After the start of Russiaʼs full-scale war against Ukraine, NATOʼs eastern flank countries — in particular Lithuania, Poland, and Estonia — are actively preparing their hospitals for possible crisis situations in the event of aggression from Russia.
Politico writes about this.
All countries on NATOʼs eastern flank are reviewing crisis response protocols for medical facilities, organizing training, investing in helmets and body armor for medics, and moving operating rooms underground.
In Estonia, hospitals, ambulances, and doctors receive instructions on how to act in a crisis situation — when there will be many wounded and they will have to treat injuries that rarely occur in peacetime: explosion injuries, gunshot wounds, burns, amputations, head and spinal injuries.
This year, Lithuania will hold seven joint military exercises and more than ten civil security trainings for medical personnel, said Health Ministry spokesman Julianas Gališanskis. The country is also creating an emergency medical team. Last month, young doctors organized a forum on medical preparedness for war. Some doctors are traveling to Ukraine to see firsthand how hospitals operate during shelling, mass injuries and power outages.
“The question is not whether [Russia] will attack. The question is when, ” said Ragnar Vaiknemets, deputy director general of the Estonian Health Board.
Russia’s invasion of Ukraine has shown that modern wars no longer spare medical services — or civilians, Politico notes. Eastern European countries are taking note. Located just 50 kilometers from the EU border with Belarus, Vilnius University’s Santaros Clinics is developing underground infrastructure, shelters, helicopter landing pads and autonomous systems that will allow it to function even in the event of a power or water outage.
In Estonia, in addition to bulletproof vests for ambulance crews, they plan to issue satellite phones to maintain communication in the event of a failure of traditional networks. If necessary, they even plan to create an independent Internet network. And after Russia massively attacked Ukraineʼs energy sector, hospitals in European countries are being equipped with generators.
“We know for sure that Russia is attacking civilian infrastructure and energy facilities, which means that there cannot be situations where a hospital is not working due to problems with the power plant,” Vaiknemets said.
Many hospitals in Eastern Europe are particularly vulnerable because they were built using Soviet-era designs, so experts are looking into ways to convert basements into operating rooms if needed.
In addition, Estonia is purchasing mobile medical units — temporary treatment centers that can be deployed in emergencies. While European countries have an average of 11.5 intensive care beds per 100 000 population, “wartime needs may require 3-5 times more capacity,” says Bjorn Guldvog, a special advisor to the Norwegian Directorate of Health.
What problems may arise?
However, even the best-prepared hospitals cannot function without medicines, special supplies and equipment. For example, Estonia has allocated €25 million for supplies for mass casualties, including orthopedic equipment, tourniquets and trauma kits. And in Latvia, healthcare facilities have been required to maintain a three-month supply of medicines since the Covid-19 pandemic.
The labor shortage is a problem for the Baltic states, which already have a shortage of medical personnel. For example, Estonia, with a population of 1.3 million, has almost half as many medical workers per capita as Germany.
But there is another problem: in the event of war, not all doctors are ready to stay in the country and work. While some specialists — especially those without families — say they would stay, a survey in Lithuania showed that more than a quarter of medical workers would leave, a third are not sure, and less than 40% would stay. Estonia expects similar sentiments.
Modern attacks can hit targets hundreds of kilometers away, putting hospitals and civilian infrastructure far from the front lines at risk. This means that countries that do not border the war zone also need to prepare to receive the wounded and refugees.
Jos Josten, medical advisor to the European External Action Service, the EU’s diplomatic corps, warned that EU solidarity would be put to the test in such circumstances. “If Lithuania is taken over, who will take care of the Lithuanians, because Lithuania will no longer exist? But the EU will remain,” he said.
He also called on European institutions to create funds to help civilian and military victims, as well as those who will be forced to flee.
For more news and in-depth stories from Ukraine, please follow us on X.