On 23 January 2010, I participated in a DOD Bloggers Roundtable with Captain Bruce Lindsey, USN, Commanding Officer of the USS Carl Vinson (CVN-70).
I asked him what advice would he give future carrier captains that find themselves responding to a natural disaster?
CAPT. LINDSEY: That’s a good question. And I think what you have to say is each one of these natural disasters is different. Although you can say that there is a humanitarian assistance, disaster relief, and that is a core competency of the United States Navy, each one of these is slightly different.
In my mind, I’ve been thinking about that, and it seems to break down into two types. One would be the hurricane-type of relief that you’d have in Katrina. The other would be this earthquake relief that we’re doing down in Haiti.
So there’s a little bit of difference there. The infrastructure is broken in both of them, is damaged very heavily. But the injuries are so severe in an earthquake, whereas I think in the hurricanes you don’t have as many injuries in that regard — the damage done to the bones and the head trauma.
So there is a little bit of difference, and so I’d say to them that you need to think about that. But really, what we do is we rely on the ingenuity of the United States sailor.
Like I said, they created this water tree, and that came from the Lincoln carrier, when they were doing Banda Ache. They had created this, and so our sailors went online, found the lessons learned, and created another one, improved it, tweaked it a little bit so, as I said, we can put out a lot of water.
So I would say that you have to be flexible. You have to have — believe in your sailors, because they’re the ones that will have the solutions to the problems that you face immediately upon arrival.
I wore my navy history hat for my other question and asked Captain Lindsey, “can you tell us where the ship was when the earthquake hit and what would you like the historians to write about the Vinson’s role?”
CAPT. LINDSEY: We had just gotten under way for our first deployment after a little over four years in the shipyard, on a complex refueling/overhaul. Got under way on 12 January.
And within 12 hours, we got the order to head south towards Mayport and onload helicopters, maintenance personnel, and as much supply as possible, and get under way eight hours later — not pulling into Mayport, but continuing on to get down here as fast as possible.
As you are well aware, a nuclear aircraft carrier has speed as its advantage. And we used that advantage, going over 30 knots the entire time, to arrive off of Haiti on Friday in the early morning, and started conducting flight operations immediately.
So I think that that is one thing I think is important, to see that the speed and then the flexibility of how we tailored the flight deck to this mission.
Full transcript here.
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On 22 January 2009, I participated in a DOD Bloggers Roundtable with the Normandy’s Commanding Officer, Captain Jeffrey Thomas Griffin, USN.
I asked him what would you want Naval history to record about the Normandy’s first nine days off the coast of Haiti?
CAPT. GRIFFIN: Well, I would say, first and foremost, that we were in what we refer to as a 24-hour readiness that’s readiness for sea, which means I have to be able to get under way no later than 24 hours. And I was pretty proud of the crew that we almost halved that, especially getting the call at 2:30 in the morning when we had to recall the entire crew and get things rolling.
So I just think maybe our response that we were under way in a little more than half of our requirement to be under way, and that just shows, you know, the can-do spirit of the American sailor and how when they’re called upon for a real-world mission like this that they do what they need to do to get the ship to sea safely.
Full transcript here.
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Christopher Munsey wrote in the 9 August 2004 edition of Navy Times an article entitled, “Navy medicine moves closer to combat zone: Hospital ships likely to retire, surgical teams head ashore in new plan to treat wounded.”
According to Munsey:
The Navy’s retiring top doc says combat medicine is better done on the battlefield than on a ship at sea.
As a result, hospital ships like Comfort and Mercy soon will be retired. And the recent trend toward smaller, more flexible and more mobile hospitals on land will continue.
Vice Adm. Michael L. Cowan, the Navy surgeon general and chief of the Bureau of Medicine and Surgery, said the most visible symbols of Navy medicine, the hospital ships Comfort and Mercy, likely will be retired in the coming years.
“They’re wonderful ships, but they’re dinosaurs,” he said.
