Chapter 2168 - Medical Logistics Work

This seemingly perfect system operated dismally in practice, hamstrung by shortages of specialized personnel and medical supplies.

During previous Senate conflicts, battles rarely lasted long; overall casualties remained low. Concentrating most health resources for blitz-style responses generated generally favorable results—excepting severe external trauma and infections, treatment survival rates ran quite high.

Throughout Hainan Island security operations, troops predominantly encountered small bandit groups—sparse numbers, low quality, crude weaponry. The Fubo Army typically maintained absolute superiority. Combat casualties proved extremely rare; medical logistics demands even rarer.

Now the situation had transformed utterly. In the security campaign along West River banks, enemies were numerous, well-equipped, predominantly familiar with terrain and local conditions. Conversely, the National Army—which had assumed most routine security assignments—frequently suffered inadequate training and poor equipment.

Because numerous units reorganized from surrendered forces, their combat resolve proved weak; battlefield casualties vastly exceeded the Fubo Army's. After each engagement, wounded requiring treatment and evacuation frequently surpassed unit handling capacity.

Bandit suppression operations predominantly occurred at company/squadron level, with battalion/brigade operational zones potentially spanning several square kilometers. Battlefields often sprawled across mountains and hills; wounded reaching battalion aid stations confronted tremendous difficulties.

"Even after arriving, they receive minimal treatment," Lin Motian stated glumly. "I've visited the units personally. Battalion aid stations deserve classification merely as dressing stations. Medic kits contain nothing useful. They manage basic wound cleaning and bandaging, barely handle simple fracture immobilization. Slightly complex wounds exceed their capabilities entirely. Some locations lack even drinking water for the wounded..."

Transferring from dressing stations to field hospitals demanded first climbing mountains, crossing ridges, then switching to boats. Jolting during transport exceeded severely wounded soldiers' endurance. Each transfer stage required prolonged waiting; numerous salvageable wounded deteriorated while waiting, ultimately dying.

The soldiers' own assessment ran roughly: "walk and you'll live" paired with "stretcher equals death." Lin Motian admitted both sayings proved essentially accurate.

Long-distance, sluggish evacuations frequently consigned the severely wounded to death after prolonged suffering. Consequently, in numerous cases, the traditional "finishing off" severely wounded at company level had resurged. Though superficially appearing "merciful"—quick death preferable to extended agony—the practice devastated morale catastrophically.

"I recognize our conditions permit very little—especially for the severely wounded. I'm a surgeon myself. Given our constraints, common massive lacerations, penetrating wounds with organ damage... I know precisely how few we can genuinely save. Whether we transport them or not makes minimal difference. But the current situation remains unconscionably ugly..."

"Don't torment yourself excessively. We in the health sector understand the Senate's medical standards intimately—others might not," Liu San lit a cigar as well. "How many 17th century armies establish field medical units? Possessing one constitutes achievement already! Recall the mid-19th century Austro-Prussian War—armies numbering tens of thousands boasted merely six military physicians! Such progressiveness remains entirely relative."

"You're correct, but..." Lin Motian couldn't release it. Working days at the field hospital had impacted him too profoundly. Knowing circumstances theoretically versus experiencing them directly constituted vastly different matters.

"Regarding resource problems, avoid excessive preoccupation." Liu San consoled him. "Hong Huangnan and I have discussed this, preparing to expand medical evacuation team establishments. Particularly stretcher teams—substantial increases required. Additionally, dedicated medical transport boats are needed so wounded avoid waiting for returning supply vessels. Even if they die, let them die in the field hospital."

"What about medical personnel?"

"We'll maximize efforts," Liu San replied. "As for Senator physicians, increasing numbers appears improbable. However, we can deploy another dozen medical students currently training for internships here. Chief Shi insists these individuals cannot approach front lines; their safety demands guarantees."

Ever since a naturalized medical assistant perished unfortunately during North River combat, Chief Shi experienced heartbreak. A "quasi-doctor" qualified by contemporary standards required over three years' health sector training—predicated on individual talent and diligent Senator physician instruction. This incident prompted General Staff and Health Department to specifically issue documentation mandating troops "protect every medical worker's safety."

"Understood."

"Additionally, initial production samples of your newly designed field kits have been manufactured, some dispatched for trial deployment. I brought a batch this trip."

"Excellent!" Lin Motian's troubled expression brightened fractionally.

Medical kits presently in widespread medic use remained exceedingly basic: wooden stethoscope, wound-cleaning implements, acupuncture needle set, small alcohol bottle, hemostatic powder packet, small Xingjun San bottle, berberine packet, small sulfonamide bottle, minimal water purification tablets, plus assorted gauze, bandages, triangular bandages, and tourniquets. This kit had persisted since immediately preceding the Second Anti-"Encirclement" War, making do continuously since.

