Q&A: Rear Admiral John M. Mateczun
Navy Caregiver
Bringing Navy Medicine to Those in Need Around the World
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Rear Admiral John M. Mateczun
U.S. Navy Medical Corps
Senior Health Care Executive
Deputy Surgeon General
As an enlisted member of the U.S. Army, Rear Admiral Mateczun volunteered for training in the Explosive Ordnance Disposal School at Indian Head, Md. He served two tours of duty in the Republic of Vietnam where he was awarded the Bronze Star Medal and was honorably discharged as a staff sergeant. He subsequently earned a Bachelor of University Studies degree from the University of New Mexico where he was elected to membership in the Phi Beta Kappa honorary society. He received a Doctor of Medicine degree from the University of New Mexico School of Medicine and was commissioned as an ensign in the United States Naval Reserve during his senior year.
Mateczun completed postgraduate training in psychiatry at the Naval Regional Medical Center, Oakland, Calif. He concurrently completed requirements for a Master of Public Health degree from the University of California, Berkeley.
After completing training, he was assigned as division psychiatrist, 3d Marine Division, Okinawa, Japan, where he also served as the assistant division surgeon. He was then assigned to the Naval Hospital, Bethesda, Md., as a staff physician. While there he became the intern advisor and transitional intern program director. Mateczun was selected as a Navy astronaut candidate and screened for medical director assignment.
During his off duty hours, he completed requirements for a law degree at Georgetown University Law Center. Mateczun became the most junior officer to become chairman of a training program in Navy psychiatry when assigned as chairman of psychiatry at the Naval Hospital, Portsmouth, Va. During that assignment, he was the officer in charge of a support team sent to the Persian Gulf in support of USS Vincennes. He also organized and directed mental health support activities for the crew and families of USS Iowa.
Reassigned to the National Naval Medical Center as chairman of psychiatry, Mateczun became the acting director of medical services during Operation Desert Shield. During Operation Desert Storm he was assigned to I Marine Expeditionary Force in Saudi Arabia as consultant on the establishment and operation of combat stress centers. He was a medical crew-member on the first flight that retrieved repatriating prisoners of war in Amman, Jordan. When Desert Storm personnel returned to the National Naval Medical Center he was appointed director of medical services.
Subsequently assigned as the force surgeon, Fleet Marine Force, Pacific, in Camp H.M. Smith, Hawaii, Mateczun was responsible for planning and coordinating the contingency wartime health services for the 80,000 U.S. Marines stationed in the Pacific.
Mateczun then assumed duties as the first chief of staff for TRICARE Region 1 at Walter Reed Army Medical Center. He was responsible for planning for the coordination of military health care services in the Northeast United States with 1.1 million beneficiaries, three medical centers, 11 hospitals and 43 clinics and operating expenses of $1.25 billion per year as well as insurance expenses of $243 million per year.
Assigned to the Department of Defense, he was appointed principal director for clinical services by the assistant secretary of defense for health affairs. His duties included policy formulation on clinical matters, including graduate medical education, quality management, military public health and health promotion in the $15 billion Defense Health Program providing health services to 8.1 million beneficiaries. Jointly selected by the service surgeons general to become the first chief medical officer for the TRICARE Management Activity, he was key to the initial organizational efforts of that defense agency.
Mateczun then assumed command of the Naval Hospital in Charleston, S.C. Under his leadership the command earned the Department of Defense Access Award and the Team Award for Reinventing Government from the Federal Executive Association. He was selected for promotion to flag rank and assigned to the Navy Bureau of Medicine and Surgery as assistant chief for health care operations where he was responsible for health care delivery in the Navy’s direct care system of 25 hospitals and 135 medical and branch clinics.
He was then selected to be the joint staff surgeon, J4, The Joint Staff and medical advisor to the chairman of the Joint Chiefs of Staff. He was the United States delegate to the NATO Committee of Chiefs of Medical Services. He was present in the Pentagon on 9/11/01 and subsequently served on the Joint Staff during Operations Noble Eagle, Enduring Freedom and Iraqi Freedom. Following this J4 tour, Mateczun was the chief of staff and program executive officer at the Bureau of Medicine and Surgery.
