Ministero della Difesa

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"Vigorous Warrior" exercise 2019 in Romania exercise - The Atlantic Alliance trains its own medical assets

Editoriale - Redazione Giornale di Medicina Militare

Roma,  18 aprile 2019

​The fifth edition of the NATO Medical training exercise “Vigorous Warrior”, held in Cincu, Romania from 5 to 12 April 2019, involved 29 NATO countries along with 10 partner countries of the Atlantic Alliance.

The Vigorous Warrior represented an initiative of decisive visibility for the Military Health Services of the NATO countries, providing a unique opportunity to showcase the specialized health structures employed with the deployment of modular field complexes consisting of tents and shelters (Role 1, 2 and 3), together with land, air and naval rescue vehicles (tactical ambulances, rotary-wing and fixed-wing aircraft for medical evacuation, boarded health facilities) and exercise national personnel to operate integrated in a multinational environment.

The exercise recorded over 2,500 participants from 39 countries (NATO and partners). Civil and military, joint and combined multinational health facilities were deployed, including over 50 modular treatment facilities of different capability (Role 1, 2 and 3) deployed on 4 separate training sites, 3 national Role 4 located in Romania, Hungary and Germany, 9 civil hospitals, different tactical ambulances, including the Italian Army "Orso" armored ambulance (VTMM), rotary wing medical evacuation (MEDEVAC) assets and fixed-wing aircraft for strategic evacuation (STRATEVAC), afloat medical assets on naval Romanian units moored in the port of Constance on the Black Sea, along with dozens of ambulances and assets of both the Romanian civilian emergency service (SMURD) and the Hungarian (HONUR).

The "Vigorous Warrior" exercise tested the operational readiness and coordination of all medical assets and facilities deployed by participating countries in a complex scenario of both warfare (NATO art. 5 - Collective Defense) and civil emergency (NATO art. 3 - Civil preparedness and Resilience), also verifying the potential of a systemic response to complex threats, including attacks in urban areas and biological emergency centers.

The Italian Defense has deployed different specialized assets, both for the management and organization of the Exercise, and for the operational / training activities with Army, Navy, Air Force and Carabinieri (Military Police-MP) personnel.
In particular, Different Services provided a decisive contribution to the success of the Exercise: The General Directorate of Military Health Services, which established the exercise features - Lineamenti di Esercitazione - associated with the Italian contribution to the exercise, along with an innovative team for responding to biological events Rapid Deployable Outbreak Investigation Team (RDOIT); the Army with the NATO health component of Rapid Deployable Corps Italy (NRDC-ITA); the Military School of Health and Veterinary along with the Multinational Medical Joint Training Center (M2JTC), involved in training and assessment of the health facilities deployed on the ground; the Joint Military Hospital “Celio” of Rome, with an advanced surgical team (Forward Surgical Element - FSE); the Command of Logistic Supports provider of the ground-Medevac capacity; the Navy with highly qualified personnel in the field of biological defense and emergency; the Air Force with a team of bio-containment and specialized personnel for strategic health evacuation involved in the operational room (Patient Evacuation Coordination Cell - PECC).

The logistic support to national assets and personnel was guaranteed by the autonomous grouping of the Ministry of Defense (Raggruppamento autonomo del Ministero della Difesa - RAMDIFE). Personnel from the Civil Protection - Health Resources Service, Catholic University of the Sacred Heart of Milan, and the "Lazzaro Spallanzani" Hospital integrated national contribution, in an interagency perspective.

The exercise once again highlighted the great potential of the health component of the Italian Armed Forces, able not only to guarantee full interoperability with Allied Countries in a war scenario, but also to further reinforce the efficiency and effectiveness of civil preparedness by ensuring dual use capabilities in civil cooperation and support for the response to disaster / emergency situations.