Suchergebnisse

Simon Tallowin, David N Naumann, Douglas M Bowley Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Birmingham B15 2TH, UKCorrespondence: Douglas M BowleyRoyal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Birmingham B15 2TH, UKTel +44 7810 308 167Email dougbowley@nhs.netAbstract: Defence Healthcare Engagement (DHE) describes the use of military medical capabilities to achieve health effects overseas through enduring partnerships. It forms a key part of a wider strategy of Defence Engagement that utilises defence assets and activities, short of combat operations, to achieve influence. UK Defence Medical Services have significant recent DHE experience from conflict and stabilisation operations (e.g. Iraq and Afghanistan), health crises (e.g. Ebola epidemic in Sierra Leone), and as part of a long-term partnership with the Pakistan Armed Forces. Taking a historical perspective, this article describes the evolution of DHE from ad hoc rural health camps in the 1950s, to a modern integrated, multi-sector approach based on partnerships with local actors and close civil-military cooperation. It explores the evidence from recent UK experiences, highlighting the decisive contributions that military forces can make to healthcare leadership and quality of care overseas, particularly when conflict and health crisis outstrips the capacity of local healthcare providers to respond. Lessons identified include the need for long-term engagement with partners and the requirement for DHE activities to be closely coordinated with humanitarian agencies and local providers to prevent adverse effects on the local health economy and ensure a sustainable transition to civilian oversight.Keywords: military medicine, conflict, humanitarianism, coaching

Defence Healthcare Engagement (DHE) describes the use of military medical capabilities to achieve health effects overseas through enduring partnerships. It forms a key part of a wider strategy of Defence Engagement that utilises defence assets and activities, short of combat operations, to achieve influence. UK Defence Medical Services have significant recent DHE experience from conflict and stabilisation operations (e.g. Iraq and Afghanistan), health crises (e.g. Ebola epidemic in Sierra Leone), and as part of a long-term partnership with the Pakistan Armed Forces. Taking a historical perspective, this article describes the evolution of DHE from ad hoc rural health camps in the 1950s, to a modern integrated, multi-sector approach based on partnerships with local actors and close civil-military cooperation. It explores the evidence from recent UK experiences, highlighting the decisive contributions that military forces can make to healthcare leadership and quality of care overseas, particularly when conflict and health crisis outstrips the capacity of local healthcare providers to respond. Lessons identified include the need for long-term engagement with partners and the requirement for DHE activities to be closely coordinated with humanitarian agencies and local providers to prevent adverse effects on the local health economy and ensure a sustainable transition to civilian oversight.

Defence Healthcare Engagement (DHE) describes the use of military medical capabilities to achieve health effects overseas through enduring partnerships. It forms a key part of a wider strategy of Defence Engagement that utilises defence assets and activities, short of combat operations, to achieve influence. UK Defence Medical Services have significant recent DHE experience from conflict and stabilisation operations (e.g. Iraq and Afghanistan), health crises (e.g. Ebola epidemic in Sierra Leone), and as part of a long-term partnership with the Pakistan Armed Forces. Taking a historical perspective, this article describes the evolution of DHE from ad hoc rural health camps in the 1950s, to a modern integrated, multi-sector approach based on partnerships with local actors and close civil-military cooperation. It explores the evidence from recent UK experiences, highlighting the decisive contributions that military forces can make to healthcare leadership and quality of care overseas, particularly when conflict and health crisis outstrips the capacity of local healthcare providers to respond. Lessons identified include the need for long-term engagement with partners and the requirement for DHE activities to be closely coordinated with humanitarian agencies and local providers to prevent adverse effects on the local health economy and ensure a sustainable transition to civilian oversight.

[Einleitung und Motivation] Sektorkopplung bzw. Sektorenkopplung ist in den letzten Jahren in der Energie- und Klimapolitik als neue Begrifflichkeit aufgetaucht. Der hohe politische Stellenwert der Sektorkopplung in der heutigen energiepolitischen Diskussion spiegelt sich unter anderem im Klimaschutzplan 2050 (BMUB 2016) und in dem Grünbuch Energieeffizienz (BMWi 2016a) wider. Sektorkopplung soll einen entscheidenden Beitrag zur Erreichung ambitionierter Klimaschutzziele durch den verstärkten Einsatz von erneuerbarem Strom in den Sektoren Verkehr, Wärme und Industrie zur Substitution von fossilen Energieträgern leisten (siehe BMWi 2016a; BMUB 2016; aber auch RP-Energie-Lexikon 2017; Wietschel 2015a). Auch in weiten Teilen der Energiewirtschaft besteht ein Interesse an Sektorkopplung zur Erschließung neuer Optimierungs- und Geschäftsmöglichkeiten innerhalb eines sich verändernden Energiesystems (vgl. BDEW 2017a; DVGW 2017). Nicht zuletzt widmet sich auch der wissenschaftliche Diskurs der Sektorkopplung. Gegenstand der Untersuchungen sind derzeit die Möglichkeiten und konkreten Ausgestaltungsformen einer Kopplung unterschiedlicher Sektoren bzw. Teilsysteme aus ökologischer, ökonomischer, technischer, regulatorischer und sozialwissenschaftlicher Sicht (u. a. IWES et al. 2015; Ecke et al. 2016, dena 2017a, Acatech 2017, Wietschel et al. 2015). Wenngleich die Erforderlichkeit sowie die zukünftige Ausgestaltung der Sektorkopplung seitens Politik, Wirtschaft und Wissenschaft derzeit intensiv diskutiert werden, existiert bislang keine einheitliche und umfängliche Definition. Statt-dessen liegen mitunter deutlich abweichende Auffassungen des Begriffs vor und es existieren eine Reihe von Definitionen bzw. Verständnisse des Begriffs Sektorkopplung nebeneinander. Eine Literatursichtung führt dazu, dass einige Autorinnen und Autoren Sektorkopplung eher sehr eng fassen und darunter nur die Umwandlung von Erneuerbaren (Überschuss-)Strom in Gase oder Flüssigkeiten fassen. Andere wiederum unter Sektorkopplung alle Aspekte der Verzahnung von energierelevanten Sektoren verstehen und hier lediglich eine Abgrenzung zu Lösungen sehen, die nur innerhalb eines Sektors auftreten, wie die Eigennutzung von einer Dach-PV-Anlage im Haus [.].