**2.1 Mission definition and timing of deployment**

Disasters around the world with the potential for the need of international medical assistance are assessed by Israeli governmental bureaus (Ministries of Foreign Affairs, Health, National Security and others), as well as by military offices and local non-governmental organizations. Sending a preliminary assessment team is important. This was the case, for instance, in the pre-FFH era, during the ongoing Cambodian disaster in 1979, were prior assessment of needs, combined with fund raising, led to an incorporation of a drafted team into a Red Cross field hospital in Sakeo, Thailand. More recently, for example, a special assessment team was en route to Haiti 11 h after news of the earthquake reached Israel [5]. An assessing advancing team to Japan evaluated the need for a full scale functional FFH, given the damage to local healthcare system and the medical needs at the disaster zone, coordinated the efforts with the local authorities and regional healthcare providers, defined the required location of the operation, and assessed specific irradiation risks [6].

**59**

*Healthcare Military Logistics at Disaster Regions around the World: Insights from Ten Field…*

Acute disaster settings often require immediate assistance, precluding time consuming prior assessment. Furthermore, by the time relief operation arrives, conditions and needs might change substantially, especially if the time required for deployment is extended. Therefore, the Israeli FFH was often one of the first international humanitarian missions active on ground, adopting the principal of "just on time and just in place", at the price of incomplete assessment and a large margin of uncertainty. To compensate for that, the FFH was designed in a way to meet unexpected situations, first by being composed of a multidisciplinary team, and second, by being self-sufficient and independent. Lastly, initiative with numerous improvisations with the help of local agencies and manpower helped coping with unexpected situations. For example, the Armenian mission, operated within a roofed stadium, transformed into a city hospital with the use of plastic sheets stretched on cables, which divided the space into functioning departments. This obviously required a substantial aid provided by local authorities and medical staff [7].

Since swift air deployment is essential to operate expeditiously, missions were airborne, deployed usually in military Hercules airplanes (that enable transportation of vehicles) and occasionally in commercial aircrafts for long-distance missions such as in Haiti/Japan/Nepal. Location of the medical relief operation was usually decided before arrival, and coordinated by pre-assessment team based on dialogs with local health care system and logistic headquarters. Issues taken into account were accessibility to patients, safety (regarding aftershocks in earthquake scenarios, or appropriate safe surroundings in a war zone), and proximity to air fields (for supplies and evacuation in case of emergency). For instance, an intact, roofed municipal sports center provided an adequate shelter and convenient location for the FFH in the snowy Kirovakan. The gymnastic stadium was divided into four functional areas by stretched cables from which black polyethylene sheets were hung, while supplies and surgical rooms were placed on the podium. In Zaire, sleeping quarters were located within an unfinished, fenced, and easily protected private house adjacent to the field hospital. In the missions to Bhuj, India and to Port-Au-Prince, Haiti, soccer fields were chosen as the operation site, because it's a well confined area, usually with one/two entrances, has walls (protection), and its

In a chaotic post-disaster environment, there is a need to utilize both long-range systems to communicate with the delegation's country of origin, and short-range systems to enable communication between site of field hospital home base and local authorities, ambulances, helicopters, as well as delegations from other countries deployed in disaster area. It includes standard walkie-talkie (130–170 MHz), loudspeakers, telephony, fax, internet, email and video conference. Range, spectrum of radio frequencies, bandwidth, weight, size, ease of usage, reliability, batteries life, and cost are important factors in determining which systems the delegation should bring to disaster area. Caution should be taken when patrolling in disaster area with long antenna near collapsed wiring in an earthquake setting. Standard military VHF radio (30–75 MHz) that are non-dependent on local network, proved to be useful in IDF missions for communication with neighboring military units from various countries. In IDF mission to Rwanda, military VHF systems were utilized for communication with vehicles moving at the range of up to 30 km from the headquarters at the field hospital, which also covered mobile short-distance communication

*DOI: http://dx.doi.org/10.5772/intechopen.88214*

**2.2 Location of the FFH**

size is adequate [8, 9].

**2.3 Communication systems**

*Healthcare Military Logistics at Disaster Regions around the World: Insights from Ten Field… DOI: http://dx.doi.org/10.5772/intechopen.88214*

Acute disaster settings often require immediate assistance, precluding time consuming prior assessment. Furthermore, by the time relief operation arrives, conditions and needs might change substantially, especially if the time required for deployment is extended. Therefore, the Israeli FFH was often one of the first international humanitarian missions active on ground, adopting the principal of "just on time and just in place", at the price of incomplete assessment and a large margin of uncertainty. To compensate for that, the FFH was designed in a way to meet unexpected situations, first by being composed of a multidisciplinary team, and second, by being self-sufficient and independent. Lastly, initiative with numerous improvisations with the help of local agencies and manpower helped coping with unexpected situations. For example, the Armenian mission, operated within a roofed stadium, transformed into a city hospital with the use of plastic sheets stretched on cables, which divided the space into functioning departments. This obviously required a substantial aid provided by local authorities and medical staff [7].
