As medics are being forced to hide underground, how do you conceal a hospital?
Military medics have been demonstrating a new idea to Nato leaders on Salisbury Plain.
Personnel from 2nd Medical Group, who provide hospital care and specialist medical support to deployed forces, showed officers from across the alliance how the mesh concept works.
In Afghanistan there was no threat from the air and casualties could be evacuated to a modern tented healthcare facility away from the frontline, treated and usually saved – but in Ukraine it's practically the opposite.
The threat comes from the skies.
And what's more, hospitals are often the actual target.
In a recent Defence Committee meeting, Dr Katie Geary, senior medical director for International SOS, a medical and healthcare company, told MPs that change was needed.
"Part of the culture is still that healthcare will get to you and you will be returned home," she said.
"In Afghanistan and Iraq we saved pretty much everyone that was tier 1 [immediate care needed].
"In Ukraine [medics are saying] tier 1 – you're doomed – tier 4 [severe injuries] – you're doomed. Wwe need palliative care in the battlefield."
In addition, the Ukraine war is increasingly playing out underground.
Defence experts predict a future where the surface battlefield becomes so exposed, so constantly monitored and so lethal that military personnel will be forced to manoeuvre beneath the earth itself.
With the evacuation chain being so dangerous, if medics are to save soldiers' lives, they must now be on the frontline themselves and they too must be concealed.
"We can no longer have a large, visible medical treatment facility that can easily be targeted," said Lieutenant Colonel Jason Cupitt, an Army Reservist who works as a consultant in anaesthesia and intensive care in civilian life.
"What we've realised in current large–scale combat operations in Europe is that there's a significant aerial threat and that threat is to medical treatment facilities as well as frontline troops."
So how do you hide an entire hospital?
That's where the'mesh concept comes in.
It breaks down a traditional hospital into nodes – with small facilities that are easier to hide.
Sections like the casualty reception, resuscitation, surgery and ward care are spread across separate bunkers and basements – maybe 100m or so apart and all hidden from sight.
Dispersing a hospital creates obvious practical challenges.
Patients, equipment and supplies must move between locations.
Lightweight, battery–powered X–ray equipment offered one example of how new kit could help medics work with less dependence on a fixed power supply.
It's likely there would still need to be a larger facility further from the frontline – but even that would need to be dug in or underground – in something like an underground car park.
The demonstration formed part of Exercise Bellatorian Cyclone.
Medics rehearsed assessing simulated casualties on arrival and moving them to the right treatment area – using several buildings at Copehill Down.
The training will help inform further development of the concept and its potential use in supporting Nato forces.
The aim is to protect medical teams while ensuring wounded soldiers receive the care they need.
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