Female IDF combat soldiers at health risk

Fighters suffer stress fractures, anemia, infection, back pain; Solution: lowering loads and effort bar, queueing up for orthopedists.

Mordechai Sones ,

Starting service healthy
Starting service healthy
צילום:IDF Spokesman/Flash 90

The public debate over integrating women into IDF combat roles continues to dominate the public agenda, with the IDF itself exacerbating the trend.

An up-to-date military document received by Arutz Sheva reveals a worrisome picture of the physiological costs paid by women in combat roles.

The document was written at the headquarters of the Chief of Staff's Gender Advisor, called "Gender Standards." Distribution of the document in units that serve women in combat roles began about two months ago. It is the most updated official document in this field in the IDF, and is intended to help integrate women in combat roles. However, reading the document presents disquieting realities.

The document sheds light on the way the IDF integrates women into the combat force, despite the serious medical consequences caused to female soldiers, and despite the damage to the operational level of the units in which women are integrated as combatants.

"Women are no different from men in motivation, command ability, leadership, personal abilities, mental and cognitive functioning," the introduction to the document states. The main difference, according to the document, "is body structure and physiology, which is reflected in differences in women's physical ability from that of men in many aspects, the most prominent of which is cardio-strength, strength (especially strength of the upper body), and speed."

Under the heading "Women's Characteristics relative to Men," the Advisor notes that body weight, muscle mass, and muscle strength are significantly lower in women, and therefore, during training as fighters, they suffer far more from "weight-bearing capability" and "muscle-skeletal injuries."

The key word for dealing with these medical problems is "adjustment": Adjustment of the duffel bag to each female soldier's weight, the adjustment of an effort bar so that it is lower for female fighters than men's, and fitting roles to match the physical characteristics of the girl fighters. It amounts to a drastic lowering of combat achievement requirements to accommodate female fighters.

Increased risk of heat injuries

Women in combat have lower bone density and lower aerobic capacity than men, and women have a "higher sweating threshold and a lower sweating rate," the study notes.

The implications of this fact, as they appear in the IDF document, are: "higher stress fractures, lower aerobic performance (running and trekking) and increased risk of heat injuries."

The solution established by the army for this reality is: "Adequate nutrition, adequate sleep, strict stress management, and adjustment of job requirements and the training bar." To avoid heat injuries, "follow the safety department's recommendations and on adequate sleep hours".

From the document: Common injuries and medical recommendations

1. Stress fractures

"Stress fractures are common in both sexes during training, but they are more common in women, and women are more exposed to stress fractures than male fighters, and there are specific types of stress fractures that are very rare in men and are at times observed in women, such as pelvic bone fractures."

The IDF notes that stress fractures do not lead to severe illness or long-term consequences, except for hip fractures that sometimes progress to full fractures with serious consequences.

With this, "Sickness due to stress fractures interferes with training, leads to a great loss of training days among female combat soldiers, and mainly indicates that this is an 'unhealthy framework' with too much stress on the female fighters" (emphasis A7s). The IDF stresses that "the frequency of stress fractures is influenced by many factors, including nutrition (mainly calcium and vitamin D), the stress bar, and the amount of sleep time."

The solution found by the Advisor for this common injury is "seven hours of sleep a night, a balanced diet + stress bar should be observed." Men are given six hours of sleep per night, and only in the mixed battalions is an additional hour of sleep possible.

2. Lower back pain and knee pain

"Lower back pain and knee pain are a common complaint among male and female fighters. In most cases, this is an unspecified pain that passes with time. In a few cases, investigation raises problems that require lowering the profile and removing the female soldier from combat duties."

The IDF notes that with most female soldiers who dropped out of the training process, low back pain and knee pain were among the factors that prevented the completion of the training.

The solution found by the Advisor for this common injury is: "Lowering weight bearing to the minimum required, adjusting heavy duffel bags to female fighters who are able to carry them, and physical training that emphasizes strengthening the core muscles and leg muscles."

3. Anemia

"Anemia is much more common in female fighters than in male fighters. Usually due to lack of iron due to reduced dietary intake and blood loss from the menstrual cycle."

The IDF notes that blood loss causes a decrease in aerobic fitness and increases the chance of stress fractures. The solution found by the Advisor for this common injury: "A blood test should be performed to detect anemia and iron deficiency in female fighters at the beginning of recruitment, and treatment accordingly."

4. Urinary tract infection

"While in the field, many female fighters refrain from emptying or complain about lack of sufficient time, combined with poor hygienic conditions, increasing the risk of infection of this kind."

The solution found by the Advisor for this health phenomenon: "Maintaining hygiene and providing optimal access to facilities will reduce urinary tract infections."

In the document received by Arutz Sheva, the Advisor provides a unique medical response to female fighters: Keeping appointments for orthopedic specialists and gynecologists for fighters on Sundays and Thursdays in the clinics, increasing physical therapy hours, checking for anemia before starting basic training and supplementing missing nutrients (iron) as necessary, "Unit Disposal Procedure" - in units with female combat soldiers.

Nutrition adjusted to female combat soldiers

In the mess hall at training bases where female fighters are found, "the values ​​of calcium, protein and iron were enhanced by the introduction of high-quality foods" such as cheeses, fish, eggs, and tahini from whole sesame.

The diet menu contains 2,300 calories per day on average, with fighters eating an average of 3,250 calories a day.

"The amount of protein in the female fighter's menu should be about 72 grams a day (compared with 91 grams per day in men). "The amount of iron required for women is 50 percent higher than the amount needed for men." In addition, "Female vegetarian fighters must be adequately addressed in terms of alternative protein sources, including the replacement of meat products with canned fish or cheeses, soy products, tofu, and legumes in the mess hall."

Under the heading "Building the Female Fighter" there are clear instructions regarding the training process which requires "work according to an approved training program adjusted to the female fighter's effort curve".

In addition, "in mixed companies, there is a need to work according to different measures of standards for male and female fighters. A training program must be approved with an emphasis on the mixed companies."

In the process of training the command hierarchy, emphasis should be placed on the physiological differences between men and women in the physical aspects of the training. In addition, the female fighters should be allowed seven hours of net sleep, to ensure the presence of logistical details suitable for female fighters such as clothing, menstrual needs, weapons, and more.

The document also states that "lowering weight burdens" should be performed, and specifies, for example, the use of lighter radio equipment, and "four cartridges in the vest instead of six."

It was also determined that the maximum weight allowed for females is 33% of body weight compared to 40% for fighting men. "Injuries should be closely monitored in mixed battalions, with the cooperation of the medical corps, physical fitness personnel, and commanders."