the mag
How to Win Friends and Inoculate People: The Navy’s Strategy for Saving the World
by the mag - June 24, 2010 - 3:00 PM

by David Axe

For millions of people in Latin America, Africa, and Asia, the U.S. Navy no longer conjures up images of war games and nuclear submarines. Instead, the sight of American sailors means one thing: free medical care.

In recent years, the Navy has started dispatching dozens of hospital ships—some as big as shopping malls—to aid developing nations. The crews consist of doctors, nurses, engineers, pilots, volunteers, and even acupuncturists, all there to help. But as mental_floss reporter David Axe learned while visiting the Kearsarge ship in Nicaragua, the Nashville in Gabon, and the Comfort in Panama, these missions aren’t about altruism; they’re about winning friends and influencing nations.

Soft Power

The U.S. Navy has been in the medical business for decades, often setting sail in response to earthquakes or hurricanes. But until recently, these missions were for emergencies only, and not part of a bigger diplomatic strategy. It took the Iraq War to change that.

After years of failing to pacify Iraq with firepower, the Pentagon decided it needed to think outside the arsenal. The result was a new theory called “soft power.” The idea is to send the military into potential conflict zones—along with other government agencies and civilian volunteers—years before any fighting breaks out. The troops hand out free medical care, aid local governments, and build roads and schools. Basically, they do anything they can to be of assistance.

By giving everyone a helping hand, soft-power programs hope to improve the United States’ image and leave a lasting, positive impression of America on the citizens of other nations. “It’s about influencing generations to come,” says Navy Commodore Frank Ponds.

Beginning in 2006, the Navy sent ships to places where conflicts were simmering. Then, in November 2007, Defense Secretary Robert Gates made soft power official policy during a speech at Kansas State University. Now, it’s all the rage at the Pentagon. There is at least one major soft-power mission to Asia, Africa, and Latin America each year, meaning U.S. Navy ships are already becoming an increasingly common sight all across the world.

The Nuts and Bolts

The Navy’s two largest hospital ships, the Comfort and the Mercy, are 900-ft.-long modified oil tankers with triage bays, surgical wards, and 1,000 patient beds. To give you an idea of how big that is, each ship is nearly on par with Los Angeles’ Cedars-Sinai Medical Center in scale. In fact, during its “Operation Continuing Promise” mission to Latin America in 2008 the Comfort treated more than 100,000 patients.

According to Captain James Ware, the medical operations commander on the Comfort, his staff of nearly 200 doctors and nurses can perform almost any procedure, from plastic surgery to physical therapy. The only things they can’t do are open-heart surgery, total joint replacement, and organ transplants, because they lack certain specialized pieces of equipment.

Naturally, the setup for all of this is fairly complex. Teams of doctors and nurses go ashore and establish “instant” health clinics. There, people can get treatment for simple medical and dental problems; they can pick up free meds from a portable pharmacy or free eyeglasses from a military optometrist; they can even get basic veterinary treatment for their pets and livestock. But when the procedures are more complicated, the Navy transports patients onto the ships. In Latin America in 2008, Operation Smile, a nonprofit organization specializing in facial plastic surgery, set up shop aboard the Kearsarge and shuttled in patients. During the ship’s four-month tour, its doctors treated 15,000 people and repaired 200 severe cleft palates.

For more difficult surgeries, the Navy has developed a high-tech system called telesurgery to help its doctors consult specialists back in the United States. The combination of networked digital video cameras, speakers, and flat-screen televisions allows surgeons at sea to communicate with specialists in America. When the program made its debut during the Comfort’s 2008 stop in Antigua, Army Colonel Ernest Lockrow, the doctor in charge of developing the system, reported that they experienced only a half-second delay.

Managing the Press

In some areas, the patients treated at these hospital ships have never seen a doctor before, so the Navy’s arrival can be an almost miraculous event. But if soft power sounds like all good news with no downside, there’s a reason. The Navy carefully manages the press coverage of its hospital ships in order to emphasize the positive. It’s all part of the strategy. For every person his doctors treated in 2008, Commodore Ponds says he wants 10 other people to hear about it. It’s no surprise that most Navy hospital ships sail with large numbers of reporters on board. In August 2008, Navy doctors performed eyelid surgery on an 11-year-old boy to remove a mysterious growth that had impaired his vision and made him an outcast in his Nicaraguan village. Of course, there was a journalist standing by to get a quote from him the moment he could see again. The boy reportedly said, “I can now read my textbooks … I am very happy.”

In reality, soft power isn’t perfect. A visit by one of the Navy’s hospital ships is like instantly building a brand-new, full-service hospital in one of the world’s poorest communities, running it at full capacity for two weeks, and then shutting it down in an afternoon. All the high technology can’t replace the sustained, hands-on care a patient could get from a permanent, local clinic. Comfort surgeon Commander Timothy Donahue, for instance, admits that he had to avoid doing tricky procedures that could require highly specialized follow-up care.

