BG Dr. med. Stefan Kowitz MBA
Future Forces Forum Future Forces Exhibition 2016 World CBRN & Medical Congress (CEBIRAM) 2016
Medical Advisor of NATO’s Allied Command Operations
Operational Challenges for Future Medical Support in NATO Missions
Recent destabilizing developments around the globe and within the Euro-Atlantic periphery highlight, that the Alliance has to address an increasingly volatile, complex and uncertain security environment with emerging transnational and multidimensional threats in an ongoing climate of fiscal austerity. The ultimate role of military medical health care system - supporting the troops in performing their tasks by preserving and restoring their health and fighting strength - remains unchanged.
Without the Nations Medical Services providing reliable and sustainable medical support for NATO missions and operations, there would be a strong reluctance for politicians and military leadership to commit their forces for missions or operations. Additionally, the public’s expectation of quality medical support to troops continually grows. An effective and reliable military medical support system improves troop morale, and assists in maintaining the trust of military personnel, the public, and its political leadership. The influence of these factors leads to an increasing requirement for a shift towards development, delivery, sustainment and preservation of multi-national deployable medical capabilities in support of the Alliance's Level of Ambition.
Multi-nationality/interoperability poses a number of key challenges including the formation of an effective command structure. To preserve the recent successes of the multinational health care system (i.e. low Disease Non-Battle Injury rates, high survival rate, high quality care), it is important to use the lessons learned in our recent operations to develop or improve existing best practices related to interoperability.
The experiences of recent missions have demonstrated the importance of direct access, and a strong connection between the medical function and the operational community to realize effective and medical planning. Medical decision-making is dependent on the efficient processing and distribution of environmental, operational, tactical, and casualty data. Such information is fundamental to effective medical planning, deployment health surveillance and the administration of personnel support to the deployed force.
After the Wales Summit, NATO nations refocused their efforts to generate medical support for large-scale formations in a collective defence and conventional environment. The spectrum of the medical support will be related to the golden hour, prolonged field care, with longer transportation timelines, but using early medical assistance during the mainly provided ground medevac period, and triage, where the aim is to provide medical support in away, that enables the treatment and improves the chances of survivability to the greatest number of patients .
There will be always be concerns regarding capacity versus capability. By using experiences of prolonged field care and effective operational medical planning, the aim is to follow the MC 326-3, that “medical care is based on internationally accepted best medical practice”.
The medical contribution to operational planning is twofold. On the one hand is the input of medical expertise to the general planning process. On the other is the development of a Medical Concept and Medical Support Plan for the operation. The environment of such an operation is characterized by following factors: longer possible periods lacking of air superiority, high tactical and also operational mobility.
With the lack of air superiority, higher number of casualties the planning process has to calculate a greater number of MTFs and higher MEDEVAC capabilities (ground and air). For the Air component, a Theatre PECC linked to an Air Component Headquarter has to be planned, to coordinate the movement out of the theatre to rear countries. The high mobility on tactical and operational level will require movements and deployment of medical units in compliance with the Humanitarian Conventions. Therefore, the medical units will require more support for movement, supply, and communication. All this adaption for a collective defence scenario will require a higher amount and capacity of deployed medical units.
To ensure continuous route of medical care, the medical HOST Nation support - military and civilian- in countries associated with NATO mission, and the deployed NATO forces have to be coordinated for collective defence scenarios. The linkage of medical military assets with medical HNS capabilities has to be organized and planned by the different nations. The collocation of military MTFs beside civilian hospitals in such a crisis provides a synergy-effect.
Building on the successes of the health care system from previous and current missions - low DNBI rates, high survival rate- it is very important to use the experiences of last missions especially best practices and LI/LL to support further development of medical interoperability. The aim of all our efforts will be the further enhancement of medical capabilities, readiness and responsiveness.
Brigadier (MD) Dr. med. Stefan Kowitz, MBA
General Medicine Physician; Executive MBA Health Care
Member of the Scientific Advisory Board of the Department
of Military, Disaster and Law Enforcement Medicine (Faculty
of Medicine of Semmelweis University Budapest)
Married, 4 Children and 3 grandchildren
March 1979: entry into military service as a medical officer candidate
Medical degree at University of Köln and Gießen
Clinical Training and Education at Military Hospital in Gießen and Koblenz
Director of Medical Centre, Rennerod
Commander of Medical Squadron AFCENT Brunssum /NLD
Commander of Medical Battalion 11, Leer
Commander of Field Hospital Regiment 11, Fürstenau
Section chief at the Surgeon General of the Army, Mönchengladbach/Koblenz
Assistant chief of the “Bundeswehr Joint Medical Service“ activation staff, MoD Bonn
G3 Regional Medical Command I, Kiel
Deputy G3 Joint Medical Forces Command (Operations, Exercises, STRATAIRMEDEVAC)
Medical Advisor to the JFC HQ, Brunssum, / NLD
Chief Division X (Further Development, Capability Analysis and Research) of the
Bundeswehr Medical Office, Munich
Chief of Division I (Medical Service Planning, International Cooperation Concepts and
Development) of the German Joint Service Headquarters, Koblenz
Director of the NATO Center of Excellence for Military Medicine, Budapest/HUN
Since August 2016 Medical Advisor for the Supreme Headquarters Allied Powers Europe (SHAPE) / Allied Command Operations (ACO) for NATO
1995 Deputy Commander of German Field Hospital, TROGIR, HRV
2005 Medical Director and Advisor at HQ ISAF KABUL, AFG
2011 Commander of German Medical Task Force (26. DEU Contingent ISAF), AFG
Federal Cross of Merit on Ribbon
Hungarian Service Medial of Merit in Gold Grade
NATO Medal ISAF
United Nations Medal