Crewed by Military Sealift Command civilian mariners, Comfort deployed for what became Operation Iraqi Freedom in January 2003.
About 1,200 medical and support personnel from National Naval Medical Center Bethesda, Md., and other East Coast clinics staffed the Comfort’s 1,000-bed hospital last year. The ship’s hospital treated coalition wounded, prisoners of war and Iraqi civilians…
… “They were designed in the ’70s, built in the ’80s, and frankly, they’re obsolete,” Cowan said.
As an alternative to Comfort and Mercy, options are still being studied to include trauma treatment spaces aboard the Navy’s next generation of amphibious ships, he said.
The eventual move away from big hospital ships at sea is mirrored by a trend toward smaller, more flexible and more mobile hospitals on land, Cowan said.
Thank God the COMFORT and MERCY survived the cutbacks and were not prematurely retired.
The absurdity of them being labeled obsolete was dispelled less than 5 months later when the USNS MERCY was activated in response to the devastating Indian Ocean tsunami of 26 December 2004.
Moreover, according to the commanding officer of the USNS MERCY’s Medical Treatment Facility, “When the Indonesian military leader in Banda Aceh thanked Mercy there were “tears in his eyes,” proving that a “hospital ship can be the best diplomat of the 21st century.” (p. 96 of Waves of Hope: The U.S. Navy’s Response to the Tsunami in Northern Indonesia h/t Information Dissemination
Fast Forward to Haiti today. Could the Port-au-Prince airport have handled all the additonal flights needed to ferry the medical capability, personnel, and supplies etc brought to the relief mission by COMFORT? I doubt it.
By Jim Dolbow
USNI Blog has received many inquiries from medical personnel across the country interested in volunteering aboard the Navy hospital ship USNS COMFORT. We are so proud of our readers.
Please expess your interest in serving to Project Hope.
Project Hope has partnered with the U.S. Navy for over 50 years. They are currently taking applications for volunteers. Please go here to volunteer.
Project Hope rocks! I saw them in action aboard COMFORT last year. I want to go to medical school just so I can volunteer with them.
Good luck with your applications! Remember, Haiti relief operations are a marathon and not a sprint so dont despair if you are not down there next week.
Thank you. Please keep us posted.
I wrote the following in the February 2008 edition of Proceedings (pre-blog)….
Nobody asked me, but…
By Lieutenant Jim Dolbow, U.S. Coast Guard Reserve
Let’s Have a Fleet of 15 Hospital Ships
Each one of the Department of Defense’s five regional combatant commands should have three hospital ships permanently assigned to their respective areas of responsibility. Why so many, you ask?
It’s so simple that it can be summed up in two words: medical diplomacy. Former Health and Human Services Secretary Tommy Thompson (who coined that term) was right on target when he said, “medical diplomacy is the winning of hearts and minds of people in the Middle East, Asia, Africa, and elsewhere by exporting medical care, expertise, and personnel to help those who need it most.” Moreover, according to Thompson, “What better way to knock down the hatred, the barriers of ethnic and religious groups that are afraid of America, and hate America, than to offer good medical policy and good health to these countries?”