Another problem is that most Navy personnel are trained to handle war, not peace. To work with civilians, many have had to completely rethink the way they do their jobs. Marine Corps Major Alison Thompson flew some of the most daring combat missions in Afghanistan before joining the Kearsarge as a hospital chopper pilot. When landing in a war zone, Thompson would shoot at anyone rushing towards the helicopter, for fear they might attack. But in Nicaragua, impoverished residents often run towards the chopper looking for food. Even if someone were caught stealing something from her helicopter, Thompson’s orders are to let them go. This new way of thinking is the hardest part of her job, she says.

In Africa, the Navy has faced similar problems. When the Nashville tried to set up a clinic for abused children in Gabon, none of the sailors gave a second thought to the camouflaged uniforms they were wearing. But when the children saw their military garb, they thought the Americans had come to enslave them. For several minutes, there was complete pandemonium, as the children ran, screamed, and hid. “They’ve had difficult lives,” explained Gabriela Escudero, a State Department humanitarian official. In the end, it took Escudero’s gentle coaxing to convince them that the sailors were there to help.

To bridge that gap between the military and the people they’re trying to help, the Navy has begun recruiting civilians. No fewer than 300 volunteers from several major non-governmental organizations, such as Project Hope and the Church of Latter Day Saints, joined the Comfort in 2008. The ship’s crew even included one California acupuncturist. “Diversity is going to make an organization that much better,” said Captain Bob Lineberry, commanding hospital officer on the Comfort.

Copycats

Soft-power missions are sometimes messier than the Navy admits, but they still beat withholding aid until a crisis arises. And if imitation is the sincerest form of flattery, then soft power is a smashing success. The Dutch navy asked for American help launching its own hospital-ship mission last summer, and last June, the Chinese navy contacted the Pentagon requesting permission to send a 10-man medical team to visit the Comfort during the hospital ship’s planned visit to Colombia. “They’re putting together a hospital ship and are interested in how we do our business,” Captain Ware explained. During the Cold War, superpowers fought for control of the Third World by selling arms and staging coups; today, they’re competing to be the world’s best helpers. In the end, soft power may prove to be exactly the type of strategy we need to make the world a better place.

This article originally appeared in the September-October 2009 issue of mental_floss magazine.

More from mental_floss…

Fordlandia: Henry Ford’s Ill-Fated Foray Into the Brazilian Jungle
*
How an Earthquake Spawned Massive Immigration Fraud
*
Toilet Paper History: How America Convinced the World to Wipe
*
Strange Geographies: The Happy, Haunted Island of Poveglia
*
Spell It Out: 16 Abbreviated Company Names Explained

twitterbanner.jpg

« Previous Post   -   Next Post »
Click here to get a Risk-Free issue of mental_floss magazine
Comments (27)

  1. That is so cool – I was stationed on the Kearsarge two years ago. We did not do a lot of medical care but we did a lot of painting and repairing of schools, orphanages, etc.

    posted by FrankieA on 6-24-2010 at 10:00 am

  2. It’s great to see the military budget being spent in such constructive ways. May more of it come!

    posted by R4i on 6-24-2010 at 11:45 am

  3. hey thats cute and all. so, why is it again none of my friends have health coverage? beyond the fact they can’t even remotely afford it?

    posted by panda on 6-24-2010 at 11:54 am

  4. I know people stationed on the USNS Mercy on its current deployment. From Facebook posts from one of my friends, they’ve got a tough job, but they’re doing well (if not looking forward to returning home).

    posted by Steve from San Diego on 6-24-2010 at 11:56 am

  5. I’m glad the US can give free health care to hundreds of thousands of people in need of care around the world. When will they go around the impoverished areas of the US and hand out free health care, including PT and plastic surgery? I’m all for charity of third world countries, but don’t the people at home deserve the same level of charity too?

    posted by Jaime on 6-24-2010 at 12:39 pm

  6. Hey Panda, I can completely see what you’re saying, surely your friends must be destitute and starving and couldn’t possibly have access to a computer, or can afford ten minutes of their day avoiding muggers or working outside in crappy conditions for pennies a day. So yeah, I can see how you feel that way. Oh and by the way, I’ve been more than happy while I’ve been on any of my western pacific deployments, to take some of the few days off we get to go paint an orphanage, or play ball with a kid that has only seen one on TV, or hand a a plate of hot food to someone who hasn’t eaten a full plate in weeks.

    posted by Gil on 6-24-2010 at 12:51 pm

  7. that’s awesome. my tax dollars can go to other country’s healthcare, but not my own. neat. and by neat i mean absolutely horrible.

