The U.S. Navy is no stranger to humanitarian missions. But with the emergence of “smart-power” doctrine, focused on building alliances and exporting stability, professional capacity and good governance to what Tom Barnett calls “the gap” of the developing world, Navy humanitarians have found themselves on the front lines of U.S. and world security, especially in Africa (via Africa Partnership Station) and Latin America (by way of Operation Continuing Promise). In April 2009, the Navy hospital ship Comfort set sail from Virginia on a four-month mission to deliver medical, engineering and training assistance to seven Latin American nations. David Axe interviews some of the key participants.
by DAVID AXE
Coast Guard Chief Ray Francis, pictured center, is an independent duty corpsman assigned to Comfort for Operation Continuing Promise.
Axe: What’s your job?
Francis: I provide medical support, on the ship and off the ship, including medical support for the ship’s crew. I’m also an assistant site leader for the medical site ashore.
I assist the site leader in tasks such as site set-up, patient flow, patient control, provider support, crowd control, force-protection assistance and assistance to providers when the site leader is busy. We tag-team, together.
Axe: What’s the hardest part of the site leader role?
Francis: The biggest challenge is to establish patient flow and control, and provider flow and control, because we want patients coming into the facility to be welcomed, and providers it provide service so there’s no interruption of flow. We try to make everybody happy, on both sides.
Initially, when we first went to Haiti, I would speculate that the whole crew was overwhelmed by the large number of patients … but as soon as we started to get a nice flow for the process, things smoothed out, and the overwhelmed feeling subsided.
There have been some times when things have not gone well, because of site setup, and crowds can get out of hand. Most of us have adapted, with hand signals and things like that. The lack of translators at a particular site does make or break our process. What we have established with us as assistant site leaders, we have two or three teams that work together, for continuity at the sites. We talk to each other at night, to see what we can change, what works and doesn’t, and take those back the next day. Anything out of our control, we pass up to command. Say, if 15 translators doesn’t work, and we need 20. Of course, there are things that are out of their hands, too, and out of our hands.
Axe: How have the ashore sites changed, as you’ve learned?
Francis: When we have an entry point and an exit point, that works well. Sometimes the entry and exit are close together, and that causes problems. At first, we had bottleneck. When a crowd gets into one small entry point, things bottleneck and that slows the process down. So we segregate the opening of the entry point [from the exit] to make it flow. If you want dental services, come over here. If you want medical, optometry — over here. If you’ve ever been to Disney, the serpentine lines, we developed that into our patient flow. Putting people into those lines, made it a lot easier. If dental wanted 20 patients, we knew which lines to go to, as opposed to: we want 20 patients and there’s a huge crowd by the door. We’ve taken that and passed it along to our [advance coordinating] teams.
Axe: What’s been the most memorable experience for you?
Francis: A personal one? When we were in Haiti, our first mission, the first site, there was this lady. She was probably about 82, 83, and came in very weak, and had some help coming into the site. However, that was it, nobody assisted her at all [after that], so I had a little time to help her out, and ended helping her through the whole flow of the system, checking her in, sitting her down, getting her some water. I got her a wheelchair, guided her through the whole process, saw the doctor, got her medication, and we finished up. That stands out so much, because here you have a frail 83-year-old lady, and when she got out of the wheelchair, she bear-hugged me, and it felt like she wasn’t 83. It felt like she was 23. She appreciated everything. I got a translator and she said thank you very much for everything I did.