Mateczun was selected for promotion to rear admiral and assumed command of the Naval Medical Center San Diego, the military’s largest academic medical center employing 6,200 military, civilians and contractors with an operating budget of $380 million. Under his leadership, Naval Medical Center San Diego deployed over 1,000 personnel in support of Operations Iraqi Freedom, Enduring Freedom and Unified Assistance. The Medical Center also received, treated and rehabilitated over 200 wounded Marines and sailors.
He is board certified in adult psychiatry as well as Forensic Psychiatry and is a certified physician executive. He is a Distinguished Fellow of the American Psychiatric Association and has been an examiner for the American Board of Psychiatry and Neurology. He has an academic appointment as Associate Professor of Clinical Psychiatry at the Uniformed Services University of the Health Sciences.
His awards include the Navy Distinguished Service Medal, Defense Superior Service Medal with Oak Leaf Cluster, Legion of Merit with two Gold Stars, Bronze Star, Defense Meritorious Service Medal, Meritorious Service Medal with Gold Star, Navy/Marine Corps Commendation Medal, Army Commendation Medal, and Navy/Marine Corps Achievement Medal.
Admiral Mateczun was interviewed by MMT editor Jeff McKaughan.
Q: Good morning, Admiral. Could we start with the state of Navy medicine? Deployments and OPTEMPO are a strain on people and equipment—how is the Navy coping?
A: Navy medicine is coping well. Let’s focus on three areas—Current combat and humanitarian missions, support at home bases, and our people and equipment.
Looking at our current mission, since the start of OEF and OIF, Navy medicine has supported the war on terrorism by providing medical care to deployed sailors and Marines, to those who have returned and to their families while maintaining our commitment to serve those who have gone before us.
At present, Navy medicine itself has over 3,700 personnel deployed in direct support of operational forces. Approximately 20,000 Navy medical personnel have gone in harm’s way since the beginning of OIF/OEF. This includes our Reserve forces. Since the start of OIF/OEF, Navy medicine has also provided medical support to 18 Army missions with 1,362 personnel. This includes an active duty/Reserve detachment that deployed to the U. S. Army medical center in Landstuhl, Germany, an expeditionary medical facility and two forward deployed preventive medicine units in Kuwait in support of the U. S. Army Central Command; an expeditionary medical facility at the Horn of Africa in support of USCENTCOM; and the Joint Task Force in Guantanamo Bay.
We are currently engaged with USSOUTHCOM in planning for a USNS Comfort Humanitarian Assistance Mission in South America which was announced by the president for mid 2007 and we are also planning a Pacific Partnership mission which will continue the humanitarian mission started by USNS Mercy’s deployment in mid 2006.
While we support the warfight, Navy Medicine is also prepared to respond to homeland defense disaster relief missions similar to the USNS Comfort deployment to New Orleans as a part of JTFKatrina and international disaster and humanitarian relief missions similar to the USNS Mercy deployment to Indonesia as a part of Operation Unified Assistance.
Q: What about support at home?
A: Navy medicine continues to provide world class medical care and support to CONUS and OCONUS personnel, family members, and authorized beneficiaries. Our major Navy medical facilities, such as Bethesda, Balboa, Portsmouth, Camp Pendleton and Camp Lejeune are committed to providing the best care our country can offer to our returning wounded and their families.
We have a partnership with Veterans Administration to leverage common core competencies where we can. Examples include the VA Medical Center and Naval Health Clinic in Great Lakes, Ill. We are also working jointly to consolidate medical center services in the National Capital area at the new Walter Reed Military Medical Center at Bethesda, Md. We are facing new challenges related to traumatic brain injury [TBI] and post-traumatic stress disorder [PTSD] and seeking to improve our knowledge and care in those areas.
Q: Can you give me a general overview of your people and equipment?
A: Since commencement of OIF and OEF, many Naval Medical Department personnel have experienced deployments as part of ship’s company, with the Fleet Marine Force, and aboard deployable medical platforms such as EMF’s and hospital ships. In high demand for deployments are field medical corpsman, surgical and mental health personnel, primary care providers such as independent duty corpsmen and physician assistants, and environmental health personnel.
