Emergency medicine in conflict zones rests on precision, discipline, and respect for protocols. A conversation between a military doctor and a female doctor from Doctors Without Borders showed that although they work in the same environment, the reality of their work differs fundamentally. The common denominator is efficiency and preparedness – the price of mistakes is far too high.
When medicine goes to war
Military missions are strictly organized: there is room for training, a clear division of roles, and standard procedures that everyone knows. Humanitarian teams, by contrast, operate in a less protected environment, and their security rests mainly on the quality of care provided, neutrality, and community trust. Doctors Without Borders have a reputation for being “first in, last out” and accept calculated risk, not a gamble. According to the UN, humanitarian workers are also facing record levels of violence, which only increases the pressure for discipline and clear rules.
Triage, evacuation, and a trauma plan
In the military, “everyone knows what to do” – from the first report of a casualty to admission to the hospital, where precision and repeatedly drilled scenarios are decisive. Humanitarian teams in an active conflict generally do not travel out to the patient; it is safer if the patient comes to them, and then the protocols adapted to the context and the available medicines or equipment are followed strictly. Elsewhere, for example in Ukraine, evacuation ambulances and a train help move the wounded from the front to the rear. In mass disasters such as earthquakes, it is crucial to first develop a plan – sometimes even after a longer consultation – and only then stick to it rigorously, because improvisation at that scale has its limits.
Lessons for hospitals at home
Experience from missions shows that triage and trauma plans must be taken seriously and practiced regularly; even if they work “only” at 70%, they still save lives. Briefings and debriefings, systematic reports, and a culture of learning from mistakes without punishment are important – otherwise errors repeat. Protocols exist, but they also have to be followed and audited; insurers and quality data should play a role too, not just figures on costs or waiting times. The fundamentals, however, remain the same as in combat: efficiency, uniform procedures, and the readiness of the entire team.
