Tag Archives: hospital ship

USNS Comfort’s Latest Humanitarian Mission Throughout Latin America

The Southern Tide

Written by W. Alejandro Sanchez, The Southern Tide addresses maritime security issues throughout Latin America and the Caribbean. It discusses the challenges regional navies face including limited defense budgets, inter-state tensions, and transnational crimes. It also examines how these challenges influence current and future defense strategies, platform acquisitions, and relations with global powers.

“My plain and simple message to our friends in the region is ‘the United States is a reliable and trustworthy security partner….Latin America and the Caribbean are not our backyard. It’s our shared neighborhood… And like the neighborhood … where I grew up, good neighbors respect each other’s sovereignty, treat each other as equal partners with respect, and commit to a strong neighborhood watch.”  Vice Admiral Craig Faller, USN,  before the Senate Armed Forces Committee, Sep. 25, 2018. 

By W. Alejandro Sanchez

Introduction

USNS Comfort (T-AH-20) has finished another deployment to the Western Hemisphere as part of the Enduring Promise initiative. The U.S. hospital ship’s latest tour took it to Colombia, Ecuador, Honduras, and Peru where it provided free medical assistance to thousands of individuals in need. This is an example of medical diplomacy at work and a great initiative to improve U.S.-Latin American relations at a time when more cohesion among governments in the Western Hemisphere is needed.

Current Deployment

Comfort is a large vessel, with a length of 894 feet and a beam of 105 feet, the same as its sister ship, USNS Mercy (T-AH-19) – the two are converted San Clemente-class super tankers. According to the U.S. Navy, each platform “contain[s] 12 fully-equipped operating rooms, a 1,000 bed hospital facility, digital radiological services, a medical laboratory, a pharmacy, an optometry lab, a CAT-scan and two oxygen producing plants,” along with helicopter decks. Hence, the vessel is able to provide for vast numbers of patients simultaneously with different services. The vessel’s most recent tour, the sixth time that it has been deployed to the region, lasted 11 weeks.

Comfort was well-received by the local populations. For example, the vessel was in the city of Esmeraldas, Ecuador, from 22-26 October. According to the Ecuadorian Ministry of Defense the medical staff attended between 500-750 per day, while a Southern Command press release stated that “Comfort has treated more than 4,000 patients, including nearly 2,500 medical patients, 1,100 optometry patients, 450 dental patients, and performed 81 surgeries.” An Ecuadorian ministry press release explained “The arrival of the vessel is part of the strengthening of defense relations between Ecuador and the USA.”

Comfort then traveled to Paita, in northern Peru, where it treated over 5,000 patients, according to the Peruvian government. The U.S. hospital ship also donated wheelchairs and medical supplies. The Peruvian government noted that this is the third time that Comfort has visited Peru, in 2011 it provided medical assistance to 7,352 patients, and in 2007, it aided 9,223 Peruvian citizens.

TRUJILLO, Honduras (Dec. 10, 2018) – Hospitalman Eric Trybus, from Oklahoma City, Okla., helps a patient walk to a medical station to receive treatment at one of two medical sites. (U.S. Navy photo by Mass Communication Specialist Seaman J. Keith Wilson/Released)

The vessel’s stops in Colombia and Honduras had similarly positive results. In Colombia, the U.S. hospital ship docked in Turbo (Antioquia) and then Riohacha (La Guajira), with the local government estimating that some 7,400 patients were treated by Comfort’s medical staff. As a final point, it is worth noting that the citizens of these nations were not the only ones to receive treatment aboard Comfort. Case in point, while in Colombia medical personnel also helped Venezuelan migrants who have settled in Riohacha as they flee the political and socio-economic crisis in their homeland.

Discussion 

Enduring Promise is an example of a medical diplomacy initiative that helps promote a positive image of the U.S. In this case, the people that were helped by Comfort, along with their families and other loved ones, will likely now have a more positive view of the U.S. and its military due to the free and professional medical services they received. An indigenous person from the Wayuu ethnic community in Colombia described Comfort’s visit as a “blessing from God” as it helped vulnerable communities, peasants, and Venezuelan migrants, according to Colombia’s daily El Nacional. Even more, governments also get a load taken off their shoulders, as Comfort provided services that local medical services could not offer, or were too financially costly for families to afford. For the U.S. and its partners, this was a win-win situation.

