Article written by BG de Haan (NLD) at the occasion of the 50th CIOMR Anniversary.
C.I.O.M.R – I.C.M.R.O.
Interallied Confederation of Medical Reserve Officers.
Just after the end of World War II, the Cold War started to divide the Allies of yesterday: Americans and West-Europeans on one side, Russians and satellite states on the other.
At that time Major-General Dr. Jules Voncken (B) was Secretary General of the International Committee of Military Medecine and Pharmacy (ICMMP), located at the Military Hospital of Liège.
This Committee, first known as the Standing Committee for International Congresses of Military Medicine and Pharmacy was the result of the collaboration between the health services of the different allied Armies, during World War I. This collaboration could not be limited to war times and in 1920, General Jules Voncken, M.C., then Commandant, delegate of the Health Services of the Belgian Army to the 28th meeting of the Association of Military Surgeons of the U.S.A. (AMSUS), met with Commander William Seaman Bainbridge, U.S.N. Together, they thought of setting up an International Congress which would assemble the military doctors from the active services and from the reserve to allow the exchange of their experiences their thoughts and their wishes.
The first International Congress of Military Medicine and Pharmacy was held in Brussels from July 15 to July 20, 1921. Close to 500 participants military doctors and pharmacists from allied or associated armies, as well as neutral countries participated. They discussed treatment of fractures, venereal and tuberculosis diseases, prophylaxis, gas warfare but above, the general organization of Armies Health Services.
So it became a worldwide committee, organizing congresses where Soviet, American, Asian, African, and European medical officers and pharmacists could meet and exchange their experience. In addition the Committee ran an International Office of Military Medicine Documentation and published a monthly “International Review of the Army, Navy and Air Force Medical Services”. In 1938, the Committee adopted the name “International Committee of Military Medicine and Pharmacy” and a few years ago the name changed to International Committee of Military Medicine.
General Voncken, who was the first Secretary General from 1921 to his death in 1975, found in 1947 this Committee not the right forum to treat medical defence problems in such an open way, and more specifically certain medical problems connected with a new pathology arising from the use of atomic weapons of great power; and this all in the CIMPM, meeting-point of the allies of yesterday but adversaries of tomorrow. Faced with the paradox that potential adversaries could meet in an international organization, and noting the fact that the North Atlantic Pact was being prepared as a background to the future NATO Alliance, General Dr. Voncken, keen to maintain international exchange and contacts and conscious of the future importance of the Reserve, conceived the idea of establishing an inter-allied entity.
The Brussels Treaty of Ecomonic, Social and Cultural Collaboration and Collective Self-defence, provided the opportunity for which he had been waiting.
This ‘Brussels Treaty’, signed in March 1948 by Belgium, France, Luxembourg, the Netherlands and the United Kingdom represented the first formal step in the direction of the North Atlantic Treaty by establishing what became known as the Western Union.
But the organizational plans of the future NATO did not allow for an interallied medical body (at that time, there was still no question of Euromed). Dr. Voncken suggested already in November 1947 that medical reserve officers establish a committee with international and scientific contacts, on the lines of ICMMP (this because of the lack of interest of the regular Forces). The committee would be limited to the signatory countries to the Alliance.
Dr. Voncken’s opinion was very clear: there was room for an international allied medical organization that would consider the problems of the Forces and of organization that arose in NATO. This suggestion was translated into practice.
Dr. G. Decharneux, assistant at the University of Liege and a leading personality at the clinical level and in teaching, became interested in Dr. Voncken’s projects, and established contacts with the French organization of Medical Reserve officers and with Dutch Medical Officers.
On November 21, 1948 “Le Comité Interallié des Officiers Médecins de Réserve” (C.I.O.M.R.) was founded. Proposed by the Belgian Union of Medical Reserve Officers in Brussels at the Royal Military Academy, it was to be an association comprising the Reserve doctors of the countries in the North Atlantic Alliance. Present at this ceremony were the Minister of Defence from Belgium, the Inspectors General of the Medical Services of Belgium, France and the Netherlands, the Chief of the Hospital Service in the Luxembourg Army, and Representatives of the Canadian and American Medical Services in Germany.
This Committee would act along the same lines as the ICMMP but be limited to Allied Medical Reserve organizations.
