Monday, March 19, 2018

Navy Wants To Deactivate Hospital Ship

The Navy operates two hospital ships:  USNS Mercy and USNS Comfort.  The Navy is planning to retire one of the two as part of the 2019 budget.  Perish the thought of cancellling an LCS but retiring a hospital ship is just fine.

ComNavOps is not a big fan of presence, deterrence, or soft power but if you’re going to conduct soft power operations a hospital ship is about the best example there is.  It’s hard to imagine a bigger positive impact than providing advanced medical care to areas of the world that lack it.

Here’s a few facts about the ships (1).

“When not in use, these ships operate with a skeleton crew. But in as little as five days, each can be converted into a 250-, 500- or 1,000-bed mobile hospital with a crew of 1,200 Navy Physicians, Nurses, Corpsmen, Technicians and support staff. These are some of the most highly trained medical personnel in the world – working together as only a Navy crew can – with the skills to handle primary, trauma, pediatric and orthopedic care. Each ship has 12 operating rooms, with specialized trauma centers and post care-unit beds included.”

Here’s a few highlights of Mercy’s career from the official Navy website (1).

USNS Mercy was built as an oil tanker, SS Worth, by National Steel and Shipbuilding Co., San Diego , in 1976. Starting in July 1984, she was renamed and converted to a hospital ship by the same company. USNS Mercy was commissioned 8 November 1986.

“On 27 February 1987 , MERCY began a training and humanitarian cruise to the Phillippines and the South Pacific. The staff included U.S. Navy, Army, and Air Force active duty and reserve personnel; U.S. Public Health service; medical providers from the Armed Forces of the Philippines; and MSC civilian mariners. Over 62,000 outpatients and almost 1,000 inpatients were treated at seven Philippine and South pacific ports. MERCY returned to Oakland, CA , on 13 July 1987.”

“On 9 August 1990 , MERCY was activated in support of Operation Desert Shield. Departing on 15 August, she arrived in the Arabian Gulf on 15 September. For the next six months, MERCY provided support to the multinational allied forces. She admitted 690 patients and performed almost 300 surgeries. After treating the 21 American and two Italian repatriated prisoners of war, she departed for home on 16 March 1991 , arriving in Oakland on 23 April. USNS MERCY is currently homeported in San Diego, California.”

USNS Comfort, like Mercy, was built as a sister oil tanker and converted to a hospital ship.  Comfort is based out of Norfolk and has had a career similar to Mercy.

USNS Mercy


The Navy will do anything to keep building worthless LCS vessels but a ship that actually helps people and enhances America’s reputation is going to be retired.  Where’s the logic?

We’ve all but officially acknowledged that war with China is coming.  Do we think there won’t be casualties and lots of them?  Hospital ships will be desperately needed – the LCS won’t be.  So, which one are we cutting?

The Navy has an endless string of bad decisions and this is the latest and one of the most egregious.



___________________________________




23 comments:

  1. This is just the latest in a long line of dumb stupid decision-making from the top brass unbelievable

    ReplyDelete
  2. While I don't disagree with you on the optics, I would suggest it might not be as bad as we think.

    Having been part of several relief situations in the military and civilian work the amount of, "Good press" we get for this type of work is smaller than we think and not very lasting to the community as a whole. Sort of a what have you done for me lately idea.

    What I read was that the Mercy was not being retired but inactivated for half the year. If that is true then do we have an agreement with other western nations that they will send their white ship with a cross? If so I suggest that seeing the ship is the same for western nations no matter the accent of the doctors.

    Another mitigating factor with most disasters the ship can't act alone. It often requires a military presence for the first phase of the relief. I suspect most disaster can and for the first phase must be handled totally with the operating rooms on the Amphib or carrier. During that phase it is just as easy to build a field hospital than it is to wait for the hospital ship.

    What happens when the hospital ship arrives is that the worst cases get sent there and the rest have been handled. Ultimately for many operations the hospital ship has too much capacity and by the time it is up and running is not really needed.

    ReplyDelete
    Replies
    1. You may be missing the most useful aspect of the hospital ship as well as the military use.

      1. We need hospital ships to support combat. War is coming with one or more of Iran, NKorea, Russia, or China. It's inevitable and just a matter of when, not if.

      2. The soft power value of a hospital ship is not during disaster relief. As you correctly point out, barring pure, dumb luck the hospital ship is never going to be near enough to a disaster to make much difference. Plus, a disaster needs food and infrastructure aid more than advanced medical care. I would not even attempt to send a hospital ship to perform relief missions unless it just happened to be very near and there was a demonstrated need for large scale, advanced medical support.

      The soft power value of a hospital ship lies with scheduled port visits to countries lacking advanced medical care. During a four week stay, a hospital ship can treat thousands of cases of serious ailments. Those people will never forget that assistance. That's soft power that is effective.

