If hospitals and clinics are so often targeted during armed conflicts, it is for good reason: in wartime, a state's health sector is an integral part of the military apparatus because it allows soldiers to be sent back to the front after being rehabilitated. Attacking it is therefore a preferred military strategy to weaken the "enemy" and reduce a country's ability to replenish its supply of cannon fodder(1)... ---- The progress of the militarization of our society could be judged by the measures taken to put society at the service of the military in anticipation of wartime, and in particular by what is planned in terms of using civilian health services for military purposes. Because after the "remote" wars, the "external operations" of the 2000s-2020s, the governments of European countries and the USA are preparing public opinion and the material resources for a war they call "high-intensity" (this term appears in several places, but notably on the website of the French Armed Forces Health Service and in the booklet "Everyone's Responsible" - see box). The implication is: war will soon no longer be on TV. We are being promised it at home, in color, in pain, and in shortages. Live, or at least as a consequence of external operations. Wars that will therefore cause many deaths and injuries, and for which governments are counting on the fact that their "chances" are highly dependent on the ability to quickly rehabilitate and send the wounded back to the front.
Given this context, the military believes its own healthcare system (the Armed Forces Health Service) will be insufficient (14,000 personnel, no less!), and that civilian healthcare facilities must prepare to dedicate themselves to the care of soldiers. We will draw on information from France, as well as Germany and the United Kingdom, to document this.
And all this without deluding ourselves about the fact that current rhetoric is certainly preparation for a future without a future, but also paves the way for budget cuts and learning to operate without equipment in peacetime.
Ensuring that civilian healthcare facilities are available to prioritize the treatment of military personnel
An article in Le Canard enchaîné from last August warns that "the services of Catherine Vautrin's (Minister of the Armed Forces) ministry have asked the Regional Health Agencies[ARS]to prepare healthcare workers for an armed conflict." They are referring to a memo from the Ministry of Health sent to the directors of the ARS on July 19th, asking them to be ready by March 2026 for a possible "major engagement." There is no mention of direct French involvement, except alluded to, but rather of the support it would provide to other countries as a member of NATO: "In the current international context, it is necessary to anticipate the modalities of healthcare support in a high-intensity conflict situation," explain the officials from Avenue Duquesne. As a signatory to the Washington Treaty, France may have to take any necessary measures, including the use of force, in response to an armed attack directed against one or more member states of the North Atlantic Treaty Organization (NATO). In practical terms, this would mean that hospitals in metropolitan France would have to prepare to become rear bases for allied countries. Plans include creating "medical centers to receive patients returning from the combat zone near a bus or train station to facilitate the repatriation of foreign soldiers to their home countries," where "100 soldiers per day for two consecutive months, or even 250 patients per day for three days" would be treated. And the rest follows suit: "Civilian hospitals must be prepared to receive between 100,000 and 500,000 personnel over a period of 10 to 180 days," and the healthcare workers there "will have to trade their traditional operating room for the battlefield, regardless of their area of expertise," to bolster the armed forces' health service. "Particular attention to the management of post-traumatic psychological disorders and to the physical medicine and rehabilitation sector is also recommended by the Ministry of Health." Le Canard concludes by unearthing a memo from February 2025, which stated that the eight military hospitals in mainland France (primarily treating civilian cancer patients undergoing chemotherapy) should be available and redirect their patients to prioritize the treatment of soldiers wounded at the front.
In the same vein, another text (2) informs us that it was decided in 2008 that the German Red Cross would come under military command in the event of war.
