I was testing scrolling issues and checking decoration and ribbon sprites, so I modded the save game to show more medals. They all have different names, and will be somewhat moddable too! Each stat that I track can be used in a medal commendation, but you wouldn't be able to mod "headshot medals" without writing code to track headshots.
I agree that it would be really cool for countries to give their own medals, but that may be difficult... at the moment, I have "X Campaign Medal" for having Y amount of missions in country X.
However... it could be possible to create unique medals from different countries. It would just require manually adding each and every one, unlike my generic "X Campaign Medal". The more I think about it, the more I like the idea of a "Order of Canada" commendation for having like, 10 missions, 3 terror missions, 50 kills, 5 stuns, 0 civilian kills, 0 friendly fire... you know, something super unique.