      While there are certainly optics associated with this, and they look bad, the actual value produced for the dollars spent is the real issue and a hospital ship, used as I described, is a far better value than yet another LCS that has no value.

      Delete
  3. According to Wikki, the LHD's are second to the hospital ships for medical facilities. There were two in the Caribbean for disaster relief after the hurricanes.The USNS Comfort was sent to Puerto Rico as well.
    So the question is what is the Navy's plan to replace the dedicated hospital ship ?
    Paul

    ReplyDelete
    Replies
    1. Agree with you on the "soft power" aspects of the hospital ships. Congress should weigh in on this issue. The hospital ship has more value than the LCS.

      Delete
  4. Instead of asking why they want to deactivate a hospital ship, ask them why they are not planing to build a new one as a replacement?

    ReplyDelete
  5. Mercy and Comfort are too large for what we need. Too much capacity in two ships. They can only berth at deep water ports.

    We need either more numerous, smaller ships, or modular facilities that we can preposition forward and can load onto commercial or amphibious ships. Such modular hospitals can be offloaded in theater and moved closer to where they're needed.



    ReplyDelete
    Replies
    1. "Too much capacity in two ships."

      ????? Do you have any idea how many casualties we'll have in a real war? There won't be nearly enough room.

      Hospitals are big for a reason and that reason is efficiency. If you break up a large hospital then you need ten times as many doctors, nurses, techs, MRI's, X-Rays, and everything else. Plus, a large hospital ensures that the required specialist is available.

      What you're describing is not a hospital ship but an initial aid station where casualties are stabilized (the M.A.S.H. of the Korean war) and then shipped to real hospital ships. Nothing wrong with that.

      Delete
  6. There seems to be some push back from lawmakers and even the head of the United States Transportation Command, Air Force General Darren McDew.

    From the Navy Times, “I’m a big fan of hospital ships, because I love the fact that we can help injured and ill members,” said McDew. “But I’ll tell you, for every one hospital ship we’re short, we’re going to have a requirement for 479 air-refueling tankers.”

    I don't know where he comes up with 479 air-refueling tankers, but it looks like he is against the cutback.

    https://www.navytimes.com/news/your-navy/2018/03/16/lawmakers-criticize-navys-plan-to-retire-one-of-two-hospital-ships/

    ReplyDelete
  7. While your basic premise of hospital ship vs. LCS as an argument is morally correct but there are significant issues with the way those hospital ships have been used and manned (crew/med facilities) over the past 30-40 years. Its always hard to maintain a logistics capability "in case emergency (war)" in a "turnkey, just in time world". They have consistently showed up late...If we do continue w/Hospital ships it must be done smarter and jointly- the other services should help fund, too.

    b2

    ReplyDelete
    Replies
    1. I'm not sure what specific problems you see with the way hospital ships have been used. Enlighten me.

      The ships are not constantly in use. They have alternated between "idled" with a skeleton crew and full operation. That seems perfectly reasonable to me. We use them when we have a need and idle them when we don't. I would imagine one deployment a year per ship to maintain expertise would be sufficient. That maintains the capability and minimizes the operating costs.

      Bear in mind that I do not see disaster relief as a valid or useful mission for the military in general and hospital ships, in particular.

      Delete
    2. "While your basic premise of hospital ship vs. LCS as an argument is morally correct "

      That's not actually my premise. The premise is that retiring a useful hospital ship while continuing expenditures for far less useful ships, aircraft, weapons, and systems is a continuation of the Navy's seemingly endless string of amazingly poor decisions. The LCS was simply one comparative example.

      Further, it's not the moral aspect that bothers me but the value (benefit for dollars spent) aspect and, again, the LCS simply served as a convenient example of dropping good value (the hospital ship) while maintaining poor value (the LCS).

      Delete
  8. Gaahh, I am getting old. I was in San Diego when they were launched as tankers. Then, later I was back in San Diego when they were converted.
    Don't really know if a hospital ship this size is really needed. Maybe something in a new build LPD-17 class converted. Or even smaller.
    The Mercy and Comfort have around as ships for 40 some years. I would bet that mechanical things are coming to the end of their lives. These two have not been sailing on the Great Lakes where the fresh water makes it is possible to keep a ship is good shape far longer than a salty. Probably the hospital side could do with remodeling / remaking too.

    ReplyDelete
    Replies
    1. You make good points for replacing the ships but not for permanently retiring them as the Navy appears to want to do.

      I'm surprised the Army/Marines haven't chimed in about this since, in a war, they'll be the main beneficiaries.

