SA military health makes its mark at the UN

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Doctrinal and development work done by the medical arm of the SA National Defence Force (SANDF) has been recognised by the United Nations.

An SA Military Health Services (SAMHS) upgrade to its buddy care concept as well as the incorporation by the world body of South African doctrine and standards for level two military hospitals will from now on become part of UN standard operating procedure for military medics and facilities deployed under the blue helmet.
“These developments at international level prove SAMHS doctrine is aligned with international trends on care in combat operations,” Colonel Louis Kirstein said.

The inclusion of South African standards and systems in UN military healthcare planning was discussed and confirmed during the recent tri-annual meeting of the Contingency Owned Equipment (COE) work group of the UN Department of Peacekeeping Operations (DPO). South Africa was represented by SAMHS Director: Special Medical Ruling, Brigadier General Noel Ndlovu, and Force Readiness Senior Staff Officer, Colonel Theo Lighthelm. They were among 150 countries that sent delegates to the top level DPO gathering.

The 1:2:4 concept, a guiding one for SAMHS doctrine, refers to the optimal evacuation time limits needed to ensure the best possible survival option for wounded casualties.

Casualties must receive advanced life support within an hour after being wounded, reach surgical post capability for damage control surgery (controlling bleeding) within two hours and reach definitive hospital capabilities within four hours, Lighthelm said.
“An additional limit to provide effective buddy aid within 10 minutes after being wounded was agreed on during the DPO work group meeting, changing the principle to a 10:1:2:4 one,” he said.

Another SAHMS concept – a high risk buddy aid pouch with a tourniquet, haemostatic combat gauze along with bomb bandage and gloves was unanimously approved as the new standard for UN peacekeeping operations by all countries at the 10 day work session.

Discussions around Level One medical facilities and Level Two hospital capabilities took place during meetings of the emergency medicine focus group.

A Level One medical post is a re-deployable capability consisting of resuscitation, surgical and minor ailment posts that can be deployed either by land or air. It is staffed by medical and nursing officers working alongside emergency care personnel. It provides emergency care to wounded casualties, damage control surgery to stop bleeding and the treatment of daily sick reports. Casualties remain at Level One posts for only a short time before being moved to Level Two field hospitals.

The Level Two field hospital is a semi-static capability, providing specialist medical care to wounded or sick patients. It consists of emergency care facilities, operating theatres, a high care unit and wards for patient care as well as dental and psychological capabilities. In its largest form it is made up of 65 containers staffed by 350 specialists from various medical disciplines.



The building blocks of SAMHS doctrine for Level Two hospitals led to a new UN standard using the South African input.
“The adoption of these and others raised in issue papers addressing equipment and ways to render peace support internationally again show SAMHS is a leader in the military medical field,” Kirstein said.