, both Airborne Medical Companies are fully capable to parachute jump.
The SFC provides personnel to carry out special operations such as hostage rescues. As a rule, such operations are carried out under conditions where it is not possible to rely on the existing medical infrastructure of the country in which the deployment is performed. The structure of medical service support in the SFC takes into account these framework conditions. In the SFC staff unit there is a Medical Services Department under the leadership of the SFC Command Surgeon. This department ensures not only the provision of advice to the leadership of the unit, but also the detailed planning of medical service support for special operations and the technical management of the organic medical personnel of the SFC. The SFC has a major medical clinic, which ensures not only medical care during basic operations, but also the provision of medical support for a wide range of deployment options up to Role 1 level during training and exercises.
Deployments of the Special Operations Forces of the Army receive medical support from air-mobile emergency physician teams and air-mobile medical teams, as well as airtransportable Role 1 facilities. An Air-Mobile Emergency Physician Team of the SFC consists of two Special Forces Senior NCOparamedics, an SFCemergency physician, and a driver. The Special Forces Senior NCOparamedics are fully trained both as commandoand paramedics. The SFC emergency physician is a Medical (Staff) Officer who is specializes in emergency medicine and SFC-specific infantry and other medical service training.
The option of being ready for deployment in special operations anywhere in the world is only made possible by the broad and in-depth training of everyone involved. The forces providing medical care must be aware of the effects of excessive heat in the desert, tropical conditions or extremely low temperatures in Arctic latitudes in the same way as they are acquainted with the clinical pictures and specific features of the respective climate zones.
The Aeromedical Service of the Army
The Aeromedical Service of the Army is under the technical command of the Flight Surgeon of the Army. His core tasks include aeromedical care for the flying units and flying training facilities at home and abroad, the provision of advice to the aeronautical supervisors and the planning and organisation of air accident services for the support of flying operations. For this purpose he is deployed in the three army aviation regiments of the RRFD and the International Helicopter Training Centre. During deployment, both the flight surgeons and the flight and rescue medical assistants guarantee the continuous qualified aeromedical services and air accident readiness.
Army Training Facilities
The training facilities of the Army are led by the Army Training Command. The CommandSurgeon of the Army Training Command is responsible for the continuing advanced and further training of the medical services as well as the medical personnel at the Army training facilities.
At the training facilities, the next generation of commanders receives extensive theoretical and practical training in the integration of medical service personnel and resources into the conduct of operations – from the group to brigade level. Furthermore, defined personnel receive special medical and paramedical training. Here, mutual understanding and knowledge of one another is particularly important. Medical service training by qualified instructors is therefore integrated into all training facilities. The priorities in medical service training are set at the Army Officers' Academy, the NCO School of the Army and the Army Combat Training Centre. The Specialized Operations Training Centre represents the training facility of the Special Operations and Specialized Forces of the Army. Against the background of the particular tactical framework conditions in Special Operations, the ability of the deployed soldiers to provide extended self-and buddy-aid at a highly specific level is indispensable. Therefore, the forces of the Army used in Special and Specialized Operations are trained as “Combat First Responders (CFR)” on qualification levels A to C. The defining feature of this special training is the embedding of emergency medicine aspects in the deployment principles and methods of the Special Operations and Specialized Forces.
Military Experts on Mission, OSCE observers and UN observers, civilian forces as well as journalists or chemical weapons inspectors also receive training in medical services at the Training Centre of the Bundeswehr for the United Nations.
The Pack Animal Centre belongs to the 23rd Mountain Infantry Brigade and is led by a Veterinarian Staff Officer. It supports the Mountain Infantry Brigade and other military units in all conflict scenarios in difficult to extreme or difficult-toaccess terrain, including high altitudes and extreme climatic and weather conditions, with its mountain pack and riding animals, which are capable of carrying out transport and delivery tasks. During deployments and basic operations it ensures the veterinary care of the animals and their correct shoeing.
The concentration of the medical services in one Bundeswehr Joint Medical Servicehas brought with it a significant improvement in the quality of medical service care and made it possible to guarantee such medical support during operations over the last few years. At the same time it has provided the Army with room to develop a highly specialized Role 1 medical support for the special operations and specialied forces.
In addition to the further improvement of the quality of care, the focus in the future will in particular be on the means of transport for evacuating the wounded. The increasing demands placed on mobility with simultaneous protection during the assignments has to be taken into account in this way in order to continue to ensure the high-quality medical care for the Special Operations and Specialized Forces wherever their assignment takes them.