Deliberately severely injuring animals so military surgeons can practice on them is such a horrific concept that it is no surprise to learn that the practice is illegal in the UK. But the military establishment is so determined that this is the only way trainees will be able to learn to save lives on the battlefield that they are sent to Denmark for the exercises, earning them the nickname Danish Bacon.
The medical director at UK Joint Medical Command, Tim Hodgetts, recently admitted he receives letters from the House of Commons asking why the UK hasn't switched to more humane, modern methods instead of needlessly mutilating animals - yet to date the cruelty continues.
Here the director of People for the Ethical Treatment of Animals (PETA), Mimi Bekhechi, discusses the organisation's campaign to bring an end to the cruel practices and details new simulation technologies that could offer much more realistic alternatives without using animals.
Berenice Baker: When and in which country did PETA first become aware of live animals being used in military medical exercises?
Mimi Bekhechi: PETA US began its work to end the US military's war on animals in 1983 when it successfully stopped the US Army's plans to shoot homeless dogs with high-powered rifles in so-called "wound labs", which prompted a permanent ban on the use of dogs and cats for military medical training.
Since then, the group has been consistently campaigning to stop the US Department of Defense from stabbing, shooting, dismembering and otherwise maiming thousands of other animals in cruel and archaic training exercises for which more effective human simulators are available and required by federal regulations to be used.
In recent years, we convinced the US Army and the US Coast Guard to institute policies that substantially reduce the number of live animals used in trauma surgery exercises and employ modern simulation tools to replace the poisoning of monkeys in chemical attack exercises and the painful use of ferrets and cats in paediatric intubation drills at bases across the country. And in a historic move effective as of 1 January 2015, the US military has banned the use of animals in many areas of medical training in favour of modern human-patient simulators.
BB: How did PETA go about campaigning against them?
Over the years since, the Ministry of Defence has set up a number of villages which have evolved to realistically simulate combat.
MB: PETA US' campaign to modernise military medical training in the US and abroad is multi-faceted and has included collaborations with civilian and military medical experts on scientific research, medical simulation demonstrations and official complaints and pleas to government officials.
The group works with brave whistleblowers to expose harrowing details and images of the abuse of animals in these crude courses, stages colourful protests, promotes legislation to end the military's use of animals and launches online advocacy campaigns through which hundreds of thousands of people have written to government officials. It's also worked with high-profile military veterans such as Oliver Stone, Bob Barker and Gideon Raff to promote this issue.
BB: Why are animals subjected to these injuries?
MB: For military trauma training exercises in the few NATO nations that still cling to these deadly and archaic animal laboratories - Canada, Denmark, the Netherlands, Norway and the UK - animals are wounded so trainees can learn to treat traumatic injuries, even though animals have drastically different anatomies and physiologies to human beings. Military and civilian studies show that life-like human simulators that breathe, bleed and even "die" are more effective at teaching these life-saving battlefield medical skills.
For example, in horrific undercover video footage leaked to PETA US by a distraught whistleblower, training instructors hired by the US Coast Guard were seen laughing as they broke and cut off the limbs of semiconscious live goats with tree trimmers, stabbed the animals and pulled out their internal organs as the animals moaned and kicked.
Last year, PETA US also released disturbing photographs of live pigs hung from a wooden frame and shot with rifles and handguns during a military training course for members of the Danish and UK militaries. Afterwards, any animals who survive this horrible abuse are killed and often thrown away in trash bags.
BB: The Norwegian Government recently rejected an application by the Norwegian Armed Forces to use live pigs in medical training exercises. What was PETA's involvement?
MB: Working with medical experts, PETA US has compiled a dossier of the compelling military and civilian scientific research showing the superior effectiveness of non-animal trauma training methods and how these methods are used instead of animals by nearly 80% of NATO nations. We then shared this information with local Norwegian animal activists who presented these findings to the Norwegian Animal Research Authority, which then blocked the Norwegian Armed Forces' application to use animals for trauma training on the grounds that they did not provide evidence that non-animal methods were inadequate, which is required by law in order to gain approval for animal use.
Indeed, there has never been any evidence that shooting animals is an effective way to teach people how to treat traumatic injuries in people.
BB: Have you had any other successes persuading governments to stop using animals?
