At Camp Ripley, Minnesota National Guard trains Norwegian soldiers in life-saving combat medicine

CAMP RIPLEY — Staff Sgt. Justin Rehmann stood in front of 57 Norwegian soldiers one afternoon earlier this week and warned about the chaos he was about to put them through.

"We specialize in realism," said Rehmann, a Minnesota National Guard medic who runs a training program here that simulates lifesaving combat medicine. "The things you're going to go through today are as close to real combat as you can get without being shot at. We'll be putting you into an environment that's high stress, with combat casualties, and you'll have to treat them. We want to see how you'll react."

The Norwegian Home Guard troops were ready to learn as part of an annual exchange with the Minnesota National Guard. The state-of-the-art facility, one of 23 at U.S. military bases worldwide, is a vital part of the program. As 100 Minnesota soldiers were in Norway on a dayslong ski trip learning winter survival and winter warfare this week, groups of six Norwegians walked into two tiny rooms on this sprawling base in central Minnesota.

In each room, three simulated casualties lay on the floor. The specialized mannequins looked, felt, bled and breathed like humans. One mannequin, costing $100,000 and weighing about 200 pounds, had his right leg torn off below the knee, his left leg crushed. Another had several gunshot wounds and a blown-off leg. A third had a puncture injury in his abdomen. From a control room, Rehmann pumped in rancid odors such as feces and rotting flesh. He flashed a strobe light and cranked up sounds: buzzing aircraft, crying children.

"Whatever I can do to overwhelm their senses, that's what I do in here," Rehmann said.

Then the Norwegians got to work.

Similar military exercises happen all week at the Norway Reciprocal Troop Exchange, which in its 50th year is the world's longest-running troop exchange program. Norwegian soldiers practice with M4 carbines. They go through an infantry simulation training exercise, reacting to an ambush in an urban environment. There's fun too: Some are going to a Minnesota Wild game, others to the Mall of America.

During the exchange, a Norwegian flag flies alongside an American flag here. A snack table is divided: Half American snacks (Cheez-Its, Starbursts, Oatmeal Creme Pies), half Norwegian (Freia chocolate bars, mackerel in tomato sauce, tubes of caviar).

Lt. Geir Gulbrandsen, an emergency room nurse in Trondheim in central Norway, has helped with the exchange in Norway since 2014.

"It's just so important, first of all, just getting connected with people," Gulbrandsen said. "My wife was here as a Home Guard youth in 1991. Now it's my turn, 32 years later."

For the Norwegians, the exchange serves as a helpful comparison with how they do things in Norway — as well as a helpful building of this alliance during a scary time in Europe.

"A lot of things are different, but a lot of things are similar as well," said Maj. Kiwi Horgøien. "We do a lot of training with NATO during wintertime. And war is in Europe, whether we like it or not."

Norway doesn't have anything like this simulator, and it's unique in Minnesota as well. Like much of Camp Ripley's training, the Medical Simulation Training Center can be customized for nonmilitary entities as well. Minneapolis police have trained here; so have paramedics and sheriff's offices from across the state.

At the training center Tuesday, the Norwegians performed calmly under pressure. They hauled each mannequin into a separate room, simulating a space away from enemy fire. One soldier packed gauze into a blast injury to stanch the bleeding. Pvt. Henrikke Iversen plugged a gunshot wound in a mannequin's chest and affixed an occlusive dressing.

Rehmann nodded in approval.

"They're hitting all the major life-threatening injuries," he said.

Afterward, Staff Sgt. Nathan Anderson, a National Guard medic, chided them for not using a needle to relieve pressure in an injured chest. But he applauded their job.

"A couple of you looked at the airway right away, checking breathing — that was good," he said. "You guys found the chest wounds right off the bat — awesome. You weren't getting hyper-focused that there wasn't a limb there. You got your tourniquets on and started finding those other wounds. You did an awesome job."

Iversen wiped sweat from her brow.

"Very intense, very good learning opportunity," she said. "I've never been through anything like this before."

"It was more stressful than I expected," said Sgt. Sondre Holen of the Norwegian Home Guard. This is a new thing — the breathing, the punctured lung, really feeling it. We didn't know what to expect, we just had to take it as it was. I can take this experience home to my team so my squad can learn from us."