International Conference

Warrior Care Symposium 2020 

6 and 7 May, The Hague, The Netherlands

Air Cdre Rich Withnall:
The Warrior Care in the 21st Century (WC21) 2020 Symposium provides an exciting and class-leading platform for presentations and discussions amongst nations who share a passionate commitment to provide the best possible holistic support to ill and injured Service people, their families and Veterans throughout the whole of the patient care pathway.
This Symposium provides a unique forum for multilateral collaboration across a variety of medical and non-medical topics, including resilience, rehabilitation & recovery and reintegration into military or civilian life. 
As Chair, I am honoured to be part of such an important initiative and humbled by enthusiasm, expertise and energy of WC21 participants.  Once again, world-leading presenters from Defence, academia and Veterans organisations will encourage active delegate participation and interactive breakout sessions will further develop undertaken at previous Warrior Care Symposia.

As we approach what I’m sure will be a wonderful 2020 Symposium and a new partnership with the Invictus Games Foundation, we must think to the future in a global way.  There is always more to be done to help our ill and injured Service people, their families and our Veterans: new challenges to overcome; new ideas to be explored; new research to be performed; and new innovations to be implemented.
Thank all the participating nations for their contribution and commitment to this year’s event, and a special thank you to Col Eric Vermetten and his talented team from the Netherlands Ministry of Defence for their dedication and organizational efficiency that has made our 2020 WC21 Symposium possible.


Gen Mart de Kruif:
Invictus Games: believing in your strength

The symposium Warrior Care in the 21st Century will be held a few days prior to the Invictus Games, the sporting event for servicemen and women who have become physically and/or mentally injured during their deployment. Both events will be held in The Hague. Although the symposium is a different event, its connection to the games is evident. 'It is a logical combination,’ so says retired general Mart de Kruif. He was part of the team who brought the Invictus Games to The Netherlands and is the chairman of the association organising the games in The Hague. ‘The Invictus Games put the people we work with at the Warrior Care Symposium in our direct vicinity. They pass us by, giving meaning to Invictus’ motto, of being 'invincible' despite having been injured.’

Mart de Kruif served in Afghanistan, as did Invictus Games initiator Prince Harry. Between November 2008 and November 2009, he commanded from Kandahar as part of ISAF - International Security Assistance Force - over 45 000 people. 'There were casualties of course, and that is when I saw once again just how important traumatology is within military medicine,’ says De Kruif. ‘After all, the first three minutes after serious trauma determine whether or not you will survive. Great progress had been made in the area of traumatology back then and has continued to be made thereafter.' According to De Kruif, there are more things that make the Warrior Care Symposium an important event. 'You'll find a comprehensive approach is used in rehabilitation, which is very good. If someone has lost a leg it's not just about the prosthesis and the technical aspect of it, anymore. But the question "where do your strengths lie, what can you do?" is also raised.' Mart de Kruif states that things are more complicated when it comes to severe psychological trauma. ‘PTSD may come out within one year, but can just as well stay hidden for five or even thirty years. But mental health care for the military is currently going through fascinating developments, something the Warrior Care Symposium is an important part of.’

Around five hundred wounded servicemen and women from twenty different countries will be participating in the Invictus Games in The Hague from 9 to 16 May. A total of thirty thousand tickets will be made available to spectators. 'As specifically requested by Prince Harry, we will not be offering any VIP seats. Everyone must simply find a place to sit,' De Kruif agrees. 'Additionally, every day we will be inviting large groups of school children, veterans and military personnel from various departments to join us. We think it's important to have them there alongside the general public and family and friends of the participants.' Mart de Kruif pays extra attention to the children: ‘What could be better than showing these school kids, through the Invictus Games athletes, what you can achieve by believing in your own power, and just how strong people can be?’

What makes the Invictus Games so special? De Kruif: 'We hand out medals, but winning is secondary to personal achievement. A swimmer who may have lost a leg, an arm, or both, may struggle to get all the way across the water. But then when they finally do, the stadium goes wild. It is this person’s outstanding achievement, of overcoming oneself, that truly counts. Then there's the feeling of camaraderie among the participants that also makes the games so special.' However, before the Invictus Games begin, we have the Warrior Care symposium. 'The symposium is so special and important, I will definitely attend and be actively involved,’ says Mart de Kruif.  

Col Berend Berendsen:
Leave no one behind

'Warrior Care in the 21st Century is especially interesting to me because I am aware that today's soldiers are tomorrow's veterans,' says colonel doctor Berend Berendsen in his initial comments. He is the chairman of the National Care System for Veterans and member of the symposium's organisational steering group. 'In military mental healthcare, and that is my field of expertise, it is essential to consider people's entire life cycle and use that as a starting point. Meaning their time in active service, their transition back into society and their subsequent life as a veteran. An approach such as this, without an artificial severing between one stage and the other, produces the best results.'

