War Is Boring » USNS Comfort

Warships International Fleet Review: Rising Star Proposes USN Should Provide Comfort

David Axe — Mon, 24 Aug 2009 22:01:29 +0000

by DAVID AXE

In April, the U.S. Navy hospital ship Comfort – a converted, 70,000-ton tanker — sailed from Norfolk, Virginia, carrying 900 doctors, nurses and engineers from the U.S. military, civilian agencies, non-government charities and even foreign navies. Their mission: to deliver free medical, dental and veterinary care, plus engineering assistance, to impoverished communities in Antigua, Colombia, Dominican Republic, El Salvador, Haiti, Nicaragua and Panama. Comfort’s four-month cruise represents the latest iteration of Operation Continuing Promise, begun in 2007, with the goal of “influencing generations to come,” in the words of Captain Frank Ponds, commodore for the 2008 phase.

Continuing Promise, one of the Navy’s biggest ever, sustained humanitarian initiatives, is the brainchild of Admiral James Stavridis, who recently left the top post at U.S. Southern Command, in order to take the reins at European Command. Stavridis is a rising star in the world’s most powerful Navy, and is widely considered an eventual shoe-in for Chief of Naval Operations. When Stavridis speaks, people listen. But what Stavridis has been saying lately is likely to surprise a lot of Navy officers. He wants less emphasis on the raw combat power, at which the Navy excels, and more emphasis on missions like Comfort‘s.

For years, the U.S. Navy has been organized around aircraft carrier battlegroups and amphibious ready groups, usually around 10 of each. Each group, anchored by a large aviation vessel — either a carrier or an amphibious assault ship — includes surface escorts, submarines, logistics ships and its own organic air force of around 100 aircraft — and possesses more firepower than most of the world’s navies. While the precise number and composition of the CVBGs and ARGs have changed, over time, their importance has not. But now Stavridis is advocating a new kind of group, one anchored by hospital ships like Comfort, and tailored for delivering aid, not munitions. …

While Stavridis didn’t specifiy what kinds of vessels, in addition to the hospital ships, might comprise the humanitarian groups, one of Stavridis’ protégés has offered some hints. Commander Jerry Hendrix, who served under Stavridis, is on the team preparing the Pentagon’s influential Quadrennial Defense Review, due in early 2010. In an article in the professional journal Proceedings, Hendrix advocated for what he calls “Influence Squadrons,” to replace several of the carrier groups. An Influence Squadron would include vessels optimized for coastal, non-combat missions, much like Operation Continuing Promise. Hendrix proposed the Navy buy more catamaran transports and shallow-draft Littoral Combat Ships to fill out the squadrons. Adding a hospital ship to the mix would turn the Influence Squadron into a Humanitarian Support Group.

For the whole story, subscribe to Warships International Fleet Review.

(Photo: Navy)

Southern Comfort, Part Ten: The Aviator

David Axe — Fri, 19 Jun 2009 04:42:10 +0000

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

Lieutenant Landon McKinley is an aviator with squadron HCS-26, Detachment 3, assigned to the hospital ship Comfort, with 14 aircrew and two MH-60S helicopters.

Axe: Describe the detachment’s mission.

McKinley: The detachment’s purpose is to provide logistical support to Comfort‘s mission. We transport a great deal of cargo, move a lot of VIPs. Our main purpose now is patient transfer, both from shore to the hospital, and once fully recovered, we take them back home. We also provide search-and-rescue and alert launch for the ship, in case there’s someone on another ship that needs to come to our hospital for surgery.

Axe: Does this mission represent a change for you?

McKinley: From our standpoint, it’s much different. My squadron is a logistical squadron. Our bread and butter is moving people and things from point A to point B. This [Comfort's mission] is much different than normal. Usually, we’re flying soldiers, sailors and cargo from point A to B in the Persian Gulf, or we’re stationed on supply ships, moving [vertical replenishment] loads from the supply ships to warships: that’s sort of our standard missions-set.

On the surface, this mission doesn’t appear different. We’re still moving cargo and passengers, but the nature of the mission is much different. We’re moving back and forth, between ship and shore, usually only a couple miles out, so it’s run after run of patients and cargo. We’ve had the opportunity to go into some incredible places — LZs and sites that, under normal circumstances, we would not go into. In terms of flying, it’s been a fantastic experience. We’ve seen a lot of incredible places. They’re perfectly good LZs … smaller zones, a little more difficult to get into and out of. They’re not better or worse, just different.

