In total, 53 of the 67 airborne operations, i.e. 79.1% of airborne operations, ranging for SL jumps between as the jumps, involved a doctor or a nurse. few as 7 and as many as 700 over Kolwezi. Today, the troops involved are around 100, due to tactical needs DISCUSSION but also to the constraints imposed by the aircrafts. However, whatever the numbers, the constraints of the Number, type and objectives of the jumps medical support remain the same. American studies15, 16, 17 In the last 50 years, French armed forces has done 67 show the importance of planning medical risks related to airborne operations thereby acquiring a great level of the initial stage of the jump so as to assess the rate of bea- expertise, both in terms of the variety of the volumes rable attrition for the remainder of the operations. The involved and of the objectives achieved8, 9. The military rate of 6% was proposed for SL jumps. For MFF jumps, as18 involvement in the Sahel region made airborne opera- soon as a team of 10 is involved it is highly advisable to add tions topical again. Hence 83.5% of the jumps were5 a doctor or a nurse to support the medics present in every carried out since 2013 with 20 jumps in 2015, i.e. nearly team. Today, it is imaginable to realize airborne operations 30% of all the airborne operations. with more commando than in 2006 (56 dropped). The 11th airborne brigade did as many SL as MFF jumps, The total number of wounded (n = 79) represents 2.47% with, as it is the case for the Special Forces, an increasing of the troops dropped. This is quite acceptable with regards to the data usually found in training19, 20, 21, 22, 23 amount of MFF tactical infiltrations to deploy commando Nevertheless, we suspect a bias in the declaration likely to. squads. SF almost always get to their missions by high10 altitude/very high altitude jumps. The great majority of result in under estimating the light injuries. Conversely jumps (56/67) now take place at night. They require spe- the study finds 20 bruising, 16 benign sprains and 11 cific training and complex medicalsupport. Day jumps items referred to as ‘others’were reported due to the are used when situation requires a quick deployment3, 11 immediate and reassuring access to a doctor, which is or a show of force such as in Kosovo in 2004. rarely the case during training. Those wounded can ‘arbitrarily’be divided into 2 A little over half the airborne operations (37/67) hap- categories: pened in direct actions operations where medical The seriously injured (n = 32, i.e.40.5% of the teams play a crucial role, both during the initial stage wounded) include the first 6 lines of table 1, and repre-- of the jumps and for the military actions that follow. sent 1.05% of the troops dropped; Intelligence/special reconnaissance operations (espe- The lightly injured include the last 3 lines of table 1 cially with high altitude jump) benefit most from the (n = 47, i.e. 59.5%) and represent 1.54% of the troops- discreet arrival of the troops behind enemy lines. dropped. Isolation justifies the presence of a medicalteam to guarantee their safety and success. Kraghet andal.18describe a training jump close to ope- rational conditions, with nearly 8.6% of wounded The airborne operation on Kosovo aimed at showing (41/475) which exceed the attrition rate allowing the the capability to reinforce a theatre of operations. This continuation of the mission.It is interesting to note type of action is one of five defined for the French air- that the number of wounded during MFF jumps (n borne troops. For those jumps, medical teams were on7 = 19) is not insignificant. Out of the wounded, only 4 the ground to ensure medicalsupport; furthermore, had to be evacuated in the first 4 hours, with a poten- the unit jumped with his two medical teams as part of tial incidence on discretion. Few data exist in the lite- this reinforcement. rature on accidents due to combat MFF jumps .24 Two ACSAR jumps were carried out after a cyclone Indeed, the MFF tacticalinfiltrations, by night, while which destroyed an islet in the Indian Ocean and the carrying heavy loads, are never easy, and landing is crash of a DC10 plane in the Nigerian desert (terrorist sometimes ‘rough’. All the technical, aerological or attack). For the two operations, the presence of a doc- geographical conditions must be carefully analysed to tor and his team was the main stake: it was essential to limit the risks of injuries25. send immediate medical help to look after the woun- ded12, 13. Those missions are still relevant today because The tandem passengers are the most vulnerable per- of the immensity of the Sahel-Saharan States, with sonnel. They run a high risk of being injured (5 out of their many "grey areas” which cannot be accessed by 19 with 1 broken fibula, 1 dislocated shoulder, 2 bruises helicopter, and within which an aircraft or military and 1 ankle sprain). This problem is to be taken into components could be experiencing difficulties (human, account and the means to secure the landing must be a military or mechanical) and be in need of the drop of constant priority of commanding officers and jump immediate support, before a slower reinforced capabi- masters, as soon as training. lity can get to them. On French territory research is also Out of the 67 jumps, only 25 (37.3%) resulted in inju- being done in this domain14 . ries which makes this means of deployment both safe Number of paratroopers dropped injured andand reliable. For the medical staff and the commanding evacuated officers, the problem is that as soon as a seriously inju- VOL. red paratrooper needs to be looked after on the drop 94/3 Over 3000 paratroopers were dropped during those 67 zone, the whole operation is immediately impacted.26 International Review of the Armed Forces Medical Services 10 Revue Internationale des Services de Santé des Forces Armées