Airborne medics go underground to survive, Ex Mirabilis Serpent 2024

Airborne medics have gone into the “cold, dark, damp, claustrophobic, and dirty” underground as they look to apply lessons from Ukraine to improve their survivability on the battlefield.

Responding to the challenge of operating under the all-seeing eyes of drones, 16 Medical Regiment (16 Med Regt) has worked on making itself harder to detect. Troops set up medical facilities out of sight in cellars, while medics out on the ground moved by quad bike rather than Land Rovers to present smaller targets.

Major Iain MacArthur said: “The key military development in recent years has been the emergence of drones, initially as reconnaissance assets but increasingly providing a strike capability. As we’re seeing from fighting in Ukraine, drones make it harder to camouflage, conceal and protect troops and facilities. In this training, we’re thinking about what we can do to reduce our footprint and be harder to detect, so that we are better able to survive on the modern battlefield and continue delivering medical care.”

A key serial saw troops establish a medical facility in the cellars of houses on the Longmoor training area in Hampshire, with simulated patients carried in through tunnels to receive life-saving treatment in the safety of subterranean cover.

Staff Sergeant Shaun Newbury, a combat medical technician (CMT), has been on specialist training for firefighters and paramedics rescuing casualties from collapsed buildings and basements.

“Working underground is cold, dark, damp, claustrophobic, and dirty,” he said. “You have to consider ventilation and monitor the levels of a range of gases that build up in confined spaces – for instance, high or low levels of oxygen are dangerous for different reasons. In a tactical scenario, troops have to stay under cover in daylight hours and put power supply in without cabling or generator exhaust that can be spotted by drones. It’s an incredibly challenging and stressful environment to achieve the basic routines of life, let alone delivering battlefield medicine. Even the simple act of moving a casualty, whether that’s down from a building’s top floor or through a tight tunnel, becomes difficult. We’ve seen our medics really show their problem-solving skills, whether that’s coming from their military experience or people who are cavers or climbers in their personal life.Everyone has been engaged and interested in this training, because the relevance of being able to operate in these conditions is obvious when you see news reports from Ukraine.”  

Frontline medical care is provided by Pre-Hospital Treatment Teams (PHTT), made up of a doctor, a nurse and CMTs working from a tent. The usual practice would see a PHTT travel in a Pinzgauer patrol vehicle and a Land Rover Battlefield Ambulance, but this was scaled down to two quad bikes to be less visible.

Corporal Kayleigh Dawe, a CMT, said: “On quad bikes, we’re smaller and move faster so we’re a harder target to spot and it’s easier for us to hide amongst trees and buildings. We can also get much closer to a casualty, so we can provide initial treatment and extract them to safety more quickly.There is a trade-off with the amount of equipment we can carry, but we’ve put a lot of thought into it and prioritized our kit to be able to deliver the same level of medical capability.”

The experimentation took place during Exercise Mirabilis Serpent, which is preparing the regiment’s 19 Medical Squadron to be on very high readiness for operations as part of 16 Air Assault Brigade (16 Air Asslt Bde), the British Army’s global response force.

16 Med Regt provides the full spectrum of medical support to 16 Air Asslt Bde, from care at the point of wounding to life saving damage control surgery, as well as looking after troops’ general health needs. Its personnel - including consultant orthopaedic surgeons, dentists, biomedical scientists and CMTs - are specially trained and equipped to deploy by parachute, helicopter, or airlanding.