Germany (Joint Medical Service), Federal Republic of
Dr med Michael Tempel
Lieutenant General MC
Basic Task of the Military Medical Service
The core task of the Bundeswehr Joint Medical Service is to protect, sustain and restore the health of service personnel. This is of particular relevance in the case of deployments abroad, where service personnel is exposed to exceptional health hazards (that they do not face at home). The work of the Bundeswehr Joint Medical Service is based on the guiding principle that ill, injured or wounded personnel on operations are to be given medical care, the outcome of which corresponds to medical standards in Germany. This applies across the entire spectrum of medical care and services. Through its staff and resources, the Medical Service also provides medical care to military personnel in Germany.
Consistent orientation towards mission-related tasks, the streamlining of command and control structures and the continued focus on tasks that require a medical licence are essential determinants of the Bundeswehr Joint Medical Service.
In order to achieve these goals and maintain personnel sustainability, the Bundeswehr Joint Medical Service comprises a total of approximately 14.650 military and 2.700 civilian posts.
The Surgeon General is the commanding general of the German Joint Medical Service and, in medical matters, exercises control over the medical services of all branches of the German Armed Forces.
He also commands the Bundeswehr Medical Service Headquarters located in Koblenz, which at field army level is the highest military medical command in Germany.
All command and control structures of the Bundeswehr Medical Service are organized at the Bundeswehr Medical Service Headquarters, focusing on a process-oriented organisation rather than on customary staff branches. In the training branch, for example, staff from personnel
management work alongside staff from operations and readiness.
A feature unique to the Medical Service is its responsibility for the organisation and management of Strategic Aeromedical Evacuation (StratAirMedEvac) operations. This responsibility includes stationing, military security, alerts and mobilisation.
At division level, two commands and the Bundeswehr Medical Academy are subordinate to the Bundeswehr Medical Service Headquarters.
The Operational Medical Support Command in Weißenfels is responsible for and coordinates the deployment of medical personnel, air and ground assets, and material. Medical regiments and medical logistic centres are its main assets for fulfilling this task.
Regional medical treatment facilities have been placed under the authority of the Regional Medical Support Command in Diez. Medical care for active-duty personnel is provided by major medical clinics, which also offer specialty services, and medical clinics.
The Bundeswehr Medical Academy is the centre of competence for military medical research, development and training and is located in Munich.
Five Bundeswehr Hospitals located in Koblenz, Ulm, Berlin, Hamburg and Westerstede are directly subordinated to the Bundeswehr Medical Service Headquarters as well as the Central Institutes of the Bundeswehr Medical Service at Kiel and Munich and Supervisory Centres
for Public Law Tasks of the Bundeswehr Medical Service North (Kiel), West (Koblenz), East (Potsdam) and South (Munich).
In the future the Bundeswehr Joint Medical Service will have five regiments, elements of which will be stationed at or close to Bundeswehr hospitals in order to strengthen the training and exercise system and to increase options for the mutual support between field units and Bundeswehr hospitals.
Three Medical Regiments are stationed in Weißenfels/Berlin, Rennerod/Koblenz and Dornstadt.
The Medical Service Rapid Reaction Regiment in Leer combines all airmobile and airborne medical capabilities of the Bundeswehr Joint Medical Service to ensure that medical care and support are made available to troops on deployments abroad within a very short period of time. During longer deployments, rapid response forces are relieved by stabilization forces.
Basic training of medical trainee soldiers and predeployment training of medical personnel are provided by the Medical Training Regiment in Feldkirchen.
All hospitals are operated by the Bundeswehr and provide medical care not only for service personnel but also for civilian patients.
Institutes, Research and Public Health
Veterinary and pharmaceutical laboratory diagnostics including potable water and food examination are provided by Central Institutes of the Bundeswehr Medical Service at Kiel and Munich.
Medical research in the field of detecting and preventing of CBRN-Threats is conducted in the laboratories of the institutes affiliated with the Medical Service Academy in Munich. The Bundeswehr Institutes of Microbiology, of Pharmacology and Toxicology, and of Radiobiology are also stationed in Munich. The Bundeswehr Institute of Preventive Medicine will be established in Andernach and will provide research and operational assets for injury protection, health protection and surveillance capabilities.
