With over 40 different navies operating nearly 500 submarines worldwide the possibility of a submarine getting into difficulties is very real. Many lives have been lost in submarines in peacetime over the years, but it was probably the tragedy of the Kursk that really brought the complex and demanding skills of submarine escape and rescue sharply into focus.

   International co-ordination and understanding has come a long way since then. The Submarine Escape and Rescue Working Group (SMERWG), a NATO led group of experts, meets annually, and at the last meeting, which was held in St Petersburg, Russia, it was satisfying to note how quickly openness and cooperation have become the norm. The drive to develop and share research work and operating techniques has led to a leap forward in international co-operation in this expensive and hugely challenging field. Exercise Sorbet Royal is an important opportunity, not only for the unprecedented number of NATO and non NATO countries involved to continue to develop and prove submarine escape and rescue operating techniques, but also for the international medical teams to exercise the highly specialised medical skills involved. The unique problems of operating at depth under high pressure with large numbers of casualties suffering from the effects of decompression or potentially poisonous and debilitating gases present wide ranging and acutely diffi cult medical priorities.

   I am immensely proud of the work NATO’s submariners are doing. They have proved their fl exibility, versatility and endurance, time and time again; making an important contribution to international co-operation in what was once the most secretive arena of warfare.