Defense Perspective: In the field / From medical care to drones, nation must bolster capabilities 

The Yomiuri Shimbun
Self-Defense Force medical personnel conduct an exercise at a field operation system in Camp Mishuku in Setagaya Ward, Tokyo.

This is the second installment in a series that will monitor ongoing international developments and identify necessary tasks if Japan were to become embroiled in a contingency. This will involve putting a spotlight on the Self-Defense Forces, which play a fundamental role in Japan’s defense; the defense industries and the Japan Coast Guard, which jointly support national security along with the SDF; and measures to protect the public in the event of a national emergency.


The Ground Self-Defense Force conducted a “battlefield conditions” exercise Nov. 9 at Camp Mishuku in Setagaya Ward, Tokyo.

As SDF medics and nurses surrounded a blood-spattered human dummy with its internal organs exposed, one participant shouted, “Let’s start with the abdominal injuries!” while another proclaimed, “Apply suction to the bleeding area!”

The “emergency medical treatment” was conducted in a temporary field hospital on the premise that an SDF member had been injured by a shell fragment on the front line. Amid a tense atmosphere, the medical staff quickly found the wound, stopped the bleeding and finished up the treatments.

In times of conflict, first aid must be performed under various constraints. Shells can rain down during an operation, and medics may have to work amid noise and vibrations from blasts. Nighttime treatment requires working in limited light to avoid detection by the enemy.

“Medical care is vital to maintain war-waging capability,” said a top-ranking member of the SDF’s medical instruction department. “It’s a morale booster to know you’ll be rescued if you get wounded. We’re repeatedly conducting ‘realistic scenario’ training.”

Russia’s invasion of Ukraine has highlighted the need to prepare for a prolonged war. Until recently, however, the SDF had not realistically envisioned how it would respond to an invasion, spotlighting its lack of autonomy as a military organization. As a result, the SDF is taking steps to make improvements in various fields, including its medical system.

Armed forces in the United States, France, Germany and other countries have their own facilities to produce blood products for life-saving transfusions, but the SDF relies on the Japanese Red Cross Society. The Defense Ministry plans to install a specialized production facility in the next fiscal year.

From next fiscal year, the ministry plans to secure about 40 large ambulances that can each carry eight patients, and expand the SDF’s transport system.


Compensation for those killed in battle and their bereaved families is a fundamental part of any contingency plan. For example, in the case of a 35-year-old master sergeant (or petty officer 1st class) who had a wife and two children and an annual income of approximately ¥5 million, the survivor’s pension comprises a lump-sum payment of ¥22 million and ¥4.1 million per year.

A death gratuity is also paid. Currently, the gratuity can be as much as ¥90 million for individuals who lose their lives in the line of work, such as a dispatch worker providing nuclear disaster-related relief. However, the amount to be paid out for line-of-duty deaths in a domestic emergency has yet to be decided.

Masahisa Sato, an LDP House of Councillors member and a former GSDF member, has called for such payments to be higher than ¥90 million in the event of a contingency.

Many issues need to be addressed for the SDF to become a battle-ready organization.

First, there is an urgent need to resolve ammunition shortages, secure mass-production lines and expand the spread of munition depots — the majority are currently concentrated in Hokkaido — to the southwestern part of Japan.

“It’s essential to acquire key ammunition as quickly as possible. said Defense Minister Yasukazu Hamada at a House of Representatives Security Committee on Oct. 27. “We need to increase production capacity and work systematically to secure ammunition depots.”

Munition depots are considered dangerous facilities, and local understanding is essential for their establishment. It is difficult to promote such efforts in Okinawa Prefecture, where there is strong resistance to military matters due to bitter memories of the Battle of Okinawa.

In April 2019, the defense ministry deployed mid-range, multi-purpose missiles — among other munitions — at the GSDF’s Camp Miyakojima on Miyakojima island in the prefecture. But this gave rise to backlash due to the ministry not providing sufficient explanation to the islanders. The munitions in question were subsequently withdrawn from the island. Since June 2021, however, munitions have once again been stored in the prefecture’s military depots, but the 2019 event was a bitter lesson for the ministry.

The ministry deems it difficult to build new depots in the prefecture and is currently making arrangements to use the U.S. military’s Kadena Ammunitions Storage Area in the village of Yomitan, among other facilities.

Reconnaissance mainstay

Unmanned drones are playing a key role in the Ukraine war. The Ukrainian military uses drones in an offensive and reconnaissance role, while the Russian military deploys them to attack Ukrainian infrastructure.

The SDF has only just begun using drone technology. In early October, the GSDF and the U.S. Marine Corps conducted a joint training exercise at the Kamifurano maneuver area in Hokkaido.

The exercise involved the GSDF and Marines flying different types of drones in search of attack targets. Previously, the GSDF relied heavily on intelligence gathered by its reconnaissance units to identify targets, but nowadays, drones have become an indispensable part of Japan-U.S. cooperation.

“The JSDF does not have many drones, and their quality is low,” a senior GSDF official said. “[JSDF] units aren’t accustomed to using them, and they can’t be used in actual combat yet.”

Full-fledged drone use is expected to help the SDF cope with personnel shortages and reduce potential casualties.

The defense ministry plans to start trial of unmanned, attack-type aerial vehicles among SDF units in fiscal 2023 to bolster defense of the nation’s islands, with an eye on a full-scale rollout in the future.

To help strengthen its information-gathering system, the Maritime Self-Defense Force will begin testing SeaGuardian — a remotely piloted aircraft manufactured by U.S. General Atomics Aeronautical Systems Inc. — at Hachinohe Air Base in Aomori Prefecture in fiscal 2023.

Improving cyberdefense capabilities is also a serious issue. The SDF’s Cyber Defense Command, which was launched in March, has only 540 personnel, while China has a similar force with 175,000 staff. In addition to expanding the nation’s defense forces, it is also crucial to consider measures to secure and train human resources.

Within a limited time frame, the SDF will be forced to make major changes to become an organization capable of waging continued battle and making potential adversaries hesitant to attack Japan.