1. The background
Military missions and crisis situations often require flexible and rapid solutions, especially when it comes to providing medical assistance. This is why mobile hospitals, which can be quickly relocated, have become a crucial part of the military healthcare system. Our customer needed a solution that was lite-weight, easy to transport, set up and dismantle, modular, and adapted to deployments across a variety of terrains and weather conditions. The solution was meant to provide a safe and convenient accommodation space for the patients and allow for a doctor’s workstation, including all the medical equipment that a Role 1 hospital requires. This meant a stringent set of requirements regarding indoor temperature, light level, and access control.
2. The challenge
The modular hospital had to consist of 2in1 and 3in1 modules transportable via air, sea, or land, packaged inside standard 20ft containers. Speed of deployment was a key challenge, as the hospital had to be ready for relocation within 8 hours. In addition, these hospitals had to be capable of deployment with a very short delay (24-48 hours, including transportation from the warehouse to the site and setup), across a variety of terrains, often lacking ready access to modern infrastructure. This is no easy feat, as the hospital must be fitted with the medical equipment needed to fulfill its mission. In this specific case, the modular hospital was to be deployed to Saaremaa, Estonia’s largest island, and fulfill a Role 1 duty during the COVID-19 crisis.
Our engineering team determined that the RAPID heavy-duty high-pressure inflatable shelter was the best option, as far as the soft shelter component was concerned. These shelters only require the simplest logistical support for deployment, are built to withstand extreme weather, and, crucially, can be connected either to other shelters, length- and crosswise and to other shelters, such as containers and vehicles. This was very important as the modular hospital included many containers used as treatment modules. At the same time, the RAPID shelters are impervious to temperature fluctuations, which means that they only require minimal on-field maintenance and are appropriate for long-term missions. As an additional benefit for the customer, the shelter has a fully integrated structure, in which the side walls, roof, gable, and floor form a single unit, ensuring rapid setup and unrivaled water tightness.
3. The result
The spider-like structure was swiftly erected next to Kuressaare Hospital on the Estonian island of Saaremaa in April 2020, due to the COVID-19 crisis. This was done in just a few hours to increase the island’s intensive care capacity and provide extra beds. Four weeks later, the medical unit was packed up just as quickly and returned to the defense warehouse, as the number of patients decreased. It is currently serving the Ukrainian Army, together with three similar modular hospitals, a testimony of the structure’s reliability across a variety of terrains.
All modules have 20 minutes of deployment and repack time. Modules can be used independently or as a part of the modular hospital. The container-field hospital, along with the military personnel and civilian staff, can provide up to 20 intensive care units and 40 additional beds. This significantly boosted the intensive care capacity of Saaremaa Hospital. The hospital was ready to admit patients from April 2, configured to accommodate the maximum number of patients needing emergency and intensive care. As a Role 1 level hospital, the mobile unit includes one doctor’s workstation, an area for first aid, and four patient holding costs. These field beds can be equipped with ventilators and other medical equipment and can be used even while the unit is on the move.
ROFI provided the RAPID shelters used for the ward and triage modules of the hospital. The wards are equipped with folding beds and include an active care workstation, as well as an area for patient observation and accommodation. The unit has built-in leveling legs, which makes loading and unloading from a truck or barrow possible without extra cranes or lifting units. With ISO 1CC Certification, all the modules used in this project are designed for easy transportation by sea, land, and air.
In this specific configuration, the ward module includes:
- 2 shelters with climate control;
- 20 cots;
- 3 connection ramps;
- Stainless steel furniture;
- 360-degree outdoor lighting;
- 1 workstation with:
- Monitor with defibrillator
- Procedure lamp;
- Device cart;
- Percussor;
- Line warmer;
- 1 observation bay;
- Refrigerator;
- Infusion warming cabinet;
- Touchscreen monitor.
The ward consists of two 215 ft² shelters that can be easily extended, providing a total capacity of up to 40 patients. It is designed to operate in temperatures ranging from -40°F to 122°F. These mobile hospitals meet military requirements and can be delivered by conventional vehicles. They can be deployed within 10-20 hours over a 373 miles radius by land, or up to 932 miles by air. Installation can be conducted by up to two people without a crane, as all modules are self-elevating. Thanks to its container-type design, the solution can be mounted on any frame truck. This results in a vehicle that offers more space than conventional slide-out systems and the Rolling Unit can be driven by a category B, BE, or C1 license holder. When unfolded, it provides a spacious area with no steps on the floor.
Conclusions
NATO’s requirement to have a hospital ready for relocation within eight hours can be met by this configuration in just a couple of hours. The modules shrink to the size of a standard container for transport, so no special equipment is needed to move them to the next location. An important feature of these solutions is that the trauma center module can operate completely autonomously. It has a separate power generator and all the necessary resources to start up first, then gradually connect the rest of the hospital to it. The modularity and connectivity of the system also allow users to configure the hospital according to their needs. All the parts do not necessarily have to be in the same position all the time. As a testimony of the modular hospital’s rapid deployment capabilities, after serving as a COVID-19 Role 1 unit in Estonia, it was dismantled at the end of the sanitary crisis and redeployed in Ukraine, to serve the armed forces involved in the war against the Russian Federation.
