1 Maritime Engagement Missions CAPT Jim Terbush MC USN Fourth Fleet Surgeon

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Maritime Engagement Missions

CAPT Jim Terbush MC USN

Fourth Fleet Surgeon

Maritime Strategy: – Core Capabilities

• Forward Presence

• Deterrence

• Sea Control

• Power Projection

• Maritime Security

• Humanitarian Assistance and Disaster Response (Smart Power)

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Purpose

• The purpose of these missions is to train U.S. personnel while providing humanitarian assistance to our Host Nations and send a strong message of U.S. compassion.

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Endstates– Security, stability and cooperative

partnerships are enhanced throughout the region and countries visited.

– U.S. personnel are trained and postured to return and conduct future humanitarian support and disaster relief missions.

USNS MERCY (T-AH 19) anchored off the coast of Chuuk, Federated States of Micronesia

PACIFIC PARTNERSHIPPACIFIC PARTNERSHIP

Solomon Islands30 July – 12 AugSolomon Islands30 July – 12 Aug

Marshall Islands

17 - 28 June

Marshall Islands

17 - 28 June

Tonga22 Aug – 2 Sep

Tonga22 Aug – 2 Sep

Samoa5 – 16 Sep

Samoa5 – 16 Sep

Kiribati1 – 14 July

Kiribati1 – 14 July

New Caledonia

16 – 19 Aug

New Caledonia

16 – 19 Aug

Cairns23 – 26 July

Cairns23 – 26 July

Pearl Harbor 8-9 June

24-25 Sep

Pearl Harbor 8-9 June

24-25 Sep

San DiegoSan Diego

PACIFIC PARTNERSHIP 2009PACIFIC PARTNERSHIP 2009

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Bangladesh

CambodiaEast Timor

Indonesia

Kiribati

Marshall Islands

Micronesia

New Caledonia

Palau

Papua New Guinea

Philippines

Solomon Islands

Samoa

Tonga

Vietnam

PACIFIC PARTNERSHIP 2006-2009

Legend

MERCY 06 PP 09

PP07 MERCY 10

MERCY 08

PP10 CP10

A young patient onboard USNS MERCY walks for the first time in seven years after surgery on his leg: Republic of the Philippines

Photo: Department of the Navy/Department of Defense collection

The U.S. Navy Amphibious Assault Ship USS Kearsage (LHD 3)

CONTINUING PROMISECONTINUING PROMISEMissionsMissions

10UNCLASSIFIED//FOUO

Port Au Prince, Haiti9-20 Apr

Port Au Prince, Haiti9-20 Apr

Santo Domingo,Dominican Republic

21 Apr – 2 May

Santo Domingo,Dominican Republic

21 Apr – 2 May

St Johns, Antigua5-16 May

St Johns, Antigua5-16 May

Norfolk, VANorfolk, VA

Miami, FL 4-6 AprFt. Lauderdale, FL 26-28 Jul

Miami, FL 4-6 AprFt. Lauderdale, FL 26-28 Jul

La Union, El Salvador21 Jun – 2 Jul

La Union, El Salvador21 Jun – 2 Jul

Corinto, Nicaragua3-14 Jul

Corinto, Nicaragua3-14 Jul

VBN, Panama18-21 Jul

VBN, Panama18-21 Jul

Colon, Panama24 May-2 Jun

Colon, Panama24 May-2 Jun

Tumaco, Columbia6-17 Jun

Tumaco, Columbia6-17 Jun

Cartagena, Columbia20-23 May

Cartagena, Columbia20-23 May

CONTINUING PROMISE CONTINUING PROMISE 20092009

CP-09 deliverables

• Continuing Promise 2009 services provided:• Patients treated: 100,049• Surgeries conducted: 1,657• Prescriptions filled:    135,000• Dental patients: 15,003• Animals treated: 13,238  • Seabee’s construction projects; 13 complete

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Bahamas

Barbados(Lesser Antilles)

Belize

Brazil

Chile

Colombia

Costa Rica

Dominican Republic

Ecuador

El Salvador

Guatemala

Guyana

Haiti

Honduras

Jamaica

Nicaragua

Panama

Peru

Suriname

Trinidad & Tobago

Uruguay

Mexico

Continuing Promise Countries Visited 2007-2009

CP10

CP10

Hospital ship USNS Comfort (T-AH 20) receives supplies from the

supply ship USNS Peary

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LHD CharacteristicsHelicopter Deck• Nine spots• Hangar deck• 43X CH-46 equivalents

Well Deck• 249 ft L x 76 ft W x 26 ft 8 in H• 4X LCU

Ship's Boats• 2X Mk-12 36 ft LCPLs

Cargo Handling• 1X 40-ton aircraft elevator aft• 1X 20-ton aircraft elevator port• Vehicle Square: 28,700 sq ft• Cargo Cube: 156,000 cu ft• 5X Centerline cargo elevators• 1X Longitudinal pallet conveyor• 2X 3-ton Monorails

UNCLASSIFIED//FOUO

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Expected Medical Capabilities

• Direct provision of medical care:– General and specialty surgical care– Primary care for children and adults– Consultative care for children and adults– Obstetrical/Gynecological consultative care– Dental Care– Ophthalmologic services (e.g. cataracts)– Optometry services (glasses)

• Public Health initiatives:– Immunization services – De-worming– Food and water system assessments– Structural assessments– Assistance in setting up public health systems– Veterinary services– Epidemiologic/Public Health consultation (i.e. assistance in Avian

Influenza preparedness)

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Expected Medical Capabilities

Infrastructure support:– Basic biomedical repair– Engineering assessments– Water/sewer system assessments– Structural assessments – IM/IT and COMS assessment/support

Medical/nursing education:– Grand rounds -- mutual education with

training in both directions (tropical medicine being one example)

– Mid-wife training– Basic nursing skill training

Veterinary services– Large animal focus – livestock/food chain– Care and immunizations– Working Animals

Photo: Department of the Navy/Department of Defense collection

Cooperative Surgery with Dominican medical staff on board the USS Kearsarge: CARIBBEAN SEA

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Engineering Capabilities

• Broad range of capabilities: – Building repairs and improvements examples -

clinic or school rehab projects– New construction

(small projects) example - pump house– Pier repair– Road repair/construction– Runway repair– Drainage projects, trenching etc.

NGO Partners

• Development experience• Cultural and language skills• From the American people

CP-07 International Aid donated $111,000 worth of medical supplies, Hugs Across America donated 600 teddy bears, Lion’s Club International donated 30,000 pairs

of eyeglasses, PAHO donated $20,000 worth of sealants and varnishes, Project Hope donated $3.4 million in vaccines, medical supplies and books

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2020

What We MeasurePhysical Impacts

Outputs and outcomes of the engagement activities Medical Treatments, Engineering Projects, Training Classes Increase in capability and/or capacity resulting from a training event

Impacts on Attitudes Change in attitude towards the U.S. or U.S. Military Essentially encompasses different intended audiences:

National/Regional/Local officials HN Armed Forces HN Populations Participating PN and NGOs/PVOs

Impacts on Behaviors Change in behavior resulting from a change in attitude due to the

mission Very difficult to measure since there is no clear cause and effect

link and these likely take awhile to become observable