In order to adapt to our new operating tempo, Navy medicine has implemented a global sourcing personnel strategy, and initiated a Navy medicine dwell, or Safe Harbour policy. We are working closely with specialty leaders, detailers and career planners to identify follow-on assignments of choice for deployed personnel.
Regarding our equipment, we have deployed bio-medical equipment repair technicians (BMETs) worldwide to provide preventive maintenance and repair for various types of medical equipment.
We also have resources available at the combatant command/ component command level to replace equipment. Due to environmental conditions, we have reviewed organic equipment such as tentage for EMF Kuwait, which is being replaced with hardened facilities. Medical facilities, such as Bethesda, San Diego, Portsmouth, Camp Pendleton, and Camp Lejeune have been upgrading the facilities and programs they require to treat returning wounded sailors, soldiers and Marines.
Some of our future medical logistics initiatives include positioning forward forces with the defense medical logistics endto- end supply chain. We also promote greater commonality in medical materiel used in both institutional and operational environments. I need to make mention that our blood banks do a great job of getting blood forward and we all need to help their mission by donating blood if we can.
Q: How is Navy Medicine doing on meeting its overall staffing numbers? What about in specific skill such as surgeons, nurses, anesthesiologists, etc.?
A: Navy Medicine’s overall manning is 90 percent or above for physicians, medical service corps officers and nurses. Dentists are currently manned at 89 percent.
Certain skill sets are in high demand because of their requirement to provide combat service support to Navy, Marine Corps and Army or joint units. These same specialties are experiencing shortages in the civilian sector and can be difficult to recruit or retain on active duty. These communities include general surgeons, emergency medicine specialists, physician assistants, psychiatrists, psychologists, family physicians, radiologists, anesthesiologists, dentists and nurses.
The Navy has recruiting and retention incentives and special pays that address these critical health professional areas. The National Defense Authorization Act of 2007 authorized additional specific incentives that Navy will be using to target these skill sets. The Navy continues to develop strategies and action plans to ensure Navy medicine is fully staffed in the future.
Q: There have been some significant changes in the area of human subject protection for the Navy haven’t there?
A: The Navy’s Human Research Protection Program (HRPP) has achieved considerable progress in ensuring the safety and welfare of human subjects in Navy research—a critical Navy mission.
In early November, the Secretary of the Navy [Donald] Winter revised Navy instruction [SECNAVINST 3900.39D] that provides the Navy’s policy for protecting subjects in research. The instruction provides updated guidance to all Navy commands and activities, both medical and non-medical, including the systems commands, operational forces, training commands, and non-Navy institutions that conduct Navy-supported research.
Under the new policy, the surgeon general of the Navy is designated as the single point of accountability for the Navy’s human research protection program. The surgeon general approves all assurances for Navy commands that wish to conduct research with human subjects, and monitors continued compliance with human research protection regulations and policies. The chief of naval research provides expertise and support for monitoring human research protections at non-medical sites and non-Navy institutions conducting Navy-supported research.
The Navy HRPP staff, which is based at the Bureau of Medicine and Surgery, is familiarizing Navy researchers with the new guidance. The team has developed an on-line training program and an authoritative and helpful policy on education and training. A new Navy HRPP website with links on the Navy Medicine and Office of Naval Research homepages, as well as a newsletter—“Research Protections Update,” were launched as means of disseminating up-to-date information on human research protections. The team is visiting Navy research sites to evaluate compliance with Navy policy. It’s also participating in collaborative efforts with human research professionals from the other services on looking at joint policies and procedures to simplify and streamline them across DoD.
A June 2006 site visit by the director, Defense Research and Engineering [DDR&E]) found that “Navy senior leadership is extremely committed to a high caliber program that is highly regarded not only within DoD but also [among] the non-federal organizations.”
A DoD-wide training day I attended was a great success. More than 400 human research protections staff members from all the services participated in a forum that gave them the opportunity to discuss policies and programs, and to ask questions of the experts. We found that people are interested and want more information and education. We’re already planning another such training day and developing educational online tools for investigators and staff.
