First Aid for Navy: Gigantic Hospitals Readied for Seas

When Navy Secretary John F. Lehman Jr. and his top advisers met in 1981 to map long-term military strategy, they were startled to learn that the blueprints for a 600-ship Navy did not include a single hospital vessel.

“We found we had no way to care for casualties,” Lehman recalled in a recent interview. “There were just no plans.”

Today, the results of that Pentagon brainstorming session can be seen in San Diego Bay--two gigantic ships adorned with red crosses on the outside and enough room inside for 1,000 beds each.

Nearly three football fields in length, each hospital ship contains 12 operating rooms, intensive care wards for 80 patients, a morgue with 22 spaces and landing pads large enough to accommodate the military’s largest transport helicopters. Their combined price tag is $510 million.

The Navy has not maintained a hospital vessel in peacetime since the late 1940s. In the past, the United States waited until the outbreak of war before converting liners and freighters into hospital ships and rushing them to combat areas. The last hospital ships were put in moth balls after the Vietnam War.

“It does signify a change both in priorities and in philosophy. . . . “ Adm. Carlisle A. H. Trost, the chief of naval operations, said in an interview last week. “The whole idea in combat is to return the casualty who doesn’t require long-term hospitalization to his operational unit as quickly as possible.

“We’d gotten to the point where our ability for caring for casualties on a mass scale had really declined to the point of near nonexistence.”

Due for delivery within the next six months, the two new hospital ships will be larger than all but a few land-based hospitals.

“There is no other country that has anything like this capability,” said Dr. William Mayer, the assistant defense secretary for health affairs. “These things are truly unique. This is American medicine at its finest aboard a ship which can be put any place in the world.”

A First for Navy

The hospital ships are being converted from 90,000-ton supertankers, a first for the Navy and the contractor, National Steel and Shipbuilding Co. of San Diego.

The Navy initially planned to put the Mercy and the Comfort on standby status in Oakland and Norfolk, Va., respectively, and assign skeleton crews to maintain the ships in case of war or other emergency need.

But last month President Reagan announced that he will send the Mercy to the Philippines as part of a $10-million emergency aid package. The ship and its crew of military doctors and nurses are scheduled to spend four months early next year operating a general outpatient clinic in the Philippines and elsewhere in the South Pacific. They are expected to treat a variety of cases, including malaria, strep throat, eye diseases and basic dental work.

The “humanitarian mission” was first proposed by Adm. James A. Lyons Jr., commander of the U.S. Pacific Fleet in Hawaii.

“I looked at what was going on in the Philippines and some of the promises Mrs. (Corazon) Aquino had made to the Philippine people and it seemed to me that she needed some early successes if we were going to sustain the atmosphere of hope,” Lyons said in an interview.

No ‘Direct Relationship’

Lyons denied that the trip was planned to bolster the United States’ image among Filipinos or to improve the military’s chances of renegotiating its agreement to operate naval bases in the Philippines, which expires in 1991.

“This is part of helping rebuild the nation,” Lyons said. “I wouldn’t want to draw a direct relationship between this effort (and the lease agreement). This is done in helping to restore and build a viable democracy in the Philippines.”

The relief project in the Pacific--the ship will move on to undesignated locations after the Philippines--promises numerous logistical problems.

Every feature of the Mercy--from the helicopter landing pads to the built-in oxygen lines running to the beds--were designed solely to provide emergency surgical care to wartime casualties, not to dispense routine medical care, according to Navy officials.

In preparation for the relief effort, shipyard workers currently are figuring out how to convert the Mercy’s medical wards into waiting rooms and provide access for civilian patients to board the massive hospital ship, said Fred Hallet, a company spokesman.

In addition, the use of military doctors and nurses aboard the Mercy will likely reduce the level of health care at overcrowded medical facilities for American military personnel and their dependents. To ease the burden, Navy officials have announced plans to use Filipino physicians on the Mercy and fly U.S. medical personnel to the Philippines so they won’t waste time sailing across the ocean.

Wants Ships Kept on Standby

Trost said the tour of the Philippines will give Navy personnel an opportunity to become familiar with the hospital ship. But after the trip, the Navy’s top uniformed officer said, he will urge that the two hospital ships remain in port on standby status, despite the “great temptation” to send them around the world on other relief missions.

“They are not really designed for the type of operation the Mercy is going on,” Trost said. “. . . It’s geared to bring large numbers of serious casualties on board and handle them. It’s a casualty hospital.”

The Navy, which had not built a hospital ship since World War II, argued to Congress that it needed the Mercy and the Comfort to participate in emergencies or long-term conflicts.

One of the early supporters of the ships was Sen. Pete Wilson (R-Calif.), a member of the Senate Armed Services Committee. Wilson said in an interview last week that he was surprised the Navy did not have one hospital ship in its fleet. Following the Vietnam War, the hospital ships Sanctuary and Repose were taken out of service.

Trost blamed the lack of hospital ships on “a combination of budget priorities” and “benign neglect.”

Features on both hospital ships include a satellite lab, pharmacy, library, gymnasium, physical therapy equipment, eyeglass center and barber shop. The ships also have four distilling plants, each capable of producing 75,000 gallons of fresh water a day.

While each hospital ship will require an operating crew of only 14 officers and 54 crewmen, the proposed medical staff and support crew would number 1,192.

The Comfort is currently undergoing sea trials and will be delivered to the Navy next spring. The Mercy will be commissioned on Nov. 8 and is scheduled to sail for the Philippines in March.