NATO Logistics Handbook October 1997

Chapter 5: Logistic Support for Peace Support Operations Medical Support 514. As contrasted with conflict operations, PSO will be characterised by smaller numbers of Alliance casualties, spread over wider areas, and most likely due primarily to Disease and Non-Battle Injury (DNBI). Alliance personnel may be in remote locations far from lines of communication, making medical resupply, patient evacuation, hospitalisation, and preventive medicine services difficult. Integration of medical support structures from Non-NATO Troop Contributing Nations will most likely be required. Modifications to the normal deployable medical support structure may be necessary to ensure care is available at near-peacetime standards. Specialty care (including surgery) and both air and ground evacuation may need to be placed further "forward" than in a conflict scenario. The force must also be provided with an appropriate mix of medical resources to ensure that medical support provides all necessary medical functions. It must also cope with language barriers, and be able to operate in the multinational environment. High emphasis must be placed on preventive medicine programmes to reduce the incidence of food and water-borne disease, insect and rodent-borne disease, and environmental injuries. In many PSO the use of civilian experts may prove to be of benefit during the planning process. 515. Whether or not medical care will be provided to the local populace must be decided during the development of the concept of operations. Normally deployed military medical systems are not optimum for providing care to local populace, refugees, or displaced persons. Military medical systems are, for the most part, designed to provide acute care to traumatised young healthy male personnel. If civil populations are to be provided care, these groups will have large numbers of the very young, the very old, females, and those requiring chronic care. It must also be remembered that if the medical support package is tailor-made for the NATO multinational force it is to support, it will have little spare capacity to provide for such contingencies as treatment of local civilians, refugees, or displaced persons. Therefore, a clear medical mission must be given from the outset of the planning process.