Q: The use and capabilities of telemedicine continue to grow. How is the Navy taking advantage of the resources that it has in this regard and what would you like to do to enhance how it utilizes telemedicine?
A: The use of telecommunications or digital communication formats in the medical field, or “telemedicine” is in wide use in our Navy health care enterprise and the Military Health System today. This capability is especially important in today’s Navy with its large deployed patient population. Telemedicine’s use today ranges from a simple telemedicine encounter with two doctors discussing a difficult case between the battle space and a stateside military treatment facility to videoconferencing to perform a remote mental health encounter and utilization of a telepharmacy system to continuously ensure patient safety. A unique fleet need is for remote radiographic and specialty consultations to keep our deployed sailors receiving state-of-the-art health care, wherever they may be located on the world’s seas.
Telemedicine enables us to make better use of the skills of our specialists, helping patients anywhere in the world receive the finest care medicine has to offer. An additional advantage is often increased mission effectiveness and a significant cost savings when we are able to avoid unnecessary medical evacuations or referrals. This is highlighted by the work being performed daily by our dermatology specialists who offer consultation through secure emails with high-quality photos. They provide timely and accurate consultations to remote treatment facilities, ships at sea and battlefield corpsman. Today’s telemedicine communications capabilities also enable X-ray and CT scans to arrive at the desktop PC of a radiologist within our system. These capabilities ensure rapid interpretation and swift diagnosis.
Telemedicine also enables us to help our patients stay well and enjoy life outside of a hospital, even with chronic conditions which require close monitoring. Patients can use monitoring devices or record key information so that their physicians can better monitor their condition and keep them healthy. We currently have home health telemedicine projects which allow patients with congestive heart failure and diabetes to upload their daily weights and glucose results to their physicians remotely. These systems have demonstrated decreased hospital admissions, significant cost savings, and improved lifestyle. With these systems we believe Navy health care will remain on the cutting edge of medical technology and superior patient care.
Telemedicine capabilities today are assisting us in keeping our patient population healthier and greatly extending the expertise of our health care providers. The military health system is leading the way for the country in digitizing health care records and I believe this is just the beginning. We believe we are still only in the early stages of exploiting the enormous potential that this technology offers to patient care. Navy Medicine plans to continue to exploit the capabilities of telemedicine, cognizant of the requirements for securing the privacy of our patients. We believe it does and will continue to assist us in providing high quality health care around the globe.
Q: What is your take on the planned merger of Walter Reed Army Medical Center and the National Naval Medical Center? What are some of the biggest issues that need to be addressed when considering what has to be done and where the planning is at this stage?
A: The merger of Walter Reed Army Medical Center and National Naval Medical Center in Bethesda is a great opportunity for joint military medicine. This particular BRAC action is transformational in truly integrating the medical delivery systems in the National Capital area. Undoubtedly there will be challenges during a construction project of this scope and magnitude but by the fall of 2011 our servicemembers and military beneficiaries will have tertiary care integrated and sited at a single medical center and coordinated with an extensive network of community hospitals and ambulatory clinics.
This will lead to greater effectiveness and outcomes for patients and provide enhanced stewardship of the resources our country has provided. It will also enable us to practice medicine in an integrated, multi-service environment. This is what we need to do everywhere military medicine goes, in the National Capital Area, overseas and on the battlefield. This and many other BRAC actions are enabling steps in that direction.
The medical center commanders are leading a complex integration process that goes far beyond bricks and mortar. Under their leadership, clinical departments are moving toward operating as a single, multi-service staffed entity and already beginning to operate as cohesive clinical departments before they realign physically in Bethesda. They also have taken a market-based perspective in managing the health services for our patients through aligning the health care facilities in the National Capital Area to best serve the needs of the population, closest to where the populations work and live.
The medical center merger and the construction of the DeWitt Army Community Hospital at Fort Belvoir are enormously complex challenges. We have the very best and brightest people committed to ensuring that we execute this mission in the most effective and efficient manner and will ultimately deliver the absolute highest quality care to our beneficiaries.
