We have some smart readers at War & Health and this has never been so clearly demonstrated than in the last few days. Early in the week, I briefly discussed a proposal to add hospital ships to the US Coast Guard. Over the next few days I received counter-arguments in the comments section and over email from a number of highly experienced and knowledgeable readers. The primary counterclaim is that the USCG is grossly undermanned to crew one, let alone many, hospital ships. Two great comments from TEJ and Leesea summarize the problem:
TEJ Writes:
CG only has a dozen or so physician assistants. The 50 or so medical officers, 50 or so dental officers, and dozen or so pharmacists are all detailed from the US Public Health Service. All the CG nurses are civilians. The USCGR has no medical, dental, pharmacy, or nurse officers. Even the CG Auxilliary has let die on the vine its limited medical officer program. The US Navy, with its huge medical, nurse, medical service, etc. corps has difficulty apring enough practitioners to field these missions. I don’t see how the CG could do it. You can’t inflate their (borrowed) medical, dental, nurse, medical service corps by 200% just to be able to surge them out every other summer. Besides, the creation of DHS has stretched the CG thin with LE missions, they are not in the market for an additional non-core mission.
Leesea Writes:
As someone who helped introduce the Hospital Ships to MSC, I think I can say conclusively that the USCG is completely under manned and not set up to operate them. What the authors fail to appreciate is that the crew alone on these ships ranges from 25 in ROS to 125 CIVMARs in FOS. The Medical Treatment Facility aka hospital, ranges from 40 to 1200. The MSC provides all the ship’s crew while large MTF/Hospitals and the naval reserves provides all the needed medical and support personnel. The USCG & PHS are simply NOT sized or structured for T-AH operations.
I cannot speak for the authors, but I (personally) never envisioned Coast Guard medical personnel manning the hospital ships. Rather, the Coast Guard would be charged with coordinating the operation and operating the ships, while the mission’s medical personnel (riders) would be drawn from all branches of the armed forces, allied states, and partner NGOs. This mixed medical staff has already been tried with success on the USS Boxer and USS Kearsarge. To be clear, I am not claiming the USCG is better suited than the Navy for health diplomacy, in fact I discussed the Navy’s role in health diplomacy just last week. Rather, I am interested in debating the relative merits and challenges faced by employing different institutions in health diplomacy.
Christopher R. Albon is a political science Ph.D. specializing in armed conflict, public health, human security, and health diplomacy.
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{ 2 comments }
Sir
CG would be able to spare the machinist mates, boatswain’s mates, damage controlmen, etc. to man a hull or two, but unless you build it on an existing CG platform you would need new ‘C’ schools and training pipelines; new maintenance infrastructure including supply chain, forecasted dockside availabilities, etc; career paths for sailors leading in and out of these units; doctrine to guide a mission very different from most of what they do; etc.
Of course these are not insurmountable obstacles, but my point is that CG is doing it now with the National Security Cutter and Response Boat Medium; will have to do it again with the Fast Response Cutter and Offshore Patrol Cutter; will do much of the same with new fixed- and rotary-wing assets; and also for any new polar rollers that come down the pike. That’s a lot for a small service to digest.
Over the last few and next few years the CG is integrating many new core and non-core missions and platforms. I don’t see something as extraneous as a hospital ship being a higher priority than what’s already in play.
Concerns about about where the people will come from and the CG’s ability to execute new missions are both canards in my book. Take World War II as an example. On 7 December 1941, the CG had 29,000 personnel. Less than 4 years later, it ranks swelled to over 175,000 plus new missions like ASW and operating landing craft. More importantly, just because it is a CG hospital ship, it’s medical personnel don’t have to wear CG blue. As pointed out in the article, the docs could be civilians, contractors, from the other 4 service branches, coalition personnel.
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