MOBILITY AS A GUARANTEE OF LIFE: ORGANIZATION OF THE WORK OF FORWARD SURGICAL GROUPS (FSGs) IN MANEUVER WARFARE

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Amir HARIMADOV

Captain of the Medical Service

Senior Resident of the Department of Forward Surgical Groups, Zaporizhzhia Military Hospital

Roman KUZIV

Lieutenant Colonel of the Medical Service

Commander of the Military Medical Clinical Center of the Eastern Region

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Movement Tactics, Safety, and Effectiveness

In modern warfare, the concept of a “static hospital” on the frontline has effectively disappeared. The enemy hunts medical points with the same priority as command posts. Therefore, our main weapon, apart from the scalpel and intubation kits, is mobility. A forward surgical group must be ready to change location within a matter of hours without losing operational capability.

In this article, I would like to systematize our experience regarding relocation, outline the key problems, and propose ways to address them in order to preserve the lives of our medical personnel and the wounded.

Problematic Issues During Relocation

Relocation is always a crisis moment. It is the time when we are most vulnerable. The main problems we face are:

1. Logistical chaos: Accumulation of property. Groups often become overloaded with excess equipment and everyday items that are difficult to load quickly. Proper and clear inventory management, with assignment of responsible persons during relocation, also becomes a problem due to personnel rotations.

2. Lack of reconnoitered locations: Orders to relocate often arrive suddenly, while the new deployment site — the “entry point” — does not meet safety or hygiene requirements: flooded basements, lack of ventilation, small room areas, lack of electricity and heat supply.

3. Loss of communication: During movement, vehicle groups are often split apart, radio communication is jammed by electronic warfare systems, and Starlink operates unstably while in motion without specialized equipment. More often, movement in convoys is impossible due to the threat of enemy strikes.

4. Threat from the air: FPV drones and enemy reconnaissance drones — “Orlans,” “Zalas,” and others — make any daytime movement of vehicles extremely dangerous.

5. Interaction with civilians: There is almost always a communication problem with civilian administrations of local communities regarding the selection of a new location. In most cases, they refuse to provide premises to the military, and for some reason this also applies to the medical component without exception.

Safety of Movement and Deployment: Survival Algorithms

This is the most important section. The medical cross on a vehicle is no longer protection, but a target. Hospitals are not cover, but a direct target for the enemy.

During movement:

• Dispersion: Movement in a convoy is prohibited. Vehicles must move at intervals of 100–150 meters or in small groups of two vehicles with a time gap.

• Electronic warfare coverage: Every medical vehicle, especially those transporting personnel and heavy equipment, must be equipped with mobile electronic warfare systems of short range to protect against FPV drones.

• Spectrum analyzers: The lead vehicle should have a frequency analyzer, such as “Tsukorok,” “Chuika,” or equivalent systems, for early detection of enemy UAV activity.

• Light discipline: Movement should mainly take place at night or in the “gray zone” — dawn or dusk — using only night vision devices for the driver. No headlights.

During deployment:

• The principle of depth: Priority should be given to basement premises with concrete roofing or specially equipped bunkers, dugouts, and similar shelters.

• Camouflage: Entrances to premises should be covered with thermal blankets or special curtains so that heat from the operating room does not “glow” in the thermal imaging camera of an enemy drone. Movement of personnel around the facility should be minimized, especially in military uniform, as medical personnel have their own uniform.

• Vehicle separation: Evacuation vehicles must not gather near the entrance. The sequence should be: arrive — unload — move away into cover, such as wooded areas, hangars, or similar shelters.

Systematization of Processes: From Chaos to “Tetris”

To solve the issue of speed, we are implementing a modular packing system:

• Standardization of cases: All property is distributed into shock-resistant boxes, labeled and numbered according to priority. For example: “Resuscitation 1” is opened first, while “Consumables Reserve” is opened last.

• Loading checklists: Each member of the group has an assigned area of responsibility. The surgeon is responsible for instruments, the anesthesiologist for monitors and ventilators, and the driver for the technical condition of the vehicle and fuel.

• “Pack-up in 30 minutes” training: We conduct regular rapid pack-up drills. The standard, according to literature sources, is from the command “Pack up” to engine start in 30–45 minutes. However, under our conditions and given the amount of equipment, pack-up time is 90 minutes, and deployment time is 120 minutes.

Technical Safety Measures in Modern Conditions

We cannot ignore the technological progress of warfare. Support for a forward surgical group now includes not only medicines and medical equipment, but also:

• Electronic warfare systems — stationary and vehicle-mounted: For covering the location of the stabilization point.

• Drone detectors: To alert personnel about an approaching threat and provide time to take shelter.

• Starlink with camouflage: The antenna should be buried or camouflaged into the terrain, the cable should be buried, and the Wi-Fi router should be shielded so that the signal is not visible from a long distance.

Motivation of Personnel

Relocation is physically demanding work, often performed in mud, cold, and under stress. As a commander, I see the following motivational levers:

• Personal example: The group leader does not stand aside but carries boxes together with the medics. Leadership means being present during the hardest moments.

• Understanding the mission: Everyone must understand that our speed equals the life of a wounded soldier. We relocate closer in order to shorten the evacuation distance. We are the soldier’s hope for survival.

• Safety and psychological relief as a priority: People work more calmly when they see that the commander cares about their protection — the presence of electronic warfare systems, reliable shelters, and armor.

Special attention must be paid to personnel rest, because the work of medical personnel is extremely difficult both physically and morally. Therefore, organizing a rest area, duty schedules, and quality nutrition is extremely important.

Conclusions

War is changing, and we are changing with it. Today, a forward surgical group is a high-tech, mobile, and protected organism. Our task is to make the relocation process as well-rehearsed as the algorithm of a surgical operation. Only a systematic approach, strict safety discipline, and technical equipment will allow us to fulfill our main task — to save the lives of the defenders of Ukraine and all those who have suffered from enemy actions.