I’m not sure of the ship’s capability to move large cargo [on its own]. So we’ll move wheelchairs and other large cargo, from ship to shore — our advantage is our ability to move this cargo. If the ship is in port, there are no issues, we can bring the cargo to the deck and crane it off. But getting supplies off the deck and onto a boat — I’m not sure how feasible that is.

Axe: What’s it like, flying from Comfort, compared to other ships?

McKinley: It’s a bit different. The flight deck is much higher and in a different location. Usually, there’s a nice clear area off the back [of other ships] where there’s nothing but ocean. But here we’ve got a hangar bay on the back side of the landing pad, and also the majority of the ship behind us. That can make things a little bit slower for us. When on a supply ship, there’s a smaller military presence aboard. There’s actually more Navy on this ship than I’m used to dealing with on a supply ship. It’s interesting, the coordination between the Navy and civilians.

In terms of patient transfers, we treat them just like we treat anyone else, whether VIP or doctors or a load of troops going to a ship. They’re going to have the same safety equipment. We know the cargo is slightly more precious, with a load of kids, vice load of SEALs, but for most part, we handle them basically the same.

This whole thing has been new and exciting for me. One of my favorite days was one of the first days the operation got into Haiti. It was exciting, seeing how the machine was going to work, with the coordination of so many people. There was also the thrill of seeing a new place, watching a different set of trees and roads going by.

(Photo: DoD)

Southern Comfort, Part Nine: The Master

David Axe — Thu, 18 Jun 2009 03:57:53 +0000

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

Captain Thomas Finger is a licensed, civilian seafarer in Military Sealift Command, and the master of the MSC hospital ship Comfort.

Axe: How has the ship performed, so far?

Finger: This is a relatively challenging environment, going to ports where we have very little support, that aren’t used to handling ships of this size. There’s a lot of coordination required. We have to do a lot of things ourselves, where we might be able to count on shore support, if we were going into fully developed ports. We have them all pretty much IDed ahead of time. For example, in Haiti, which is relatively undeveloped, we had to take special steps for making water there, because we had no access to potable water from an approved facility. In the Dominican Republic, we were out in an extremely exposed anchorage, and had issues getting support services out to the ship, because of sea conditions. We worked closely with the husbanding agent in port and the embassy’s [military liaison] mil group.

We’ve gotten phenomenal support from the mil groups with garbage. There have been some issues with getting trash over the side, so got with the husbanding agent and the mil group and the embassy staff and worked with the local government and came up with a way to properly screen garbage and make sure it went to where wanted it to go. That kind of thing comes up, when they’re not used to the Navy coming in.

In Panama, we were generating 30 cubic yards of trash, on a daily basis. We can compact that, to get it down smaller. We have methods on board for handling medical waste. We do not transfer medical waste to host nations.

For each port we’re working with, we’re putting together a file we can pass on to other crews: you want to anchor here, not there, the husbanding agent here had trouble with this service — that type of thing.

Axe: What’s been the most rewarding experience for you, on this mission?

Finger: This is the third mission I’ve been on, and the capstone of my career. From a personal point of view, this is the most rewarding ship I’ve been on. To see the looks in the little kids’ eyes … The Seabees had taken a vacant lot, with potholes, and yesterday built a ballfield. They brought the kids out. You see them going into optometry, kids who never had glasses and never could see. The optometry folks give them glasses, they can see clearly — it’s great.

(Photo: DoD)

Southern Comfort, Part Eight: The Master

David Axe — Mon, 15 Jun 2009 04:58:30 +0000

by DAVID AXE

Captain Thomas Finger, pictured, is a licensed, civilian seafarer in Military Sealift Command, and the master of the MSC hospital ship Comfort.

Axe: How would you describe your job?

Finger: We [the civilian MSC crew] handle ship’s navigation and ship’s functions, like hotel services, to the embarked [mission] personnel. … If we were a hospital on land, we would be the building and maintenance department.

Axe: What’s the hardest part of your job?

Finger: The biggest challenge is the size of the ship. This ship is almost 900 feet long and 100 feet wide, with a draft of 30 feet. There are a lot of places we cannot get to, pier-side. The only site could get pier-side [so far in Continuing Promise] was here in Panama. There was just not enough water, not enough piers, not enough tug boats to get us alongside. The big challenge, then, is how get mission personnel where they need to go. The patient and crew launches are run by ship’s crew. If the weather picks up, is it still safe to run boats? What steps can we take to mitigate that risk? I’m proud to say, we’ve anchored at exposed ports and still been accident-free.