One important fact to mention is that Comfort visited Ecuador. A few years ago, when former President Rafael Correa was in power, this trip would have been unthinkable, as the former South American leader was known for his anti-U.S. sentiments. He famously expelled the U.S. military from its base in Manta, in 2009, and he was a close ally of the late-Venezuelan leader Hugo Chavez.

Nevertheless, President Lenin Moreno has carried out a complete turnaround to Ecuador’s foreign policy by rapproaching the U.S. In recent months, the Ecuadorian Esmeraldas-class corvette BAE Los Ríos (CM 13) participated in the U.S.-sponsored UNITAS multinational exercise in Colombia, personnel from the U.S. Naval Small Craft Instruction and Technical Training School visited the South American country, and Defense Minister Oswaldo Jarrin has visited the headquarters of U.S. Southern Command. Comfort’s visit, thus, is the proverbial cherry on top of the cake of improving bilateral relations.

As for Honduras, the visit is likewise significant as a caravan of Central American migrants, mostly Hondurans, is attempting to enter the U.S. as they escape poverty and violence in their homeland. Comfort’s visit to the Central American state is an example of SOUTHCOM and the U.S. Navy providing humanitarian aid to Hondurans in need, irrespective of the rhetoric coming out of Washington lately. Hence, it is refreshing to read SOUTHCOM’s 25 October communique, which explains that “the embarked medical team will provide care on board and at land-based medical sites, helping to relieve pressure on national medical systems caused partly by an increase in cross-border migrants. The deployment reflects the United States’ enduring promise of friendship, partnership and solidarity with the Americas.”

China’s Peace Ark 

As a caveat to this analysis, it is necessary to mention China’s hospital ship, Peace Ark. In a previous CIMSEC commentary, “The Significance of U.S. and Chinese Hospital Ship Deployments to Latin America,” the author discussed how both Washington and Beijing utilize their hospital vessels as diplomatic tools in order to improve their image in countries that said ships visit during their humanitarian tours. As it turns out, both ships would be deployed simultaneously to the Western Hemisphere. While Comfort visited the aforementioned nations, Peace Ark visited Antigua and Barbuda, Dominica, the Dominican Republic, Grenada, and Venezuela. Even more, on 15 November the Ecuadorian Ministry of Defense announced that the vessel had docked in Guayaquil to provide medical assistance to as many as 3,200 patients.

While governments are free to decide which vessels from foreign powers can enter their ports, it is impossible to avoid the irony that the hospital vessels of two nations that continue to be at odds with each other, from trade wars to incidents in Asian waters, are back-to-back welcomed in the territory of third-party states. As a result, Ecuadorians living in the Esmeraldas and Guayaquil regions enjoyed free medical services from two rival powers, while Quito maintains good relations with both nations.

Final Thoughts 

Medical diplomacy is an effective way to improve bilateral ties between the U.S. and its Latin American allies. Comfort’s visit to four Latin American nations, Colombia, Ecuador, Honduras, and Peru will improve the U.S. image at the grassroot level, as the citizens of these nations that received free and professional medical service will know that, irrespective of the current rhetoric coming out of Washington, U.S. medical personnel are still there to help those in need.

Wilder Alejandro Sanchez is a researcher who focuses on geopolitical, military and cyber security issues in the Western Hemisphere. Follow him on Twitter: @W_Alex_Sanchez.

The views expressed in this article are those of the author alone and do not necessarily reflect those of any institutions with which the author is associated.

Featured Image: TRUJILLO, Honduras (Dec. 6, 2018) – The hospital ship USNS Comfort (T-AH 20) is anchored off the coast of Honduras as part of an 11-week medical support mission to Central and South America as part of U.S. Southern Command’s Enduring Promise initiative. (U.S. Navy photo by Mass Communication Specialist 1st Class Scott Bigley) 

The Significance of U.S. and Chinese Hospital Ship Deployments to Latin America

The Southern Tide

Written by W. Alejandro Sanchez, The Southern Tide addresses maritime security issues throughout Latin America and the Caribbean. It discusses the challenges regional navies face including limited defense budgets, inter-state tensions, and transnational crimes. It also examines how these challenges influence current and future defense strategies, platform acquisitions, and relations with global powers.

