Intended for healthcare professionals

Clinical Review ABC of conflict and disaster

Military approach to medical planning in humanitarian operations

BMJ 2005; 330 doi: (Published 16 June 2005) Cite this as: BMJ 2005;330:1437
  1. Martin C M Bricknell, chief medical adviser,
  2. Tracey MacCormack, health services attraction and retention officer
  1. Headquarters Allied Rapid Reaction Corps, Germany
  2. Canadian Forces Health Services Group Headquarters, Ottawa, Ontario, Canada.


    Military medical forces may be the only medical services available in the immediate aftermath of conflict and are often required to coordinate the re-establishment of civilian services. UK military medical services have a long history of providing assistance in humanitarian emergencies.

    Military medical planners apply a structured approach to determine the requirements for medical support to military operations. This “medical estimate” has two outputs. The first develops health promotion and preventive medicine advice and actions to help maintain the physical, psychological, and social health of the military force. The second output develops missions and tasks for the medical elements of the force.

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    British Army ambulance in a refugee camp in Kosovo, 1999. Military medical forces may be the only medical services available in the immediate aftermath of conflict

    Estimate format

    In military medical planning, a planner is given a mission by headquarters. The planner is required to assess this mission to establish missions for his or her subordinates. If the mission is unclear the planner may seek further information from intelligence reports or reconnaissance. Thus, the critical task is interpretation of the mission in order to give subordinates instructions to fulfil the planner's interpretation of the problem.

    Background information—At the start of an estimate it is important to assemble background information. This might include maps, situation reports for the local area, news reports, and information about prevalent diseases. Internet sites hosted by international aid organisations such as the United Nations, World Health Organization, US Centers for Disease Control, and the UK Health Protection Agency may contain useful information. Less formal sites such as ReliefWeb and Well Diggers Workstation contain much practical information.

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    The five steps of the military medical estimate

    The steps in the estimate

    An estimate follows five steps: mission analysis, evaluation of factors, consideration of courses of action, commander's decision, and development of the …

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