Axe: What does a typical day look like for you?

Finger: Our day starts a 5 o’clock, when we get up to launch the boats. At daybreak, we embark the medical personnel and engineering teams going ashore. Depending on where we are, that can be as many as six boat runs. Once we get that done, we normally start setting up for moving cargo ashore …

With 900 people on board, we generate a lot of trash. One of the biggest things is, how are we going to, in an environmentally safe manner, get trash ashore for disposal. Normally, a barge comes from the beach and we lower trash by hand or by crane into the barge and get it moved ashore.

We have an embarked helicopter detachment on board that will supplement boat transfer. But we can’t be moving cargo or garbage or even personnel by boat, when we’re doing flight ops. We’re constantly working with the mission staff, the hospital staff and the helicopter staff, to keep things flowing.

Axe: What are the advantages of having civilian crew?

Finger: We are civil service employees, documented by the Merchant Marine or Coast Guard. This is a Coast Guard-certificate ship, run by the Department of the Navy with a Merchant Marine crew who are all civil service employees. There are 40 such ships in the fleet. All of the non-combatant ships in the U.S. Navy are Military Sealift Command-run.

The biggest advantage is the size of the crew. All of our personnel are licensed and experienced. The Navy will have on-going training programs, for example for junior enlisted sailors, up on the bridge, doing gopher stuff and learning a job. But our crew come on board, fully trained and fully documented. We have a crew of 64, plus four cadets who are trainees. If the navy operated ship like this, the crew would be a little over 200.

The second advantage is that we don’t have any [operations tempo] restrictions. If we have a ship that has just returned from a six-month deployment, and something comes up, we can take that ship that just returned and turn it right back around and send it out on a deployment again. The Navy can’t.

(Photo: DoD)

Southern Comfort, Part Seven: The Coastie

David Axe — Fri, 12 Jun 2009 22:27:18 +0000

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.

(Photo: DoD)

Southern Comfort, Part Six: The Nurse

David Axe — Tue, 09 Jun 2009 20:03:59 +0000

by DAVID AXE

Elie Malloy, pictured, is a volunteer Intensive Care Unit nurse from Salt Lake City, working with Project Hope, as part of Operation Continuing Promise.

Axe: What’s your job?

Malloy: The patients are elected before we come. They go through their surgery, through the post-anesthesia care unit, some go to the [inaudible] floor for an overnight stay, and if they have more high-risk surgeries, they come to the ICU, where I receive them, as a nurse, and keep an eye on them overnight. I get them up walking, eating and ready to go back home …

I also have been able to take a role, splitting my time going ashore, and from there moving patients where they need to go, assisting the doctors.

Axe: What’s the best part, and the hardest part, of your work?

Malloy: The best part of being out here is the patient interaction. One of our first patients in Haiti, I was able to see her pre-surgery. She had a huge fibroid uterine [benign tumor] and looked nine-months pregnant. She had been like that for two years. We were able to take that out with a hysterectomy. I was able to care for her for two days in the ICU, as well. And I saw her on shore, the day she went ashore. It was lucky for me to interact with her that way, and see her joy at being a relatively normal person again, not carrying around that fibroid any more. Her gratitude was amazing.

The hardest thing for me is probably communication. There’s so much I’d like to say and do, that I’m limited [in]. Even with a translator, they’re not saying exactly what you want to say, and you don’t know exactly what’s being portrayed. You can do a lot with sign language and smiling, but there’s a lot that gets lost.

It’s challenging as a patient, coming into such a surreal, uncomfortable environment. We’re doing all these random things to you, you can’t understand.

Axe: Are you taking time off your job to volunteer with Project Hope and the Navy?

Malloy: I was in middle of moving somewhere, so I still haven’t found a new job.

I didn’t necessarily know what I was getting into, coming out here. It’s been a great experience. It took a little while to understand how to get things done, what my role is as an NGO volunteer. Every hospital has their series of protocols and procedures. It’s the same here.

(Photo: DoD)

Southern Comfort, Part Five: The Doctor

David Axe — Sun, 07 Jun 2009 18:08:03 +0000

by DAVID AXE

Captain James Ware heads the hospital on Comfort, pictured, with a staff of some 200 doctors, nurses and other medical professionals. On a four-month deployment, Ware’s people might treat some 100,000 patients.