“The security environment in Latin America and the Caribbean is characterized by complex, diverse, and non-traditional challenges to U.S. interests.” Admiral Kurt W. Tidd, Commander, U.S. Southern Command, before the 114th Congress Senate Armed Services Committee, 10 March 2016.

By W. Alejandro Sanchez

USNS Comfort (T-AH-20) has become a regular visitor of Latin American and Caribbean waters as it often carries out humanitarian operations in those regions. Mostly recently, it was deployed to Puerto Rico to assist those affected by Hurricane Maria. Furthermore, there is now an extra-regional hospital ship which is also traveling to these areas, namely China’s Peace Ark (866 Daishan Dao), a Type 920 hospital ship that is operated by the People’s Liberation Army Navy. Given that the governments these two platforms belong to are experiencing growing national security tensions it is necessary to discuss their activities and put this medical diplomacy in its proper geopolitical context.

This commentary is a continuation of an essay that the author drafted for CIMSEC titled “The uses of the U.S. Navy’s Fourth Fleet;” and draws from an analysis by CAPT John C. Devlin (ret.) and CDR John J. Devlin titled “Aligning HA/DR Mission Parameters with U.S. Navy Maritime Strategy.”

USNS Comfort

We will not supply an exhaustive list of Comfort’s operations throughout Latin America and the Caribbean, but will rather provide some highlights. Most recently, as previously mentioned, Comfort was deployed to Puerto Rico to assist those in need after Hurricane Maria hit the island. The vessel also traveled to Haiti after the 2010 earthquake to assist with the relief and support efforts as part of Operation Unified Response.

Additionally, Comfort has been deployed to the region as part of initiatives like the Partnership for the Americas and Operation Continuing Promise. Countries that were visited during these voyages include Colombia, Dominica, Ecuador, El Salvador, Honduras, Jamaica, Peru, among others.

USNS Comfort (T-AH 20) (U.S. Navy photo)

It is worth noting that Comfort is a large vessel, with a length of 894 feet and a beam of 105 feet, the same as its sister ship, USNS Mercy (T-AH-19) – the two are converted San Clemente-class super tankers. According to the U.S. Navy,  each platform “contain[s] 12 fully-equipped operating rooms, a 1,000 bed hospital facility, digital radiological services, a medical laboratory, a pharmacy, an optometry lab, a CAT-scan and two oxygen producing plants,” along with helicopter decks. Hence, the vessel is able to provide for vast numbers of patients simultaneously with different services. For example, according to the magazine Dialogo, some 19,000 patients were treated by Comfort personnel when the vessel docked in Belize and Guatemala as part of Continuing Promise 2015.

Peace Ark

As for Peace Ark, the Chinese vessel is newer than Comfort, as the former was commissioned in 2008 while the latter was commissioned in 1987 – a two decade difference. The newer vessel reportedly measures 583 feet in length and displaces 10,000 tons fully loaded, and fields a Z-9 helicopter. It also has 300 beds for patients, eight operating rooms and 20 intensive care units. When deployed, its crew is made up of up to 328 plus 100 medical personnel.

In a 2014 article by USNI News, Peace Ark’s Senior Captain Sun Tao declared, “other than internal organ transplant …or any kind of heart disease treatment, [Peace Ark] can pretty much do any kind of treatment.” The article goes on to note that “This includes, perhaps not surprisingly, traditional Chinese medicine. A room onboard Peace Ark is specifically reserved for the ancient therapies of cupping, massage, and acupuncture.” 

Medical workers treat mock wounded people during an exercise aboard the Chinese navy hospital ship Peace Ark Sept. 15, 2010. The ship on Wednesday arrived in the Gulf of Aden to provide medical service for the Chinese escort fleet, as its first overseas medical mission. (Xinhua/Zha Chunming)

Because the Chinese vessel has also been deployed throughout Asia and Africa in the last decade, Peace Ark has traveled significantly fewer times than Comfort to Latin America and the Caribbean. Its first tour was “Harmonious Mission 2011, a 105 day trip in which the platform visited Costa Rica, Cuba, Jamaica, and Trinidad and Tobago. The platform returned to the region in 2015, visiting countries like Barbados, Mexico, and Peru.

