Article: Pierre Rennotte

The Belgium Role 2 Medical Treatment Facility: Force Readiness Generation Process

(source: COMOPSMED/DELCOM)

The Medical Component of the Belgium Armed Forces has three main tasks:
a. The medical support of operations;
b. The medical preparedness of the armed forces;
c. The readiness of the Medical Forces.

To carry out its primary mission, the Medical Component must have a series of operational modules covering the entire chain of treatment and evacuation of the wounded and sick (continuum of care). These modules include field hospitals, known to us as Role 2. There are several types, from the lightest and most mobile to the most comprehensive, better equipped but more static: Role 2 Forward (R2F), Role 2 Basic Highly Mobile (R2B HM), Role 2 Basic (R2B), Role 2 Enhanced (R2E). The Medical Component acquired two new R2Bs in 2021 and a series of extentions and enhancing moduless to convert one of them into a R2E. To reach the Initial Operational Capability (IOC) level for these new capabilities, MCC (Medical Component Commander) had planned to deploy an R2B in the second half of 2023 for a four- to six-month mission abroad. To prepare for this, a Force Readiness Generation Process was established. As part of this programme, an evaluation exercise was organised in Leopoldsburg in October 2022 (exercise GREEN LIGHT 22). This evaluation showed that our junior specialised surgeons/ anaesthetists/nurses did not yet have suffi cient technical skills in Damage Control Resuscitation (DCR), Damage Control Surgery (DCS) and Advanced Trauma Life Support (ATLS). Our specialised medical teams could not be ready in the second half of 2023 to treat war casualties this soon. This review had two immediate consequences. The first was to set up a specific training programme for junior surgical teams. The second was, on the recommendation of ACOS Ops & Trg, to consider sending the R2B to Franceville (Gabon) as part of exercise TROPICAL STORM ‘23, instead of a high-intensity mission, and to integrate the free medical aid programme set up by the Gabonese defence for a period of 10 weeks. Following the earthquake that struck Turkey and Syria on 6 February, Belgium sent a field hospital to the affected region to provide aid to the victims and replenish the completely destroyed local medical infrastructure. The Medical Component consistently participated in this humanitarian operation by sending numerous specialists, doctors, pharmacists, nurses and lab technicians,

Aerial view of the field hospital in Turkey (source: COMOPSMED/DELCOM)

In Franceville (Gabon) (source: Tom Bolsius)

as well as a large amount of medical equipment and medicines. Unfortunately, this mission aff ected the R2B’s planned deployment to Gabon. Exercise Tropical Storm will continue, but the deployment of medical teams will be limited. The Medical Component will not deploy a R2B at Franceville as planned, but will only provide surgical teams in the two reference hospitals during the exercise period. This setback in the capacity development project and the fi rst operational deployment of Role 2 should not deter us from looking to the future with optimism. The Medical Component, in collaboration with colleagues from the Field Accomodation Unit, CIS, Movement Control Group and logistics, has made great progress during the various deployment exercises. We now have all the necessary elements to consider deployment by road, sea and/or air. 5 EMI will receive the medical equipment for the second Role 2B in the next few weeks, and hard work is underway to procure the necessary consumables to reach the operational level and inventory level required by NATO by the end of 2023. The new training concept for surgical teams has entered its implementation phase. It includes courses and exercises as well in Belgium as abroad (ATLS, DCR & DCS, dead & life tissue training, etc.), evaluations of our teams by foreign organisations (NSHQ, France, Great Britain, etc.) and the deployment of these teams in austere but safe environments (Democratic Republic of Congo, South Africa, etc.). This concept is not set in stone and will certainly evolve in the coming months/years based on feedback, changing needs and new training opportunities in Belgium and abroad. Role 2 capacity development will also be intensified. Working groups will be established to develop various Role 2 Forward concepts (Land, Special Ops and Navy), as well as the replacement of the Role 2 Light Manoeuvre NEO being the future Role 2 Basic Highly Mobile. Most of these new capabilities are part of the land component’s CaMo (MOtorised CApability) project, in cooperation with our French counterparts who are developing a similar project (SCORPION). In addition, two exercises are already planned for 2024. A first one in March 2024, which aims to deploy the R2F Land prototype, and a second one in October 2024, which aims to deploy the R2F and the R2B simultaneously. Today, let us prepare in an orderly, methodical and mutually agreed manner for the operational readiness of these various capabilities, making every eff ort to acquire the necessary medical, tactical, logistical and administrative skills. The future remains uncertain, as the international news shows, and we could be involved sooner than we think.