Q: The subject of combining the service’s research and development efforts under a single roof as well as combining the surgeons general offices has been in the news lately. What is the Navy’s position on the concept?
A: We all have unique service cultures and customs with which we closely identify and service specific missions to which we remain dedicated. Joint warfighting is still a relatively new concept when compared to the depth of service experience that we have. There are a number of distinct advantages a joint or unified medical command could achieve. For example, currently we replicate everything we do in the infrastructure that supports our medical services. All three systems do financial management and operations and logistics. We don’t have standardization and we spend a lot of money and time reproducing the work required in managing a large health care system. This inefficiency of effort has to be weighed carefully in the modern environment where we must deploy jointly in order to support the warfighter and balance that with service-specific roles as well.
Standardization would allow unity of effort such that a broad spectrum of providers across our individual services would share common training background, the type of equipment they use, supplies, financial management systems, metrics and communication to evolve to a single operating medical system supporting the joint warfighter. Increasingly we will deploy jointly at the hospital level of care. Force health protection and health service support delivered jointly, particularly at the hospital level, can be delivered effectively and efficiently.
Ideally, all U.S. medical personnel on the battlefield—regardless of service affiliation—should have the same training, understand the same communications systems and operate the same equipment because we are all there for the same reason: to provide combat service support to our fighting forces. It does not matter whether the casualty is a soldier, a sailor, an airman or a Marine. Any casualty should receive the same high quality of care at the point of injury and through all the medical handoffs required on the road to rehabilitation, family reunion and health service medical personnel should be trained to provide a system that results in this same level of care. Along with the Army and the Air Force, Navy medicine is actively pursuing the concept of standardized operating procedures to ensure consistency of health care and interoperability of our medical forces.
The services have proven that they can work well together at joint facilities abroad. For example, Landstuhl Regional Medical Center in Germany has been a cooperative Army/Air Force effort for more than 10 years and is currently jointly staffed by all three services.
Our current efforts in Iraq and Afghanistan have highlighted problems in making medical combat service support interoperable. Being able to exchange supplies, equipment and people is harder if each service is not trained and equipped in the same manner. It is the interoperability and interdependence of combat service support that has the potential to be the greatest advantage and the greatest benefit of a more unified medical structure. At the same time, it could save money by decreasing the headquarters requirement that comes from having three separate and what some call stovepiped systems.
Active, reserve and retired servicemembers and their families— as well as thousands of military medical professionals—have a vital stake in military medicine’s transformation and continued evolution. With military medicine now costing some $23.4 billion per year, gaining efficiencies is an important goal. But any plan must also ensure that the access and quality of medical services remains high.
The Center for Naval Analyses has estimated that $344 million a year in efficiencies could be achieved by combining into a joint medical command. Efficiency and unity of effort must be goals of our vision of the future while we must not sacrifice the effectiveness of combat support to individual services as we travel the road ahead.
Q: What are some specific areas where the Navy has the lead in R&D?
A: We have a coordinated Navy medical research and development program that concentrates on six major vectors of research, and we are recognized as the leader in several specific initiatives across these vectors. I will give you just one or two examples for each research vector.
The first is in medical countermeasures for infectious diseases. In 1999 the Navy malaria research program conducted the very first trial, ever, of a DNA vaccine for preventing malaria in healthy humans. Subsequently the virology, malaria, and biological defense programs at Naval Medical Research Center [NMRC] joined in a unified agile vaccinology effort to accelerate nucleic acid vaccine development efforts against malaria, dengue and anthrax. In January 2007, the malaria program achieved another milestone, launching a clinical trial that tests the world’s first adenovirus-vectored malaria vaccine. Additionally, the enteric diseases program at NMRC is one of the world’s leading developers of vaccines to combat Enterotoxigenic E. coli, and Campylobacter, two of the major infectious disease threats to deployed military units, and travelers to developing countries.