The new medical kits he'd designed bore designations "Type 35 First Aid Kit" and "Type 35 Military Doctor Kit," conceived for distribution based on the original medic field case—serving as improved and expanded versions respectively, in Medic and Military Doctor configurations.

The Type 35 First Aid Kit incorporated partial enhancements to the original. Two tung oil cloth lining layers were added inside the original cowhide case enhancing waterproofing. Acupuncture needles and wound-cleaning implements underwent substantial simplification in the medic first-aid kit, the cleaning set retaining one each of: knife, scissors, needle, thread. As compensation, surgical instrument types and quantities for battalion-level medical stations increased. Beyond alcohol, small bottles of iodine glycerin and hydrogen peroxide were added. Chinese patent medicine variety expanded dramatically: original hemostatic powder and berberine received improved formulations; snake medicine, burn ointment, Angong Niuhuang pills, and oral opium tincture were incorporated. Chemical pharmaceuticals added oxytetracycline—now mature in production quantity—plus refined morphine designated specifically for emergency deployment. Certain configurations added pituitary extract and adrenal extract alongside corresponding syringes and needles. Dressings remained fundamentally unchanged, with addition of five-color casualty tags adapted from PLA protocols: red bleeding tags, white fracture tags, black infectious disease tags, yellow poisoning tags—since the Fubo Army wouldn't encounter radiation injuries, blue tags were provisionally designated for "other injuries" including frostbite, burns, and stings.

The Type 35 Military Doctor Kit received supplementation with additional instruments and medications. Beyond discretionary medicines, dressings, and instruments from the first-aid kit, the Military Doctor Kit incorporated several saline solution and glucose injection bottles. Additionally, expanded quantities and richer variety of epidemic prevention disinfection pharmaceuticals were included. Several compact medical instrument packs were added: small orthopedic packs, wound-cleaning packs, midwifery packs (addressing civilian requirements when garrisoned locally), plus a slightly larger general instrument pack simplified and synthesized from exploratory laparotomy packs and amputation packs—naturally, given current material deficiencies, items like wire saws and Kirchner wires weren't included in any instrument packs. Splints and plaster bandages were incorporated, alongside simple resuscitator bags, metal tracheal intubation tubes, and metal urinary catheters. Since size and weight exceeded ordinary field case parameters, the Military Doctor Kit abandoned backpack configuration, instead being equipped with detachable handles and wheels for mobility.

"Honestly, the simple resuscitator remains controversial. Some believe that given current conditions, significance of transporting and resuscitating field casualties unable to maintain autonomous respiration proves extremely limited—thus the simple resuscitator balloon could be omitted. However, this item isn't difficult manufacturing; possessing another resuscitation option proves beneficial."

"Honestly, nothing proves useless—only insufficient." Lin Motian smiled bitterly. "According to my original conception, the medic first-aid kit shouldn't contain wound-cleaning implements whatsoever—merely simple bandaging followed by evacuation. Complete wound-cleaning implements belong in the Military Doctor Kit. But reconsidering, possessing not even needle and thread in the first-aid kit appeared excessively pathetic, so I incorporated this minimal version. Because the medic first-aid kit must provide most basic healthcare not exclusively on battlefields but also during peacetime, needle and thread were retained. But conceptually, wound cleaning should be performed via the Military Doctor Kit."

"Regarding individual first-aid packs, the plan underwent revision per your suggestions, but the Enterprise Planning Institute reports current enamel bowl production capacity remains insufficient—additions must occur gradually."

The new individual first-aid pack incorporated an enamel bowl plus a wide belt. The belt measured two fingers' width, cotton construction with numerous close-interval punched holes, usable as tourniquet. The enamel bowl served for temporarily containing intestines protruding from abdominal penetrating wounds in injured soldiers—naturally also usable as eating utensils.

Originally, every Fubo Army soldier possessed one first-aid pack, but these items carried expiration dates. The Health Materials Factory lacked effective sealing packaging methodologies, resulting in extremely abbreviated first-aid pack shelf lives. Upon expiration, they required unpacking, re-sterilization, re-sealing—consequently inventory maintained consistently depressed levels. Full-scale production commenced merely months before the Continental Campaign, but consumption vastly exceeded prior projections. The National Army expansion plan had expanded repeatedly; combat intensity proved substantially higher than anticipated. Currently, first-aid packs couldn't achieve per-soldier distribution. Essentially only the Fubo Army and "veteran National Army" possessed them. Massive "second" and "third" wave mobilized National Army contingents lacked equipment entirely—indeed, numerous companies didn't even possess medics. After wounding, treatment options proved essentially nonexistent.

"This variety of differential treatment exerts tremendous, tremendous morale impact," Lin Motian observed. "These new National Army troops already suffer predominantly poor equipment; their medical provisions prove minimal or nonexistent. Numerous soldiers perceive discrimination. Long term, not only will troop morale fail improving, but loyalty might problematize as well. The National Army's desertion rate has climbed considerably recently."

(Chapter End)