Infrastructure is a vital defence capability delivering accommodation, training facilities and critical assets such as runways and workshops to enable our armed forces to live, work, train and deploy. Recent DIO projects include building a jetty at Portsmouth Naval Base so the aircraft carrier HMS Queen Elizabeth can dock, and resurfacing runways at RAF Akrotiri, RAF Gibraltar, and RAF Valley.

The defence estate is large, diverse and widely dispersed across the UK and overseas. In the UK, it covers around 230,000 hectares comprising military training areas, naval bases, barracks, airfields, supply depots, and offices. Construction on these sites is sometimes subject to specific defence requirements but the majority is similar to other sectors, so the new standards have been developed in accordance with comparators from industry and other government departments. They are designed to be used by MOD staff and industry partners responsible for the planning, costing and delivery of the infrastructure assets and projects funded by MOD.

The new standards, Joint Services Publication (JSP) 315, are expected to save up to 20% on construction costs by creating efficient standards, enabling faster and more cost-effective project development and delivery. They also recognise the success and cost savings DIO has achieved in recent years from increasing the use of modular construction and standardisation of designs, as well as utilising 3D digital and interactive technology.

Graham Dalton, DIO’s Chief Executive, said:

The new standards mark a step forward in how DIO enables our military to provide the most effective and efficient solutions and how we work better with the construction industry. The revised standards make it absolutely clear what our requirements are and will contribute to a significant cost and time saving on our infrastructure projects.

The new standards and supporting guidance set a series of reference designs for specific defence infrastructure requirements and benchmark capital and operational costs for the planning and delivery of MOD infrastructure.

The revised JSP 315 can be found here

Ten years ago, senior nurse Chris Carter took a risk which would prove to be life changing. Leaving a job that he loved in the NHS for a leap in the dark – a career with the British Army.
It was a choice that not only changed his life, but arguably it also changed the lives of many Zambians critically in need of nursing care.

Because his decision not only led to a new job, it also indirectly opened the door to a new and unexpected adventure when, rich in operational experience, he later answered a call for volunteers to go to Zambia to teach critical care.

A rewarding experience in the making. But he wasn’t expecting to end up heading a team which would be collaborating internationally and leading a program which would have a national impact on the future health care set up in a sub Saharan Commonwealth country.

A new job a new life

It all started with that choice he made at the crossroads of his caring career. He said :

At the time it was at the height of the Afghanistan and Iraq campaigns, and I was looking for a new opportunity,

I’d always wanted to work internationally, and I’d always had the aspiration to work in a combat zone. Another aspiration was to test myself in a developing country and I knew the Army could offer me all that. I felt, if I don’t do this now, I never will.

A decade after taking that decision, Chris, 39, is now a Major in the Queen Alexandra Royal Army Nursing Corps, and all of those aspirations have been answered, and more.

Today he is a critical care nurse and a nurse lecturer working in the Defence School of health-care education, a military unit embedded in Birmingham City University.
There he heads up a team responsible for training the Armed Forces future student nurses.
He has a tour of duty of Afghanistan tucked under his Sam Browne belt, as well as other deployments to the Middle East.

For many that would be more than enough to keep them occupied. But the urge to serve is strong in Major Chris Carter.
Which is why in 2015 he answered an ad in a medical journal for volunteers to set up a critical nursing care program in sub Saharan Africa. And so, his intense relationship with the Commonwealth country of Zambia began.

Looking at the list of skills and life experience that the job called for, it was clear that Chris had just what the doctor ordered.
And as far as he is concerned it’s his career in the Army that he has to thank for that. He said:

In the Army, it’s not that they give you opportunities as such, they are available, and if you seek them out, and work hard for them, then you can get there.

Nursing in Zambia

Zambia is a stable land locked, low income country with 60 per cent of the population living in rural communities. Yet whilst it is poor, Zambia is training its doctors and anaesthetists, helped by international investment in terms of money and resources.