Significance

At a local level, the arrivals of these vessels are a welcomed development as they provide medical services that local populations may not be able to obtain otherwise from their local governments. Thus, it probably matters very little to the inhabitants of these areas whether a hospital ship flies either a U.S. or Chinese flag, as long as they provide health services that are needed. Indeed, articles published by Latin American and Caribbean media outlets that reported visits by either Comfort or Peace Ark included generally positive statements by local authorities and patients.

At a geopolitical level, these hospital ships carry out humanitarian assistance and disaster relief operations (HA/DR) that are in line with their respective navy’s overall strategies of aiding populations in need. Moreover, and unsurprisingly, these visits help to boost up the image of the nation deploying the platform in the eyes of the hosting government and population. For example, a 2011 article by Mercopress that discussed Peace Ark’s arrival to Jamaica had the following statement “the mission is part of a global campaign by Beijing to portray its rapidly growing military as a responsible power.” Similarly, the aforementioned CIMSEC article states that HA/DR operations “are a vital part of U.S. Navy maritime strategy by ensuring regional stability through building partner nation capacity and expanding our sphere of influence.”

While an exhaustive analysis of each nation that Comfort visits is beyond the objectives of this commentary, it is worth noting that the countries it regularly visits are those that the U.S. has good relations with, though there has been one notable exception. In 2011 Comfort docked in Manta, Ecuador: this is was a significant visit as then-President Rafael Correa was known for his anti-Washington rhetoric and for having ordered the shutdown of the U.S. military facilities in Ecuador in 2009. Thus, it is somewhat bizarre that President Correa would authorize a (unarmed) U.S. ship to enter his country’s territorial waters. It would be interesting if the government of Venezuela would similarly allow Comfort to dock in Venezuela’s coast, given the problematic situation of the country’s health system. Nevertheless, the tense bilateral relations make it highly unlikely that Caracas would authorize such a visit, or that Washington would offer it in the first place.

Moreover, as far as the author can determine, Peace Ark has only visited countries whose governments recognize the People’s Republic of China and not the Republic of China (ROC/Taiwan). It will important to monitor if future Peace Ark deployments include countries that still maintain relations with Taipei, as Beijing may be looking to obtain the recognition of Taiwan’s last remaining allies in the region – the latest nation to switch sides was Panama in mid-2017.

Ultimately, setting aside the geopolitical motivations for the deployment of these vessels, the humanitarian activities that they carry out ensures that both Comfort and Peace Ark will continue to be welcomed across the Latin America and the Caribbean as future harsh climate events will require greater humanitarian assistance and disaster relief operations.

In 2017 alone, regional navies had to carry out major relief operations. Case in point, the Peruvian Navy (Marina de Guerra del Peru) deployed several platforms to the country’s northern regions to provide assistance after torrential rains hit many areas. Similarly, the Colombian Navy (Armada de Colombia) has deployed offshore patrol vessels to transport humanitarian aid to areas hit by floods. Even more, the Honduran Navy (Fuerza Naval) has acquired a multipurpose vessel, Gracias a Dios, to combat maritime drug trafficking and to provide assistance to coastal communities. In other words, humanitarian assistance has been a key component of naval strategies, and its importance will only increase in the near future, meaning that support from allies will remain a necessity for many Latin American and Caribbean states.

Final Thoughts

USNS Comfort and China’s Peace Ark have carried out commendable humanitarian work throughout many coastal communities in Latin America and the Caribbean as their tours in these regions have helped individuals who would otherwise have trouble accessing medical services. These humanitarian assistance deployments will continue to be necessary in both the short- and long-term. As for the geopolitical value of such deployments, they are a non-dangerous and effective example of “soft power” via which both Beijing and Washington utilize to maintain and improve their image in these regions.

Alejandro Sanchez is a researcher who focuses on geopolitical, military, and cyber security issues in the Western Hemisphere. Follow him on Twitter: @W_Alex_Sanchez

The views presented in this essay are the sole responsibility of the author and do not necessarily reflect those of any institutions with which the author is associated.

Featured Image: This a Chinese hospital ship. Called the Peace Ark, this ship is under the command of the Chinese Navy. (Photo by Jake Burghart)