Putting Medical Boots on the Ground: Lessons from the War in Ukraine and Applications for Future Conflict with Near Peer Adversaries.

In the past 20 years of the Global War on Terror (GWOT), the United States has seen substantial improvements in its system of medical delivery in combat. However, throughout that conflict, enemy forces did not have parity with the weaponry, capability, nor personnel of the United States and Allied forces. War against countries like China and Russia, who are considered near-peer adversaries in terms of capabilities, will challenge battlefield medical care in many different ways. This paper reviews the experience of a medical team, Global Surgical and Medical Support Group (GSMSG), that has been providing assistance, training, medical support, and surgical support to Ukraine since the Russian invasion began in February 2022. The team has extensive experience in medicine, surgery, austere environments, conflict zones, and building partner nation capacities. This paper compares and contrasts the healthcare systems of this war against the systems utilized during the GWOT. The lessons learned here could help the United States anticipate challenges and successfully plan for the provision of medical care in a future conflict against an adversary with capabilities close to its own.