Medical Diplomacy, A Coast Guard Mission?

National Defense Magazine publishes the next contribution to the medical diplomacy discussion, but this time it comes from a rather unique point of view. A pair of bloggers, Craig Hooper and Jim Dolbow (ok so maybe they both have real jobs) come together and look at medical diplomacy as a role for the Coast Guard. This is a very clever idea.

A future hospital ship should be tied into some sort of modularized container system that may mirror the modules used by the Navy’s Littoral Combat Ship. A ship that might be charged with high-tempo combat trauma care will need a flat deck that is able to withstand the heat and weight of large helicopters. A well deck also would be recommended, although it could be passed over if the ship is able to dock or maintains an organic docking system.

Under a two-tier system, smaller, cheaper ambulance-like platforms could work in tandem with a larger, more expensive command-and-control “trauma” platform or aid ship tenders where the crew of a smaller, low-endurance craft can take a breather or swap out crews.

A Coast Guard modular mothership as a hospital ship? There is a lot to like here, and give credit to Jim Dolbow for building upon his discussion of the same topic earlier this year. When I read the National Defense Magazine article, I was reminded almost immediately of something Lee Whaler had sent me earlier this year, a PDF by Steve Douglas put out in 2005. The concepts Steve Douglas discussed dealt with a modular emergency medical capability for HSVs, but if you look at what was put out there, you might observe a gross amount of inefficiency in the concept as presented.

However, in the process the PDF does a very good job of is highlighting how the Germans have applied the modular medical bay concept to their Berlin class replenishment ships. It is very impressive and would fit very well within the medical sea base concept promoted Craig Hooper and Jim Dolbow. If the Coast Guard was able to build something like that into the T-AKE hull, and find a way to offload the modules onto a ship-to-shore connector, one would essentially have a disaster response ship for both foreign and domestic use. One of the engineering challenges would be to create power interfaces that can support the modules either on ship or when moved to land, and deployable generators for rapid offload to shore with the modular containers.

Is the Coast Guard the appropriate service for hospital ships? Hard to say, there is legitimate debate space here. I go back to something I read by Captain Bob of the USNS Mercy (T-AH 19), who made it clear that unarmed commercial designs run by the MSC is the best model in his opinion, because the ships do not get associated with a national military capability rather from a perception of a national humanitarian capability. That is not a trivial thing if true, because shaping perception is a major part of the purpose of medical diplomacy.

That doesn't mean the Coast Guard shouldn't have hospital ships though, indeed the Great While Fleet of hospital ships is an idea whose time has come for serious consideration and discussion in my opinion, and credit both authors for pushing the conversation forward and introducing new and interesting aspects of the medical diplomacy buzz.

Also check out Christopher Albon's take on the article at War and Health.

H/T: Matt Armstrong