Axe: What has been your most complex operation?

Ware: We’ve done 700 surgical procedures, including general surgeries on hernias and plastic surgery. The EMT surgeons have done some dramatic life-changing surgeries. One patient hadn’t seen for 10 years, then the optometrist brought sight to her eyes. One grandmother here hadn’t seen her grandchildren. Her grandchildren had to cook for her. After three days, she had sight in both eyes and looked forward to cooking for them.

Axe: What about the training aspect for host nations?

Ware: We’ve got people from Canada, Brazil, France, The Netherlands, and also the seven countries we’re going to. Training is working hand-in-hand together. Often you see three surgeons working together — not because they have to, but because they want to. No one has to be the lead. They’re very comfortable sharing in the good-will, the gratifying humanitarian work you don’t normally see in the private sector, especially in our country. The Dutch team aboard … their government had agreed to bring in three surgical teams, rotating six weeks apiece, including civilian doctors, one surgeon, one anesthesiologist, two OR nurses, two technicians — five individuals, per team. They basically come together, form a team in Holland and come to the ship, where they will provide 20 percent of the surgeries we do on this mission, for a total of 300-to-400 procedures. They interact with our doctors and we interact with them.

Project Hope agreed bring 14 individuals, just for the [host-nation] training package. They plan, months in advance, the type medical training they’ll do.

We train host nations in: advanced cardiac life support, pediatric life support and basic life support. We’re training hundreds or even thousands of providers in the host countries.

It’s a three-prong attack: Comfort doctors go out to a local hospital, as in Antigua, where they went to one large local hospital. We bring 10-to-15 dentists on board the ship from each country to train with Comfort‘s equipment. For nurses, there’s a one-to-three-day training course.

Some Comfort providers are, in turn, trained by host-nation doctors. In Panama, doctors taught Comfort in infectious diseases, such as malaria. Panama is an expert in infectious diseases.

Southern Comfort, Part Four: The Doctor

David Axe — Sat, 06 Jun 2009 19:54:52 +0000

by DAVID AXE

Captain James Ware, pictured center, heads the hospital on Comfort, with a staff of some 200 doctors, nurses and other medical professionals. On a four-month deployment, Ware’s staff might treat some 100,000 patients.

Axe: How does Comfort compare to a civilian hospital?

Ware: We’re currently staffed for 250 beds, but our hospital could be as large as 1,000 beds. The reason for the difference is the nursing staff that we have on board. Comfort herself is staffed at Baltimore, Maryland, to develop a 1,000-bed hospital in a five-day period, but requires 200 nurses to run the hospital. Most people think in terms of doctors, but to run a hospital, it’s really the number of nurses that matters. A 250-bed hospital requires 85 nurses — that’s our current manpower structure.

In terms of capability, we have the equipment and supplies to do all types of procedures — everything a normal hospital of 1,000 beds does, except three procedures: open-heart surgery, which requires a very specific type of pump; also, total joint [replacement], because in America, hospitals require a certain type of positive, negative air pressure; the third is organ transplant, again a material thing, in that we don’t have the proper equipment.

But we have instruments to do all other major types of surgery. If I had the nursing staff, the only other key ingredient would be the specific type of surgeons aboard. For Continuing Promise, we have plastic surgeons, facial surgeons, orthopedic surgeons, general surgeons, children’s orthopedists, urologists, children’s general surgeons, OBGYN, dermatologists … we have a wide spectrum of skill-sets. The only type of surgeon we do not have on board that we would have in a war scenario is a neurosurgeon. We could have one flow on board within 72 hours.

Axe: What’s a hospital ship’s biggest advantage over a civilian hospital?

Ware: This ship was built very specifically for combat-casualty care, with a very specific way for patients to come on board. It was built for mass infusions of multiple combat casualties. Our ER is huge, with a casualty receiving area that has 50 individual bays that are very accessible in a mass casualty situation. It also has the ability to drive the [casualty] management piece. Imagine 50 wounded Marines coming aboard by helicopter in an hour … I don’t think most hospitals have that capability.

For a humanitarian mission like Continuing Promise, we are focused on structured, organized medical service, so that [mass-casualty] piece is not really utilized. What we do have is 12 operating rooms we’d use in a combat-casualty scenario. Presently we can operate four to eight of those, depending on the nursing service. We’re going to expand that with an NGO in Nicaragua, and go from five operating rooms to eight in a matter of one day. We’re like a Lego hospital. We can build in capacity very, very quickly.

