FEATURES OF MEDICAL SUPPLY OF COMBAT OPERATIONS DURING MILITARY OPERATIONS IN AFGHANISTAN


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Abstract

Relevance. The relevance of this topic is to study the impact of the level of medical supply on the provision of timely assistance to the wounded and sick. Also, the paper considers one of the urgent problems of medical supply, the improvement of medical support and supply during hostilities.
Goal. To study the features of medical supplies during the war in the Republic of Afghanistan (1979-1989). To draw conclusions about the work done by the medical supply authorities.
Materials and methods. Study, systematization and analysis of the literature on the subject of the study.
Results. The peculiarities of the medical supply of the Armed Forces of the USSR during the military conflict in the Republic of Afghanistan were formed.
Conclusion. The results of the study prove the effectiveness of medical supplies for the troops of the 40th Army of the USSR in Afghanistan. At the same time, considerable work was done to improve the medical support of units and various military institutions, which later found its application in the Soviet Army.

Full Text

Relevance. To date, it can be argued that the competent medical supply of troops with medicines and medical products contributes to timely assistance to wounded soldiers, thereby reducing the loss of personnel during hostilities. All of the above confirms the relevance of the chosen topic, and gives rise to further research.
The purpose of the study. The study of the features of the medical supply of the USSR troops during the military conflict in the Republic of Afghanistan in the period from 1979 to 1989 with various types of medical equipment by studying the activities of military units, medical institutions, medical warehouses and the impact of external factors such as climate and unfavorable epidemiological conditions.
Materials and methods of research. Periodicals, historical literature, the study of medical supplies from military medical journals, structuring information from Volume 1 of educational literature (Experience of medical support of troops in Afghanistan 1979-1989 in 5 vols. Vol. 1: Organization of medical support of troops), research of problems and solutions to the military conflict in Afghanistan.
The results of the study. Military operations in Afghanistan lasted from December 25, 1979 to February 15, 1989. They are the longest after the Great Patriotic War of 1941-1945, in which the Armed Forces of the USSR took part. Despite the difficult situation in which the work was carried out to restore the health of the wounded and sick, the medical service of the 40th Army of the USSR Ministry of Defense achieved impressive results. [1]
At the agreed time, the columns of the 40th army entered the territory of Afghanistan. In addition to combat units with medical stations, the limited contingent of Soviet troops (ACS) included OMedB (separate medical battalions) and hospitals. According to the directive of the General Staff of the USSR, military units had to be staffed in accordance with the norms of supply for wartime.
At that time, the norms of medical property were calculated depending on the units: if it was a regiment, then the property was relied on for 2 days of military operations; if it was an OMEDB, then the property was calculated for 300 victims for 5 days; the calculation for the hospital was calculated by the total number of victims according to the number of beds for 1 month.
A unique feature of the military operations in Afghanistan was the presence of a limited contingent of the armed forces of the USSR, as well as the fact that they took place in unfavorable climatic, natural and epidemiological conditions. Our medicine had to deal not only with harsh climatic conditions, such as a sharply continental climate, heat and dryness, which caused sunstrokes and overheating of the body in military personnel, but also the fight against infectious diseases such as viral hepatitis A, intestinal infections, typhoid fever, amoebiasis, malaria.
At the initial stage of military operations, following the introduction of the armed forces into Afghanistan and over the next few months, medical equipment and equipment were replenished directly from Tashkent medical warehouses, since when moving across the state border of the USSR, troops and medical personnel had to overcome the highlands during the fighting in the winter season.
In addition to combat factors that had a negative impact on providing troops with medical equipment, the climate of Afghanistan also became another test for the medical service. The quality of medicines, immunobiological preparations, and disinfectants was under threat due to the high air temperature. The lack of good-quality drinking water, and sometimes even its absence, reduced the possibility of manufacturing various dosage forms, the efficiency of the pharmacy and medical staff, and also led to a deterioration in the condition of sick and wounded servicemen.
In addition, meteorological factors, including the low oxygen content in the atmosphere, had an impact on the combat capability of the 40th Army. Oxygen starvation led to overstrain of all body systems of servicemen and, as a result, mountain sickness arose. Due to the lack of oxygen, the condition of the wounded also worsened. Under such unfavorable conditions, the healing time of light wounds increased, the period of bone fusion increased [2].
In order to provide medical assistance to the victims, medical workers needed an additional sufficiently large amount of antibacterial drugs, painkillers, antiseptics, vitamins, water disinfection and anti-epidemic measures, sterile dressings, including individual dressing bags, tires and oxygen-breathing apparatus.
