US military must be prepared to play humanitarian assistance role in Ukraine crisis

At the latest NATO summit, President Biden announced $1 billion in new funding for food, clean water, shelter and medical care for those in Ukraine and those who fled to neighboring countries, but there could be a role for more direct assistance if requested by affected countries.

Since the start of the Russian invasion on February 24, more than 4.1 million people have fled Ukraine and up to 6.5 million have been internally displaced, around half of them children Ukrainians, according to the United Nations.

The initial response from nations surrounding Ukraine has been generous but may not be sustainable. Foreigners kindly opened their homes and their governments offered health services to Ukrainians. Current estimates indicate that 2.6 million Ukrainians fled to Poland, 609,000 to Romania, 365,000 to Hungary, 387,000 to Moldova and 281,000 to Slovakia.

However, neighboring countries like Poland and Romania may soon reach a point where they will be overwhelmed by the influx of refugees. Officials in Krakow and Warsaw are seeking assistance to deal with displaced people in Poland. Warsaw’s computer system was unable to keep up with the volume of information about new arrivals. In Romania, shelter, diapers, infant formula and SIM cards remain in high demand. Germany echoes similar sentiments as up to 15,000 displaced people arrive every day.

In response, the United States Agency for International Development, or USAID, at the Department of State dispatched a Disaster Response Team, or DART, to the area. If warranted, USAID offers assistance to host countries through the Office of Foreign Disaster Assistance, or OFDA.

In addition to these efforts, it is worth considering the U.S. Army’s Humanitarian Assistance and Disaster Response, or HADR, core capabilities for this crisis. US forces have responded to a myriad of global disasters. Whatever the disaster, be it a tsunami, an earthquake, or a disease outbreak, the U.S. military provided critical resources, transportation, medical supplies, and centers treatment, as well as logistical support in emergency circumstances. Of course, host nations (or NATO) must first request humanitarian assistance from the US before US military HADR invocation processes can move forward.

The US military has unmatched expeditionary medicine and logistics capabilities and expertise, and the need for medical support and supplies is acute. Another essential capability of the US military is the response to chemical, biological or nuclear threats. Since the washington time and other news outlets have reported President Biden’s warning about Russian chemical attacks in Ukraine, planning for this scenario can help. Of course, any aid provided by the US military would have to be carefully calculated to avoid widening the conflict.

Military HADR is not a long-term solution to a humanitarian problem. Joint Publication 3-29, the official U.S. Army policy on humanitarian assistance by the Joint Chiefs of Staff, states that Foreign Humanitarian Assistance, or FHA, is intended to supplement or supplement efforts civil authorities or host country agencies with primary responsibility for providing assistance.

Further, it states that “crisis response and limited emergency operations are generally of limited scope and scale and are conducted to achieve a very specific objective within an operational area”. In other words, military assistance in humanitarian crises is only meant to be temporary. It plays a bridging role to help agencies on the ground provide direct relief.

The risks of outbreaks of infectious diseases such as COVID-19 among a population already affected by low vaccination rates increase exponentially with crowded spaces, lack of sanitation or personal protective equipment and health services. limited health caused by war conditions. Policy makers must also consider other infectious disease threats; for example, drug-resistant tuberculosis is prevalent in parts of Ukraine.

Host countries and relief agencies must be prepared to deal with communicable diseases such as polio, tuberculosis and COVID-19, while managing non-communicable diseases and acute conditions that are common among displaced people – all simultaneously managing the logistics of food and housing, reuniting families, obtaining travel permits in the host country, and planning for onward movement and transition of care.

It is expected that there will be trauma-related injuries, either from exposure to weapons or by accident, including burns and inhalation injuries. Some may be victims of torture, rape or other intentional injuries. This situation may require high-level medical, surgical, obstetrical, pediatric, or behavioral care that is beyond the capabilities of the host nation or relief organization. These factors militate in favor of the American military presence of the HADR as soon as possible.

Although the military is not the best long-term solution to a humanitarian problem like this, if called upon to assist, military planners will set the conditions for an orderly transfer of HADR operations to host nations. , non-governmental organizations or NGOs and private companies. agencies.

Additionally, the US military has a long history of working with and alongside NGOs on numerous occasions to ensure a smooth transition. For example, NGOs regularly participate in US Navy medical missions aboard hospital ships. Although several experienced US and international NGOs are currently on the ground, the US military’s unparalleled skills in HADR operations can provide the infrastructure needed to coordinate disparate efforts.

Many US-based NGOs and private organizations already provide humanitarian assistance in the region and, if called upon, it is likely that the US military will explore relationships with these entities, as described in the policy. Logistics, operations, and public health capabilities are as important as medical care in this situation, so coordination with a balanced collaboration of organizations, each with unique capabilities, will be paramount to the success of relief efforts.

As the world faces a potentially more dangerous phase of war – which may include exposure to unconventional weapons – it is prudent to be prepared for rapidly escalating humanitarian challenges and the limitations of host nations in the war. region to cope with further waves of displacement. Short-term collaboration between US military planners and US-based NGOs and humanitarian organizations is warranted and should be undertaken.

Louis C. Tripoli, MD, Rear Admiral (Retired), United States Navy and former Command Surgeon, United States Indo-Pacific Command, is an advisor to AM LLC, a leading solution provider K-12 and community health. The views of Dr. Tripoli do not represent official US government or DoD policy.

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