Evacuation is the most hard component of the system, due to the fact that the lesson from Ukraine shows that NATO doctrines frequently neglect – says Prof. Bartłomiej Guzik, manager of the 5th Military Clinical infirmary in Krakow. He besides tells about the Malopolska Military Medical Institute and the INKA Group, which integrates social organizations with the military to aid in a crisis situation.
Illustration picture.
On May 6, you are beginning a Multidisciplinary Clinical investigation Support Centre. Is this part of building infirmary medical facilities for emergency situations?
Prof. Bartłomiej Butzik: The full construction concept Malopolska Military Medical Institute, which is intended to supply facilities for peculiar troops – especially those from the south of the country, but besides many individuals in the region – is based on respective pillars. The basis is the improvement of surgical facilities: trauma surgery, abdominal, chest or head. The second component is the interior infrastructure.
To work effectively, we request to treat in a modern way. And here comes the function of the Multidisciplinary Centre for Clinical investigation – thanks to it we can conduct clinical trials, implement fresh technologies and therapies. This allows not only to treat civilian patients, but besides to make the competences needed in crisis situations.
At what phase is the creation of the Malopolska Military Medical Institute and what function is it intended to play?
The task is being prepared at legislative level at the Ministry of Defence. The Institute is primarily to support peculiar troops and build medical facilities for them. This is peculiarly crucial in the region where many key military units operate: NIL, AGAT, JWK Lubyniec, office of the peculiar Forces Component, or 6th Airborne Brigade.
One of the key tasks is to make the capabilities of SOST, or peculiar Operations Surgical squad – surgical teams capable of operating soldiers in all conditions. specified capacity already exists in cooperation GROM au Military Medical Institute in Warsaw – our goal is to make and supplement it. The aim is besides to guarantee that Poland has this capacity full certified and recognised in NATO structures.
Prof. Bartłomiej Guzik, manager of the 5th Military Clinical infirmary in Kraków.
Do we request more specified centres in Poland?
Definitely. Army improvement must go hand in hand with medical development. Throughout the country, the alleged "St. military-friendly hospitals, and in parallel, discussions are held on the inclusion of further facilities in this system. It is simply a long-term process that covers various regions of Poland and different models of cooperation.
A good example is the Kraków Narutowicz Hospital, which is very close to our hospital. This is the closest medical unit, which is why it is natural to build cooperation between us. Different models are being considered at this stage. It is part of talks between the Ministry of Defence and the city of Kraków. akin processes besides take place in another cities, including Ełk or Przemyśl.
It is besides worth noting that Kraków has a peculiar function in this area – in addition to a strong clinical base, the seat works here. Medical Army Command. This facilitates coordination and regular cooperation between the military and civilian wellness protection.
Can Kraków become 1 of the main centres of medicine in the battlefield?
It has the possible – there is simply a concentration of military units: 2nd Polish Corps, DKWS and peculiar and airborne units. They all require efficient and well-organized medical protection. However, building the position of the field medicine centre is simply a process. We are just entering this role, but we are consistently developing competences and facilities.
Against the background of NATO countries – where are we present with the preparation of combat medics?
We have been utilizing the experience and training centres of NATO countries for years, which gives us very good models to build our own capabilities. Parallelly in fresh years, Poland has been developing and equipping the army very dynamically – in many areas we are now at the forefront of the Alliance countries.
In this context, the improvement of field medicine and the training of combat medics are peculiarly important. They are the ones who supply first aid straight at the scene, and it is their function – in my opinion – that is even more crucial present than the doctors themselves, erstwhile it comes to the alleged point of injury, which is to save lives in the first minutes.
We can build this ability utilizing our own resources – both military and civil. That's why we make the Combat medicine Training Center, which combines the experience of soldiers with academic facilities. We cooperate, among others, with the Jagiellonian University, wellness Sciences Department or WSB Academy to make the widest possible training base and guarantee the highest level of staff preparation.
More than 800 medics have come to the Medical Legion, bringing together volunteers from the medical sector who are ready to act. Much or small at this phase of building specified a reserve?
This is the first phase erstwhile doctors are inactive considering a form of cooperation with the military. Medical Legion – like Cyber Legion – it is an component of building staff reserves. And this reserve must emergence gradually. If 10,000 people abruptly came forward, it would be a problem due to the fact that you can't train them all in specified a short time. That's why this dynamics is right. We do not operate in conditions of immediate danger – rather, according to the rule of “you want peace, prepare for war”. And that's what we do: step by step.