Currently we have 14 surgeons, 50 physicians, 13 dentists, plus pharmacists, physical therapists and nurse practitioners: 172 health-care providers, in all. Plus 10 to 11 providers from NGOs, even an acupuncturist from California.

(Photo: DoD)

Southern Comfort, Part Three: The Commodore

David Axe — Fri, 05 Jun 2009 04:10:09 +0000

by DAVID AXE

As commodore for Operation Continuing Promise, Navy Captain Bob Lineberry oversees the activities of around 900 humanitarians, including military and civilian doctors, nurses, veterinarians, engineers and trainers.

Axe: How do make sure that the services you deliver to your host nations are sustainable, after you leave?

Lineberry: We’ve worked very closely with all our host nations’ ministries of health and governments, U.S. embassies, the State Department, and U.S. AID to ID where can we best help the country with that long-term sustainment issue. Every country has been different.

What can we best bring with a team of 900 folks? In Panama, we have great capability in providing basic life support system training, as well as advanced life support. In Panama and as well as in Antigua, it’s in the thousands of doctors, nurses and health-care providers we’ve trained in the latest [life-support] procedures. The Ministry of Health will tell us where might we be best suited or who might we best train. We’re looking as well at the embassy, for what’s the long-term effect of helping these folks.

Axe: How do we know that “smart power” works to improve our security?

Lineberry: Are we gaining valuable experience with our team? We take health-care providers from the armed forces and our partners and get four months of experience. We’re doing just that. Today we’re sending [in] some 52 Naval Reserve health-care providers and [sending home] back 52. In that aspect, we’re achieving our goals of getting maximum training experience for the armed forces.

We look at this in every port, the positive aspect of our presence here. Southcom has analysts come back and ask how effective was this trip. It’s all been positive: folks getting what they need, fostering good will and building partnerships in the Caribbean.

Axe: If you could do this deployment over, what would you do differently?

Lineberry: In the planing of this, we certainly could have had better participation from, I would say, our NGOs up-front. It would be much better if they were aware of this mission and the requirements. Within 30 days prior to us starting this mission on 1 April, we were [still] trying to finalize the numbers [of volunteers] for some of the humanitarian missions to provide us.

I would like to see larger engagement from the embassies — not that they’re not engaged, but [I want] much more participation in the planning process. Typically, [there's] a person from the [embassy's] military group or another embassy-assigned lead, and there is so much more capacity there in the embassy: in public affairs, strategic communications. Some of these things we can certainly do better, the next time around.

(Photo: DoD)

World Politics Review: Chinese, U.S. Navies Consult on Humanitarian Mission

David Axe — Thu, 04 Jun 2009 04:36:20 +0000

by DAVID AXE

In April, the U.S. Navy hospital ship Comfort , pictured, sailed from Virginia with 900 doctors, nurses, engineers and civilian volunteers aboard. Comfort‘s mission: to deliver humanitarian aid to seven Latin American countries over a four-month period, “building relations with many countries, and strengthening already-strong bonds,” in the words of mission commander Bob Lineberry, a Navy captain. In the first two months of their tour, Comfort‘s staff treated 29,000 patients, including performing more than 500 surgeries. They also helped rebuild hospitals and conducted medical training with local health professionals.

Operation Continuing Promise is aimed at reinforcing existing U.S. ties with Antigua, Colombia, Dominican Republic, El Salvador, Haiti, Nicaragua and Panama — and bolstering those nations’ health infrastructures. In the last three years, the Navy has launched similar “smart power” missions in East and West Africa, and the Pacific. The missions typically entail one of the Navy’s two hospital ships or three-dozen amphibious ships spending four to six months visiting poor countries to render medical, engineering and security assistance.

Most U.S. Navy smart-power missions include participants from other developed countries. Brazil, Canada, France and the Netherlands sent medical personnel to reinforce Comfort‘s American staff. Perhaps most surprisingly, the Chinese navy has requested a consultation during Comfort‘s upcoming stay in Colombia. A Chinese team will board the 70,000-ton-displacement, converted oil tanker for 10 days of training. “They’re putting together a hospital ship, and are interested in how we do our business,” explained Navy Capt. James Ware, senior doctor aboard Comfort.

