Trends in Medical Shelters
INNOVATIONS PROVIDE FAST CARE FOR WARFIGHTERS
The U.S. military depends on a variety of deployable shelters from large aircraft hangar compartments to individual oneman tents to assist warfighters in carrying out their missions. Innovations in shelter technology have been particularly beneficial to military medical missions, which increasingly depend on the ability of temporary shelters to keep patients alive through their ability to house proper care facilities for wounded servicemembers.
The military services depend on a wide range of shelter manufacturers for various configurations of shelters. However, there is often some agreement among the military branches as to what constitutes a shelter for specific scenarios. For example, the U.S. Army, Navy and Marine Corps all turn to Base-X Inc. of Fairfield, Va., for many of their surgical shelters. Army forward surgical teams (FST), Marine Corps forward surgical suites (FSS) and Navy’s expeditionary medical units make use of the shelters to treat patients in the field, said Brian Dearing, Base-X vice president of business development.
“We are especially proud of our relationship with the Navy’s Fleet Hospital Program,” Dearing noted. “We provide the only level III medical facility in the Central Command theater—it’s actually in Kuwait. That’s a 24-hour/7-days a week medical facility that has been running for more than three years. It’s a very harsh environment and Base-X has been providing the shelter, air conditioners, heating, lighting and infrastructure for that for more than three years. It has been very successful. We are very proud to be associated with those great Navy doctors and great Navy medical folks,” Dearing added.
While three out of four of the services use the shelters overseas, the National Guard Bureau has also made use of the shelters, both overseas and domestically. The National Guard helped serve as a conduit for expansion of the medical shelter market to state and local government as well, Dearing explained.
“The National Guard units serve as an interface from the federal to the state and the local,” he said. “We have a tremendous amount of progress for medical shelters in surge hospitals. With various state and local and regional governments, we provide miniature hospitals for stabilization and treatment in place [STIP]. It’s kind of a civilian version of an Army forward surgical team or a Marine Corps forward surgical unit, but the demographics are widely different.”
Army medics will largely encounter physically fit young men and women with trauma injuries. First responders providing homeland security services, however, may encounter a broad range of the population from the very young to the very old with the potential for pre-existing medical conditions or limitations on top of injuries inflicted by a terrorist attack or natural disaster. Those conditions may call for a mass triage or for medical isolation of contaminated individuals.
In such cases, warfighters and responders have come to depend on Base-X isolation units, which stand up in minutes and meet all Centers for Disease Control and Prevention requirements for isolation units.
“Our shelter-based isolation units meet all of the same requirements as isolation units in brick-and-mortar hospitals, but they are very portable and very low-cost,” Dearing stated. “They are a nice addition to a brick-and-mortar hospital that has a requirement for additional isolation capability but is not going to have the resources to build a brick-and-mortar solution.”
FULLY INTEGRATED SHELTERS
Mobile Medical International Corp. (MMIC), headquartered in St. Johnsbury, Vt., prides itself on a medical shelter system that provides everything warfighters require to get up and running right out of the box. The company’s shelters are carefully crafted to meet all U.S. health care standards for medical operations. MMIC created its original military shelters from the ground up with these requirements in mind.
“We took into consideration things such as HEPA filters, positive airflow relationships, proper cleanable and scrubable surfaces and we set up with a medical application in mind from the very beginning,” Rick Cochran, MMIC president and CEO, told MMT.
“We didn’t simply take an ISO container and retrofit stuff into it,” he continued. “We literally built a design from the ground up for a new shelter platform. Now we have a series of those platforms.”
MMIC’s very first Army contract in 1988 described a requirement for a family of deployable medical shelter systems. MMIC developed such a family, ranging from small tents for FSTs to field hospitals. MMIC’s focus on rapidly deployable, fully integrated shelter solutions led to its recent introduction of the Mobile Single Pallet Unit (MSPU), a complete shelter contained within a standard 108 x 88 pallet for transport by a C-130 or other military aircraft. The MSPU comes complete with its own generator; air conditioning system; nuclear, biological and chemical filtration system; and integrated lights and electrical drops.
At the press of a button the shelter is released from the pallet. Once the shelter is rolled out, another press of a button starts an air blower that sets up the shelter very quickly. MMIC’s self-contained shelter systems, deployable in 30-60 seconds, save even more time as they eliminate the need to bring in a generator, environmental control unit, lights and other equipment.
In addition, Cochran said, separate parts of a shelter system require separate containers for shipping them, which increases the warfighters’ logistical footprint.
“We mitigate significantly the sheer task of keeping track of equipment,” Cochran declared. “The Army really worries about the impact of IEDs [improvised explosive devices] along the road. If you take out one of the key components, you lose your ability to fulfill your mission. That’s not true in our designs. If a system were to go down, most of our systems have integration. You can take any system, turn it on, and then you are ready to go.”
The Iraqi government was so impressed by recent demonstrations of the MSPU that it purchased eight of them for use by its own military forces.
