Biopreparedness and Public Health by Iris Hunger Vladan Radosavljevic Goran Belojevic & Lisa D. Rotz

Author:Iris Hunger, Vladan Radosavljevic, Goran Belojevic & Lisa D. Rotz
Language: eng
Format: epub
Publisher: Springer Netherlands, Dordrecht

10.4 Health Care in the Armed Forces

The Basic Constitutional Law (Grundgesetz) prohibits deployment of armed forces within Germany, with some rare exceptions such as emergency relief in the case of a natural disaster. The civil-military cooperation (CIMIC) within Germany is based on the Law on Civil Protection and Disaster Relief (Gesetz über den Zivilschutz und die Katastrophenhilfe des Bundes). In addition, the Federal Armed Forces (Bundeswehr) are deployed in humanitarian aid and multinational UN or NATO crisis containment missions abroad. Currently, about 7,700 military personnel are deployed on various missions such as ISAF or KFOR [7]. Some of these missions take place in tropical or subtropical areas and thus soldiers might contract not only diseases endemic in Germany but also pathogens and parasites endemic in these regions. Many of these pathogens are considered to be biological agents that may potentially be misused by terrorist or militant groups.

The health care for soldiers is the responsibility of the Chief of Staff of the Medical Service (Inspekteur des Sanitätsdienstes der Bundeswehr, InspSan) at the Federal Ministry of Defence (Bundesministerium für Verteidigung, BMVg). The implementation of public-legal tasks in the fields of hygiene and infection protection is the mission of the BundeswehrMedical Office (Sanitätsamt der Bundeswehr, SanABw) and the medical commands (Sanitätskommandos, SanKdo). However, these structures are currently undergoing organizational changes due to the structural reform of the Bundeswehr.

Disease surveillance, prevention and control, and hygiene supervision are the responsibility of special departments of health and veterinary services at the SanABw and at the medical commands. Laboratory and investigational support is provided by the BundeswehrCentral Institutes of Medical Service (Zentrale Institute des Sanitätsdienstes der Bundeswehr, ZInstSanBw) in Coblenz, Kiel and Munich (comparable to the civilian country health investigation offices), the special branch of tropical medicine of the Bundeswehrat the Bernhard Nocht Institute in Hamburg, and the BundeswehrInstitute of Microbiology (Institut für Mikrobiologie der Bundeswehr, InstMikroBioBw), which was established in 2002 in Munich [8].

In case of outbreaks of communicable diseases in military communities, inspection, sampling, epidemiological and laboratory investigations, as well as anti-epidemic countermeasures will be performed by fact-finding or epidemiological investigation teams and specialists of the Bundeswehrhealth and veterinary services using medical intelligence. In parallel, military practitioners, clinicians and microbiological laboratories report diseases or notifiable pathogens: to the local public health officers and health agencies as required by the IfSG.

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