Militarizing the minds of healthcare workers
Ensuring that civilian facilities are available to care for wounded soldiers is one thing; convincing medical personnel that their primary activity will be to rehabilitate them and maintain a reserve workforce for the front is quite another. Another text, published in spring/summer 2025 in VitalSign Magazine, by a collective of workers from Bristol's two largest hospitals in the UK, argued against the militarization of the healthcare sector (3). It reports on attempts to shape public opinion in the UK... Selected quotes:
"Last year[2024], General Sir Roland Walker, head of the army, warned England that it must be ready to wage war against Russia in three years." "If we are heading towards a scenario where we have this level of injuries and this type of armed conflict, the healthcare system should be doing nothing but that. That's the stage of escalation we're at," he added. (The Telegraph)
"On June 5, 2024, the German Federal Cabinet adopted the "Rahmenrichtlinie Gesamtverterdigung" (Framework Directive for Comprehensive Defense), under the control of the Federal Ministry of the Interior. This ensures, among other things, the extensive integration of the civilian healthcare system under the control of the Bundeswehr[German Armed Forces]. In March 2024, Health Minister Lauterbach announced the Health Security Act. The law provides for the regulation of medical care in the event of a disaster or war by placing it under the control of the military." (...) Germany will provide the bulk of care for war wounded in future armed conflicts in Europe, and its network of 650 local clinics and 36 university hospitals will be the main military platform in Central Europe."
They note that the Covid pandemic laid the groundwork for the integration of civilian and military structures in crisis situations in the name of emergency and disaster medicine.
Training healthcare professionals in war medicine
The same text cites several examples of "skills maintenance" in war medicine... the examples come from hospital-military partnerships in Chicago, and between the University of Colorado and South Africa or Ukraine.
"As the Level 1 Trauma Center at the University of Chicago Medical School marks its fifth year of service, it celebrates a key element of its success: partnerships that provide new resources for the center and maintain the skills of military personnel." Members of the Army's 59th Forward Resuscitative Surgical Team (FRST), based at Fort Bragg in North Carolina, seamlessly integrate with their civilian counterparts to provide critical care to patients at the South Side Academic Medical Center. Patients receiving this care include those with closed or penetrating wounds. This allows FRST members to maintain their trauma skills-which they might need on a future battlefield-while also providing additional resources to the trauma center. UChicago Medicine's comprehensive trauma program treated nearly 5,000 patients in 2022, including more than 1,700 individuals with traumatic wounds, most often resulting from firearms or stab wounds. "And since the number of wounded in Chicago's South Side or other underprivileged neighborhoods isn't enough, the U.S. military has to go further, for example, to South Africa: 'The Department of Defense has awarded Army researchers from the University of Colorado School of Medicine $15.6 million to go to South Africa and study issues related to long-term care for patients with severe bleeding, head injuries, multiple traumas, and complex wounds-injuries often encountered in South Africa, and in a battlefield setting.' The same university is also sending researchers to Ukraine: 'The Department of Defense has awarded $5 million to faculty members in the Department of Emergency Medicine to work with partners in Ukraine on the clinical and logistical challenges associated with large-scale modern warfare operations and long-term care for the severely wounded.'" "Everyone's Responsible"
Propaganda to make us feel vulnerable and in a world in crisis
Last fall, a small crisis management booklet, originally titled "Everyone Resilient," was released under the title "Everyone's Responsible." Under the guise of offering advice on how to cope with any type of natural disaster that might impact daily life, public services, and communications, it is in fact a way to promote the idea that armed conflict is possible and that it won't be so dramatic, provided we are prepared to face it.
The ad reads, "In the current context of the deterioration of our strategic environment, the prospect of armed forces deployment can no longer be ruled out. The military is preparing for this at the national level, and with our partners and allies in NATO and the European Union." Among other advertisements for the various branches of the armed forces, there is an incentive to join the "health reserve" (a community of volunteer healthcare professionals who can be mobilized by the state and intervene at very short notice to provide support during exceptional health situations): at EUR300 per day for doctors, psychologists, or midwives, and EUR100 for nursing assistants or healthcare managers, it feels like a carrot is needed to get healthcare workers to abandon their ethics...
Reverse triage
Among the hardest pills to swallow for the medical world - and civil society! - is reverse triage. Modern warfare depends on the return of wounded soldiers to the front after they have received medical treatment. The general objective of medicine is therefore reversed: instead of the usual triage where a patient is assessed and treated according to medical priorities, even the smallest injury of soldiers must first be evaluated, and treatment is no longer based on the severity of the admitted person's condition, but on their ability to recover and return to the front... or on their role.