At the outset, membership of the Committee was limited to Belgium, France and the Netherlands.
The first President was Dr. Julien Huber from France an outstanding Colonel of the French Army Reserve and Veteran of World War I and II.
Dr. G. Decharneux became the first Secretary General Permanent (1948-1960).
The statutes were established in January 1949 in Paris.
In 1948, C.I.O.M.R.’s Aims were:
- To establish friendly relations between doctors in the Allies reservist formations.
- To study and discuss problems concerning the medical reserve officer, his medico-military training, his instructions and his technical experience.
- To promote of a real and effective collaboration with the medical and hospital services of the regular Forces.
- To give the Command maximum support in the study of medical problems and assistance in matters connected with the morale of the troops.
The goals were achieved by holding two meetings each year: one in the spring, of an administrative nature, and one in the summer, to concentrate on scientific matters.
The number of members gradually increased. The first countries to join were Italy and Luxemburg, which took over the presidency between 1954-1956 and 1958-1960, respectively. The Federal Republic of Germany’s membership in 1961 was of great importance, because it marked a definitive break with the past. Germany took up the presidency as early as 1964.
Dr G. Decharneux stepped down in 1960 after an outstanding 12 years as Secretary General.
The CIOMR then took the important decision to limit the term of Secretary General to just two years, although he could be re-elected, as could the Deputy Secretary General and the Treasurer. The president serves a two-year term and is not re-electable. Continuity of the CIOMR is provided by the re-electability of the Secretary General. The Presidency rotates according to a fixed list.
- Scientific meetings
The major part of the CIOMR’s activities remains tied to scientific matters.
- A one-day programme drawn up by the Military Medical Service of the host country.
- A one-day programme drawn up by members.
- One-and-a-half days of (a) guest speaker(s) and/or own members.
The subjects covered give an important overview of developments in military medical science.
Subjects and discussions to cover, among others:
- Medical care on the Front:
where and when?
how and what with?
Adequate care on the Front can not only save many lives but also prevent permanent invalidity.
More burns victims can be expected with the development of modern weapons.
- Psychological problems
Increasingly more attention is being devoted to this subject, which is gaining in importance.
- Consequences of humanitarian missions.
Humanitarian missions demand knowledge not only of military medical science, but equally of public health. The doctor at the scene is faced not just with the medical care of his own party but also with that of the civilian population – and this cannot be, and is not allowed to be, turned down. This means that the doctor involved must be trained in gynaecology, obstetrics, paediatrics, and, perhaps, tropical health care.
The CIOMR is a strong proponent that a part of this training should be given in an international context. In addition, the countries involved in humanitarian and peace-keeping missions are not involved in war and are not threatened.
The soldier and his family at home expect that in the case of wounding, sickness or accident, that he receives the same medical care that he would in his home country.
Where possible, delegates should bring subjects covered by the scientific meetings to the attention of national military medical authorities.
- First Aid Contest
At the initiative of the CIOMR, particularly Dr. G. Decharneux, a First Aid Competition was held for the first time at the 13th CIOR Congress in Brussels in 1970. First Aid at the Front deserves the same priority, according to the CIOMR, as shooting accuracy, map-reading, swimming and completing an obstacle course. The adage remains: First aid is supplied by the wounded person himself, secondly from his comrade, and thirdly from the Military Medical Service.
Originally, each country put together a single team to take part in the First Aid Competition only.
The CIOMR remained of the opinion that each Reserve Officer should have sufficient knowledge of First Aid. It insisted, therefore, that each team participant should take part in the First Aid Competition.
There was a discussion lasting many years about the possibility of incorporating a First Aid Competition into the CIOR Competition.
It can be said with satisfaction that the problems have been overcome and that for the last four years each sports team must participate in the First Aid Competition. The exercises are the same for each team.
The CIOMR is extremely grateful to the CIOR, and particularly to Commission VI, for the co-operation it has received, so that the First Aid Competition could be completely integrated into the CIOR Competition.
The CIOMR, which bears the responsibility for the First Aid Competition, consults with the host organization for many months in advance.
