OPERATION SMILE Virginia Beach, May 17th 2014

GEN Jean-Paul Paloméros

Supreme Allied Commander Transformation

NATO’s Medical support

Committed together for Peace and Security in the 21st Century

Crisis Complexity

HUMAN

SECURITY

CRISIS

NG

Os

Globalization of the world

Emergency Humanitarian situations increase

Global Media Communications

Public Opinion

Armed Forces

contribution

NATO’s contribution

to help the population

• Under the mandate of the United Nations SC

• Provide security to people, and protect all those who support and

assist them.

• NATO can provide valuable logistical, organizational, technical and

human capabilities (Darfur ,Sudan, Somalia)

• The NATO Response Force (which is a combat tool!) is also ready

for conducting disease relief operations ;

• NRF was first used in Pakistan for this purpose in 2005

• Support to Katrina

• Comprehensive approach with other stakeholders, UN, IOGs NGOs;

• Medical support

• Special focus on women and children .

UNSCR 1325

The “Women perspective”

“The harsh reality is that, in many conflicts areas today, it is more dangerous to be a woman than a soldier” AF Rasmussen

UNSCR 1612

In Afghanistan; (2002-2010); An average of 2 children killed by IED every day

In 2012, 1304 conflict related child casualties

• 1/3 by Improvised Explosive Devices

• 1/3 by shelling and shooting between pro-government forces and Taliban

• 10% as suicide bombers,

• ISAF has acknowledged 74 collateral damages from air strikes by the

international military forces for 2012, for 1975 sorties with weapon release.

• ISAF related collateral casualties represent 3% of the total casualties for 2012

and 2013.

Medical Support in NATO Context

During the Cold War

Treatment and evacuation of a large numbers of battle casualties

Low emphasis on multinational solutions

Today

“War amongst the people” Sir Rupert Smith

Deployment of (multinational) forces to any area for any mission

Focus on mobility, interoperability, sustainability, more often through a multinational and comprehensive approach;

Effective and reliable medical support;

o Maintain the trust of military personnel

o Help the population; Win the “heart and mind” of the wider public

o Preventive medicine

o Medical intelligence, epidemiological surveillance, patient regulation

Challenges

Medical shortfalls in many Allies

Urgent requirement for implementing

Multinational solutions

Modular approach

Medical Support in Operations

Policy

Health is a key multiplier of fighting power

Nations retain their legal duty of care as an employer

Multinational support within a theatre is a shared responsibility

between Nations and the NATO commander

Operational Principles

Timeliness of Treatment; the “golden hour”’

Continuity of Care,

Medical support Integrated within the operational planning

Key asset

• Helicopter

Medical Support in Operations

Functions to be performed

Medical Force protection

Emergency Medicine

Primary care

Secondary care

Evacuation

Uttermost important role of each soldier : “each soldier is a medic”

Medical Support in Operations

Means

Medical command and control system

Integrated treatment and evacuation system

Role 1, primary care, close support; embedded medics (national) , resuscitation and treatment of shock , stabilization,

Role 2 and 3, continuum of surgical care and preparatory surgery;

Role 4 full spectrum of medical care (national civilian health system)

Medical logistic systems

Specialist areas

1

2

3

4

Role 1

Role 2

Role 3

Allied Transformation

Command’s role in the medical field

• Enhances medical interoperability;

wide approach; Doctrine, human, organization, training, facilities,

materiel, logistics

• Promotes a multinational approach for addressing shortfalls, under

responsibility of a the lead nation;

for critical and complex functions; roles 2 and 3

• Ongoing works in ACT;

Sharing of the information, standardization …

Promotion of multinational exercises (Vigorous Warrior, Trident

Juncture 2015

Animates works of Center of Excellence

Important work to address the IED and massive IED.

Reserve Forces

• Clearly, a good solution to address medical capability shortfall in most of NATO countries,

• An invaluable source of expertise and experience,

• Availability of Reserve Forces depends heavily on national policies

• Various categories of personnel, not employed on full time military service

• CIOMR (conference interalliée des officiers médicaux de reserve)

• Now 18 NATO nations members and 5 non-NATO nations members

• “Bridge “ with civilian society, particularly relevant in the medical field.

Module Types: Surgery

NATO UNCLASSIFIED-RELEASABLE TO PfP

Surgical Care (SC)

• Resuscitation (RE)

• Pre-Hospital Care & Life Support (PCLS)

• Primary MEDEVAC (PVAC)

• Primary Management (PM)

Surgery

Enhanced Modules

• Damage Control Surgery (DCS)

• Radiography (RAD)

• Laboratory (LAB)

• Ward (WD)

• Supply (SUP)

• Create standardized component modules • Able to rearrange, replace, combine and interchange easily • Build optimized groupings for task

Improve levels of care Use across full spectrum of operations

Cooperation - practical example

• Afghanistan : Medical means put at the disposal of civilian population…

• Syrian refugees in Jordan; French operation Tamour in collaboration with the UN-HCR, High Commissioner for Refugees

• Health and Humanitarian aid for 120000 refugees

• 38 000 vaccinations,

• 22 000 consultations,

• 350 surgery acts.

Medical Support to the population

Way ahead;

Training and monitoring of local Medics

“Give a man a fish and you feed him for

a day. Teach a man to fish and you feed

him for a lifetime”. Chinese Proverb

OPERATION SMILE Virginia Beach, May 17th 2014

GEN Jean-Paul Paloméros

Supreme Allied Commander Transformation