Between Secretary Thompson’s wisdom and the fact that the Navy’s two hospital ships, USNS Comfort (T-AH-20) and Mercy (T-AH-19), have proved themselves to be outstanding ambassadors of good will during their recent deployments, I say the Navy should go to the Office of Management and Budget and Capitol Hill and ask for the funds to begin laying the keels for an additional 13 hospital ships. The pros strongly outweigh the cons on this issue. For example:
•It would be a great boon for the shipbuilding industry that so desperately needs some work to remain afloat;
•There’s no shortage of hearts and minds to win in any of the regional combatant commands;
•Joint Chiefs Chairman Admiral Mike Mullen said when he was CNO that he’d hand a part of his budget to the State Department “in a heartbeat,” assuming it was spent in the right place. These additional platforms in a medical diplomacy role would remedy the need to transfer funds from DOD to bolster the diplomacy efforts of the State Department;
• The wrath of Mother Nature is not projected by the experts to lessen any time soon. Additional hospital ships would speed up the U.S. response to natural disasters around the globe, saving lives in the process. Gone would be the lengthy transit times from San Diego or Baltimore. (emphasis added)
Unfortunately, the same people who several years ago wanted to decommission both the Mercy and the Comfort have now been diagnosed with advanced bureaucratic arteriosclerosis. Besides needing some follow-up care after reading this article, they will most likely use some red herrings to argue against expanding the size of the Navy’s hospital fleet, including: money is tight, other assets could perform the same mission, and there is not enough personnel to sail them. To borrow a line from U.S. Army Brigadier General Anthony G. McAuliffe of Bastogne fame, I say “Nuts.”
First, for less than one day’s cost of the wars in both Iraq and Afghanistan, a tanker could be built and equipped to be a state-of-the-art floating medical facility. The potential dividends would be similar to the huge favorable swing in public opinion enjoyed by the United States after the Mercy’s 2005 humanitarian mission. According to Kenneth Ballen of Terror Free Tomorrow, “nationwide polls of Indonesia and Bangladesh conducted in August 2006, following the Mercy’s visit, suggest that a remarkable 85 percent of Indonesians and 95 percent of the people of Bangladesh were favorable to the Mercy’s mission.” No small feat indeed.
Second, manning the ships will not be a problem given proper recruitment and retention efforts. The new ships could sail with an expanded hybrid crew of civilian mariners, joint forces and coalition medical personnel, non-governmental organizations, and civilian volunteers to include retired military personnel. Also, instead of reducing the Navy’s end-strength as currently envisioned, some Sailors could be retrained as corpsmen. Contractors could also be hired. Headhunters could recruit plenty of doctors that would want to serve their country while at the same time getting a reprieve from insurance paperwork, TRICARE, and Medicare, etc.
“Let’s roll” by building a fleet of 15 hospital ships. We have some hearts and minds to win.
Yesterday, afternoon, I participated in the Department of Defense’s Bloggers Roundtable with CDR. Mark Marino, USN, Director of Nursing aboard USNS COMFORT (T-AH-20). My first question focused on NGOs.
Q: Can you tell us about the Comfort’s partnership with NGOs like Project Hope?
A: CDR. MARINO: Oh, sure. I’m happy to.
You know, we actually have a pretty long and significant history with partnering with a number of NGOs, not just Project Hope. On our last mission, in various forms or fashions, I believe we had easily probably 10 to 15 different partnerships going with a number of NGOs. And that might have been just either donated goods or the actual physical presence of personnel.
For this particular mission, we already have Project Hope personnel on board, and they are assessing how they can fit into the organizational structure and what specialty personnel, what specialty medical personnel they’re going to be able to bring. And I believe the goal is to slowly incorporate them — not slowly, actually pretty quickly, in the next seven days to two weeks — start incorporating the volunteers into the organizational structure.
We’ve also had feedback from Operation Smile, and there is an Operation Smile representative on board. You know, their mission has been traditionally to do cleft palate care to young children, but they have offered up surgeons and other staff to help care for our patients in other areas.
We have had — or we’ve had the Church of Latter-Day Saints reach out to us. They were partners with us on our last mission. They have — let’s see — orthopedic surgeons, emergency surgeons, general surgeons, pediatric, all the specialties in nursing, as well as ancillary services (and they have ?) respiratory technicians. And they are all willing to jump in, and they’ve got people standing by.
So hopefully in the next week to two weeks we will start rotating these people in. So again, we do have partners with us already, and they are assessing how they can fit into the organization, but in such short notice, we wanted to get our military folks up and running and on the ship, and get them in country as quickly as we could. And then we are now making arrangements to start that partnership with the various NGOs that’ll be joining us.
