Seapower - October 2008

DAVID AXE

Crew members aboard the amphibious assault ship USS Kearsarge get ready to perform a foreign object debris check on the ship’s deck Aug. 11. Kearsarge was headed to Puerto Cabezas, Nicaragua, the next day for the first stop on its humanitarian assistance mission as part of Operation Continuing Promise 2008.

nurses who comprise the “medical assault force” and the tens of thousands of people whose lives they will help improve, Operation Continuing Promise and the whole concept of medical diplomacy is something new.

Whether it remains a novelty, or finds a lasting place in the Pentagon’s playbook, however, is an open question.

‘I’m not worried at all’

Kearsarge’s most valuable cargo as it pulled away from the pier in Norfolk, Va., Aug. 6 was not the tons of medicine and relief supplies it carried, but the roughly 300 skilled medical and engineering professionals berthed in the living spaces. Instead of a Marine Expeditionary Unit, Kearsarge had embarked general practitioners, surgeons, nurses, medical technicians, optometrists, ophthalmologists, civil engineers, public health experts, entomolo-gists, medical equipment repair specialists, linguists, cultural experts, journalists and even veterinarians.

The medical specialists represented all the U.S. military services; the U.S. Public Health Service; the Canadian, Dutch and Brazilian militaries; and a range of civilian institutions, including the plastic surgery nonprofit organization Operation Smile, which specializes in repairing severe cleft palates.

All the medicos call Cmdr. David Damstra boss. By day, Damstra is the commander of Fleet Surgical Team Four. For this mission, he embarked with Capt. Ferdinand “Fritz” Ponds, mission commander, Continuing Promise 2008.

For Damstra, Kearsarge’s week-long transit, from Norfolk to its first stop at Puerto Cabezas on Nicaragua’s remote eastern coast, was a chance to get his people organized. It was an overwhelming job.

Kearsarge medical staff represented a grab-bag of disciplines. He had to organize them into teams and marry them up with the right equipment, then forge plans for getting them ashore and working.

Already there were problems. Kearsarge was underway when planners discovered shortages of generators and interpreters. There would not be enough of either, so some teams would have to make do without electrical power and with Spanish-speaking Kearsarge crew members filling in for trained interpreters. One Canadian dentist complained that without a generator, he would be reduced to simply pulling rotten teeth under local anesthetic.

On Aug. 7, Damstra sat back on his desk in his tiny one-man stateroom and sighed.

“Planning for this has been exceedingly painful,” he said.

Some help came from 55 Kearsarge crew members who had been with Boxer during the first phase of Continuing Promise. From the present jumble, Damstra was expected to achieve near-strategic results.

“Warming relations on the personal and national level — that’s the intent,” he said. “The goodwill will come in two ways: from the people we meet, and also on the national level. The majority of people we won’t see. But we do want to get the word out.”

Hence the roughly dozen journalists accompanying Kearsarge — and the local media planning to trek to the onshore clinics to cover the medical care as it happened.

The commodore made a point of dropping in on the journalists nearly every day at their makeshift workspace adjacent to Kearsarge’s always-busy gym. But for all the media’s importance to the mission, Ponds stressed that actions still would speak louder than words.

“Strategic communications is not what you put on paper,” he told the journalists. “It’s what you do.”

So the emphasis was on providing top-notch care. In the days before reaching Nicaragua, in Kearsarge’s expansive medical bay — the largest in the Navy behind the hospital ships — doctors and nurses sorted pills, swapped stories and bonded. They were from a half-dozen countries, but they all spoke two common languages: English and that of medicine.

Lt. Cmdr. Paul Wickard, from the 7,000-strong U.S. Public Health Service (USPHS), was “doing time” as a prison doctor at a federal penitentiary in Georgia when the opportunity arose to join Kearsarge for Continuing Promise. He sorted pills alongside Cmdr. Julie King, a USPHS nurse, and two Canadian Army nurses, Capt. Kim Templeton and Lt. Lauren Vera.