A loud bang echoes off the pine trees, followed by piercing snaps. Immediately, the group goes to ground. Our guide is hit. Sheltered behind a low log wall someone administers first aid as another – crouched on the opposite side of the clearing – springs to action on the radio.
What do we do next?
Thankfully, the stakes are not life or death. Our guide has not been shot. In fact, there was no one really shooting at us at all. This was a simulation built on blistering theatrics, blank rounds, and dummy flash grenades. This is Hostile Environment Awareness Training (HEAT), a simulation designed to prepare humanitarians for deployment to conflict and disaster zones across the globe.
A Simulation to Learn By
For one day, this tranquil wood in England was transformed into the site of a fictional humanitarian mission in a region ridden with natural hazards, violence, and crime. Against this backdrop, teams of UK-Med staff and register members put their composure to the test in repeated simulations from traffic accidents to drone attacks.
These teams are a mix of NHS clinicians, international medics, and professional non-health humanitarians; representative of the range of disciplines UK-Med draws on when bringing healthcare to those impacted by conflict or disaster.
In a moment’s notice, these professionals are ready to deploy anywhere around the world. From Ukraine to Somalia, these deployments carry risk. As Michelle Hanegård, UK-Med’s Director of Learning explained:
“We operate in conflict zones and hazardous environments, including earthquakes and tsunamis, so it’s possible for things to go wrong. Obviously, it’s all magnified a little bit for the simulation, but all the exercises that participants go through in training are situations that have happened to humanitarians.”
While the simulations are staged, the surges of adrenaline and flight-or-fight reactions aren’t. In a way, this is the most valuable lesson from HEAT; the more you learn about your own instinctual reactions to sudden stress, the more likely you are to identify the limitations of your knee-jerk reactions and, hopefully, overcome them.
“It's about learning how we respond in certain situations. We're learning about ourselves, we're learning about our colleagues, and we're learning how to deal with a hazardous environment.” - Michael, UK-Med volunteer
The Risks in Reality
The humanitarian sector has reached a sombre anniversary.
On the 19th of August 2003, 22 UN workers were killed in a bomb blast in Baghdad, Iraq. This led to the creation of World Humanitarian Day, commemorated each year on the same date to acknowledge the immense challenges humanitarians face in the field.
In the two decades since, 2,174 humanitarians have been killed with a further 2,612 injured, most of whom were local staff. The risks are real and have prompted many NGOs, UN agencies and the Red Cross/Crescent to ensure the provision of security training, such as HEAT, for humanitarians preparing to deploy.
For UK-Med’s deployable staff and register members, HEAT is an integral part of the training pathway.
“It’s stressful, it’s busy, we’re training for all sorts of security-related incidents, but it’s how we keep ourselves safe responding in hazardous environments overseas,” said Dan, an NHS worker and UK-Med volunteer, “There’s lots of noise and complicated scenarios, but it’s good to explore these in a safe environment so that when we do deploy we can be confident in the knowledge that we’ve had the appropriate training.”
For a frontline life-saving medical NGO like UK-Med, this training is imperative given the alarming rise in attacks on healthcare facilities and personnel.
In Ukraine, where we work, there have been more than 700 attacks on hospitals, health workers, and other medical infrastructure since the full-scale Russian invasion last year.
In the Democratic Republic of the Congo, repeated attacks on medical staff during the Ebola outbreak complicated the humanitarian response; while in Sudan the rise of violence towards health workers is forcing organisations such as Médecins sans Frontières (MSF) to reconsider their presence in the country.
These crises and conflicts show no sign of abating. In the last year alone, UK-Med has called upon its roster of nearly 1,000 professionals to deploy hundreds of them to countries such as Ukraine, Afghanistan, Somalia, and Turkey.
Many of the participants of the HEAT course will be deployed. They do not know where or when. They wait, and keep their skills sharp, in expectation of a call that will send them on a plane to somewhere far away, where someone’s life needs saving.