The COMFORT’s ability to forge partnerships with NGOs is one for the textbooks especially since, according to former President Bill Clinton, there are over 10,000 NGOs in Haiti.
According to an email I received from PROJECT HOPE, 22 pallets of donated medical supplies, valued at $177,000, have been shipped to Haiti via COMFORT.
“Just the facts, Ma’am” – Sgt. Joe Friday….
An update from the USS Bataan’s website:
USS BATAAN, At Sea – The amphibious assault ship USS Bataan (LHA-5) received two MEDEVAC helicopters at approximately 8:15 p.m. Jan. 19, with three injured Haitians receiving immediate medical care from the Bataan medical team.
U.S. Navy and Coast Guard search-and-rescue crews responded to two separate distress calls in the vicinity of Port-au-Prince, Haiti.
An MH-60S Knighthawk from Helicopter Sea Combat Squadron (HSC) 22 medically evacuated two patients with potentially life-threatening injuries just before a Coast Guard HH-65A Dolphin carrying a third patient arrived aboard Bataan.
FACT: This is 24 hours after arriving off of Port-au-Prince.
Meanwhile, the USNS COMFORT received their first patients while steaming enroute to Haiti according to Robert Little of The Baltimore Sun:
The Navy’s Baltimore-based hospital ship arrived close enough to Haiti to take aboard its first patients Tuesday night – providing urgent care to two severely injured quake victims transported from an aircraft carrier near Port-au-Prince.
Doctors were treating a 20-year-old man suffering from a spinal fracture and bleeding in the brain and a 6-year-old boy with a fractured pelvis.
The patients were brought aboard well before the ship reached its destination and hours after the crew had finished its latest round of training exercises.
I will let you decide.
By Jim Dolbow
Participated in a 1300 Bloggers Roundtable today with medical personnel aboard the USS Bataan (LHD-5).
Frustrating to say the least. The Bataan arrived last night and at the time of the roundtable some 12+ hours later (minimum), it still has not received one patient which is Bravo Sierra in my view. It has four operating rooms, 14 ICU beds, and 38 ward beds.
Given the number of people that are in desperate need of surgery, I am at a loss of words why patients weren’t brought aboard immediately.
Life is a real b**** if you survive being buried in a pile of rubble for a week only to due because of the lack of access to an operating room.
If I am wrong, tell me so.
Last night, I participated in a Department of Defense’s Bloggers Roundtable with Lieutenant General Ken Keen, commander of Joint Task Force Haiti. My Q & A follows:
Q: Can you tell us a little bit about the role of the Coast Guard in JTF Haiti?
A: GEN. KEEN: Well, like all of our services, the Coast Guard was absolutely essential. I mentioned our airmen who were instrumental in opening the airport. Well, likewise, our Coast Guard were the first aircraft seen the morning after the earthquake, and they were coming to do medical evacuations.
I mean, one of my officers was critically injured. He was standing on the fifth floor of the Montana. He found himself in the basement. He crawled out. We found him and brought him up to the ambassador’s residence, did the best we could to treat him all night. Of course, we didn’t have any real pain medication. And folks cleaned him up. But basically, he had a broken arm, some broken ribs. He had a lot of deep lacerations.
So we knew we had to do MEDEVAC, but we couldn’t do MEDEVACs that night because of safety issues. Quite frankly, we couldn’t get him to open areas where we could get the helicopters in.
So at first light, the Coast Guard had assets that were MEDEVACing folks from the embassy down by the airport because we moved them there, and we moved those individuals back to hospitals back at Guantanamo Bay.
So they showed up very quickly with some cutters as well as, obviously, aircraft. And they were flying MEDEVACs throughout that first day as we were finding folks that were hurt and injured and collecting them.
View Lt. Gen. Keen’s bio, by clicking here.
To listen to the interview live, click here.
Cross-posted over at CGBlog.org
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