      Delete
  9. The advantage of a hospital ship is huge, both for foreign disaster relief, and more importantly for U.S. civil defense, and treatment of citizens during a domestic disaster. The latter point cannot be understated as the number of U.S. emergency rooms, and by default number of trauma centers, are eliminated and consolidated due to a range of factors. Consider the value of a hospital ship following a major earthquake on the West Coast, or hurricanes and floods on the East Coast, or in the Gulf.

    Recall that a hospital ship is a self-contained equivalent to a major hospital and trauma center (level 3 if I recall), and apart from not placing demands on infrastructure, it brings a heliport, communications, electricity, and potable water to the scene.

    The cost of a container ship modified into a hospital is nothing compared to a warship. We could buy a new base hull, with 25-30 knot capability for well under $200 million, adding a flight deck and equipping a trauma center would be pricey, but the total price could be had for ~$400 million. Medical personnel could be assigned when required (or reservists mobilized) along with FEMA, USAID, air detachments, Seabees, and so forth, but the base crew should be less than 40.

    I could justify four modern hospital ships, loaded with medical supplies, disaster relief supplies, a Seabee battalion worth of heavy equipment, and CBRNE gear just for U.S. civil defense and national disaster preparedness. If we wanted to deploy them occasionally I would push for six. Surely this is worth several LCSs as CNO pointed out.

    On foreign benefits, I have seen the diplomatic power of a couple of dozen Medical Deployment Exercise (MEDRETE) teams of U.S. military doctors, nurses, and dentists treating people in El Salvador, and Honduras. These MEDRETE deployments provided everything from inoculations to life changing (good sense) surgical procedures for upwards of 30,000 people each deployment. That included working with USAID, as well as foreign civil and military health agencies.

    GAB

    ReplyDelete
  10. IIRC neither of these ships were sent to West Africa when there was the ebola epidemic. Instead, a super-inefficient (personnel to patient bed ratio) presence on land was established IIRC.

    I wonder if maybe these ships lack the preparations to deal with infectious plagues (capacity to sterilise equipment, sterilisation of air in ventilation system, quarantine rooms).

    I read a lot about the 'flying hospital' aircraft of the USAF, hardly ever of any use of those hospital ships.

    ReplyDelete
    Replies
    1. Yeah, I wondered about that, too. All I can figure is that hospital ships are set up for trauma as opposed to infectious disease control, as you pointed out, and would not have been appropriate for the task. Or, maybe the main effort was so far in shore that a hospital ship would not have been useful? I have no idea.

      Good question. Sorry I don't have an answer.

      Delete
    2. The two USN hospital ships are operated by MSC and have been active, mostly in the Pacific rim, and in Latin America. They have the sterilization facilities (they operate a 12-bay OR), I suspect the issue is they offer too much capacity, rather than too little, and because the ships are not assigned medical staff on a day to day basis, it requires a major effort to collect medical staff together to deploy them. Most of the readily deployable USN medical corps are assigned to FMF units, and we know how the USMC can be about giving up assets...

      The Navy, perhaps stupidly, has not made it a policy of advertising their employment, nonetheless, the ships are, or should be, a key element of U.S. civil defense. There is no capability like a floating hospital. Look at the population sizes of major U.S. cities, and then look at how many are on coasts.

      The USAF and USA medical assets are wonderful and do great work, but the handful of USAF medical transport aircraft are really a luxury in the face of a major war, or a no notice disaster (1906 San Francisco earthquake).


      If the Navy were a bit more Joint, and had more imagination to invite USAF, USA, National Guard, Canadian and Mexican military medical staff, NGOs like the Red Cross, Doctors without Borders, etc. to train/deploy with the ships, it could create a powerful tool to respond to calamity.

      GAB

      Delete
  11. The problem with these hospital ships is that their existence gives the powers-that-be a justification to deploy them. The Navy is supposed to fight wars and protect sea lanes. The Navy is not in the global health care business. Nor is it the Navy's job to "provide relief." If we need to deploy hospital ships to win hearts and minds, we have already lost.

    ReplyDelete
    Replies
    1. Of course, there's always the rationale that we're Americans and we just like to help people!

      Delete
  12. And of course, the Chinese are now doing this and would therefore we would be allowing their influence to spread further without counter. https://en.wikipedia.org/wiki/Type_920_hospital_ship

    ReplyDelete
    Replies
    1. Exactly. We'll be pulling back from the world stage and the Chinese will be further expanding their sphere of influence and making inroads in Africa and elsewhere.

      Excellent observation.

      Delete
  13. What we are seeing is the possible realization that murica does not have enough money to pay for procurement / maintenance after the "administration fees" are paid and the half hearted attempts to scale back operations without appearing to be doing so.

    I believe that the US Navy operates such large hospital ships because of the need for 2 possible expeditionary operations in enemy territory.

    ReplyDelete

Comments will be moderated for posts older than 30 days in order to reduce spam.