For those that do not know, I currently live in South Africa. For the last three weeks, the country has experienced a strike of 1.3 million government workers, including nurses and hospital workers. The effect on the public health care system has been devastating. Since the strike started, all government hospitals are either closed or barely functioning. Furthermore, newborn patients in intensive care units were abandoned by their nurses and one non-striking nurse was beaten and stabbed by protestors. There is no end to the strike in sight.
In response, the South African government deployed its health workers of last resort: the military. The South African Military Health Service (which interestingly is its own branch of the South African military) has sent medical personnel to 37 hospitals around the country. These military doctors and health workers are charged with keeping at least some public emergency services open. This is not the first time a nation has relied on the military to provide health service during strikes. In February, Nigeria deployed Army and Air Force doctors and nurses during a state hospital strike. While far from ideal, the world’s militaries provide a valuable but under-recognized service as the health care providers of last resort.
Christopher R. Albon is a political science Ph.D. specializing in armed conflict, public health, human security, and health diplomacy.
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Depends on context. When deployed internally, a crisis point has been reached and military health professionals (MHP) are indeed last resort. Under normal circumstances, the market or civil service address the health requirements of a population. Under extraordinary circumstances, MHP’s — who are trained to keep armies on their feet and marching forward — can be turned to.
As you and Dr. Cooper recently observed, the U.S. has been effectively using it’s “excess” MHP capacity in support of activities like Operation Continuing Promises (OCP), which takes healthcare to places in need using our USNS hospital ships. Showing this side of the United States turns MHP’s into our providers of first resort and a front line of defense. Small efforts like OCP can help foster conditions that build trust and mitigate those circumstances that breed disease, poverty and future conflict. Wish we could do more of it. From a Navy perspective, we’re looking at how can better configure our force and ensure our people are trained to deal with irregular challenges that include humanitarian assistance and disaster recovery.
Excellent points, Scott.
But, we must be conscious that it is not simply that we use our excess capacity, but how we use it. Like everything else, activities like OCP aren’t a silver bullet. We have to continue to figure out what we want from these activities, and how best to achieve them.
Wholly agree with the “how” being more important than just doing, and it’s part of the calculus when float plans are made. I don’t think anyone considers OCP (or similar) a silver bullet. It will take continuous missions, making return visits over a period of years if not decades to make a real and lasting impact. It’s easy to see the cause and effect when we send boatloads of Marines out to retake a vessel under pirate control. We can justify that expense. It’s harder to justify the soft power missions like medical deployments because there isn’t an immediate result. With consistent engagements like OCP, Africa Partnership Station and Pacific Partnership over a long period of time, we may mitigate those conditions that encourage piracy or domestic unrest. It’s hard for to shift the war-fighting paradigm. Docs and nurses are really special forces, who scout out and combat the poor health conditions and high mortality rates that lead to social breakdown and external conflict. SEALS and Marines solve problems in the terminal phase. The medical profession can be key to addressing national security challenges before they exist, by influencing the health and welfare of people.
Exactly. Soft power is about relationships, and relationships take time and many, many interactions to develop.
The reward comes when civil unrest threatens to occur in a country, but the US is able to avert armed conflict by using relationships developed over years of soft power missions in the region.
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