North Macedonia, Republic of

Basic Task of the Military Medical Service 

• Performance and control of preventive-medical activities, in the units and centres of the ARM.
• Primary health care of the ARM and MoD employees.
• Specialist health care of the ARM and MoD employees.
• Medical provision of Field training activities of the ARM units and VIP persons and delegations from the country and abroad.
• Participation of the medical personnel in peacekeeping missions.
• Bearer of the accomplishment of the partnership goal to construct a Role-1 Mobile field hospital for medical support of the ARM.
• Medical training of the ARM and MIA personnel, as well as of members of NATO and PzM countries. 

Structure 

Medical Personnel:       

-Officers                                   59

-NCO                                      131

-Civilians                                  37

-Paramedics                           181

After the new transformation of the Army from 2015 the medical department in General Staff does not exist. Its role has taken J4/GS – Logistic section in General Staff.

The Military Medical Service is organized in the Military Medical Centre (MMC) and military ambulances in each garrison. This Centre is part of Logistic Support Command.

The Military Medical Centre (MMC) provides protection and improvement of the ARM members’ health and consequently provides a high level of combat readiness of the units, commands and centres of the ARM. It was established in 2010, with the transformation of the former Military Hospital, located in the same building on the Boulevard “Ilinden” about 2 km from the centre of Skopje. Being integrated into the health system of North Macedonia, MMC opens opportunity and access to its services for the Army personnel as well as for all the citizens of North Macedonia, thus confirming its primary motto HEALTH FOR ALL. As an institution of outpatient polyclinic type, MMC implements and enforces the national system for electronic scheduling of examinations and interventions.

Military Medical Centre is organized into four departments:

• Preventive Medicine Department (PMD)
• Military Ambulance
• Specialist Consultative Activity Department
• Medical Training Department (MTD)

Approximately 160 persons work in the Military Medical Centre. The Centre is equipped with modern equipment, with modern ground vehicles, several armoured vehicles.

Preventive Medicine Department (PMD) 
The essential task of the PMD is improvement and maintenance of health and readiness of the ARM members through Conducting preventive-medicine activities in the units, centres and commands of the ARM:

• Hygiene – prophylactic and anti-epidemiologic measures,
• Sanitary inspection and hygienic-epidemiologic assessment,
• Disinfection, fumigation and pest control,
• Systematic specialist check-ups (AVL, MoD employees, before and after a mission, voluntary military service, schooling abroad and in diplomatic-consular offices). 

PMD is organized into 5 departments, which function as organizational-professional unity in the course of work:

• Epidemiology department
• Hygiene-chemical department
• Microbiology department
• Occupational health department
• Medical informatics department.

Epidemiology department – monitoring the epidemiological situation of the units and vaccinations control; 

Hygienic-chemical department controls the accommodation, food and water. In this department’s laboratories water and nutrient supplies analyses, as well as toxicological analyses of biological and other materials, are performed; 

Microbiology department, which includes diagnostics bacteria, viruses, fungi and protozoa as well as causes of infections in humans, and microbiological control of water and food; 

Occupational Health Department, which has the capacity for carrying out more packages of systematic specialist checkups. This department owns the only lab in the country where most advanced testing ionizing (gamma spectrometric analysis of water, soil and food), and non-ionizing radiation are performed.

Military Ambulance 
Military Hospital (Garrison Hospital) is an organizational unit of the MMC that provides primary health care to all contributors of the Health Insurance Fund. The hospital employs general and family practice specialists and dentistry specialists. Based on the need for a higher level of health care, primary care physicians through the “MY APPOINTMENT” system, enable their patients to schedule the necessary diagnostic procedures and examinations. Within the hospital, there is a modern and well-equipped biochemical lab. Medical teams provide medical support for the needs of the ARM members as well as for the various activities organized by other institutions in the republic.

Tasks: 
• Primary general-medical care
• Primary dental care
• Laboratory
• Pharmacy
• Medical provision in the barracks and during field training activities of the ARM units
• Medical provision of VIP persons and delegations from the country and abroad during visits of the ARM and the MoD.

There are 9 military ambulances, in different towns. Each ambulance has a section for evacuation with several ground vehicles. Approximately 250 persons work in these ambulances, and the ambulances are under Military Medical Centre Command. 

Specialist Consultative Activity Department 
In the specialist consultative activity department, MMC owns a well-equipped capacity, where health care consumers are able to receive the necessary services in the following areas and diagnostic procedures:

• Internal medicine with ECG diagnostics, ergometry, ultrasonography;
• Psychiatry; 
• Neurology with electroencephalography, electromyography;
• Psychological service;
• X-ray diagnostics;
• Otorhinolaryngology with audiometry;
• Ophthalmology with computer measurement of visual acuity, contactless measurement of intraocular pressure;
• Dentistry with orthodontics practice where mobile and fixed orthodontic appliances are made for all age groups of all insured in the Health Insurance Fund. 

Tasks: 

• Systematic specialist check-ups
• Specialist health care of the ARM and MoD employees in the domain of ambulance-polyclinic specialist services. 

Medical Training Department (MTD) 
Medical Training Department (Regional Medical Training Centre-RMTC) is unique in its spatial and personnel capacities, which during its existence and activity developed into a national and regional centre for conducting medical training of military medical and non-medical personnel not only of the ARM but also of the armies in the region, the PfP member countries and other state institutions (special police forces, border police, embassies, civil organizations). The team conducting the training is comprised of instructors who are certified by the Swiss Medical Training Centre. 

Tasks: 

• Training for rendering emergency assistance and self-assistance,
• Training for life-savers,
• Training of medical teams and
• Training of instructors
• Training and practice of the medical personnel of the ARM.

Field Deployments 
In the RMTC 7 types of courses take place:

• TTC1 (Train the Trainer Course) - Level 1;
• TTC2 (Train the Trainer Course) - Level 2;
• BCLS / ACLS Course (Basic Course in Lifesaving / Advanced Course in Lifesavers);
• PDMTC (Prior Deployment Medical Training Course)
• BSABAC (First Aid Course and Self Aid Course);
• MT1 (Medical trauma support) – Level 1;
• MT2 (Medical trauma support) – Level 2. 

Carries out medical training of the ARM members, members of other state institutions in the Republic of North Macedonia, as well as for the needs of NATO and Partnership nations. Two international medical exercises were organized in North Macedonia ,,MEDCEUR 2011” and ,,SHARED RESISTANCE 2013”. Carries out medical training of the ARM members, members of other state institutions in the Republic of North Macedonia, as well as for the needs of NATO and Partnership nations.
Two international medical exercises were organized in North Macedonia ,,MEDCEUR 2011” and ,,SHARED RESISTANCE 2013”.

Military Field Hospital

Missions 
Participation, with personnel, in the ISAF mission in Afghanistan, as part of the Joint Medical Team from the Adriatic Charter countries (Macedonia, Croatia and Albania) in nine rotations, in the period between 2005 and 2009. 

Participation, with personnel, in 17 rotations in the mission ALTEA/EUFOR in Bosnia and Herzegovina in the period between 2006 to June 2015. At the moment participation with one doctor in Austrian medical team. 

Participation, in past, with five officers for preventive medicine, in the EUFOR command. 

Participation, with a surgical team, in the mission of ISAF – Afghanistan, as part of the Norwegian field hospital. This mission started in 2008 and finished in 2012, seven rotations.