But it soon became clear that more was needed. Hence the advert. Major Carter said :

The Drs there realised that their project to develop health care was not going to reach its full potential unless investment was also being made in nursing staff,

The doctors were being trained in current practice, applied in the context of a developing country, dealing with diseases totally different to what we see in the UK, but which are common there. But without the nurses who do the majority of the care, the project wouldn’t work.

Initially the task facing Chris was to visit Zambia’s main hospital and help them to identify what they needed and to develop their framework for developing their nursing staff.

No funding? No project? No problem!

But before he could do that, another little problem lay before him. He said:

What transpired was that, despite what the advert said, in fact there was no project, no funding – nothing.

Undeterred, Chris and a small core of volunteers from the UK kept calm and carried on. He said:

Given my background, my contacts and my operational experience linked with my role in nursing education I convinced The Tropical Health and Education trust, a UK NGO, to fund me for a two week needs assessment.

Since then Chris has been to Zambia seven times, staying for periods of two to four weeks. He said:

In 2016 we worked with the Zambian Ministry of Health. We went to 16 public hospitals which meant a round trip of 4,980 kms in a Land Cruiser. There isn’t a bit of the country, off road or on tarmac that I haven’t seen.

On this epic trip he asked at each hospital, ‘What critical care can you realistically provide in your hospital? What are the challenges you face, and how are your nurses being employed? And that was the first time that they had had that snapshot of what was going on.

Gathering all that information, Chris and the team then wrote a report for the Ministry of Health. In it they recommended what they could do as a project team to help build the country’s capacity in nursing capability.

From this, what the Zambians identified as essential was a graduate nursing programme.

Major Carter said:

What tends to happen is that a lot of money is spent on educating Drs, and while nurses might get the odd short course, which is valuable, what is needed is a structured framework which can contribute to the long-term career development of an individual.

Get that right and it means you have a reliable capability, you prevent people from getting demotivated because they don’t feel valued, and for places like Zambia, it stops the haemorrhaging of talented nurses who go to work in neighbouring countries who can pay more.

Armed with this information Chris went into battle attracting funding from DFID, the EU and from Birmingham university, who also provide him with all the professional back office functions and governance needed to keep such a project running.

Zambian priorities

From nothing, Chris has built up the team which has grown from just four enthusiasts into a truly international collaboration. Working closely with the Lusaka College of Nursing, the Zambian union of nursing organisations, the Ministry of Health and the General nursing council, Chris makes sure that whatever his team delivers, it is in accordance with the Zambian’s own priorities, but with his guidance, in the context of the UN’s sustainable development goals such as providing universal access to health care and building a framework for quality, lifelong learning. He said:

We are helping them to build up a critical mass of trained nurses, helping to develop a graduate cadre and in turn future leaders, future researchers, future educators. We’re building a framework for life.

And this must all be done in an atmosphere of cultural sensitivity, another skill which Chris picked up from his time in Afghanistan. He said:

We have to be aware that our way of doing something may not be the best way for them. It is all about helping them to find their own solutions.

Take the basic practicalities as an example of what he means by that. In a country which has 73 regional dialects, how are you going to provide a universal training package?

When the majority of the population live in remote villages, how would someone get health care if they had a ruptured appendix, or if they had broken their leg, or had an obstructed child birth, at night – how would you get them to a hospital which is two hours away, at night along a road which has no lighting.

It’s easy to see that sensible solutions to health care provision must be seen in this harsh context.

Such has been the success of the project, 900 health care workers have been trained since 2015, that the Army is keen to explore the benefits for the UK Armed Forces. Last year Chris took six students from the Defence School of Health, one from the navy, the rest Army, to Zambia as part of their training.

Benefits for training UK Armed Forces nurses

Not only do they get to see the treatment of diseases such as TB and malaria, which while rare in the UK, in their careers they will have to know about, but perhaps more importantly the pressures of practicing in a resource limited environment. Major Carter said:

We watched a Dr performing a procedure and I talk the students through it. I tell them to watch how he and the nurses were working – only opening equipment when they needed it, so they don’t waste anything – because it’s too precious.