'The National Care System for Veterans offers specialised social work and psychological care. Its trademark being the smooth cooperation between military and civil partners,’ Berend Berendsen explains. 'We have invested hugely in it over the last ten years and are now ready to take it to the next level. For example, instead of waiting for treatment statistics to get back to us, we'd like to be measuring the experiences, satisfaction and results of our target group directly. Furthermore, we would like to ensure a smoother changeover from active service back into society through better care. Because that transition can cause military personnel a lot of difficulties.' Is this civil-military model something other countries could adopt? Berendsen:  'It isn't a one-size-fits-all exportable product. Every country has its own military culture, identity and history. And not every country defines the term veteran in the same way. But the Dutch approach is definitely something of interest to other countries and the Warrior Care symposium offers a good opportunity to share our approach with them.'

'Veterans are a special group of people,’ Berend Berendsen continues. 'They are well-organised and very active in helping their comrades. This is mostly in the form of baseline care, offered by co-veterans and coordinated through the Veteran Platform, the national partnership of veterans’ organisations. This is also made evident in their running of veteran community centres and veteran cafes. A sort of ecosystem has developed with buddy support from the veterans, the Netherlands Veterans Institute, the National Care System for Veterans and other contributors. Keep in mind, however, that most veterans do well. They look back positively on their service. For them veteran organisations have mostly a social function.'

'Within our care system we focus as much as possible on the areas of "the influential veteran" and being "sustainably healthy",’ says Berendsen. 'By "influential veteran" we mean the individual influence of the veteran on the care provided. This can and should happen because today's veterans are usually emancipated and well-informed. Sustainably healthy entails that while we are of course there to treat people who are sick, we would like to grow into an organisation that helps people stay healthy too. Preferably sustainably healthy.' However, as Berend Berendsen concludes, 'the Veteran National Care System's overarching motto of course is and remains: "leave no one behind". We believe in it and it is what we stand for.'

Prof dr Col Eric Vermetten:
'Warrior Care is a unique brand'

'Warrior Care In The 21st Century is about what we must consider and what we can expect, regarding the latest in military medical development. It's not only a question of what the military will look like in the future, but also what the medical side of the military will look like. Our focus is on what we think the possibilities will be in twenty years’ time.' Says the unmistakably driven Eric Vermetten. 'The primary focus is innovations in medical care for the wounded warrior, active or post-active,’ he adds. 'In order to have a clear picture and understanding of what is to come, the symposium will start with a program segment in which a true connection is made between the past, the present and the future.'

Colonel Prof Dr Vermetten is a psychiatrist by profession. He is able to oversee important areas of the military medical field and has many contacts, both in the Netherlands as well as internationally. He is the strategic advisor for scientific research in the Dutch military mental health sector, and professor at the University of Leiden and the ARQ National Psycho-trauma Centre. As chairman of the symposium programme committee, Vermetten is confident in the support of a few other key figures: 'a conference this big is always about teamwork'. These being from the Netherlands Veterans Institute, the Military Medical Rehabilitation Centre, the Royal Netherlands Army and from specialised military medical departments, some are veterans. Additionally, there is an international advisory group with input from Canada, Great Britain and the U.S.A..

The two-day symposium is structured to allow participants the opportunity to gain as much knowledge and do as much networking as possible. Eric Vermetten: 'Each day consists of four blocks with plenary sessions, two before lunch and two after. In every session, speakers and the warriors themselves will take the floor. We will then invite someone who has either been physically or psychologically injured during a military mission and discuss that with the aid of a specialist's insight.' Running parallel to the plenary sessions there will be three work group sessions in which each work group will take on one of the three main themes of Warrior Care: resilience, recovery/rehabilitation, reintegration. 'These are small groups of around twenty to thirty people who will be answering specific questions, questions that they were given as homework upon their registration,' Vermetten explains. 'At the end of the symposium there will be an official announcement about this including the proceeds for the research agenda and priority list linked to the Warrior Care core themes. Furthermore, on the second day of the symposium, there are twelve spaces allocated for pitches on innovative breakthroughs in knowledge.'

'The symposium is very future focussed because there are important, if not revolutionary, developments taking shape within the military health service. For example, in the area of physical rehabilitation there are spectacular new developments in prosthetics, including the use of robotics. And think of the vastly improved possibilities with virtual reality within military mental health care (MGGZ).' Says Eric Vermetten, who effortlessly adds more relevant issues: 'The use of medicinal cannabis and psychedelics for example, but also the important and pertinent issue of moral injury will be discussed during the symposium.'

When will he be satisfied? Eric Vermetten: 'I will be satisfied when people say "we're going to do this again in two years’ time". So that the collecting and sharing of information and the enthusiasm for this continues by passing on the baton. Whether that be to Denmark, France, Germany or another country. Because there is nothing quite like Warrior Care, it is a unique brand.'