Medical countermeasures for CBR and toxic environmental threats is another. In addition to the agile vaccine development efforts against anthrax, the Navy’s biological defense research program developed and maintains the handheld and nucleic acid tests used by our entire fleet and much of the country to detect biological threat agents. Additionally, to ensure DoD’s preparedness to deal with radiation-induced bone marrow injury, NMRC runs the DoD Marrow Donor Recruitment and Research Program. This program developed the advanced procedures used throughout the world to perform HLA typing to match patients to donors by direct analysis of the HLA genes themselves.
Environmental medicine and physiology is important in maintaining and enhancing human performance to support military operational missions and has been a long standing area of Navy medical R&D expertise. The development of means to prevent the onset of illness or degradation of readiness in extreme environments of heat, cold and lack of oxygen have all been topics of Navy medical R&D. The identification of the effects of sleep deprivation and means of mitigation have been developed in our laboratories. These research studies have provided the tools to enhance mission performance and prevent or delay degradation of fitness and cognitive skills in active duty personnel. Navy researchers are world leaders in research on the prevention and treatment of decompression sickness, and the Naval Institute for Dental and Biomedical Research [NIDBR] is a national leader in dental mercury abatement, having developed a process that removes 99 percent of the mercury from dental wastewater. NIDBR is also a leader in the development and evaluation of forward deployable dental dressings for field treatment of fractured teeth and lost restorations.
Operational medicine Navy medicine takes a lead role in fullscale exercises that test the equipment, procedures, and other factors that can result in greater survivorship in a disabled submarine. Much of the information learned from these exercises is reflected in the Naval Sea Systems Command Technical Manual, for which the Naval Submarine Medical Research Laboratory develops the medical component. Likewise, motion maladaptation syndromes and other vestibular related conditions can adversely affect operational performance. Many of these conditions are normal reactions to abnormal stimuli. The Naval Aerospace Medicine Laboratory is a leader in developing countermeasures to these normal, but incapacitating, reactions. A whole range of countermeasures including tactical decision aids for operations involving real or apparent motion, down-time recommendations and pharmacological measures have been developed to deal with this important topic area.
The area of occupational health and medical informatics is important to Navy medicine. The Naval Health Research Center [NHRC], San Diego has the lead in epidemiologic studies spanning the entire career of military personnel, including deployment history as well as occupation-related health issues. With the development of combined career history and medical databases, many studies are being conducted on the relationship of deployments, occupation and other factors to disease and injury. A major effort in this regard is the Millennium Cohort Study that NHRC established for the Department of Defense. The largest longitudinal study ever conducted in the military, it follows over 125,000 deployed personnel for a period of over 20 years to ascertain the occurrence of health outcomes. Navy medical R&D also is a leader in development of programs for health behavior modification such as reducing smoking and alcohol abuse. In medical informatics, Navy medical R&D is a recognized leader in the development and maintenance of comprehensive illness and injury databases on operationally deployed personnel under situations where electronic capture of medical data is most difficult. To provide the highest quality data in a timely manner, NHRC developed the Navy and Marine Corps Combat Trauma Registry and employed the Navy Medical Knowledge Management System for far forward data collection. This system has provided unmatched data collection and analysis for evaluation of effectiveness of personal protection equipment and effectiveness of treatment far forward.
Lastly, I would like to mention combat casualty management. Hemorrhage is the leading cause of death on the battlefield. The Combat Casualty Care [CCC]) Directorate at NMRC plays a leading role in evaluating hemostatic bandages and treatments [e.g., platelets] in animal models of hemorrhage to ensure that the best possible product is available for deployed troops. CCC is also a leader in the development and testing of next generation resuscitation fluids, including hemoglobin based oxygen carriers, and a leader in the development of technologies to accelerate wound healing, and in the characterization of traumatic brain injury resulting from exposure to blast overpressure.
Q: Do you see outsourcing becoming more prevalent in military medicine or will that trend even out in the coming years? What are the benefits of outsourcing from a command and funding perspective?
A: Outsourcing will most likely even out in the next five years, as we find the right mix of personnel for Navy medicine. We will continue to contract for providers and support services where we find opportunities to optimize clinics and hospitals. There obviously will be a continued need for care from the managed care support contractors— and there will be opportunities to bring care back to the MTFs where we get quality that we monitor and the best return on investment whenever we can. We must optimize both our military facilities and the private sector care we use.
