Centre for Disaster Medicine established at the University of Gothenburg

Since 2019, the Institute of Clinical Sciences has been hosting a knowledge center in disaster medicine (KcKm V). Until April 2022, this knowledge center held a framework agreement with the National Board of Health and Welfare for research and development projects in the field of disaster medical traumatology.

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The new center is now designated as a knowledge center by the National Board of Health and Welfare for research and development in the field of disaster medicine with a focus on total defense. The current operational period extends until the summer of 2029.

"The goal is to continue the existing activities, which encompass research, development, and education in disaster medicine, all within the framework of the new organizational structure," says Yohan Robinson, associate professor, trauma surgeon, and director of the center.

The center encompasses both the Sahlgrenska Academy, with several participating institutions, and the Faculty of Social Sciences, where the Department of Global Studies is involved.

Aim to strengthen disaster and military medicine as an academic field.

Yohan Robinson has achieved a lot in his career since obtaining his medical degree in Berlin. He first connected with Sweden as an Erasmus student at the Karolinska Institute in 2000. His dissertation in 2005 focused on the aging of red blood cells in male athletes. In connection with this, he also developed an indirect EPO doping test. He was recruited to Uppsala University and became an associate professor there. He has earned both an MBA in international healthcare management and a European Master's in Disaster Medicine (EMDM), but the list is actually much longer.

"Service as a trauma surgeon in the Armed Forces, both in Afghanistan and Mali, provided me with an additional perspective on disaster medicine, especially concerning war injuries, security aspects, logistics, and ethical challenges. I could bring that experience into the development of disaster medicine," says Yohan Robinson.

Research thrives through teamwork
 

Today, Yohan works as the Medical Research Director for the Swedish Armed Forces and leads a team of ten experts and researchers at the Centre for Defense Medicine (FömedC) in Gothenburg.

"Research is a team effort. It's rare that a single researcher solves a task entirely on his own. It's through collaboration that we gain the most insight. I appreciate research projects where scientists from multiple disciplines and scientific traditions come together to create new knowledge. It creates an incredible sense of flow," says Yohan.

Yohan enjoys working within extensive networks and has proven this ability by establishing the National Board of Health and Welfare's first research centre in disaster medicine in Gothenburg. Now, the centre has become a university-wide hub for disaster medicine.

Many limb injuries among civilians in war
- We have already submitted our first report to the National Board of Health and Welfare - Civilian Injury Landscape in War, it's a knowledge foundation regarding the injuries that affect the civilian population in times of war," says Yohan Robinson.

The freshly released report is a systematic literature review and compiles the available scientific knowledge in the field over the past 50 years.

The report shows that civilians are primarily affected by injuries to the upper limbs, followed by head injuries, chest and lower limb injuries. Burns account for 16 percent of the injuries, followed by abdominal and pelvic injuries, and spinal injuries at four percent. 25 percent of all injuries were suffered by children, and their injuries were similar in distribution to those of adults (see Figure 3 below).

- Information about the injury landscape is crucial for preparedness planning for both civilian and military healthcare in total defense. Actually, we were surprised that the injury landscape has remained so consistent over the past 50 years, despite many new weapon systems," says Yohan.

The National Board of Health and Welfare is the sectoral responsible authority for emergency preparedness in healthcare. They have been tasked by the government to develop key figures and dimensional target models based on these key figures for healthcare planning in civilian defense.

Increased disaster medical capability - enables a stronger defense

Even though the pattern of injuries has remained relatively constant, the perspective on how healthcare should be led and organized during heightened preparedness and war has changed over the years. Sweden's security situation has led to the assessment that an armed attack on Swedish territory is more likely now than ten years ago. Therefore, the parliament and the government have decided to enhance societal resilience through investments in a stronger defense. This includes an increased capability in disaster medicine and the ability to receive injured personnel from the Swedish Armed Forces and allied nations.

Sweden's disaster medical handling capacity during war increases when personnel have a high level of knowledge about the Armed Forces' medical care chain, NATO's defense medical doctrine, host nation support, and Sweden's civil defense. This includes knowledge of international law and military medical ethics, medical leadership, as well as knowledge of treating injuries from chemical, biological, and radiological warfare.

"With the new centre, disaster medicine has been clearly prioritized at the University of Gothenburg. I hope that we will be able to contribute to both basic education, further education, and doctoral education in the field. There is significant interest in the subject among students and researchers. Together, we will create conditions for a Sweden prepared to handle all types of disasters - 'all-hazards.' It's exciting to be a part of this journey," says Yohan Robinson.

Text: Susanne Lj Westergren