Zygmunt F. Dembek reports back from EpiMilitaris – Poland’s International Bioterrorism Conference

The 3rd International EpiMilitaris Scientific Conference was held from 13-16 October 2014 in Ryn, Poland. This annual international bioterrorism symposium attracts government, military, and civilian leaders from throughout Europe and the United States to meet and discuss their experiences and best practices for the prevention and response to bioterrorism events and natural disasters.

The sponsors of this conference included the Epidemiological Response Centre of the Polish Armed Forces (headed by Col. Arthur Zdojewski), the Polish Military Medical Training Center (led by Col. Zbigniew Aszkielaniec), the Polish Civil Defence Agency (directed by Col. Zbigniew Piontek), and the US Defense Threat Reduction Agency (DTRA).

Over the past three years epidemiologists, physicians, and scientists have met at the historic castle-hotel Zamek Ryn, located in the city of Ryn in northeastern Poland’s Masurian Lake District. While there, they have exchanged information on state-of-the-art biodefense measures and technologies.

Battlefield medicine

The purpose of the conference and practical exercise was to develop standards for field medicine based on Polish and allied nation health experience, and to demonstrate advanced capabilities for field medicine application and biological threat response, particularly those that support command decision-making process after incidents where biological agents have been used.

The encompassing theme of this year’s EpiMilitaris conference in Ryn was battlefield medicine, and drew more than 100 attendees to this international symposium. This incorporated the operation of the healthcare system in the field, organization of health services in crisis and war, best practices of civilian and military field hospitals, medical evacuation, and novel medical technologies including rapid diagnostic laboratory.

Conference topics included:

  • Battlefield medicine with particular emphasis on field hospitals
  • Rapid field diagnostic capacity in field laboratories
  • Rapid Deployable Outbreak Investigation Team (RDOIT)
  • Medical evacuation of biological casualties
  • CBRN medicine
  • CBRN forensic analysis conducted in a contaminated zone
  • Health services preparations and management during crisis or war
  • Health service operations during missions, rescue and relief operations
  • Medical training systems
  • Toolsets to support the chain of command
  • New technologies to support the field medicine decision-making process
  • Threat detection and reporting
  • Response and recovery after biological incidents

Poland’s partnerships

Article 2Poland became a member nation of the North Atlantic Treaty Organization (NATO) on 12 March 1999, and has partnered with the US State of Illinois under the US National Guard’s State Partnership Program since 1993. This has involved the cooperative exchange of military-to-military training opportunities. The State of Illinois is a natural partner for Poland, as the city of Chicago (the third largest city in the US) is home to well over a million residents of Polish descent. Both countries, and particularly the State of Illinois and Chicago have benefited from this peer-to-peer training, with enhanced capacity and the formation of long-lasting professional and personal relationships.

Poland has also held membership in the International Security Assistance Force (ISAF) – a NATO-led security mission – with deployments of its military medical personnel and assets to Afghanistan, and had previously been an active member nation of Multi-National Force– Iraq (MNF-I).

Biological resiliency

Another highly successful result of this collaboration with the US is Poland’s participation in the Transatlantic Collaborative Biological Resiliency Demonstration (TaCBRD) – a joint project between Poland and the US Departments of Defense, State and Homeland Security, significantly enhancing capacity to detect and respond to a biological attack. The TaCBRD demonstrations and analysis to counter a wide area biological event were modelled and discussed by participants during the conference, with particular emphasis upon reducing the time required for Poland to recover from a biological event. A video of US and Polish Army forces working together during a TaCBRD demonstration in Lodz, Poland can be seen here:

https://www.dvidshub.net/video/296049/tacbrd-poland#.VPNrAPnF8bw

Speaker topics

Dr Bryan Christensen reported first-hand from his experiences in the Ebola ‘hot zone’ in Lagos, Nigeria, where he had just been assigned as a participant in the US Centers for Disease Control and Prevention (CDC) Ebola response team. Dr Christensen had worked to train local physicians and nurses on proper infection control principles and practices, with emphasis on personal protective equipment. He also reported on his work with the World Health Organization (WHO) and Médecins Sans Frontières (MSF) in constructing an Ebola hospital and preparing for increasing numbers of Ebola cases.

Professor Zygmunt Dudkiewicz described the history of battlefield medicine, with its considerable improvements during the late 19th and early 20th centuries. I then gave a presentation highlighting the coordination now required by military and civilian health authorities for the consequence management subsequent to a modern day bioterrorism event, and also described potential deployed scenarios and challenges for the Rapid Deployable Outbreak Investigation Team.

Representatives of the Polish Army discussed battlefield medicine doctrine and practice, field diagnostics, and organization and operation of epidemiological teams operating in areas of the mission. Crucial training of health personnel and the use of emergency procedures specific to the battlefield were also examined. Topics of immediate relevance to medical personnel included experiences with the use of anesthesiology and intensive tactical care in the field in Afghanistan, lessons learned from improvised explosive devices (IEDs), long-distance aeromedical evacuation of biological casualties, and contemporary training modalities for field medicine for healthcare providers.

Battlefield demonstration

A demonstration of Polish capacities in battlefield hospital, laboratory, patient transport, decontamination, and treatment facilities was performed during the conference by military medical units of the Polish Army. Simulated contaminated biological casualties were brought from the battlefield setting and transported in a biologically secure transport environment to a field treatment hospital, where they were diagnosed and treated accordingly. Live television news coverage of containment care transport, triage and treatment of a contaminated casualty, along with the mobile hospital used by the Polish Army, was recorded on Polish TVN television, and can be viewed at:

http://www.cresz.wp.mil.pl/plik/flash/epi14.mp4