On the way to the CFR: The Airborne Medical Troop

In 1990, the then Commander of the 1st Airborne Division of the Bundeswehr, Major General Bernhardt, issued a directive for the planning of the airborne casualty clearing station and the air-mobile medical teams, recalls Carsten Dombrowski about the development towards Combat First Responder in the Bundeswehr. The aim of this directive was to ensure the capability to provide medical care to airborne or airdropped paratrooper units immediately at the scene of the operation. However, how did this decision come about, long before the Bundeswehr itself had modern concepts of the current use of SOF (Special Operations Forces) Medics and FST (Forward Surgical Team) in Special Forces operations? The year 1990 was fundamentally marked geopolitically by the collapse of the East-West conflict, thus the end of the era of the Cold War. Rigid structures that had functioned for decades in a bloc conflict with front lines and nuclear deterrence. The way of the wounded was clearly defined, the medical service and troop medical service of the organizational units were well rehearsed.

High Flexibility in the 1st Airborne Division

The 1st Airborne Division, as well as the 1st Mountain Division, were already exceptions during this time. Flexibility and adapted, situation-dependent operational methods were characteristics of these elite units. The Airborne Division, with the capability for parachute jumps, distinguished itself not only by pride in weapons, but also by actual performance compared to other army units. Being a paratrooper means something. To endure personal hardship, but also to bring the necessary motivation to everyday service. This applied in large parts also to the medics deployed in this division. Organized in 3 Airborne Medical Companies (250/260/270) of the Airborne Brigades 25, 26 and 27, these companies formed the main cadre of medical forces. In addition, each of the paratrooper battalions had an integrated troop medical service. That is, each paratrooper company had two medical NCOs plus teams responsible for the medical care of the combat companies. Everyone knew each other and knew how the other functioned. This so-called Colour relationship had proven itself and was tested. At the troop staging area, the battalion doctor with his medical group leader was deployed. All of this was very close to the front line. At the level of the battalion command post, about 3 to 5 kilometers behind the FEBA (Forward Edge of Battle Area). However, since the strength of the airborne forces already lay in a high degree of flexibility and speed due to the air loading/airborne capability, it was clear that the deployed medics had to be trained and equipped accordingly. They should not be a hindrance. Everyone knew that the combat units would pay close attention to how well their medics could keep up. Therefore, this directive issued by General Bernhardt was a logical and consequential decision.

Helicopter or Parachute Jump

Various methods were tested. However, the focus was always on the transportation of materials. Parachute jumps or landing with CH 53, as well as Bell UH 1 D, were known methods. The issues were more about which, how much, and how the packaged material should be carried. Limited material resources were available in the jump pack or cargo bag. Material dropped separately was at risk of getting lost. A problem that all parachute units worldwide had and still have. Therefore, in the responsibility of Airborne Brigade 25 (CALW) and the Parachute Battalion 253 (NAGOLD), several attempts were made to at least test the level of air-mobile medical teams. Parachute jumps from Bell UH 1 D and landing with CH 53 were the means of transport for this. Ideas were developed and discarded as impractical. Either the packing materials were unsuitable or were not accepted by the deployed airborne medics. Material supply worldwide was still in its infancy. No comparison with the rugged, lightweight, and practical equipment of today.

Only after many attempts and further conceptual development did a viable concept emerge. Unfortunately, this concept did not then become widely implemented in the unit. Political events, such as the dissolution of the 1st Airborne Division, the establishment of the Central Medical Service, the beginning of operations in the Balkans, and a realignment towards Out of Area missions, caused all these considerations to disappear into drawers or archives.

On the way to the Combat First Responder

Only many years later did they reappear in a further developed or adapted version. Concepts that are still relevant today, naturally adapted to new material possibilities and operational principles. The basic idea of having special military medics on site with the Special and Specialized Forces is the maxim of professional elite units. KSK (Special Forces Command = Special Forces) and EGB (Extended Basic Qualification = Rangers). Paratroopers have optimized this basic idea and raised it to a high level. For me, it was a moving and exciting time. To have been part of this development from the first series of experiments to the current state with CFR (Combat First Responders) was a beautiful experience.

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