Life in a Field Hospital

The field hospital has illustrious beginnings, the first having been designed by Isambard Kingdom Brunel in response to requests from Florence Nightingale when she was working in the Selimiye Barracks in Scutari, Crimea.

Appalled by the conditions her patients were experiencing, she appealed to the British Government to do something, and in 1855 Brunel was commissioned to design the world’s first pre-fabricated hospital.

Designed in just six days, before being manufactured and shipped from the UK as a prefabricated flatpack, The Renkioi Hospital included innovative ventilation, drainage and temperature control mechanisms and could be constructed as a series of units, each housing 100 patients.

While Brunel’s original was made of wood (described by Nightingale as ‘those magnificent huts’), the field hospitals we have today are housed in heavy duty tents, which can be erected by just two people in 60-seconds; with a full field hospital able to be up and running within two days.

The evolution of healthcare in the field: Renkioi Hospital compared to UK-Med's facility in Ukraine.

Field Hospitals Today

Gemma Blakey is UK-Med’s Associate Director for Logistics, responsible for the deployment of our field hospitals and mobile units. “Once we have a call and a consignee to ship to we can start preparing. Upon arrival in country we look to erect and start seeing patients within the first 48-72 hours of the kit arriving,” she explained.

``We currently have one fixed field hospital. This can house a team of 20 to 30 doctors and nurses, with the capability of treating at least 100 outpatients per day.`` - Gemma Blakey, UK-Med's Associate Director of Logistics.

“The actual setup of the hospital is flexible to adapt to need. But generally we take 13 large tents for the hospital facility and then 30 smaller tents for staff if they need to camp at the site. The hospital is fully equipped, with the team taking out everything they think they’ll need,” she said.

“Items are all packed and ready on the shelves of the warehouse” she added. “From stationary and consumables, to incinerators, filtration units, pumps, ultrasound machines, oxygen concentrators and defibrillators. We have our own generators too, meaning we’re fully autonomous as a unit.”

The field hospitals UK-Med has are for primary health care (like a visit to your GP), minor wounds and injuries, and maternity care. “This is classed by the World Health Organisation (WHO) as a Type 1, while field hospitals that can do surgery and house in-patients are classed as Type 2,” Gemma explained. “We don’t have surgical or inpatient capacity, so the surgical teams we send out will embed in an existing facility with established equipment/medical suppliers.”

UK-Med can deploy a field hospital anywhere in the world at short notice, but the quality of the facility and healthcare are always paramount. “Despite being able to pitch a field hospital virtually anywhere, inside the tents we conform to all the usual rigorous health and safety guidelines,” Gemma explained.

UK-Med's mobile facilities, such as this one in Ukraine, have allowed staff to treat thousands of patients wherever there is a need for emergency healthcare.

“In disasters, our field hospitals can help with some of the initial needs – and we do have the ability to support with some major traumas. But, what’s even more important is that after every disaster you’re often left with a huge amount of people who are incredibly vulnerable and have no access to healthcare. And this is what the Type 1 hospital has the ability to do – provide this for at least 100 patients every day.  We can provide the reassurance to a pregnant mother, we can give a grandma her diabetes medication, we can check for an increase in malaria. Those things don’t stop because there’s been a disaster. And if we don’t treat those things then an initial disaster can embed, creating more long term and wider -spreading consequences for the population.”

A Doctor’s Experience of Working in a Field Hospital

Dr Ram Vadi, UK-Med’s Health Director has worked in several tented or temporary structures in humanitarian settings around the world.

“It drives you to adapt and work outside your own comfort zone in ways you probably wouldn’t have imagined in your clinical training. You soon come to realize that while the environment and living conditions are far more challenging than working in a temperature controlled hospital, you provide an invaluable service to people who have very often been left with nothing and have faced much harder predicaments and it pushes you to make the best with what you have and find pleasure in the work you do,” he said.

“In many ways, working in a field hospital is no different than working in a regular hospital, if we look at the standards and quality of care we aim to deliver. We want to help patients get the treatment they need, do it in an effective and equitable manner, and ensure that it’s being delivered safely for both the patients and the practitioners. The patient always comes first, and it’s something we stress in all our global deployments: to help provide quality healthcare when it is most needed.

“What really makes it unique from a normal hospital is the setup and environment. Working in an open setting, sometimes it can be extremely cold (for example, Turkey in February reached between -10 to -20) but then, operating in Sub-Saharan Africa, temperatures can often go well beyond 40 Celsius. It can be a cramped and exhausting environment, with patient, families and practitioners all inside.

In a humanitarian emergency, field hospitals provide pathways to healthcare in environments where pre-existing health infrastructure has been damaged or overwhelmed.

“The setup of a field hospital also drastically differs from a regular one in that we don’t hold a large amounts of bed capacity, medications, supplies etc. We bring out the all items needed to run our operations for the expected duration of time, however some types of cases are beyond our remit and we need to ensure we work with local and other international actors to support cases. Managing our supplies and clinical operations in a distant nation can also prove to be challenging, as re-supply is not always available and we aim to not purchase from local providers to prevent shortages in supply chains. It can be difficult at times, but we aim to do the best we can.

“The patients we see in our field hospital are in many way similar to those we might see in our own clinics or hospitals. For example, we still receive sick children, pregnant mothers, patients with scrapes and broken bones, and those who need follow-up care for pre-existing conditions. The trauma we see in disaster zones can often be quite overwhelming in the initial days, as well as the pure patient load. Add onto that, that many of the settings in which we deploy into are endemic for malaria, cholera and other tropical illnesses and our patient profiles drastically changes from those we are normally used to dealing with.

“While our facility is meant to be treating patients during daylight hours, the reality of many humanitarian responses is that we are always on-call and may have cases present to the clinic in the middle of the night. We allocate some members of the clinical staff to be on duty if this occurs, to ensure that our teams are getting adequate rest, however should a disaster happen in the night while we are deployed, we all need to be prepared to respond.”

Working with UK-Med

If you have the determination to make a difference, and would like to work with UK-Med, visit our vacancies page or follow us on social media.

UK-Med staff fall into three main categories: core staff, country programme staff, and register members. Core staff are full-time employees of UK-Med and ensure the continuing function of our operations overseas and at headquarters.

Country programme staff are part of our more established and longer-term humanitarian responses, such as our current Ukraine mission.

Register members are recruited to support surge and emergency response requirements, volunteering to be on call for certain times of the year. They deploy for short periods at a time (usually between 4-12 weeks).

UK-Med doesn’t only recruit clinicians. We draw on a wide range of specialisms to support our mission, including logistics, operations, human resources, communications, and finance.