• Home
• About us
• Events
• Archive
• Reader Inquiries
• Media Information
• MCIF-Awards
• List of suppliers
• Forum
• Contacts

Content

• Home
• Portrait of a National Medical Service
• Organization of Medical Support and Experiences in Operational Medicine
• New Challenges in Medicine
• New Developements in Medical Equipement and Technology
• Reconstruction, Reports from NGO's

Partner of MCIF

Articles

Exercise „Vigorous Warrior 2011” – A Multinational Medical Approach Demonstration

Nations that participated in the display are: CZE, FRA, DEU, NLD and HUN - the NATO Centre of Excellence for Military Medicine (MILMED COE) catalyzed the exercise and provided a single point of contact for the foreign troops. The field demonstration was the most important day of “Exercise Vigorous Warrior 20011 (VW11)”, which planning phase started in June 2010 followed by the execution phase 31 May-10 June 2011. Evaluation of the exercise will be finalized in September 2011 during “VW11” evaluation conference. The “VW11” participants strongly believe that their efforts and Surgeons General’s field visit contributed to the success of the 35th COMEDS Plenary, which was evaluated by its Chair Brigadier General Rob VAN DER MEER as a “revolutionary plenary” of its history.

Main Section

Set-up of the scene
Multinational military medical cooperation is an everyday practice in current operations. The demand to provide the same advanced level medical care in remote and austere environment of the military operations is challenging almost all the NATO allies. Shortfalls in personnel of medical services and decreasing financial resources on national sides are two good reasons why to develop interoperability. Nevertheless, the history tells us that building up trust and credentialing for the clinical personnel of different nations are not the easiest tasks. The language, the different educational and training background, different medical instruments or simply the different set up of the operation theatre can slow down the integration of the team and can hinder the fully operational capability of the Medical Treatment Facility. Attempts to mitigate these factors are traditionally bilateral agreements, but the most effective way is the standardisation of capability and common pre-deployment training. The concept of demonstrating multinational medical units to work as brothersin- arms in a Hungarian exercise field came into shape a year ago, when Hungarian Surgeon General BRG Andras Nemeth invited the COMEDS to Budapest. Right after that the preparation and planning were immediately commenced. Nations volunteered to provide force and they also recognized this opportunity as a great chance to demonstrate their national assets to the COMEDS audience. The medical display was embedded into a wider Hungarian Battle Group exercise “Dynamic Cooperation 2011” and therefore EXCON and Real Life Support were shared with them. The first challenge was to prepare separate documentation for the “Vigorous Warrior 2011 (VW11)” and to concert the exercise planning of the two parallel events. After the preliminary planning conference four nations indicated their participation: CZE, FRA, DEU, and NLD. Hungary as framework nation provided the support for the whole event. The NATO Centre of Excellence for Military Medicine (MILMED COE) was involved in the planning in the earliest time of the preparation. MILMED COE served as subject matter expert to facilitate the planning phase, to conduct the multilateral negotiations and to provide a clearinghouse function for all communication with foreign force providers IAW current NATO procedures described in Bi-SC Directive 75-7. The MILMED COE facilitated to hold the series of necessary planning conferences with several visits to training field to determine the best location and event flow for participants and visitors. Synchronization of intents and possibilities of the Host and Participating Nations was a permanent challenge during the whole planning phase, but finally it was possible to overcome all the problems as a result of flexibility of participating planners. The scenario of the exercise was elaborated and managed by MILMED COE inclusive of all the direction of the exercise flow.

Scenario of the exercise The dynamic display was planned to be an 80 minutes long narrated exercise that realized a controlled-play scenario modelling the full spectrum of multinational military medical management of an emerged MASCAL situation in accordance with the standing NATO medical policy and doctrines. The scenario was embedded into a North Atlantic Treaty Article V. based fictitious national defence operation, assuming that the NATO member Hunnia is the home country and Pannónia the aggressor. Following Pannónia’s attack on Hunnia the Alliance’s forces had been already deployed into the Joint Operations Area (JOA) for collective self-defence supporting the assaulted member nation to restore and maintain the security of its territory.

Exercise Units
Friendly Forces (FF):

 

• FF1: One transport helicopter (Mi-17) provided by HUN.
• FF2: One Medical Evacuation (MEDEVAC) helicopter (V3-A Sokol), crew including medical personnel and medical equipment provided by CZE.
• FF3: One MEDEVAC helicopter (Mi-17), crew including medical personnel and medical equipment provided by HUN
• FF4: One Role 1 Medical Treatment Facility (MTF) with two BTR-80 SKJ armoured ambulances plus the 12 imitated casualties provided by HUN.
• FF5: One Damage Control Surgery Module (DCSM) 4 personnel and equipment (4 m3, 1000 kg) provided by FRA.
• FF6: One ROLE 2 LM MTF with personnel and equipment provided by DEU with HUN and NDL detachments.
• FF7: HUN Military Hospital (Role 4 MTF) – displayed only in the closing video insert.

Enemy Forces (EF): showed only in the initial situation video inserts.

The casualty management was displayed through 7 distinguishable tactical phases. The audience, supported by audio-visual aids, could watch the whole casualty flow with the parallel medical events from point of wounding to definitive treatment. Initial and closing phases were displayed by video inserts while the internal ones, the most intense medical actions, were presented real-time in front of the spectators. In addition to the spectacular sight from the tribune the utilization of mobile cameras and a mega LED screen allowed the audience to visualize the simultaneous ongoing outdoor and indoor events of the two echelons at the same time. Figure 1

shows the schematic operational map and visual plan of the dynamic display all in one.

Concerning the quality in the full continuum of care optimal level interoperability between medical personnel of different nations and services was a key prerequisite. It was challenged at couple of various interfaces like the first handover of casualties for the forward rotary wing MEDEVAC (HUN and CZE), the next handover of casualties between the forward rotary wing MEDEVAC teams and the surgical stations (CZE, HUN and DEU, FRA, HUN), the cooperation between the Role 1 MTF and the settled DCSM personnel (HUN and FRA), and the teamwork within the multinational ROLE 2 LM Medical Treatment Facility (DEU, HUN and NLD).

First Impressions
The overall feedback about the exercise was very positive. The evaluation from the Co-Director of the Exercise - BRG Nemeth the HUN Surgeon General - was very laudative when multinational medical troops were lined up in the parade ground. All the guests of 36 NATO and partner countries were really impressed by the well driven, real time and live camera supported demonstration. Although lessons have started to be learned and observations were captured the real after action review and discussion is planned to be held in late September. Its outcome will certainly determine the future of exercise “VW11”.

MILMED COE Lessons Learned (LL) Branch was deployed and tasked to manage the Lessons Learned process throughout the planning and execution phases IAW NATO LL procedures. The methodology of data collection was making interviews with the main stakeholders and distributing questionnaires among all national seniors. Questionnaires were referring to the different phases of the event and specifically to the multinational medical co-operation. Every participating nation was approached and requested to provide feedback. Medicine is diverse and empiric science, however differences should not hamper the operation or prevent to foster multinational medical cooperation. According to the participants’ first impressions further multinational exercises and trainings have to get priority to achieve better interoperability and enhance understanding of different national standpoints.

Ltc (MC) Dr. Antal Zsolt KISS (HUN A)
Doctrine SO1 (Deputy Chief of Interoperability Branch)

Service

News