QUICKLY DEPLOYABLE
DHS Systems LLC, based in Orangeburg, N.Y., started up with the idea of a rapidly deployable medical shelter in 1984. Its founders were inspired by a pop-up trade show display and created the company’s first pop-up shelter based on a strut-and-hub structure.
Prior to the introduction of the popup shelter, warfighters had to spend several hours erecting medical shelters. DHS Systems cut down on that set up time significantly, Naeran Rubio, DHS Systems communications specialist, told MMT, through the production of its DRASH family of shelters. The shelters range from small units of 109 square feet up to 1,120 square feet.
“Other companies have followed in our footsteps, but this was the first one,” Rubio explained. “Our shelters are very quickly deployable. Some of the man-portable shelters, which can be carried, can be set up within 15 minutes.”
“The design is very rugged. The structure is based on a strut-and-hub design that connects the joints,” she added. The DRASH frames are constructed of a composite material called titanite, using an exclusive design patented by DHS Systems. Titanite is extremely strong but flexible—independent testing has determined it to be 270 percent stronger than aluminum.
The fabric of the shelters also is unique. The patented material, called Xytex, is fireretardant and water-repellent. It resists ultraviolet rays and provides total blackout capabilities for warfighters. “It withstands all sorts of weather conditions from the arctic to the desert heat. It provides a very comfortable living or working environment,” Rubio said. “We have about 12,000 shelters deployed with U.S. military and NATO forces. We have accompanying trailers that can carry the shelters from place to place. They can also be used for power generation.
DHS Systems has a sister company, Reeves EMS LLC, that customizes medical shelters for emergency medical services. It has expanded the DHS military line of shelters for use by individual fire departments and health authorities. One of its offerings is a large medical processing center, measuring 95 feet, 10 inches long by 19 feet, 10 inches wide.
“It is a field mortuary,” Rubio commented. “You would do triage, crime scene processing, decon, identification of remains in a disaster when processing. There are other applications as well.”
The Turkish 3rd Corps, a NATO Rapid Deployment Corps unit, recently was impressed by the capabilities of large DRASH medical facilities and commandand- control centers. It purchased series of shelters for a medical facility measuring 21,936 square feet and a command facility measuring 47,986 square feet. “That is 35 DRASH shelters making up command and control,” Rubio remarked. “It includes shelter, mobility, lighting, heating, cooling, floors, power distribution and everything together in one package. The Turkish Army is very interested in acquiring the best shelter technology out there. They need something that is going to provide proper protection for their communications technology. They made the investment to use the DRASH shelters.”
SPACE CONSIDERATIONS
CAMSS Shelters of Washington state has been providing replacements for old TEMPER tents with its CAMSS20EX expeditionary shelters. In June, CAMSS replaced TEMPER facilities at Dobbins Air Reserve Base, Ga., enabling its Combat Training Center with the ability to provide food preparation and kitchen equipment operation training to its personnel through the new CAMSS20EX BEAR kitchen shelter system.
The design of the shelter makes it ideal for practical, everyday purposes, Morgan Brooke, CAMSS program manager, told MMT. “Our CAMSS20EX has a straight sidewall, and that has really taken off,” he said. “It has been available for several years now, and lately people have seen the advantage on the straight sidewall in so many ways compared to rounded or slanted sidewalls. It gives the user so much more usable space.”
CAMSS Shelters manufactures a whole series of shelters from small command posts to large deployable aircraft hangars. The shelters are designed to be transportable on standard pallets. But the CAMSS20EX has been highly visible lately, replacing TEMPER tents at Balad Air Base in Iraq to create the largest in-theater hospital for the Air Force in the course of Operation Iraqi Freedom.
The Balad hospital demonstrated the ability of the CAMSS shelters to adapt to the varying needs of the U.S. military in different environments, Brook noted. “We made our shelters to fit what they already had in place,” Brooke said of the Balad Air Base hospital. “They had concrete pads with their hospital equipment and everything. We made our shelters to fit onto those concrete pads with side doors and side connectors and a number of different options. It fit that hospital’s needs.
“They put our CAMSS20EX in the same place as the TEMPER tents within 10 days. The hospital maintained operations throughout the whole switchover. Our ability to do something like that and meet those needs really separates us from many others,” he added.
CAMSS Shelters has manufactured commercial structures for more than 20 years and military shelters for more than 10 years. As it looks to the future, the company continually seeks ways to improve its shelter offerings, particularly through improving the set-up time of the shelters and reducing their cube volume and weight.
“We are constantly working to make our shelters lighter, quicker and faster and at the same time keeping them rugged and durable,” Brooke said. “We really focus on the durability in addition to the quality. The folks in the field need to rely on a shelter that is going to be used in harsh environments. We have been pretty successful in providing the military with a high-quality shelter that meets a lot of different needs.”
RUGGED SOLUTIONS
Integral Designs of Calgary, Canada, specially manufactures custom-ordered shelters for use by special forces and other specific missions.
“We have been making single-wall tents that have been going to special forces. We manufacture small-run nice items in the 1-100 quantity range. Our brand name doesn’t pop up all over the place, but some people find that we get the job done,” Evan Jones, owner of Integral Designs, told MMT. The company does a great deal of its commercial business with mountaineers who require a durable tent for use on rugged terrain.
