.S. naval forces perform a wide range of non-combat-related missions, including rescues at sea, transport of emergency personnel and relief supplies, and emergency medical response operations. These medical response operations have occurred both within and outside the United States, most recently in the disaster relief responses to Hurricane Katrina and the 2004 tsunami in Southeast Asia. Although the U.S. Navy has a long history of humanitarian assistance,¹ these missions are not always in response to emergencies, as most recently demonstrated by the hospital ship USNS Mercy (T-AH 19) during her five-month humanitarian assistance mission to Southeast Asia from May through September 2006.

The USNS Mercy anchored off the coast of Jolo City, Philippines, in June 2006. The Mercy’s staff assisted thousands of local citizens with medical and dental care. U.S. Navy photo by Chief Photographer’s Mate Edward G. Martens.

The USNS Mercy is home-ported in San Diego, California, while her sister ship, the USNS Comfort, is home-ported in Baltimore, Maryland. The Mercy was originally constructed as an oil tanker, the SS Worth. Although her keel was laid in 1976, conversion to a hospital ship began in 1984, and she was commissioned the USNS Mercy in 1986, the third ship in the U.S. Navy’s history with that name. She has a total patient capacity of 1,000 beds, 11 operating rooms and all the support services found in shore-based facilities, including ICU care, diagnostic and interventional radiology suites, a computed tomography scanner, main and satellite laboratories, dental, optometry, physical therapy, blood bank services and medical gas services. She also has a flight deck that can support any helicopter. (Detailed information about the USNS Mercy is available at www.mercy.navy.mil).

Local children in Tawi-Tawi, Philippines, wave goodbye to the medical staff from the USNS Mercy after a Medical and Dental Civil Action Project during Mercy’s visit to the city on a scheduled humanitarian mission, June 2006. U.S. Navy photo by Journalist Seaman Ryan Clement.

Medical staff attached to the Medical Treatment Facility aboard the USNS Mercy in August 2006 prepare for surgery during the ship’s visit to Kupang, Indonesia. U.S. Navy photo by Mass Communication Specialist 2nd Class Timothy F. Sosa.

The goal of the 2006 mission was to coordinate with host nations and nongovernmental relief organizations (NGO) to provide medical, dental and other humanitarian assistance both ashore and afloat at mission sites in the Philippines, Indonesia, Bangladesh and East Timor.² This mission exemplified cooperation and teamwork, as it joined medical assets from the U.S. Navy, Army, Air Force and Public Health Services with those of military health care professionals from Canada, India, Singapore, Australia and Malaysia. The NGOs included Project Hope, Operation Smile, Aloha Medical, the Tzu-Chi Foundation, International Relief Teams and the University of California-San Diego Pre-Dental Society.³ This was the second deployment aboard the Mercy for many who had participated in her tsunami disaster relief mission from the previous year.

The entire mission was to last five months, planning for the transit time between San Diego and Southeast Asia, the time at each of the 10 mission sites and the transit time between them. Although originally planned as a humanitarian assistance mission, a disaster relief operation was also mounted in response to the magnitude 6.3 earthquake that occurred near Yogyakarta, Indonesia, in May 2006.⁴ Experts in preventive medicine, internal medicine, family practice and pediatrics augmented the 3rd Marine Expeditionary Force’s Navy medical team while the Mercy continued her humanitarian assistance mission in Zamboanga, Philippines.

The surgical specialties aboard the Mercy included adult and pediatric general surgery, gynecology, oral/maxillofacial, plastic, orthopedic and urology. Advance teams ashore screened patients prior to their transport by either boat or helicopter. The anesthesiology department consisted of two anesthesiologists and two nurse anesthetists with augmentation from allied military and NGOs. The hospital ship’s operating rooms contained the same contemporary equipment used in shore-based U.S. Navy and civilian hospitals. The case variety included cleft lip and palette repairs, herniorraphies, thyroidectomies, myomectomies and complex orthopedic fracture repairs. In addition to life-altering surgery, the helicopter detachment’s medevac role facilitated life-saving surgeries as well.

The USNS Mercy is anchored off the coast of Tawi-Tawi, Philippines, June 2006, while providing a multitude of medical and dental care for the people who live in this region of the South Philippines. U.S. Navy photo by Chief Photographer’s Mate Edward G. Martens.

The desire to serve as many as possible, with limited time at each mission site, led to very long days in the operating rooms. Also challenging was balancing surgical complexity and recovery with the time available at a mission site. This challenge was overcome through close cooperation with the host nations and coordination with their medical teams. The Mercy team cared for more than 60,000 patients and performed more than 1,000 surgeries at mission sites in the Philippines, Indonesia, Bangladesh and East Timor. Other activities included preventative medicine surveys and inspections, repair of biomedical equipment, construction projects by the U.S. Naval Construction Force (Seabees) and health care-related education.⁵

The key to the success of this mission was the interoperability among personnel, regardless of uniform, specialty or nationality. The flexibility, communication and central focus on the mission led to team-building that facilitated a high-volume case load in an environment of patient safety, setting the standard to which future military humanitarian assistance missions will be compared.

References:
1. Siegel AB. A sampling of U.S. naval humanitarian operations. Available at www.history.navy.mil/library/online/humanitarian.htm. Accessed January 22, 2007.
2. US Pacific Fleet Public Affairs. Mercy humanitarian mission to begin. Available at www.navy.mil/search/display.asp?story_id=23226. Accessed January 22, 2007.
3. US Pacific Fleet Public Affairs. USNS Mercy visits Hawaii. Available at www.cpf.navy.mil/news_images/Mercy/news.htm. Accessed January 22, 2007.
4. Caballero J. USNS Mercy assists in quake relief. Available at www.cpf.navy.mil/news_images/Mercy/news/0605/060531a.htm. Accessed January 22, 2007.
5. 36th Wing. Andersen members return from USNS Mercy humanitarian mission. Available at www.pacaf.af.mil/news/story.asp?storyID=123026867. Accessed January 22, 2007.

Dale F. Szpisjak, M.D., Cmdr., Medical Corps, U.S. Navy, is an Assistant Professor of Anesthesiology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, and former Head, Department of Anesthesiology, USNS Mercy.