Health Systems Strengthening
The CHSR offers support to health systems strengthening efforts, identifying and recommending changes in policy and practice in health systems outside of the MHS, so that they can better respond to health system challenges. Additional work supports NATO allies in understanding their health and trauma systems preparedness for LSCO.
ASSESSMENT OF UKRAINIAN MEDICAL SYSTEMS: SUPPORT OF TRAUMA AND COMBAT CASUALTY CARE IN ACTIVE COMBAT ZONE
The US population is impacted by the availability, quality, and rapidity of pre-hospital care in the event of large-scale emergencies. Historical examples include natural disasters, terrorist actions, and structural failures. The US military and civilian health systems benefit from lessons learned during a large-scale emergency response, particularly when austere or inclement conditions, site security, or supply issues in regions complicated by challenges to communications, air space, and more.
This research aims to improve understanding of large-scale response through examination of the military and civilian trauma systems in Ukraine (UKR) since the Russian invasion, with the expectation of sharing lessons learned to build adequate military and civilian capability to respond to large emergencies. The objective of this award is to describe the challenges and needs of the Ukraine health and trauma system and how they have changed since the Russian invasion and evolved with drone warfare and sustained combat operations. This work will generate recommendations and lessons learned for technical and operational training, tools/devices, and system strengthening. These lessons learned will assist Ukraine with the ongoing conflict and will also provide insights to inform current and future multi-domain medical operations for the United States and its allies.
ASSESSMENT OF THE CIVILIAN-MILITARY INTERFACE IN THE TRAUMA AND REHABILITATION SYSTEMS OF NORDIC COUNTRIES
The populations of the High North countries are impacted by the threat of near-peer conflict occurring in Europe and the growing importance of the Arctic region in geopolitical affairs. Assessment of the civilian trauma/rehabilitation systems, their synchronization with the defense departments, and potential gaps in the operation within these countries during the war is critical. This assessment will provide a framework for the defense departments and trauma/rehabilitation systems in the Nordic countries to grow their capacity, capability, and function, providing a predictable and sustainable system, should large-scale ground combat operations commence.
This study will provide a comprehensive analysis of civilian and military trauma systems in Nordic Countries utilizing an organized assessment methodology and will be the first comprehensive review of these systems. Current trauma/rehabilitation medicine practice in NATO countries is built on experiences from Operations Iraqi Freedom, Enduring Freedom, and New Dawn. However, LSCO will be markedly dissimilar to those conflicts, and this project will inform the injury pattern types expected in LSCO to fundamentally shift the preparations needed when navigating the new world of LSCO and military medicine. If there are gaps in the capability or capacity to deliver trauma and rehabilitative care in Nordic countries, this project will identify them and enable changes in clinical practice to address the gaps via targeted GHE programming.
PREVALENCE OF WAR-RELATED ABUSES AND MENTAL HEALTH SYMPTOMS IN UKRAINE SINCE THE START OF THE WAR
Human Security objectives in Ukraine are critical to advancing global efforts towards sustainable peace. This research aims to explore the specific goals and strategies that
guide the involvement of human security processes in Ukraine. By understanding these objectives, we can enhance international frameworks, inform policy, and promote practices that better support conflict resolution and peacebuilding and in turn lessen the risk of a Large-Scale Combat Operation that would require an Article 5 NATO event and thus pull the US into a larger conflict in Europe. And, by studying conflict-related sexual violence (CRSV) which are more than 50% of the human security pillars in Ukraine, this research aims to galvanize the US public to support initiatives that address CRSV. It underscores the importance of collective action and informed policymaking in combating CRSV, ultimately contributing to a more just and humane world. By strengthening the connection between the US public and international human rights issues, this fosters a sense of global solidarity and responsibility towards those affected by conflict and violence. Understanding the human security issues in Ukraine is necessary to inform current and future medical operations and support for Ukraine, the United States, and the North Atlantic Treaty Organization (NATO).