As a complement to the state's medical safety system, the INKA Group was created on your initiative...
The group is an effort to transfer to the Polish ground the solutions we observe in Ukraine. It is clear from the experiences of the doctors there, with whom I have the chance to talk, that the function of NGOs in medical evacuation is crucial, among others, due to the fact that they have unmarked cars and the infrastructure tested repeatedly.
It is about spontaneous mobilization, which is celebrated for Poles – due to the fact that we love scowls and it is beautiful – to strengthen the previously prepared cooperation system: between NGOs, hospitals and administration. This will make emergency assistance faster and better coordinated.
That is why we are already working with many organisations that have very different competences and assets. any of them specialise in medical activities, others in logistics, others in the registration and recognition of the needs of the population, for example in situations of influx of migrants or victims. These include Caritas, the Polish Red Cross, the Polish Scouting Union and the Scouting Union of the Republic, the Maltese Order and the Malta Medical Service Association.
INKA is to support the system, not replace it. Hence, we place large emphasis on training and joint exercises including participation 11 The Malopolska Territorial Defence Brigade. The first major test in June: at the ZHP Centre in Korzkow. We will train with volunteers various crisis scenarios.
What is the preparation of civilian hospitals for emergency situations today?
We make a training strategy for directors and staff of civilian hospitals. We started 2 years ago, and in the last year we have definitely accelerated and conducted them very intensively. They cover both organisational issues – i.e. the roles of institutions during the crisis – and very applicable issues. We are talking here, among others, about support for peculiar troops and about the handling of CBRN threats (chemical, biological, radiological and nuclear), which are related to weapons of mass destruction.
In parallel, we are building a strategy of cooperation with the administration. We already have direct communication between our infirmary and provincial offices, which is crucial for coordination. This is simply a immense undertaking, due to the fact that our area of medical safety belongs to the largest in the country and includes, among others, Łódź, Silesian, Świętokrzyskie and Małopolska voivodships. We are talking about a very large number of facilities to be prepared.
This is all happening – is it besides late? Experts say that, at the present rate, it may take respective decades to prepare adequate field medics. Is the strategy ready present to receive a large number of wounded?
Coordination of the inflow of wounded will belong primarily to military and field hospitals – they constitute the core of the treatment at R3 and R4 levels. civilian hospitals will take over patients later erstwhile care becomes more predictable.
As far as staff is concerned, the shortcomings concern the full wellness system, so they will besides be a challenge in conflict situations. It is so crucial to increase the number of specialists in areas specified as surgery, orthopaedics and anesthesia. Here, the function of rescuers and alleged "combat medics", i.e. people operating straight at the site – at the earliest phase of providing assistance.
At the same time, systemic action is being taken – on the 1 hand, a concept arises reconstruction of the Military Medical Academy, on the another hand, existing infrastructure is utilized to make medical training for military needs.
What are you most afraid about as a doctor and infirmary manager erstwhile it comes to preparing the strategy for a possible conflict?
Evacuate.
Why?
This is simply a lesson that flows from Ukraine, and at the same time the most hard component of the full system. On the 1 hand, we have a NATO doctrine that assumes evacuation to R4 level in six hours, but we know that this is not working under war conditions. Patients frequently neglect to get there at this time, and the evacuation strategy itself changes dynamically, even all 2 weeks, due to the fact that escape routes are recognized and attacked by Russian troops.
Therefore, my top concern is not about mobilization itself – this 1 we have rehearsed. It's more about who gets into the strategy and what condition. Hence the function of INKA and Combat medics – people who are able to keep the patient alive as long as possible under the conditions of "point of injury".
It is besides crucial to make the ability to deliver blood straight to the battlefield and fresh means of evacuation, including the usage of drone troops. due to the fact that today, this evacuation looks completely different from the classical NATO doctrine. In Ukraine, almost no soldier is evacuated by helicopters.
Because a landing isn't possible...
Exactly. In many cases evacuation takes place on foot. Therefore, INKA is to build the ability to work closer to the battlefield line: reaching the injured and its safety on site. The point is to keep him alive as long as possible until he's evacuated.