“These people want to get high altitude and they need as much shelter as they can get with as little weight as possible. It needs to withstand hostile terrain,” Jones described. “When you look at military in particular, the guys going into Afghanistan after 9/11 had to behave a lot more like mountaineers. The traditional military guy has 100-pound backpacks, which are carried in a jeep. Folks that have to carry their own gear around are motivated to get stuff that is light and high-performance.”
Much of the high performance of the Integral Designs tents can be attributed to the eVENT fabric used to make them. eVENT fabric, owned by the General Electric Co., consist of a waterproof membrane with tiny pores that allow the material to breathe.
“It’s much more comfortable and breathable than established things like Gore-Tex. We were on of the pioneers with using the eVENT fabric,” Jones said. “GE bought the technology for pollution control because you now have a fabric that serves as a membrane where water particles can’t pass through but air can. So they are using it for pollution control and a lot of other things. It’s a good example of how fabrics and textiles in one industry cross over into another.”
HEALTHY TROOPS
Montgomery Marketing Inc. (MMI), based in Montgomery, Ala., began manufacturing ruggedized products in 1975. Around 1993, it began making military shelters.
“We manufacture only shelters,” Maurice Green, MMI director of sales and marketing, told MMT. “They are one-, two-,three- up to six-man shelters. We are the first company that has made an individual shelter and has treated it with permethrin.” Permethrin helps to keep troops health because it is an insecticide that effectively keeps bugs out of the shelters, Green said.
“Nowadays, the services are treating their uniforms with permethrin so that bugs don’t come near them,” he observed. “Why not treat shelters the same way? That’s what we do. We are the only company to treat some of their shelters with permethrin. The Marine Corps thinks it’s a great idea and we are under contract with them right now.”
Some of the MMI tents have a patented pop-up system that enables quick deployment. A Marine could take such an MMI shelter from its pouch, remove a strap, and instantly pop up a shelter in three seconds, Green said. When it is time to pack the shelter up, the Marine rolls it up into a figure 8 and puts it back into its pouch, which is all of 13 inches round.
Green, himself a retired Marine Corps officer, knows firsthand how important it is to protect the well-being of warfighters by keeping the smallest enemies away. “I spent a lot of nights out on the ground. We didn’t have anything like this when I was in the service. The bugs would have a field day,” he commented. “Now the individual soldier can get a good night’s sleep away from bugs. Not only that, but you could be in danger if you are on patrol during the day and get scrapes on you. When you are lying there at night, the bugs could infect you by sunrise the next morning. They could get into your cuts and you will be infected when you wake up.”
SOLID GROUND
Rapidly deployable shelters for temporary use is highly prized by military forces, but more and more often, shelters that are easy to transport and set up are forming semi-permanent bases for long-term operations. As the U.S. missions in Iraq and Afghanistan have continued and grown, warfighters have relied upon deployable shelters to house important functions. But they often find the sand beneath their feet isn’t suitable for long-term habitation or supporting sophisticated equipment.
Fortunately, Signature Flooring of New York City has the solution. “For a military medical tent, you need to be able to roll gurneys. You need to be able to roll equipment like X-ray equipment and move it over this floor. So the rigidity of the floor is important,” said Arnon Rosan, Signature Flooring president and CEO.
“So we tend to use our mid-range floor in medical shelters because it can handle this kind of equipment traffic,” he continued. “Something that we have learned over the years specifically with regard to medical tents is that in general you need a smoother, non-textured surface because you need to be able to clean it effectively. In a surgical environment, all types of stuff fall on the floor.”
Old shelter floors actually trapped medical waste and dirt because they had a series of channels and grooves intended for drainage in the shelters. New floors are smooth with a slight anti-skid surface, Rosan said. More rigid floors can support heavier equipment. As tactical operations and medical centers grow, they require more computers and other electronics.
“So we are seeing more durable modules,” Rosan commented. “That comes at the expense of transportability. We are finding the customer seems to be okay with a slight increase in volume as long as they are getting something that is stronger and more rigid.”
In addition, with more and varied equipment comes the need for more cable channeling in shelter floors.
“So we have two systems that we use for cable channeling,” Rosan explained. “One is an integrated system in most of our modules that lets you bury cables underneath. The other is a diamond plate channel that fits in-between sections where you can drop the cables in from the top. That’s a trend that will continue as computers become more important in the military environment.”
Signature Flooring offers floors for a wide variety of commercial purposes as well. In fact, the company’s solution for establishing military floors on snow and ice—and now sand—was inspired by a commercial application of its floors.
“We use the same system to cover hockey arenas or ice arenas as we do now for cold weather shelters,” Rosan said. “It has a layer of air insulation between a bottom and a top layer. People care about their comfort and whether they are cold or hot. They can use this in multiple areas in sand or mud. In general, our floors go inside the liners of existing tents but they could go outside the liner or with no liner as well.” ♦