The current hybrid war in Ukraine clearly shows the impacts of modern warfare on civilians. Infrastructure, including healthcare facilities, energy sources, and every entity supporting the lifeline of the people are under attack, leaving no options but to leave the country for those who can. Since the outbreak of the conflict, over three million Ukrainian women and children have migrated to the neighboring countries. Although women and children might be the healthiest groups among refugees, they create other challenges within healthcare.

Qualitative and quantitative methods which describes all possible impacts of the war on the refugees’ situation in three periods of time.

Migration: During this period, besides the risk of trauma, there are other types of diseases such as infectious diseases that influence the outcome of the migration.

Settlement: This period consists of emergency physical and psychological conditions that bring the refugees to the hospitals. Hygenic issues and exposure to new diseases such as Covid-19 can be part of this period. Additionally, there might be social adjustment issues that need to be discussed.

The post-conflict: Consists of PTSD and other psychological impacts of the war, which may change the course of the life of many survivors. The final impact of the failure in social adjustment may also result in long-term socio-cultural issues.

We expect that the results of the submitted projects demonstrate the unforeseen physical and psychological wounds in refugees, irrespective of their age and background. One major outcome would be the failure of the social adjustment and if possible, a comparison with previous wars’ refugees.

The research will conclude by presenting a summary of all results and categorization of the conditions that influence the well-being of refugees as well as the host country. New recommendations will be available based on the experience gained and the results presented.

Hurricane Ian impacted Southwest Florida in September 2022 leaving massive destruction. Notably, the barrier islands were isolated by destroyed bridges and docks. Delivery of Search and Rescue, Medical Care, and other aid required a joint Civilian-Military Air Operation to provide essential services.

This presentation will detail the just-in-time development and operation of a massive joint civilian-military air operation in order to provide essential disaster response services.

Components of the joint air operation included:

• the establishment of a regional air asset request center

• creation of a command structure for air mission tasking

• the use of an airborne military air traffic control asset for forward control

• setting up a helibase at an international airport

• creation of multiple helispots in remote damaged areas with forward control assets

• the coordination with numerous private, NGO, municipal, county, state, federal, and military agencies

• heavy, medium, and light lift helicopter operations

• both civilian and military dedicated medevac

• hoist and water rescue operations

• accommodating a US presidential visit during operations

Together these operations supported the transportation needs of Search and Rescue, Medical, Command, Planning, and Logistics Operations for XXX days until the establishment of reliable ground transportation.

This presentation will not only provide insight into the planning and operation of the joint air operation but will also share the impacts on the medical care from the physicians who were directly involved in the medical care delivered on the barrier islands of Florida.

Training in disaster medicine can be partly theoretical but it must include a large practical part. If part of it can be developed through exercises in virtual reality or on a computer, the realization of life-size disaster exercises bringing together all the disciplines is of great help in this learning. Exercises of such magnitude are difficult to carry out in civilian life for reasons of resources and cost. We therefore wanted to develop this disaster medicine course with the three French-speaking civil universities but also with the Royal Military School for the practical part.

Collaboration agreements were established between three civilian universities (ULB, UCLouvain, ULiège) and the Royal Military School. The army thus provides the infrastructures of the Belgian military units to organize the exercises, personnel, means of make-up, vehicles, and security, all free of cost. Coordination meetings before exercises are also organized during the year by the army.

The exercises are organized in complete safety conditions on military fields, isolated from the civilian environment without disturbing the daily functioning of civilians. Access is authorized and organized for the various disciplines (firefighters, police, red cross and other participants). Nearly 100 people (victims, firemen, policemen,...) and 50 vehicles per exercise make the scenario completely believable. Different scenarios are repeated six times to complete the training of 80 students.

The collaboration between civilians and military has made it possible to set up quality training integrating a large part of life-size exercises at no cost and in complete safety. This ends the course by integrating in practice all the knowledge learned during the theoretical part and the virtual exercises.