As the distance from the state border increased, the need for medical support increased, as sanitary losses increased, despite the fact that the service stocks were depleted, and there were no own supply bases. Based on this, medical supplies were provided by the warehouses of the Turkestan Military District (TurkVO), which were delivered to the medical supply departments, namely to the hospitals of the cities of Shindand, Bagram, Kabul. The wounded and sick who needed hospitalization were evacuated to medical institutions in TurkVO. A more extensive range of medications for pre-evacuation treatment was also required [3].
The deployment of medical warehouses and medical institutions was carried out simultaneously. The placement took place in accordance with two main operational directions: Kabul (in Uch-Kyzyl) and Shindand (in Kushka). Further, a scheme for supplying troops with medical equipment was developed, which could ensure maximum independence of their groups.
The delivery of medical equipment in the Kabul direction was particularly difficult, since automobile convoys had to overcome a mountain massif with a single high-altitude transport tunnel at the Salang pass. For three years, the pharmacy of the 650th military hospital, located in the Kabul direction (Kabul), served as a supply base and carried out the acceptance and distribution of medical equipment.
Multiple losses among military personnel and the loss of equipment during the delivery of materiel led to the fact that the scheme for the supply of property was adjusted, as well as three isolated groups of troops were created for medical supplies: Kabul, Shindand and Kunduz. It took three long years to change the scheme. In the first months of 1983, by the decision of the General Staff of the USSR Armed Forces, the 3964th medical warehouse was created.
And by 1984, the scheme of providing the 40th army with medical equipment was established and maintained until the withdrawal of troops from Afghanistan.
In the first months of the military campaign, the main task of the medical service of the Turkestan military was the timely and immediate provision of medical equipment for deployment activities, as well as the organization of supply of military units participating in hostilities. In the future, the medical service of the army, despite the absence of specialists in medical supplies, had to carry out a systematic supply of medical equipment to military units and medical institutions. The absence of a specialist at the headquarters made itself felt, because it was mandatory to monitor the staffing of the formations that arrived in the 40th army, it was necessary to competently and professionally manage the deployment and organization of medical warehouses, oxygen-producing stations, medical equipment repair groups, organize the army's supply system with medical equipment, draw up related documentation.
All this work was entrusted to the medical service of the Turkestan Military District, which was located outside Afghanistan and, despite all the efforts made, could not complete the entire scope of work.
After the introduction of a medical supply officer and a pharmacist accountant to the staff of the military medical department of the army, norms for the supply of medical equipment began to be formed, as a result of which an attempt was made to organize work to eliminate deficiencies in the work of medical warehouses and the supply of troops. But still, the first officers who took office failed to organize proper order in the supply of medical equipment. As a result, the shortcomings in medical supplies have only strengthened.
During the first years of the campaign, the heads of medical warehouses, not having the appropriate conditions for the preservation of medicines, used the permission of the head of the medical service of the 40th army and made an independent decision on the release of medicines.
We found that medical equipment was released to the garrisons where the warehouses were located, as well as to nearby units. As a result, there was a shortage of medical equipment in distant parts.
The heads of medical warehouses, not having full information about who they should provide and in what quantity, made decisions based on the availability of applications received and on the amount of medical equipment in the warehouse. The property was supplied to military units in small batches throughout the year. There was no general information about the norms of the received property. Therefore, the issue of medical property was carried out on the basis of applications of the units. A similar situation was with medicines that arrived from Puli-Khumri to the 650th military hospital for the Kabul group of troops [4].
However, in the first months of 1984, thanks to the help of officers of the Military Medical Academy named after S.M. Kirov, who were sent to Afghanistan for military training, a register of all military units and medical institutions of the 40th Army that were subject to supply was created. At the time of the creation of the register, the medical service supplied 81 parts, in the future the number of parts increased to 90.

If in the spring of 1980 there were only 4 military hospitals with 700 beds in the 40th Army, then in 1986 the army already included 7 military hospitals and three infectious diseases hospitals with 2225 and 1950 beds, respectively. In addition, a rehabilitation center for 1,500 places was created. The supply of medical equipment to the troops acquired a honed and purposeful character. It was carried out according to peacetime norms [5].

