"The goal of legal regulation of war is to define the technical frames, in which the requirements of war between the civilized nations start to correspond with the requirements of humanity."

Alexander II
From the address to the International Military Commission for adoption of the Declaration on cancellation of use of explosive and incendiary bullets
Saint Petersburg, 29 November 1868

Military medical personnel are, by definition, non-combatants. However, this distinction is often lost in the chaos surrounding combat operations and complex humanitarian emergencies, placing both the medical personnel and their patients at greater risk of becoming casualties themselves. This article recommends the application of a standardized Red Cross insignia (armband) for use by Russia's Armed Forces Medical Service personnel. The authors believe this will improve recognition of medical service personnel and thereby enhance their safety and ability to provide care to victims. By extension, the authors also recommend the use of the proposed armband by all United Nations Armed Forces Medical Service personnel.

Background

Functioning under constitutional law and a growing global conscience, a nation's primary objective is to protect the rights and liberty of each of its citizens. The most important of these rights is the right to life. A nation's priorities are easily discerned by the degree to which its departments, whether explicitly or implicitly, preserve and enhance its citizensÕ right to life, freedom, basic health needs and medical care. Recent decades have seen the growth of a legal conscience and culture defining new norms within all social institutions, including national defense, public healthcare, economic development and education. These norms must, by definition and national values, also apply directly to a nation's interactions abroad, whether in a conflict or a peacetime setting.

Both the new world order and evolving social reforms in Russia have impacted the Russian Armed Forces directly and have resulted in the development of complex and specialized departments. The Russian Armed Forces Medical Service has evolved with these social changes, reflecting national values and traditions throughout Russia's historical development. With increased global interaction, there is a growing disparity between new operational performance requirements of the Medical Service and its historical activities. This has resulted in increased reliance by the Medical Service on International Humanitarian Law (IHL). The primary goal is the establishment of guidelines for conduct in war and military operations other than war, which maximize the protection of the above-mentioned human rights, and minimize harm to noncombatants and non-military targets.

Russian Federal Law regarding "Conscription and Military Service" fixes special status to Medical Service personnel and their duties. Their performance is ultimately guided by IHL developed according to the Geneva Conventions and their Protocols. This establishes the Russian Armed Forces Medical Service as a legally recognized institution under IHL, which carries with it certain performance imperatives.

Military-Medical aspects of IHL have a role in resolving armed conflicts and minimizing the consequences of humanitarian catastrophes.

The four Geneva Conventions of 1949 and two Protocols of 1977, along with other IHL agreements, were developed by the international community with the goal of creating legal protection for victims of war and armed conflict. Guidelines for providing medical care in armed conflict or other humanitarian emergencies are outlined in the 1st Protocol, Item 8, and include "the search for, collection, transportation, diagnosis or treatment - including first-aid treatment - of the wounded, sick and shipwrecked, or for the prevention of disease." Clearly the Military Medical aspects of IHL continue to constitute an internationally recognized moral imperative to provide practical aid to victims of armed violence. However, this moral imperative carries with it a substantial cost Ð the inherent risk to the lives of medical personnel and establishes this type of work as being uniquely suited for military organizations.

IHL and the evolving role of the Military-Medical Service: Transitioning from the Soviet Union to the Russian Federation

Under the former Soviet Union, the Military Medical Service was created for the primary purpose of providing medical support to its armed forces in support of Cold War operations. It subsequently had very limited experience in dealing with IHL and the now commonplace response to regional armed violence. Therefore, the Russian Federation met a historical problem when faced with the need for a civilized, IHL-based response to the prevention and resolution of internal armed conflict in the Russia and former Soviet Republics. Early attempts to respond to these conflicts without IHL guidelines and restraint led to widespread discontent of the military in the public conscience and actually led to potential concerns for national security. This articleÕs principle author witnessed these difficulties in armed conflicts in Angola and Kosovo, and through an analysis of the Chechen conflict.

As previously mentioned, only military medical-service assets can effectively address the obvious risk associated with providing medical aid on the battlefield. This fact establishes the military medical-service as a key partner in establishing and coordinating civil-military links with humanitarian organizations, particularly the International Committee of the Red Cross and the Russian Society of the Red Cross, among others, and the state (nonmilitary) structures providing protection and medical aid for victims of armed conflict. Subsequently, the Russian Military Medical Service in recent years has found itself far exceeding its traditional roles and evolving into areas of competence that require innovative approaches Ð especially the protection of its personnel and assets.

The author's concept of the designation and legal protection of military-medical personnel

The traditional armband consisting of the "Red Cross" for military-medical personnel of the Imperial Russian Army has been used since 1864. The sizes of armbands were not precisely defined anywhere. From archive records, photos and military chronicle movies of past wars, extreme variations were noted in size, color and design. The Red Cross emblem itself ranged from reverse placement of the colors of the Swiss national flag to hardly perceptible narrow strokes of the Red Cross. Even today, standardized sizes of the emblem and armband are nowhere defined. Until recently in the Armed Forces of the Russian Federation, there were no official demands to utilize special identification standards for medical personnel.

Additionally, the authors were surprised to discover that even NATO member countries consistently declaring adherence to standards and principles of IHL do not have a unified approach to this problem. For example, in Kosovo the author observed a number of countries including the U.S.A. and Great Britain, whose medical transport vehicles had Red Cross markings that could be covered, which in fact, is a breach of Geneva Conventions. We want to emphasize that the problem does not rest with one particular state or another, but that these issues are to be identified and addressed by our mutual efforts.

Conclusion

The primary author worked to resolve this situation within his country. His research resulted in the design, invention and patent of an armband for use by Russian Armed Services Medical Personnel. Once the armband is adopted by the Russian Federation, has proven to be viable and demonstrates value, it is hoped that the UN will consider its adoption for use in peace support operations.

"It is not possible to judge about the activity of private aid organizations at the theatre of war without being aware of the activities of military medical administration."
N.I.Pirogoff, 1879

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