    someday the middle class will be totally gone and the powers that be will be pleased.

    posted by argh on 6-24-2010 at 1:57 pm

  8. Amazing!

    posted by cassy on 6-24-2010 at 1:59 pm

  9. Nice shot at the beginning of Mercy’s home base of San Diego Bay with downtown in the background. If you’re ever in town take a harbor cruise of the South Bay and they’ll give you the scoop on the Mercy’s recent activities. Always gives me goosebumps and always makes me thankful of the men and woman that serve when I see her and all of our naval ships in dock. Thanks Gil.

    posted by SteveO on 6-24-2010 at 2:00 pm

  10. Gil, Thank you for your service, and thank you for writing exactly the same thing I was thinking. There is absolutely no excuse for anyone in the US to not find one of the many, many outlets for assistance, while those in 3rd world countries don’t have access to this same assistance. Because it doesn’t exist.

    posted by Amanda on 6-24-2010 at 2:04 pm

  11. And yet, the world still hates us.

    posted by TBV on 6-24-2010 at 2:17 pm

  12. When all is said and done, we will all be judged by God for what we did for the poor among us, whether they were here in America or around the world. I would rather have God say, “Well done, good and faithful servant.”

    posted by Tim S. on 6-24-2010 at 2:32 pm

  13. Gil – I too thank you expressing my thoughts (without the four letter words I had in mind). I spent the latter 70′s all of the 80′s and the first part of the 90′s in the Navy. During my time I visited and interacted with many third world countries. The ‘middle class’ in most of these places live at a level that is so far below our poverty line that it isn’t even on the radar! The Navy has always been about projection of power, and has a long history of projecting ‘Soft Power’.

    When I hear people whine about how the goverment isn’t giving them enough I think spoiled little children (of any age) who think the world owes them a living. The only thing is that nearly half of what the working middle class earns is re-distributed to people who don’t add to the economy. There are folks out there who have a genuine need for help, the reason why it is so hard for them to get it is the system strives to protect itself against those that don’t and just want a free ride.

    Opps, guess I did rant a bit.

    posted by 'Da guy on 6-24-2010 at 2:32 pm

  14. For the record, the US Navy has TWO hospital ships. Not “dozens.” Thanks Wikipedia. :-P

    posted by Tyler on 6-24-2010 at 2:34 pm

  15. This is really neat, but the idea is nothing new. NGOs and faith-based organizations have been running help ships for years. See Mercy Ships (mercyships.org) or Operation Mobilization (omships.org) for some great examples.

    posted by Rachel O. on 6-24-2010 at 2:43 pm

  16. Amazingly enough for some to hear, but Panda is correct – there are people in America that are just as poor and destitute as those in the stereotypical impoverished countries. It is sad, and never seen. No wonder people get angry at Panda.

    posted by Bakedpotatoes on 6-24-2010 at 4:49 pm

  17. I think we need to realize that just by being Americans, we are automatically richer than a huge majority of the planet. Sure, I wish we all could have the best of the best medical care, but we also don’t have to worry about dying of diseases cured hundreds of years ago. We don’t have to fear being sold into slavery or the sex-trafficking industry.

    Why does the world hate us? Because of people that say “oh that’s great that we help the poor and starving, but wheres MY free ride?”

    Ugh, get over yourselves and start doing something good for the world. The Navy is doing awesome work–keep it up!

    posted by KerriD on 6-24-2010 at 5:02 pm

  18. Those who compare poverty in the United States to poverty in the third world have never been to the third world. I’ve worked in both, lived two years in the Philippines and spent another six months working in Bakersfield, California. Bakersfield was ranked as the worst city in the United States in a quality of life survey just a few months ago because “Bakersfield has the highest poverty rate of any major market, as well as the lightest concentration of management and professional jobs, weakest inventory of big houses, and smallest percentages in the three educational categories that track adults with high school diplomas, bachelor’s degrees and advanced degrees.” I worked in several of the slums areas there on a charity mission.

    Poor? Sure. But nothing compared to the absolute crushing poverty that I saw in the Philippines. They are worlds apart. There aren’t places in the US where sewage is dumped right into the streets, where there is no access to basic needs like clean water. If you’re poor in the US you have access to free clinics and medical assistance, which might not be great but are nonexistant in most third world countries.

