Military medecine and civil health
Did you know that plastic surgery was developed in response to military needs? We often forget this, but many medical innovations were developed thanks to the army. Because the general physical conditions of soldiers can make the difference between the success and failure of a military operation, the armed forces must ensure the health of their members. That is why they do not hesitate to invest in research and development (R&D) in health care. But how does R&D in a military context work? How do military needs impact on health research? What can we learn from the medicine of war?
Military needs in health
It might be surprising, but when we read about the history of military medicine, it appears that fights are more of an exception than the rule. Mortality rate among militaries is also low during combat. According to Tien et al (2010), among 1889 deaths recorded in the Canadian Forces between 1983 and 2007, only 5% occurred during fighting. The remaining 95% were due to accidental injuries, natural diseases and suicides. In fact, health issues are more related to public health matters than to having to care for wounded soldiers. Before the 1940’s, the lack of hygiene made infectious diseases spread easily. Improvements in hygiene and vaccination have helped reducing the risk of contracting diseases such as cholera, hepatitis or influenza. Nowadays, armed forces members are also concerned by other public health issues such as smoking, obesity, alcoholism and operational stress.
However, it seems that most soldiers’ disabilities relate to musculoskeletal injuries. The latter are important to address as they may impact the operational readiness of an army. Musculoskeletal injuries have also led to increases in healthcare costs (hospitalization, rehabilitation) and the number of working days lost. In the Canadian Forces (CF), 53% of medical releases are due to musculoskeletal injuries (Canadian Forces Health Services Group, 2010). The nature of present military missions, which are more related to war than previous peacekeeping missions the CF were used to, may explain this trend. For example, in Afghanistan, there is a high incidence of explosion-related injuries due to the frequent use of improvised explosive devices by enemy armed forces. But the aging of military personnel, physical training and heavy equipments are also pointed as important causes of injuries.
Our dossier on the military medicine and civil health
This dossier examines the link between medicine and war and how military medicine contributes to advances in civil medicine. From trauma care to infectious diseases, militaries are always looking for new ways to improve treatments and prevention. Stéphane Bédard, founder and president of B-témia, a company that is developing a “dermoskeleton” for the military sector, explains how R&D in health can be related to military needs. David Blazes, commander in the US Navy, clarifies how programs of infectious diseases surveillance created by militaries contribute to public health security. Daniel Ayotte, medical administrator, describes the role of the Canadian Forces Health Services and how they intervene to protect soldiers and civilians in emergency situations. Finally, the article of Christiane Rochon, a PhD candidate in bioethics, examines how the dilemmas military doctors come across may throw light on ethical conflicts of medicine in general. Some contributions are signed by experts from military institutions that carry out complex and controversial roles, in Canada as elsewhere in the world.
|Author :||Pauline Boinot, M.Sc.
Canadian Forces Health Services Group (2010), Surgeon General’s Report. Building On Our Strategy, National Defence
Cravic, J.-Y., Banzet, S. (2009)., La prévention des risques liés à la préparation physique du militaire, Médecine et armées, 37, 5: 465-488
Rawling, B. (2001). La mort pour ennemi. La médecine militaire canadienne, Ottawa : L’auteur, 310 p.
Salisbury, D., English, A. (2003), Prognosis 2020: A military medical strategy for the Canadian Forces, Canadian Military Journal, Vol. 4 (2)