Further elements of the force health protection program of the Bundeswehr Joint Medical Service are established at the Supervisory Centres for Public Law Tasks of the Bundeswehr Medical Service North (Kiel) / East (Potsdam) / West (Koblenz) / South (Munich) acting in preventive medicine, veterinary service, pharmacy and food safety in an interdisciplinary approach.
Medical logistics is provided by three Medical Logistics Centres at Quakenbrück, Blankenburg and Pfungstadt. All centres are also Bundeswehr pharmacies that ensure the supply of non-expandable medical supplies and individually issued expandable medical supplies.
In addition, the centres provide the repair of medical equipment through to maintenance stage 3.
During military missions, the centres provide also as a pharmacy the supply and repair of medical supplies safely in a theatre base medical material supply point.
The cross supply for non-medical supplies is ensured by logistic support points of the medical service. Furthermore they are also responsible to provide the repair of medical equipment through to maintenance stage 2.
Medical care for personnel who become ill, injured or wounded during deployment is provided through the medical evacuation chain. This chain of closely interlocking phases ranges from self and buddy aid through medical care in field medical treatment facilities to final clinical treatment and rehabilitation in Germany. The medical evacuation chain consists of four medical service treatment levels. Depending on the severity of the illness or injury, the patient will pass through some or all of these levels. Well-trained specialist personnel and efficient, mobile equipment are available for the benefit of personnel at all times.
First aid through self and buddy aid forms the start of the medical evacuation chain. Initial emergency medical care is rendered at Mobile Aid Stations (Role 1). Trained medical specialists perform on-site triage, shock and pain management as well as haemostatic measures. They also ensure the clearance of the respiratory tract and artificial ventilation.
Complementary emergency diagnostic services and treatment are provided at Mobile Surgical Hospitals (Role 2). These are able to deal with acute injuries and disorders and the relevant surgeons and anaesthetists. A Mobile Surgical Hospital consists of mobile containers. Tents are used in some cases. The size and facilities of a centre are adapted to the requirements of each deployment.
Field Hospitals (Role 3) provide in-patient and out-patient specialist medical care. They have extended surgical, intensive care and specialist diagnostic and treatment facilities and, if necessary, can stabilise casualties for direct evacuation back to Germany.
In relation to the kind and severity of their injuries Casualties are generally transported back to Germany in specially equipped Bundeswehr aircrafts within the framework of StratAirMedEvac. Special equipment includes Patient Transport Units (PTU) for the movement of intensive care patients. Six PTU can be installed in Airbus A-310 aircraft operated by the Deutsche Luftwaffe (German Air Force, see Luftwaffe).
The main elements at Role 4 level are the Bundeswehr Hospitals in Germany. If necessary, civilian hospitals and rehabilitation centres are also used. These facilities provide for the further treatment of patients who have been evacuated from the area of deployment. As a rule, strategic air medical evacuation aircraft land in the reserved military zone of Cologne- Bonn airport. From there, patients are transferred to the Bundeswehr hospitals.
Protected Casualty Transport Vehicles
1999 – KFOR / Kosovo
2002 – RS / Afghanistan
2005 – UNMISS / South Sudan
2006 – UNIFIL / Lebanon
2007 – UNAMID / Sudan
2009 – ATALANTA / Horn of Africa
2010 – EUTM / Somalia
2012 – EUCAP Nestor / Somalia
2013 – EUTM / Mali
2013 – MINUSMA / Mali
2013 – MINURSO / West Sahara
2013 – AF TUR / Turkey
2015 -- EU NAVFOR MED / Mediterranean Sea
2015 – Training Support Mission / Iraq
The Bundeswehr cooperates with its civilian counterparts where measures, personnel and resources are concerned. The purpose of cooperation is to promote a closer relationship between Bundeswehr units on the one hand and civilian authorities and the civilian population on the other. Nine centres for civil-military cooperation (CMC Support Centres) have been established by the Bundeswehr Joint Medical Service across Germany. Six of them are able to set up and operate emergency treatment stations. Three of them provide medical support logistic. All units have the capacity even on routine operational status. They also provide additional casualty transport capacity, medical decontamination facilities, and medical material packages. These centres have the facilities and trained personnel to provide rapid assistance in the case of disasters or large-scale accidents and are a valuable addition to civilian emergency medical aid resources in case of major incidents.