I challenge them… imagine you are on board a ship, or in the field. You’re not going to have an infinite supply of gloves, oxygen, swabs… when you’ve got 10 patients on a ward, and there’s only three of you, there’s no agency you can call, no extra staff, it’s just you.

Thinking differently

Chris uses the experience to get the students thinking in a different way. A way which might just make a difference when on the battlefield. He said:

I get them to think about what they would do in that situation. Which is your sickest patient at the moment? Why do you think that?

I get them to think through some of the clinical decisions they would never face in the NHS. ‘You’ve only got 10 ventilators, but you’ve got 11 patients who need it – what are you going to do?’

Keeping calm and carrying on

It’s hard to imagine how someone as busy as Chris has managed to cope with it all. He says that lots of coffee helps, and he also points out the importance of protecting whatever little spare time you have, and using it wisely.
He said:

I’m a swimmer, I like to get in the pool and just go up and down and get things into perspective.

It’s important to look at your successes. I’ve said this to people in Zambia when they get dispirited, and say ‘It never changes here’ I say, ‘look how far you’ve come in such a short time.’

This is another strength that he attributes to his time in the Army. He said:

What the Army gives you is the ability to be realistic in what you can do. Focus on the basics and do them well. That gives you a reality check. In our project it’s been about knowing what the Zambians want, how they want it delivered and on their timescales. My Army career has given me that grounding.

So, the decision he took a decade ago, to change the nature of his uniform from scrubs to camouflage pattern turned out to be the right one. Not just for Major Chris Carter, but for the people of Zambia too.

Pacific Partnership is an annual exercise involving 22 partner nations around the globe in 18 host countries. It aims to assist local communities in planning for humanitarian crisis’ whilst also teaching medical and engineering skills. 4 UK medics are involved, representing each of the 3 services.

On the 23 March 2018, whilst deployed in Yap in The Federated States of Micronesia, Corporal Darren Phillips worked alongside Japanese Military Medics to save the life of a local man who had severely injured himself. The military medics were attending Yap Memorial Hospital conducting a community health engagement when the patient arrived, having had an accident while cleaning around his home. The knife the patient used to clear out overgrown branches broke and struck his wrist causing near fatal blood loss.

Corporal Phillips provided immediate trauma care and in response said:

We are constantly trained to respond to trauma situations, we saw a patient needing immediate attention, and we acted quickly and efficiently. This is what we do. It is a great experience to be part of a multinational team working together to help people from all over Yap.

On the day in question we provided medical care to over 100 patients at the hospital, and we are looking forward to continuing with the rest of the exercise.

The defence medical services twitter account is following the exercise closely.

For more stories and photos please follow @defence_medical.

The resting place of 21 year old Serjeant John MacKenzie MM of 1st/6th Battalion, The Seaforth Highlanders has been marked 100 years after his death in the Great War. A rededication service has taken place at the Commonwealth War Graves Commission (CWGC) Anneux British Cemetery near Cambrai in Northern France.

The service was organised by the MOD’s Joint Casualty and Compassionate Centre (JCCC), part of Defence Business Services.

Rosie Barron, JCCC said:

Serjeant MacKenzie stands out as an exceptional soldier even amongst a generation where so many paid the ultimate sacrifice for our freedom. It has been an honour to organise this rededication service in his memory and to know that his family’s search for him is now at an end.

Serjeant MacKenzie enlisted at the outset of the World War 1 and served throughout the conflict until he died on 25 March 1918, shortly after the start of the German Spring Offensive. He fought in the Capture of Beaumont Hamel in 1916 and later that year was awarded the Military Medal and French Croix de Guerre. Just prior to his death, Serjeant MacKenzie was awarded a Bar to the Military Medal.

The location of Serjeant MacKenzie’s grave was discovered after painstaking research by his great nephew, Ken MacDonald, and his wife, Kath MacDonald. They discovered that Serjeant MacKenzie had been wounded and taken prisoner by the Germans. He later died of his wounds and was buried in a mass grave in the village of Inchy-en-Artois. After the war, his grave was moved to Anneux British Cemetery, where he was buried as an ‘Unknown Soldier’. With his whereabouts unknown, Serjeant MacKenzie was commemorated on the Arras Memorial.

