German medical forces are training with Japan and other partners in the care and evacuation of casualties from Okinawa to Tokyo.
Together with international partners, the German and Japanese Medical Services are training to provide medical care to a large number of casualties at Keen Sword 2027 in Japan. The Bundeswehr is focusing on medical logistics, evacuating patients from the island of Okinawa using the A400M transport aircraft, and providing Role 2 medical care in Tokyo. This is the first time that the German Medical Service is participating in the Keen Sword exercise series.
Some 100 soldiers from the Bundeswehr Medical Service are participating in the exercise in Japan from 19 to 29 October 2026. Together with the Japanese armed forces as well as American, Dutch, Philippine and New Zealand partners, they will be practising how to provide medical care to and evacuate a large number of casualties.
For Germany, a particular focus is on the interaction of different elements in the medical evacuation chain. The exercise scenario encompasses casualty care on Okinawa, air transport, and further treatment on the main Japanese island.
Diagram of the medical evacuation chain from the point of injury to clinical care and rehabilitation
Bundeswehr/Patrick GrüterichFor the Bundeswehr, the exercise will first focus on medical training with the Japanese armed forces. This will include tactical combat casualty care, cooperation in Role 2 medical treatment facilities, and the transfer of patients to Japanese Role 3 facilities.
The decontamination of casualties is also part of the exercise. A patient decontamination point will be used for this purpose. The scenario will expand over the course of the exercise. It will begin with a large number of casualties on the island of Okinawa, north of Taiwan. Japanese, American, Philippine, and New Zealand forces will conduct initial treatment there. The German Air Force will then come into play. An A400M will transport medical materiel and blood products to Okinawa and will simulate the air transport of casualties to Iruma near Tokyo.
There, the German Medical Service will provide Role 2 medical care. The medical evacuation chain will conclude at a Japanese Role 3 military hospital.
Interior of an Airbus A400M medevac transport aircraft
Bundeswehr/Patrik BransmöllerJapan is an important partner for Germany in the Indo-Pacific. Cooperation between the two countries also includes the areas of security and defence. Germany has increased its commitment to this region in recent years.
Its engagement is based on the German Government Policy Guidelines on the Indo-Pacific. These guidelines highlight the importance of a free, open and rules-based order as well as cooperation with partners in the region.
By participating in Keen Sword, the Bundeswehr Joint Support Command is contributing to practical cooperation with Japan and other partners. At the same time, the exercise offers an opportunity to practise capabilities and procedures for medical care in a multinational environment.
Keen Sword will take place in Japan. The island of Okinawa, north of Taiwan, will be supplied from Tokyo, and casualties will be evacuated to Iruma near Tokyo.
Bundeswehr/Nathalie PoulheimKeen Sword is a Japanese-American exercise series. In 2026, more than 50,000 participants from eight countries will conduct a defence and deterrence exercise in this region. Germany will be participating for the first time this year.
Germany will participate from 19 to 29 October 2026. A main focus will be the Japanese air base in Iruma near Tokyo. The exercise scenario will also include the island of Okinawa.
Keen Sword is a Japanese-American exercise series, and it is based on the fiscal year of the United States government. This starts in October.
The Bundeswehr Medical Service will be participating with around 100 soldiers. In addition, Germany will also provide CBRN defence forces, military police, and an A400M of the German Air Force.
Germany and Japan are close partners who share democratic values and a common interest in security, stability and a free and open international order. They have expanded security and defence cooperation in recent years.
This exercise is part of Germany's practical cooperation with partners in the Indo-Pacific. It is based on the policy guidelines for the Indo-Pacific of the German federal government, which envisages greater cooperation with democratic partners in the region.
This military exercise brings together different capabilities within a common medical evacuation chain: conducting casualty care in rear areas, supplying medical materiel and banked blood to troops at the front, evacuating casualties with an A400M transport aircraft, providing care in a German Role 2 facility, and subsequent treatment by Japanese forces.