    As to the article, I had the chance to tour the Mercy a long time ago and it was very impressive. Nice to see an effective use of ‘soft power.’

    posted by funkylovemonkey on 6-24-2010 at 5:10 pm

  19. To clarify: the Mormon church is officially called The Church of Jesus Christ of Latter Day Saints.

    posted by Jon on 6-24-2010 at 5:18 pm

  20. I think it’s wonderful what the Navy is doing. I’m glad to hear of it.

    By the way, the article mentioned that volunteers from the Church of Latter Day Saints joined the Comfort in 2008. Those volunteers were actually from The Church of Jesus Christ of Latter-day Saints. http://www.lds.org/ldsnewsroom/eng/style-guide

    posted by Jenny on 6-24-2010 at 5:25 pm

  21. This is all very nice – a good use of military capabilities and resources. However – before you Yanquis go patting yourselves on the back too much – a little reality check. The tiny nation of Cuba (pop. 11-million), subject to a 50-year-long economic embargo and other attempts to destroy it by the great USA, has had medical teams working all over the world since the 1960s. Thousands of medical practitioners delivering LONG TERM health care in communities where no ship could ever reach, and where doctors in those countries refuse to go… isolated communities, mountains areas, etc.

    Cuba was in Haiti for a decade before the earthquake, and continue to have the largest, best developed programme on that impoverished island.

    When the earthquake hit Pakistan a few years back, Cuba sent a huge team which was one of the few able to provide culturally-appropriate medical care to muslim women (who could not see male doctors), as Cuban women make up some 65% of medical professionals.

    Lots of detail here:
    http://www.medicc.org/ns/index.php?s=12&p=0

    Whereas one could argue that the Mercy and its medical outreach brings good PR to the US military, Latin Americans know who their friends are. Cuban physicians who stay in the communities and bring long-term benefits are respected and valued for their solidarity.

    posted by Mark Rushton on 6-25-2010 at 8:28 am

  22. The comments are just as fascinating as the article! Awesome.

    posted by Reese on 6-25-2010 at 11:26 am

  23. Well said, Reese! Each time I read a comment, I have a comment…

    posted by Hyacinth on 6-25-2010 at 12:17 pm

  24. Mark may I suggest that you abandon the evil US and move to Cuba. I am sure one of the Castro boys would be happy to have you tell the improvrished people of Cuba how great they have it – it could be worse, they could live in their sister commie state – North Korea.

    posted by 'Da guy on 6-25-2010 at 1:28 pm

  25. i’ll pass on to my friends who work full time, but still cant manage the 400$+ a month insurance costs. that they are lazy and possibly bums. and that even though they pay their tax’s. as in they pay for the military, and the insurance people in the military get. they don’t deserve any themselves. i’m sure they will see how stupid they were. thanks for setting me straight.

    posted by panda on 6-25-2010 at 2:22 pm

  26. Panda, I looked everywhere, and while it’s completely possible I missed it, I honestly did not see where anyone called your friends who work full time “lazy and possibly bums.” Instead, there were a lot of different opinions about the amount of assistance that is available for people in the US versus the nonexistent clinics, hospitals, etc., for those in less fortunate countries. But hey, I’m saving up my money for an eye exam. Maybe it’s my mistake.

    posted by Sam on 6-28-2010 at 4:05 am

  27. I am one of the multitudes of Americans that works 40 hours a week, but still cannot afford health insurance. I take care of disabled people who are fortunate enough to have healthcare provided by our government. Meanwhile my(Government funded) job refuses to offer me healthcare.
    Day by day I am slowly dieing because of this. I have chronic infection that could easily be cured with antibiotics that are handed out(at the cost of my taxes) to people all over the world, but to even get a doctor to look at me it will cost me a week’s salary at a “Free” clinic.
    The problem is not a sense of entitlement, laziness, or lack of knowledge of what is available to me. The problem is that the programs only really help those that don’t work at all, and once you make enough to survive, you lose access to the programs that provide healthcare.
    The only reason that we are really in the boat that we are is because insurance companies are the ones that set the prices that they are willing to pay(an ever-increasing number), they drive the price for doctors up by continually charging them more and more for malpractice insurance, and they limit who they will cover, both with price and more ways that they will disqualify you for coverage.
    The per-patient cost of the military taking care of the impoverished across the world is surprisingly low(though probably higher than a domestic patient because of the transportation of the supplies, the ship, the ship crew, etc.)because they bypass the need to deal with insurance companies. The patients don’t have any, the doctors do not pay for malpractice insurance, and the meds come at rock bottom prices because of the volume the government buys directly from the manufacturers(again by bypassing insurance companies).
    These insurance companies became rich to the point that they could lobby(read: bribe) politicians to stifle any reform to this system for years. Even the changes that we have been promised will be a far cry from the changes that could have been made.
    It is not the lazy, unemployed, or the truly destitute that need the insurance, they all qualify for an Access card already. It is the workforce that drives the American economy. A healthy workforce is a productive workforce.

    posted by OIK2 on 6-30-2010 at 10:55 pm

Comment

commenting policy