Further research by the MOD’s JCCC was undertaken to corroborate the evidence the family provided and the identification of the ‘Unknown Soldier’ grave was confirmed to be that of Serjeant John MacKenzie MM.

Ken MacDonald said:

Since my wife and I visited France 22 years ago and saw John’s name on the Arras Memorial, we have never given up hope of finding his grave. It feels today like 1 of my 3 great uncles has come home. We’re very grateful to the MOD’s JCCC and CWGC for arranging the rededication service, and to the relatives of other Seaforth Highlanders who joined us for the service.

Ken and Kath were accompanied by his sister, Mary, and 4 other family members in attending the service. Nine members of The Royal Regiment of Scotland were present at the rededication service to remember Serjeant MacKenzie. Also remembered were Serjeant MacKenzie’s brothers, Donald and Kenneth, both of the 1st Battalion, The Cameron Highlanders who are both still missing on the battlefields of Northern France.

A new headstone bearing Serjeant MacKenzie’s name has been provided by the CWGC, who will now care for his final resting place in perpetuity.

Melanie Donnelly, CWGC said:

100 years after he was killed, Serjeant MacKenzie’s grave in the Commonwealth War Graves Commission Anneux British Cemetery is now marked with a headstone bearing his name. He was a brave young man who made the ultimate sacrifice and we are honoured to be able to play a part in the re-dedication of his grave today. The Commonwealth War Graves Commission ensure that all those who served and fell are commemorated by name and we will care for his grave and the memorials on which his two brothers are commemorated, in perpetuity.

Honouring the fallen – additional services this week

The rededication service for Serjeant MacKenzie took place as part of a series of services organised by the MOD’s JCCC this week. The first was the burial of an unknown soldier of The Royal Scots at Bailleul Road East Cemetery in Belgium earlier today all the services are to be conducted by the Reverend Paul van Sittert CF, Chaplain to 4th Battalion, The Royal Regiment of Scotland

The Reverend Paul van Sittert, said:

It has been a privilege to officiate at the rededication and burial services of graves for these remarkably brave World War 1 soldiers. Their courage, sacrifice and service to our country is an example that should never be forgotten. The Kohima epitaph rightly reminds: that for our tomorrow they gave their today.

The burial of two unknown solders of The Royal Scots and an unknown soldier of an unknown regiment were laid to rest on Wednesday 28 March at St Mary’s A.D.S. Cemetery in France. The burial of an unknown Argyll and Sutherland Highlander will take place later in the day at Woburn Abbey Cemetery, also in France.

The UK will introduce a ban on ivory sales, Environment Secretary Michael Gove confirmed today as he set out our plans to help protect elephants for future generations.

The Government is publishing the response to its consultation on a UK ivory sales ban, and confirming robust measures that will be brought into force through primary legislation.

The ban will cover ivory items of all ages – not only those produced after a certain date. The maximum available penalty for breaching the ban will be an unlimited fine or up to five years in jail.

There were more than 70,000 responses to the consultation, with over 88 percent of responses in favour of the ban.

The number of elephants has declined by almost a third in the last decade and around 20,000 a year are still being slaughtered due to the global demand for ivory.

Environment Secretary, Michael Gove said:

Ivory should never be seen as a commodity for financial gain or a status symbol, so we will introduce one of the world’s toughest bans on ivory sales to protect elephants for future generations.

The ban on ivory sales we will bring into law will reaffirm the UK’s global leadership on this critical issue, demonstrating our belief that the abhorrent ivory trade should become a thing of the past.

In line with the approach taken by other countries, including the United States and China, there will be certain narrowly-defined and carefully-targeted exemptions for items which do not contribute to the poaching of elephants.