"The UK must now begin to prepare for potential scenarios of serious injury. Future wars between two states should be expected to result in a greater scale of injuries than what we see in modern warfare today. It is not unreasonable to expect hundreds of casualties per day during intense periods of combat, given the record-breaking total casualties (military personnel of all nationalities) in Afghanistan, which reached as high as 160 dead and 500 wounded per month. This will require that available resources not go to those who need them most, but to soldiers with the least serious injuries. 'Reverse triage' is a well-established concept, but it is unclear how widely it will be accepted in society, or even what impact it will have on the morale and will of British troops." (Ed Arnold is a Senior Fellow in European Security Research). "It is understood that in order to implement this "reverse triage" and achieve a high rate of return to the front, the army seeks to control and direct the hospital sector in wartime...
Some effects of the rhetoric on the healthcare sector
In terms of internal dissent, the state of permanent alert is being used to try to undermine it. Again via VitalSign: "Ministerial offices have told NHS (National Health Service, the UK government's public health system) nurses that they should 'drop their pay demands in order to send a clear message to Putin.'"
Furthermore, it is noted that preparing the healthcare community for wartime restrictions and constraints, possibly even before any military operations involving France are launched, already serves a purpose: to make the recurring shortages in hospitals and their degraded operations more palatable.
" Some Effects of War on Health
A persistent idea holds that war has brought advances in medical knowledge and technologies, that major wars have enabled the evolution of surgical, anesthetic, and even aseptic techniques. While periods of intense concentration of resources and capital can lead to discoveries, we must ask what purpose they serve: they undoubtedly improve emergency medicine with regard to hemorrhages and amputations (!), but certainly not the routine, everyday management of chronic illnesses. It is worth reiterating that resources for these illnesses will be cut or reduced during wartime because they are far from being considered priority expenditures... Indeed, it is impossible to engage a country in armed conflict without diverting the main resources of the civilian health sector (equipment, healthcare workers' time) toward the war effort. Goodbye to gynecology, geriatrics, gastroenterology, and disability support services... In wartime, civilian patients are neglected and morbidity rates increase dramatically.
Conclusion
As we have seen, in times of crisis, it is not the military that serves society, but society that bends to the demands of the military. Social acceptance of these plans, which place hospitals at the service of the military, is justified by brandishing the threat of our vulnerability. The ARS (Regional Health Agency) memo mentioned at the beginning of the article did indeed state that ARS directors are asked to raise awareness among "the healthcare community of the constraints of wartime, marked by resource scarcity, increased needs, and the potential for repercussions on our territory."
For the time being, official discourse presents France as a rear base for other NATO member states... But the shift and ideological acceptance of France's armed engagement will be all the easier if healthcare structures are already in place, and if we consider ourselves "resilient" and capable of coping.
Finally, it seems important to us to fight against both a medicine of returning people to work and a medicine of returning them to the front lines.
Jolan
Notes
1. While healthcare structures exist to help all those involved in a conflict recover, such attacks are also observed during the repression of demonstrations within a country, as seen during the protests in Iran in early January 2026, which led to the invasion of the Imam Khomeini Hospital in Ilam and the use of guns and tear gas inside, or a few years ago during the protests in Myanmar in 2021, during which 500 healthcare workers were arrested (reported by the "Safeguarding Health" of the "Conflict Coalition").
2. A brochure entitled "Salvarsan Against the Militarization of Medicine."
3. https://www.vitalsignsmag.org/posts... - translated and distributed as a brochure by comrades from Toulouse who also took charge of circulating it, we thank them for that!
http://oclibertaire.lautre.net/spip.php?article4635
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Link: (en) France, OCL CA #357 - Militarization of the Health Sector (ca, de, fr, it, pt, tr)[machine translation]
Source: A-infos-en@ainfos.ca
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