In addition, the army medical service conducted a garrison attachment of military units and medical institutions to medical warehouses:
— in Puli-Khumri: garrisons of Puli-Khumri, Kunduz, Faizabad;
— in Kabul: garrisons of Kabul, Charikar, Salang, Jalalabad, Bagram, Ghazni, Gardez, Shahjoy;
— in Shindand: garrisons of Shindand, Herat, Kandahar, Lashkar Gah, Gerishak.

By 1984, reserves of the main nomenclature of medicines and auxiliary means were created in the medical and medical institutions and hospitals. This decision contributed to a faster and more complete medical supply of troops.
Responsibility for the completeness and timeliness of deliveries was assigned to the GVMU (Main Military Medical Directorate) MO OF the USSR.

Despite the fighting, the delivery of medical equipment was carried out by pickup, without taking into account the distance from the supply bases.

The heads of pharmacies of hospitals, medical centers, medical supply departments were sent to medical warehouses to submit applications and receive the necessary property. Initially, the delivery was carried out by convoys or any other passing transport. But in the future, due to the dangerous circumstances of the passage of convoys, delivery began to be carried out by road and air transport without the mandatory presence of representatives of the recipient of medical property.
Discussion.
After the end of the military campaign in Afghanistan, the medical service of the USSR Armed Forces began to systematize and generalize the experience gained in providing medical equipment and equipment to the troops. It was emphasized that there was not enough medical equipment to provide more complete and timely medical care, namely, technical means for assessing the condition of wounds, modern physiotherapy equipment for hospital and military personnel, means for suppressing pain, etc. To carry out the evacuation of the wounded and sick in due time, a significant increase in the number of sanitary transport in the military unit was required [6]. Certain models of military medical equipment lagged behind the level of similar products from a number of other countries. First of all, this applied to mobile means of deployment of field medical institutions, including pharmacies and pharmacy equipment [1].
Conclusion.
Taking into account the experience of providing medical equipment and equipment during the fighting in Afghanistan, the medical service of the Soviet Army has done a lot of work to improve the material base of medical units, units and institutions. New variants of equipping various units of the military medical service with medical equipment were developed. Close attention was paid to the development of new and improvement of existing mobile medical means of evacuation of victims, the creation of individual sets of drinking water supplies, personal and group water purifiers, such as "Spring" and "Tourist 2M" [1], the introduction of highly effective means and methods of anti-epidemic protection of personnel, as well as methods of pharmacological correction of the physical condition of military personnel.

 

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About the authors

Lidia S. Pavlenko

Voronezh State University name dafter N.N. Burdenko

Email: pavlida23@gmail.com
ORCID iD: 0000-0002-9876-9808
SPIN-code: 4098-6260
Russian Federation, Voronezh, Russia, 394036, Student street, 10, Voronezh State University name dafter N.N. Burdenko

Anna V. Ermakova

Voronezh State University name dafter N.N. Burdenko

Email: AnnaErmakovaa2021@gmail.com
ORCID iD: 0000-0002-7350-6120
SPIN-code: 9384-8355
Russian Federation, Voronezh, Russia, 394036, Student street, 10, Voronezh State University name dafter N.N. Burdenko

Mikhail V. Laptev

Voronezh State University name dafter N.N. Burdenko

Author for correspondence.
Email: laptev.mic7e@mail.ru
ORCID iD: 0000-0002-3034-5953
SPIN-code: 3143-9353
Russian Federation, Voronezh, Russia, 394036, Student street, 10, Voronezh State University name dafter N.N. Burdenko

References

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  2. Акимочкин В.Е. Особенности медицинского снабжения при оказании медицинской помощи легкораненым и легкобольным / В.Е.Акимочкин, П.Ф.Хвещук //Воен.-мед. журн. 1993. - № 7. - С.60-62
  3. Семененя В.И. Медицинское обеспечение войск во время Афганской войны // Всестороннее обеспечение боевых действий. Проблемы и пути решения: тезисы докладов научно-практического семинара. Минск, 25 октября 2017. Минск, 2017. С. 91-95.
  4. Жиляев Е.Г, Гончаров СФ, Лобанов Г.П. Совершенствование полевого оснащения и оборудования для оказания медицинской помощи легкораненым, их лечения и реабилитации // Военно-медицинский журнал. 1993. № 7. С. 63—67.
  5. Военная история: Учебник. М.: Воениздат, 2008. С.209-211
  6. Нечаев Э.А. Опыт медицинского обеспечения советских войск в Афганистане и вопросы дальнейшего развития военной медицины // Военно-медицинский журнал. 1992. № 4-5. С. 13.

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