The exemptions have been tightened since the Government published its proposals for consultation, but still provide balance to ensure people are not unfairly impacted:

• Items with only a small amount of ivory in them. Such items must be comprised of less than 10% ivory by volume and have been made prior to 1947.
• Musical instruments. These must have an ivory content of less than 20% and have been made prior to 1975 (when Asian elephants were added to CITES).
• Rarest and most important items of their type. Such items must be at least 100 years old and their rarity and importance will be assessed by specialist institutions such as the UK’s most prestigious museums before exemption permits are issued. In addition, there will be a specific exemption for portrait miniatures painted on thin slivers of ivory and which are at least 100 years old.
• Museums. Commercial activities to, and between, museums which are accredited by Arts Council England, the Welsh Government, Museums and Galleries Scotland or the Northern Ireland Museums Council in the UK, or the International Council of Museums for museums outside the UK.

By covering ivory items of all ages and adopting these narrow exemptions, the UK’s ban will be one of the toughest in the world. The US federal ban exempts all items older than 100 years as well as items with up to 50% ivory content. The Chinese ban exempts ivory “relics”, without setting a date before which these must have been produced.

The UK is already showing global leadership in the international fight against the illegal ivory trade, and at a recent European Environment Council called for EU member states to follow the Government’s lead and ban commercial trade in raw ivory – which is already banned in the UK – within the EU as soon as possible.

In October, the UK will host the fourth international conference on the illegal wildlife trade, bringing global leaders to London to tackle the strategic challenges of the trade. This follows the ground breaking London 2014 conference on the illegal wildlife trade, and subsequent conferences in Botswana and Vietnam.

A ban on ivory sales in the UK would build on government work both at home and overseas to tackle poaching and the illegal ivory trade. The UK military is training African park rangers in proven poacher interception techniques in key African countries, and Border Force officers share their expertise in identifying smuggled ivory with counterparts worldwide to stop wildlife trafficking.

The CEO of Tusk Trust, Charlie Mayhew MBE said:

We are delighted that the Government has listened to our concerns and given the overwhelming public response to their consultation is now moving decisively to introduce tough legislation to ban the trade in ivory in the UK.

The narrowly defined exemptions are pragmatic. The ban will ensure there is no value for modern day ivory and the tusks of recently poached elephants cannot enter the UK market. We welcome the fact that Ministers are sending such a clear message to the world that the illegal wildlife trade will not be tolerated and every effort will be made to halt the shocking decline in Africa’s elephant population in recent years.

Tanya Steele chief executive at WWF said:

Around 55 African elephants are killed for their ivory a day, their tusks turned into carvings and trinkets. This ban makes the UK a global leader in tackling this bloody trade and it’s something WWF has been fighting hard for.

But if we want to stop the poaching of this majestic animal, we need global action. We hope the UK will continue to press countries where the biggest ivory markets are, most of which are in Asia, to shut down their trade too.

ZSL Director of Conservation, Matthew Hatchwell, said:

Legal domestic ivory markets are intrinsically linked to the illegal ivory trade that is driving the current poaching crisis. With almost 20,000 elephants poached in the last year, it is vital that countries take significant steps such as those outlined by the UK government today to close their markets and help make the trade in ivory a thing of the past. No one in the UK today would dream of wearing a tiger-skin coat. Thanks to this move, in a few years’ time we believe the same will be true for the trade in ivory.

John Stephenson, CEO Stop Ivory said:

This is a significant day for the future of elephants. The UK government has taken a momentous step. The proposed ban, with its narrow and clear exemptions, places the UK at the forefront of the international determination to halt the extermination of elephant populations by banning trade in ivory. The Secretary of State for DEFRA has shown clear leadership in demanding legislation whilst there is still time to secure a future for elephants in the wild.

The end of the ivory trade in the UK removes any hiding place for the trade in illegal ivory, and sends a powerful message to the world that ivory will no longer be valued as a commodity. Ivory belongs on an elephant and when the buying stops the killing will stop.

As profits become ever greater, the illegal wildlife trade has become a transnational organised enterprise, estimated to be worth up to £17 billion a year.

The further decline of elephants would also deprive some of the poorest countries in the world of their valuable natural capital, affecting economic growth and sustainable development.