Up to 1,000 Wounded a Day: Germany Reshapes Medical System for War

Germany is preparing military and civilian medical facilities to operate in the event of a potential large-scale armed conflict and a mass influx of wounded.

Bloomberg reported this in an article about Germany’s efforts to restructure its health care system amid the threat of war in Europe.

According to Bundeswehr estimates, in the event of an armed conflict on NATO’s eastern flank, between 300 and 1,000 wounded service members could be evacuated to Germany each day, with about one-third requiring intensive care.

The Bundeswehr’s five military hospitals would not be able to treat that many wounded on their own, meaning much of the burden would fall on civilian hospitals, which would also have to keep treating the civilian population.

Federal Health Minister Nina Warken said German medical facilities are taking measures to increase their resilience to armed conflict. These include creating additional stocks of medicines and surgical supplies, equipping protected spaces, installing bullet-resistant glass and physical barriers to protect against drones.

At the Bundeswehr hospital in Ulm, officials are considering restoring an underground medical bunker dating back to the Cold War. It is designed to accommodate about 2,000 people and operate independently for 90 days, but its ventilation and power systems would need modernization before it could be brought back into service. Medical facilities are also assessing the use of underground parking garages as long-term shelters and increasing stocks of critical medicines.

Another challenge is preparing medical personnel. Only a few hundred German doctors have practical experience treating combat-related trauma, so civilian surgeons are being trained to handle mass casualties and war injuries.

According to Benedikt Friemert, director of the Bundeswehr hospital in Ulm, Germany’s health care system is not yet fully prepared to operate under such conditions.

The Bundeswehr assumes that, in the event of war, Germany’s geographic position would make it one of NATO’s main rear-area and logistics hubs: troops and materiel would move eastward through the country, while wounded personnel would be evacuated in the opposite direction.

German military officials regard the experience of Russia’s war against Ukraine as a key factor shaping the new system of medical support and civil-military cooperation.

Germany is also developing field medicine. In particular, the Bundeswehr has ordered 149 mobile medical aid stations from Rheinmetall, which Ukraine has been using since 2023.