Q: How are the USNS Mercy and Comfort holding up? What are the plans to keep the ship technologically current with medical gear?
A: Mercy and Comfort are in excellent condition. These ships are maintained in a Reduced Operating Status (ROS-5) which requires that they be ready to activate on short notice [approximately five days]. Military Sealift Command is responsible for recurring maintenance and life cycle management to ensure the short activation timeline can be met. Prior to Mercy’s recent deployment to Indonesia, she was in the shipyard undergoing repairs and routine maintenance. Comfort is in a Boston, Mass. shipyard for a 90 day period for routine repairs to include: upgrading air conditioning systems and the engineering plant as well as spaces within the medical treatment facility. Mercy and Comfort are expected to remain in active service until 2020-2021 as a result of this continuous maintenance program.
Mercy’s disaster relief deployment to the Indonesia tsunami area in 2005 and subsequent re-deployment in 2006 resulted in positive pro-American attitudes in a predominantly Muslim country where anti-western attitudes were increasing. US SOUTHCOM plans to replicate that success in South America with Comfort’s deployment later this year.
Mercy’s recent success with her deployment to Indonesia has encouraged Navy and combatant command leadership to consider deploying one of the hospital ships every other year to conduct humanitarian assistance and training missions.
Immediately following her yard period, Comfort will embark on a 120-plus day deployment to South America, visiting nine Latin American countries. The crew will consist of Navy, Army, Air Force, U.S. Public Health Service medical personnel as well as personnel from non-governmental organizations such as Project Hope and Operation Smile who provide medical training to civilian and military health care providers and conduct humanitarian assistance and community relations projects.
NATO has taken note of the operational successes of both Mercy in Indonesia and Comfort during the aftermath of Hurricane Katrina. NATO recently created the NATO Response Force [NRF] to respond to potential disaster relief, humanitarian assistance, or military operations. To provide Level III medical support to the NRF, a T-AH has been added to their force list in a “be prepared to deploy” status [30 day ROS].
Medical equipment on board Mercy and Comfort is state-of-theart and the same equipment used by our Navy medicine personnel at medical treatment facilities worldwide. As a fleet asset, funding for hospital ship medical equipment is programmed and budgeted for by the component commanders, U.S. Fleet Forces Command and the commander, Pacific Fleet. Policy focuses on ensuring the most current technology and equipment is available to meet the primary trauma care mission in support of the warfighter.
When either Mercy or Comfort deploys, they provide the best of two worlds in that the medical capability of a “brick and mortar” facility goes to sea as a fully functional deployable Level III command to be stationed where the warfighter needs it. With the equipment on board Mercy and Comfort, the medical staffs have proven they can provide state-of-the-art medical treatment and public health services essential for the United States humanitarian and disaster relief as well as outstanding trauma care during combat operations.
Mercy and Comfort have a permanent complement of biomedical equipment technicians who repair and maintain all medical equipment. Additionally, when new medical equipment is procured and installed, the manufacturer will provide training to the ship’s biomedical department regarding the operation of that equipment and preventive maintenance.
Lessons learned from Mercy and Comfort’s deployments to Indonesia and Katrina have enabled our health care providers to determine what medical equipment and supplies are needed be effective in disaster relief and humanitarian assistance missions.
Q: With so many individuals deployed, how has that affected your training for both new and recurrent skills? Have you had to look at opportunities such as distance learning and computer simulation?
A: We have maintained training opportunity and standards for new and recurrent skills training. The impetus to deliver training and education in the most efficient and timely manner has been the driver on our use of blended learning environments with distance learning and computer simulation. Computer distance learning has been used to deliver training modules for years, and we are improving the way we do it.
The use of technology is a natural evolution in the delivery of training and education in the military as it is in the civilian sector. It allows just-in-time training, reduces training costs and frees students from time constraints that the classroom may impose. Computer- based training is only a portion of the clinical educational experience in the Navy. It is used in combination with classroom and hands-on instruction whether the subject be military-specific or medical-skills based. ♦