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Planning of medical support for maritime operations

In addition to the classic groups of on-board specialists and dentists - depending on the characteristics of the project and the marine unit used - there is also a need for individual medical service expertise. The marine medical service is regularly supported by members of the Central Medical Service of the Federal Armed Forces (ZSanDstBw), but also by reservists.

But before the medical specialist on board can do their duty, a complex path has to be taken.

Fig. 1: An example of space-time factors in maritime operations.

Maritime missions and exercises

In the maritime environment, like other Bundeswehr missions, the following applies: The medical service support follows the task of the troops. In order to ensure the medical service support of the Navy worldwide, careful planning of the medical personnel of the Marine Medical Service (MSanDst) to be deployed, supplemented by staff from the ZSanDstBw and possibly other medical services of the armed forces, is required before each sea voyage.
The decision by the BMVg as to which maritime operations the Bundeswehr will take part in with which units of the navy is the starting signal for planning the medical service approach.
Missions in which the Navy takes part with ships and boats are either special foreign assignments or equivalent obligations. The special foreign assignments include mandated missions - currently EU NAVFOR MED, ATALANTA, UNIFIL and Operation Enduring Freedom (OAE). The STANDING NATO MARITIME GROUP (SNMG) 1 and 2, NATO RESPONSE FORCE (NRF), EU BATTLE GROUP (EU BG) and Baltic Sea / North Sea rescue boat (BBO / BBS) Baltic Sea / North Sea represent the same duties.
In addition to maritime missions, the Navy takes part in numerous training and exercise projects on a national and international level. Similar to the missions, the medical staff to be embarked is planned after the units for participation in the respective project have been determined. The training trip abroad of the deployment training association (EAV) is planned every year. The EAV is the operational reserve of the German Navy and at the same time contributes to NATO RESPONSE FORCE (NRF). In addition, the national exercise Flotilla Exercise (FLOTEX), the international exercise NORTHERN COASTS (NOCO), the NRF certification exercise TRIDENT JUNCTURE and the evacuation exercise EXTRICATE OWL take place. In addition, there are training and inspection trips such as participation in GOST (German Officers Sea Training) or shipyard inspection trips.
Overall, the sea-going units are now more frequently on the move around the world, either individually or in associations that are divided up in terms of time and space (e.g. EAV 2015). This often leads to a more intensive need for support, since one is no longer continuously involved in the medical service can rely solely on the association or nearby host countries.

Medical service deployment on the ships and boats of the Navy

Fig. 2: Itinerary of the deployment and training association 2015.
In addition to the on-board medical service, other forces, e.g. B. clinical specialists, embarked on the boats or ships of the Navy.

Boats are usually manned by a paramedic. Corvettes, tenders and fleet service boats have a ship hospital. The medical service infrastructure makes it possible to take on medical reinforcement if necessary or to embark additional medical officers and medical officers / guests. Units that operate remotely receive z. B. an anesthesiological intensive care reinforcement. The embarkation of a complete on-board specialist or dentist group - as on the ships - is not possible due to the spatial restrictions.

In addition to the on-board medical service, the ship's doctor group, the ships offer space for an on-board specialist and an on-board dentist group.
A specialty is the task force provider, who grows up to his full range of medical services with a focus on emergency surgical care when up to 48 medical professionals are embarked.
In addition to the medical staff embarked in addition to the on-board medical service, there is also a regular need to fill vacancies in the organic on-board medical service (ship's doctor, first-aid officer, first-aid officer / guest).

The medical personnel to be embarked must meet the following important requirements in addition to the following:

  • Security check (Ü2 sabotage protection)
  • On-board instruction (ZA EAKK Marine: Preparatory training in the context of conflict prevention and crisis management)
  • Examination of on-board service usability (BDV)

The sequence of planning medical personnel in maritime projects

Fig. 3: Coordination of support with specialist personnel in a joint armed forces environment.

In a joint armed forces framework, the medical service approaches for maritime operations under the leadership of the Bundeswehr Operations Command between the Admiralty Doctor of the Navy (AdmArztM) in the Marine Command (MarKdo), the deployment planners in the Medical Service Command of the Bundeswehr (Kdo SanDstBw) and the Operations Command JointBw JMeddo Medical (EinsFüKdo) Voted.
The result of this coordination flows into the planning report (list of operational duty posts) for the respective project. Marine Command Department, Marines Medical Department, Operational Management / Operations Department (MarKdo San13) checks this implementation in cooperation with the Marine Command Coordination Office for Personnel Foreign Operations (MarKdo KPA) for correctness. This usually results in the need for additional medical specialists for the ships and boats of the Navy. MarKdo San13 advertises the posts to be filled in the medical service of the Bundeswehr. For the ZSanDstBw, the central coordinator, the Kdo SanEinsUstg, receives these inquiries. In-house, the Naval Medical Institute of the Navy (SchiffMedInstM), the operational flotillas (EinsFltl 1 and 2), the Naval Aviation Command and the naval schools examine their options for seconding personnel.
For registered personnel, MarKdo KPA creates a planning letter so that the soldiers can be prepared by the main troops. As soon as the soldier's ability to be deployed has been reported back to MarKdo KPA, the flight booking and the coordination of the necessary transports in the country of deployment to the respective sea-going unit are made from there.

Challenges when embarking on maritime units

Embarking on board sea-going units of the Navy poses a very special challenge. The port planning often changes, for example due to the order or the weather. As a result, the embarkation and disembarkation dates, which have been known for a long time, can now and then be postponed significantly and at short notice. Anyone who goes on a mission on board must also be prepared for the fact that a naval unit is ordered to another mission at short notice. It is also possible that a ship or boat of the Navy is planned for a completely different use. This can be associated with longer standing times on board, deviating sea areas and thus other stays in port. As a rule of thumb, the following applies here: the planned period of use ± approx. 14 days is a realistic plan. Especially for specialists and reservists, the possible standing times on board are limited due to their own convenience. This results in a high frequency of staff embarkations.

Tab. 1: Qualifications required for medical specialists in maritime operations

Whenever a wide variety of specialists and their personal equipment reach the receiving unit in a foreign port worldwide in a rendezvous procedure, something remarkable happens every now and then. For example, the San13 department learned that there is a vegetarian diet called “Lakto-Ovo”, which is offered on commercial flights and is also requested by soldiers on the way to a mission. The realization that it is possible to enter an Arab country from Germany without a passport was also unexpected. The stay there is all the more interesting when the local authorities notice it. In this way, we regularly receive unusual concerns, some with little effort, others all the more.


Tab. 2: Possibilities for further qualification of medical specialists in the marine medical service
In maritime use there are many possibilities for the use of medical specialists. In addition to the basic requirements for being able to perform his service on board a seagoing unit, use in the marine medical service requires participation in marine-specific qualification measures. In the case of medical personnel who are to be deployed in maritime operations from other organizational areas and with little marine experience, their deployment on board is decided on a case-by-case basis in order to best meet the requirements of the operations.

Date: 07.12.2015

Source: Military medicine and military pharmacy 2015/3