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I am very pleased to write the foreword to this special edition of the Journal of the Royal Army Medical Corps that collates a series of papers on the subject of the international response to the Ebola crisis in 2014/2015. This was a remarkable global health emergency requiring a significant military role to help and support the civilian health organisations engaged in West Africa. I was Director Medical Policy and Operational Capability during this period and indeed Ebola became the key issue from my first day of assignment. Important in my responsibilities was ensuring that the most senior leadership in Defence was fully aware of the capabilities of the Defence Medical Services (DMS) and the sophisticated approach that we took to mitigate the significant health threats faced by our personnel (and not just Ebola). I was privileged to observe how the whole DMS responded to the crisis, including the force generation and operation of the Ebola Virus Disease Treatment Unit (EVD TU), provision of Role 1 and 3 medical support, in-theatre training, specialist medical evacuation, force health protection, health screening of returnees and the mobilisation of our academic and research expertise. Importantly, these responses were often successfully achieved in a limited time scale and were rapidly and appropriately adapted as expertise grew. Our response demonstrated our abilities to partner with Sierra Leonean and international health responders. Our relationship with 34 Hospital of the Sierra Leonean Armed Forces continues and the development of the Rapidly Deployable Infectious Disease Treatment Facility is an outstanding example of Defence Engagement in action. We must not forget the support given by engineering, helicopter and RFA resources to underpin the DMS success. This collection of papers provides a unique record of the roles of the DMS during the crisis.
New models for co-ordination between military medical services and other actors in the global health response were established during this period. I am particularly pleased that this special edition also contains important papers from health partners including Save the Children and the Chinese Army. I believe this reflects on the international standing of the Journal as one of the leading global, specialist, military, medical journals.
The UK DMS have a strong reputation for excellence built on research, continuous improvement, innovation and organisational learning. I commend this special edition to all readers as our contribution to the global record of the response to this Ebola crisis. The recent UK Strategic Defence & Security Review1 identifies a major health crisis as a Tier 1 risk to UK national security. It behoves the DMS to assimilate the observations and lessons contained in these papers, institutionalise them and ensure that any future response to a similar crisis not only builds on them but betters them.
Surgeon Vice Admiral Alasdair J Walker OBE, QHS, FRCS
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.