US deepens Estonian medical alliances through MASCAL scenarios in Exercise Hedgehog
1 / 3 Show Caption + Hide Caption – Estonian nurse Ilmar Solom and U.S. Army Maj. Cordell Hachinsky administer medication for a mock casualty at the Role Two facility during Exercise Hedgehog in Tartu, Estonia, May 24, 2022. Collaborative learning through Global Health Engagement activities empowers both U.S. and Estonian soldiers to fulfill core NATO tasks and promote continual resiliency within emergency medical response. (Photo Credit: U.S. Army photo by Sgt. April Benson) VIEW ORIGINAL
US deepens Estonian medical alliances through MASCAL scenarios in Exercise Hedgehog
2 / 3 Show Caption + Hide Caption – U.S. Staff Sgt. Eric Espino discusses effective clinical procedures at point of injury with Estonian medics during Exercise Hedgehog in Tartu, Estonia, May 22, 2022. Collaborative learning through Global Health Engagement activities empowers both U.S. and Estonian soldiers to fulfill core NATO tasks and promote continual resiliency within emergency medical response. (Photo Credit: U.S. Army photo by Sgt. Chris Patterson-Jordan) VIEW ORIGINAL
US deepens Estonian medical alliances through MASCAL scenarios in Exercise Hedgehog
3 / 3 Show Caption + Hide Caption – U.S. Army Spc. Jose Landaverde assesses the wounds of a mock causality during the MASCAL event at the artillery battalion during Exercise Hedgehog in Tartu, Estonia, May 23, 2022. Collaborative learning through Global Health Engagement activities empowers both U.S. and Estonian soldiers to fulfill core NATO tasks and promote continual resiliency within emergency medical response. (Photo Credit: U.S. Army photo Sgt. April Benson) VIEW ORIGINAL

The crack of a smoke bomb split the silence of the clearing, which housed an Estonian artillery battalion, sending clouds of dust and the cries of mock causalities into the sky – and signifying the start of the massive casualty scenario. U.S. and Estonian soldiers engaged in several MASCAL scenarios from point of injury to Role Two, also known as limited field hospital care, during Exercise Hedgehog in Tartu, Estonia, from May 22 to May 26.

Hedgehog is an Estonian-led multinational defense exercise involving 15,000 personnel, including participants from Denmark, Finland, Latvia, Poland, Great Britain, and the United States. Hedgehog enabled Estonian Defence Force combat battalions to respond to MASCAL scenarios by means of continuous and effective self-help, ground evacuation, and mutual aid.

“We have a common understanding with the U.S. when discussing clinical guidelines or how to treat injuries,” said Lt. Hele-Reet Lille, an EDF nurse who supported multinational teams at the Role Two facility. “We should push cooperation more because it reinforces smooth integration. I didn’t even recognize the [U.S. Soldiers] were not Estonians when working in the multinational teams.”

U.S. Soldiers from 557th Medical Company Area Support split into two sections to maximize involvement in the exercise. One U.S. evaluation team shadowed Estonian evaluators during the initial point of injury to Role One care, while the other U.S. medics assimilated with Estonian medical professionals at the mobile Role Two facility.

U.S. Army Sgt. 1st Class Andy DesOremeaux served as a practical nurse on an Estonian trauma team at the Role Two facility. He offered positive feedback regarding the success of causality treatment within the multinational team.

US deepens Estonian medical alliances through MASCAL scenarios in Exercise Hedgehog
1 / 2 Show Caption + Hide Caption – Estonian Medic and U.S. Army Sgt. Matthew Culipher perform lifesaving measures on a simulated casualty during Exercise Hedgehog in Tartu, Estonia, May 24, 2022. Collaborative learning through Global Health Engagement activities empowers both U.S. and Estonian soldiers to fulfill core NATO tasks and promote continual resiliency within emergency medical response. (Photo Credit: U.S. Army photo by Sgt. April Benson) VIEW ORIGINAL
US deepens Estonian medical alliances through MASCAL scenarios in Exercise Hedgehog
2 / 2 Show Caption + Hide Caption – Estonian medics carry a simulated casualty to the casualty evacuation point during Exercise Hedgehog in Tartu, Estonia, May 22, 2022. Collaborative learning through Global Health Engagement activities empowers both U.S. and Estonian soldiers to fulfill core NATO tasks and promote continual resiliency within emergency medical response. (Photo Credit: U.S. Army photo by Sgt. April Benson) VIEW ORIGINAL

“The most rewarding experience on this mission was successfully treating simulated trauma with my Estonian counterparts,” DesOremeaux said. “I performed tasks during the trauma exercise without communicating in English. I recognized the treatment of trauma patients are the same as in the States. In understanding the trauma flow, I integrated with Estonian medical nurses and doctors. We performed the standard of care to keep soldiers alive, despite not speaking the same language.”

Global Health Engagement activities enable U.S. Soldiers to learn about Estonian medical practices and efficiently integrate into multinational teams. Exercises like Hedgehog reinforce critical partnerships to advance shared interests and maintain regional stability and security. Collaborative learning through GHE activities empowers both U.S. and Estonian soldiers to fulfill core NATO tasks and promote continual resiliency within emergency medical response.

Estonian physician Gustav Klimusev operated with U.S. Soldiers in a trauma team during the exercise. Previously serving at a medical hospital in Kabul, Afghanistan, with medical professionals from 11 other nations, Kilmusev shed real-world insight into the multinational medical environment.

“The more medical professionals work in multinational situations, the more experience we get in places we are lacking, especially the trauma treatment,” Klimusev noted. “Integration helps a lot, and the more we do it, the better qualified we are to work in a NATO environment.”

Estonia provides a unique opportunity to conduct GHE activities and effectively collaborate with NATO allies and strong regional partners. The U.S. remains committed to allies and partners in the Baltic region, and Hedgehog serves as another excellent demonstration of deepening medical alliances with Estonian counterparts.