It lays down the following requirements :
- The First Aid Competition must be a military First Aid Competition
- It should be as realistic as possible
- The tasks should be able to be judged objectively
- The judges should be appointed, as far as possible, during the spring meeting in Brussels and extensively briefed before the start of the exercise.
- Comprehensive assessment lists should be compiled, so as to make objective marking possible.
The CIOMR presents the Dr Decharneux Prize, in gold, silver and bronze, to the first three teams, respectively, in memory of our honourary member, co-founder and first Secretary General.
The CIOMR has established a commission for both the scientific meeting and the First Aid Competition to organize and evaluate these activities.
The CIOMR has recently become officially involved in the work of COMEDS. COMEDS is the Committee of Chiefs of Medical Services (NATO), which strives for compatibility in medical doctrines and training. This co-operation has led to a forum being established into which can be brought at an international level the civil expertise of reservists.
- Relationship between the CIOR and the CIOMR
The CIOR and the CIOMR have developed independently of each other. In 1955, a CIOMR Congress (Ninth) was held for the first time since its establishment on November 21, 1948, at the same time as the CIOR Congress (Eighth) in Liège.The need existed to formally establish the relationship with the CIOR and this was done in 1961.
The CIOMR received the status of national organization and the President of the CIOMR became a Vice President of CIOR, thereby taking up a seat on the CIOR’s Executive Committee. Because the congresses have been held concurrently since 1961, the President of the CIOMR has limited his activities to the setting out of the CIOMR’s activities in the EC CIOMR, during both the winter meeting and the summer congress. On top of this, the President and Secretary General of the CIOMR are placed with the CIOR Presidency during the opening and closing ceremonies.
Within the CIOR, proposals are regularly put forward to convert the self-supporting and independent CIOMR into a seventh Commission of the CIOR.
The CIOMR has been open since 1961 to all officers of the Medical Service and has, therefore, the largest number of reserve officers in relation to regular officers. The CIOR adapted its statutes at the beginning of 1983 and laid down that the CIOMR is an independent organization that is associated with the CIOR.
A number of points can be made in relation to the arguments for independence of the CIOMR.
- The Medical Service helps friend and foe.
- The Medical Service is subject to the Geneva Conventions, to which certain rights are attached but also some obligations.
- It is desirable that the Medical Service has direct access to the highest ranks, so as to guarantee the treatment and care of the soldiers and civilians entrusted to it.
The CIOMR greatly values its co-operation with the CIOR, and strives to intensify its contacts with the Commission II and V. Both Commissions handle matters which also lie within the area of concern of the CIOMR. Military medical science and disaster medical science have very much in common.
Via the First Aid Competition, there has been co-operation with Commission VI for many years.
The CIOMR appoints representatives to these Commissions so as to participate in their work.
The tight schedule for both the winter and summer meetings often make it difficult actively to participate in the Commissions’ work.
Extending these contacts has a high priority with the CIOMR.
The CIOMR is very carefully looking into the question as to how enough medical personnel can be recruited. With a reduction in the number of the military forces, these cannot just be regular officers, so that the demands on reserve personnel rise. Also, a greater part of these reserve personnel will have to be volunteers, especially in those countries which no longer have conscription.
So as to be able to function, the Medical Service must appeal to medical students who have completed their studies, and to doctors and specialists from hospitals to attach themselves to the army for some years. All of this has consequences, for which the implications have not yet been fully explored.
Undoubtedly, much has to be worked out together in an international context.
This co-operation, particularly with other cultures, demands knowledge and expertise – capabilities that can mostly only be learnt in practice. But what is needed just as much is knowledge of each other’s culture and language and, above all, mutual respect.
The key-words of the CIOMR are training and inter-operability, as laid down in the statutes of August 1992:
- To contribute to the formation and readiness of military health services, which will function effectively both nationally and internationally and to promote effective interoperability during peace or war.
- To bring to the attention of the proper authorities of NATO, recommendations and suggestions which, in the opinion of the CIOMR, will assist in improving the efficiency of Medical Services provided within NATO.
- To stimulate esprit de corps and mutual understanding between the Regular and Reserve Medical Forces within NATO.
- To maintain, through each member, a close liaison with National Medical Organizations.
- To foster a spirit of understanding and association with the CIOR.
Marcel de Haan
Res. Brig.-Gen.-Arts tit. b.d.