MB: In addition to PETA US' successful efforts, the group has been instrumental in convincing German authorities to block US Army attempts to conduct trauma training on animals for American soldiers stationed in Germany. And after more than two years of discussions with PETA US, the Polish military completely replaced the use of animals in cruel military trauma training exercises with medical simulation technology.
BB: What human-patient simulators are available?
MB: Military and civilian doctors, in collaboration with simulation engineers, programmers, designers, manufacturers and other health professionals, have created a range of strikingly lifelike and effective medical training tools that render the use of animals irrelevant.
One widely used simulator is Simulab Corporation's TraumaMan, an anatomically correct human torso that allows surgical trainees to learn and practise critical emergency procedures, such as placing a chest tube using actual surgical tools. Another, CAE Healthcare's Caesar, is a wireless electronic full-body human-patient simulator custom-designed for military training. Caesar breathes, bleeds from amputations and gunshot wounds, responds to medications, has digital eyes that blink, verbally relays symptoms and articulates changes based on trainees' performance - even "dying" if procedures are not performed correctly.
BB: How did studies prove that simulators are more effective than using animals?
MB: Numerous controlled studies by military and civilian trauma teams in Canada, the US and elsewhere have compared the learning outcomes of doctors and medics who were taught trauma treatment skills on animals to those trained on simulators that mimic human anatomy and physiology. In every single case, results show that the simulator groups are as proficient as - or more so than - their peers who used animals and that they are often more confident in their skills. This includes the findings of a recent three-year, $20m study commissioned by the US Department of Defense looking specifically at this issue.
Companies are looking at ways to utilise web-based technologies for simulation and harness the potential of developers outside defence.
Last year, US Air Force researchers published a study in the US military's medical journal showing that the TraumaMan simulator taught emergency medical skills as well as animal laboratories and concluded that "if the goal for trainers is to produce individuals with high self-efficacy, artificial simulation is an adequate modality compared with the historical standard of live animal models".
The lead author published a separate opinion piece afterwards in the journal, stating: "We have entered into an age where artificial simulator models are at least equivalent to, if not superior to, animal models. .... [The] military should make the move away from all animal simulation when effective equivalent artificial simulators exist for a specific task. For emergency procedures, this day has arrived".
BB: Are any other international governments planning a review that could see similar success?
MB: The few NATO nations still using animals in military training have formed a working group through NATO to examine the methods available to replace animal use, stating: "The use of animals for LTT [live-tissue training] has come under significant scrutiny in many NATO nations to the point where the use of animals in military medical training will have to be severely curtailed if not completely eliminated". Of course, the technology is available now and has been proven superior to animal use, and we now just need to see the political will in these nations to make the switch.
BB: The question of why the UK has not switched to modern simulators instead of using live animals is frequently brought before the House of Commons. What progress has been made?
MB: We've asked them the same question as well. Because PETA Foundation (UK) received an unsatisfactory response from the Minister of Defence in the UK and other nations, we filed a complaint with the European Commission in 2013 calling on the agency to require these countries to replace animal use with simulation technology in accordance with Directive 2010/63/EU, which requires that non-animal methods for training and experimentation be used whenever possible. The complaint is still being investigated, and if it's successful, it would prohibit the UK and other EU nations from stubbornly maiming and killing animals when superior and humane alternatives are available.
BB: If suppliers of medical simulation tools to the military are reading this, how could they get involved?
MB: Simulation manufacturers have been instrumental in creating modern tools that make medical training more effective and can save countless lives - both human and nonhuman - but more engagement with NATO and the military community in these nations is needed to educate policymakers as to the life-saving advantages offered by modernising military medical training through the use of 21st-century technology. PETA US works with many simulation companies to connect them with military officials responsible for this issue.
BB: Can you foresee a time when military training in NATO countries will have moved on from using live animals in medical training? If so, on what timescale?
MB: The days when military personnel crudely practice medical skills by shooting, stabbing and mutilating live animals are quickly drawing to a close and at the rate we're going, it will be virtually abandoned in the next five years because of the ethical, scientific, practical and economic benefits of simulation technology.
There is no scientific, ethical or legal justification for harming animals for military trauma training. This is not a choice between saving animals and saving human beings. Rather, we are advocating a switch to modern training tools that will spare animals' lives and better prepare military personnel.