Read the rest at World Politics Review.

(Photo: DoD)

Southern Comfort, Part Two: The Commodore

David Axe — Wed, 03 Jun 2009 04:37:53 +0000

by DAVID AXE

Axe: Continuing Promise is a joint and combined mission. What does each service or organization contribute?

Lineberry: We have huge capability here on Comfort [pictured -- ed.], averaging around 1,700 patient encounters ashore per day, and 25 to 30 surgeries per day, some pretty significant. We’re providing a better life for some who might not have access to that kind of care. [NGO] Project Hope has been around for 51 years, and they do this mission 24-7, 365. They were already here [in Panama], and they know the environment and help us make connections with the host-nation providers. A new part is Latter Day Saints Charities, providing some great health-care providers and educators.

Diversity is going to make an organization that much better. Ours is a combined team: Army, Air Force, Navy, Marines, Coast Guard and U.S. Public Health Service, which provides an unbelievable team of experts who do preventative medicine and education and provides veterinary services. These organizations are experts at what they do.

Our NGOs, humanitarian organizations, many of these folks have been on [the Navy's] Pacific Partnership cruise or previous [incarnations] of Continuing Promise. They do this for a living. But many of them [the individual volunteers] are not getting paid — it’s summer vacation of a sort for many of these humanitarians. It’s a great partnership with the Navy and armed forces, and adds to our already-capable force by bringing these folks who do this for a living. Project Hope: we’ve been working with them for a long time. They are around the world. Church of Latter Day Saints — they are around the world. A lot of times, Panama as an example, we had LDS Charity folks already here on the ground that serve that church, even before we arrived here — LDS Charity individuals already on the ground here working with our Advance Co-ordinating Elements setting things up for us, helping us with organizing. They know people in Colon, Panama, already, and provide translators for us, very valuable expertise. It’s a perfect team.

Axe: Has there been any resistance from any NGOs worried about a military invasion of humanitarian space?

Lineberry: I was told NGOs would be the toughest part of this, but have found them to be the easiest part, the reason being that they all have a calling in life. Their calling is they want to go out and help people. It’s so easy to get people on board, to be able to take what [Southern Command boss] Admiral James Stavridis and Southcom want us to do … to take this goodwill out to the seven countries we’re going to be visiting, and take these inviduals out to do things they want to do that we want them to do.

(Photo: DoD)

Southern Comfort, Part One: The Commodore

David Axe — Tue, 02 Jun 2009 04:17:46 +0000

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 Baltimore 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

As commodore for Operation Continuing Promise, Navy Captain Bob Lineberry, pictured with Secretary of State Hillary Clinton in Haiti, oversees the activities of around 900 humanitarians, including military and civilian doctors, nurses, veterinarians, engineers and trainers.

Axe: What’s the goal of the mission?

Lineberry: This is the third year for Continuing Promise, the second for Comfort. During there three years, we’ve gone out and done medical and engineering events in many countries. [Southern Command chief] Admiral [James] Stavridis has many goals for Continuing Promise. What the mission is doing is going down and enhancing security and stability, as a continuing mission. Primarily, it’s a medical and engineering mission, but we also do education and community-relations projects. The operation provides us an excellent opportunity for training and gaining experience, while at the same time building relations with many countries and strengthening already-strong bonds, finding new partners in countries down here. Also with this mission, we’re bringing down many NGOs and what I refer to as humanitarian organizations to help our [military] team. Over the last three years, we’ve had a huge influx of civilian humanitarian organization to help us with these missions. It’s very rewarding doing medical, dental and veterinary events out in all these countries. They’re great partners and huge fans.

Axe: How does that contribute to U.S. national security?

Lineberry: Take Panama. Comfort was here in 2007, and back here in 2009. We’ve built strong a relationship, adding on to a history and partnership here in Panama. This time, more than in 2007, we had Panamanian health-care providers working side-by-side with us, so now they have a better undertanding of what our mission is here, providing medical and dental serice to people in need. Us being here is right in line with the [U.S. national] maritime strategy, with forward presence.

Now take medical providers doing education. [In Panama] we got some excellent training in malaria [treatment and prevention]. We can take that to other parts of the world. That’s a small example of using Continuing Promise in Southcom, building partnerships, being there for our allies if they need us, when they need us. Plus, it’s hurricane season, so we’re down here planning and preparing for the next event, whatever that might be.

(Photo: DoD)