The third year of war in Ukraine in many countries in Europe has broken the illusion of security. Even after several attempts, peace negotiations have not moved almost anywhere, and more and more often the talks are turning to the possibility that the war would move more west.
“It is not a question whether (Russia) will attack,” said Ragnar Vaiknemets, Deputy CEO of the Estonian Health Council who oversees the readiness for crisis from pandemics to the war. “It is a question when.”
It is said that Russia will not be enough for Ukraine, especially in the territory of countries that would be first felt by the transfer of troops first. The Baltic States already have their experience with Russia-after more than 50 years of Soviet occupation, they are among the loudest critics of Russia. Within the EU and NATO, where they entered in 2004, they are constantly opposed to any normalization of relations with Moscow.
Russia postponing NATO to its northwest front, which allowed Western alliances to organize military operations directly on the Russian border, still perceives as a huge betrayal. And since it is a relationship based on deep distrust, the Baltic states perceive Russia as a persistent threat.
This is one of the reasons why there are no doubts for several representatives of these countries that the expansion of war among NATO states will occur once. Small countries from the Russian border are therefore trying to prepare for all possible situations. However, it is questionable whether it will be enough.
Acute lack of health care professionals
One of the problems the Baltic has is the lack of medical staff. For example, Estonia with 1.37 million inhabitants, with the conversion of healthcare professionals (3.6) per thousand inhabitants, is deeply EU. Just a little is better at Latvia, where there are 3.8 medical staff per thousand people. And it is best, according to Eurostat Lithuania, where there are approximately 4.5 medical staff per thousand people.
In the EU, in 2022, there were an average of 4.2 doctors and 8.4 nurses per thousand inhabitants. According to the OECD, it is estimated that approximately 1.2 million health professionals were missing in EU countries in 2022.
In addition to Lithuania, the Baltic states have only half of the health workforce per capita in addition to Lithuania. This could be a serious problem in the event of an open war on their borders or even on their territory. Estonia has therefore already earmarked EUR 25 million for stocks, including orthopedic aids, strangers and traumatic sets – so far it is “the only big investment we have done,” said Minister of Health Riina Sikkut.
And the Lithuanian Ministry of Health has also come up with a few points to which he wants to focus on the conflict. The key is the improvement of the medical sector infrastructure. Thanks to the support of the EU of almost EUR 254 million, the Lithuanians plan to establish the Center for Infectious Diseases, as well as the introduction of emergency telemedicine services or the general modernization of healthcare facilities.
In addition, human resources are strengthened. “This year, seven exercises with Lithuanian armed forces and more than 10 other civil protection exercises and crisis management are also scheduled,” informs Julijanas Gališanskis for the health department.
During the war, more would leave
However, it is not possible to expect every health care professional to stay in the country in the event of war and work. According to surveys, it is possible that up to a quarter of them would leave. “There are patriots, the first intervening, the people we know will undoubtedly stay,” Vaiknemets said for Estonia. “Of course, there are skeptics who say they would go to Spain immediately.” More than half of the inhabitants of the region do not yet know how they would react.
And the situation in the other two states is similar. The survey in Lithuania found that less than 40 percent of health professionals would remain in the country during the war, and a third of them were not sure of their stay. Latvian doctors would escape the escape especially if they had children who would have to stay with them during the war while they were at work.
They do not have the right training
The health professionals themselves realize that they lack knowledge and practical skills for similar situations. The ordinary doctor does not have the opportunity to learn sufficiently how to treat typical injuries such as limb amputations, burns, injuries after explosion and shooting, but also correctly assessing the triations during everyday practice.
Many Lithuanian health professionals are dealing with this by learning to help Ukrainian soldiers treated in Lithuania. In addition, some healthcare professionals set out on volunteer missions to Ukraine. In cooperation with the NGO Blue/Yellow, they organized internships in Ukraine. Traumatologists, surgeons, anesthesiologists, nurses, rescuers and mental health specialists from all over Lithuania will travel there.
According to its director Tomas Jovaiš, evacuation exercises and readiness exercises are also performed at the University Hospital in Vilnius. In addition, young doctors organized the forum, which was devoted to the readiness of health care during the war.
Some Latvian and Estonian doctors have already started special training. According to Politico, hospital staff, rescue crews and healthcare professionals are instructed on how to go to the “crisis regime”. It must address a large influx of patients and treat war injuries that are not so common in everyday life.
An unexpected problem
One of the facts that is easy to overlook is that most infrastructure in the Baltician reflects its Soviet past. This means that many Eastern European hospitals are particularly vulnerable to their construction.
“We have tall buildings, we have large buildings. They are in one complex, in one area,” Vaiknemets told Politico. Therefore, healthcare professionals are now worried about what to do if the Russians attack high -rise buildings.
“I can’t imagine working on the top floor of the hospital and just waiting for an attack,” he continues. The plan will therefore move the operating theaters as low as possible – to the basements.
They are also preparing in Germany
However, the situation is similar in addition to the Eastern borders of NATO in their center. The German Bundeswehr assumes that the war with Russia can come within four years. As it informs, Germany would then become a center for the logistics of war, and therefore the possible goal of Russian missile attacks.
It is therefore important that German hospitals are also prepared for this situation. The Federal Civil Protection Office and disasters (BBK) assumes that a larger number of patients with gunshot or explosive injuries would be treated in hospitals. According to BBK, poisoning is also possible by chemical or biological substances.
“These patients require intensive care and specialized medicines,” says BBK Ralph district. “Our health care system is well prepared for the massive influx of the victims. But not for the needs of a serious crisis. In the case of defense, we must count on approximately 1,000 other patients a day. This could overload the system after some time.”
