Director's Notes:
Civil-Military Humanitarian Action
and the USNS Mercy

The international civilian relief community’s sometimes contentious discussions about adherence to core humanitarian values in the context of a changed world continue to reverberate. These discussions generally center on identifying practical and ethically consistent approaches to providing effective humanitarian assistance. At the same time, military forces also struggle to adapt to the changed conditions of a long and asymmetric war on terror. The ambiguities that complicate what we now call ‘stability operations’ – to avoid or effect transition from conflict – make obsolete many previous operational assumptions and doctrine. These uncertainties bring unprecedented challenges to military planners and policy makers. Although it is an idea staunchly resisted by some, I am beginning to think that humanitarians and military practitioners are grappling with the same strategic problem from apparently conflicting traditions but with far less different motivations and goals than commonly believed.

It is, in any case, certain that civilian and military responders will continue to encounter one another in the field as they respond to a range of natural and manmade disasters. As important, civil and military response activities will also inevitably influence each other’s role across the continuum from humanitarian crises to stability and sustainable economic development. In short, consensus on civil-military division of labor in humanitarian crises and now even in non-crises has not moved very far. It remains very much a work-in-progress. There are, however, exceptions.

Recently, at the invitation of the Commander of the U.S. Pacific Fleet, Admiral Gary Roughead, USN, I had the extraordinary opportunity to visit the USNS Mercy, a U.S. Navy hospital ship deployed to Asia, during her call at Jolo, an island in the southern Philippines. Not only was the visit personally rewarding, it was also very instructive about the opportunities and challenges civil and military responders face in the months and years ahead.

It is not irrelevant that the USNS Mercy deployment beginning in late May of 2006 occurred only after considerable discussion and debate among military planners and funding authorities within the Department of Defense. The extensive discussions took place despite a previous successful voyage in early 2005, which was in support of populations struck by the great tsunami of December of 2004. The USNS Mercy deployed this time with the explicit mission to provide even more systematic and comprehensive humanitarian medical assistance than her earlier voyage to coastal communities in need in South East and South Asia.

On my brief visit to the ship, I was immediately struck by the stark contrasts and unexpected parallels between this large ship and the small island in the Southern Philippines in whose bay she was anchored. The enormity of the ship and her sophisticated health care capabilities contrasted sharply with the small coastal town where only 11% of the population has access to clean water. The Mercy’s force protection measures in response to security challenges presented by Abu Sayaf elements operating in the area also underlined the different approaches civilian and military actors take to promote security in pursuit of stability and improved services for populations that remain vulnerable to disaster, disease, and exploitation.

Despite these contrasts, the dedication, goodwill, and prodigious work of this diverse group of professionals demonstrated the promise of future civil-military cooperation in improving the lives of those in need of humanitarian assistance. The enthusiasm of the USNS Mercy’s international crew of civilian humanitarians, military health professionals from several allied nations, Military Sealift Command (MSC) civilian mariners, and military support staff was clearly reinforced by the smiles and appreciation they generated among those they touched from the community of Jolo Island.

People were treated, mothers relieved of worry about their children’s specific health conditions, and the elderly in the community were treated and shown proper respect and consideration. A significant number of patients returned home with their lives changed irrevocably for the better. In a real sense, substantive humanitarian benefit was achieved, perceptions of Americans and even NGOs aboard were enormously improved and, as important, civilian and military health providers were learning and working together as pioneers in an evolving world of challenges for civil-military humanitarian collaboration.

Understandably, it is often argued that the cost of the USNS Mercy deployment is far too high for the undefined national security value received through changed perceptions among poor and remote communities far from American shores. Those driven by metrics of predicable effect would have been skeptical at best at the subtle but seemingly ubiquitous euphoria that was evident among both care givers and receivers on and near the USNS Mercy during her visit to Jolo Island. However, while the benefits of the Mercy’s work in changing local perceptions of American intentions are difficult to measure, the strong impression from Jolo residents is that they are very real indeed.

It can be argued that the military has no business promoting stability through humanitarian work – that such activities are the prerogative of truly neutral, independent, and impartial civilian humanitarian organizations. But to the people of Jolo, such issues are irrelevant. Promoting national security objectives through genuinely impartial humanitarian assistance delivered by coordinated civilian and military effort is not only possible; but has until recently been significantly under-appreciated as a technique to promote security and stability. Moreover, the impact of humanitarian work can be refined and improved through effective collaboration across civil-military and international lines to the benefit of future performance in achieving both humanitarian and longer-term stability and security goals.

Ultimately, the success of the USNS Mercy will be measured beyond the great humanitarian and medical benefits her crew delivered. What it may reveal to policy makers about the benefits of humanitarian action in enhancing security and stability may be even more consequential. The USNS Mercy’s work in 2006 certainly demonstrates and reconfirms the too-often untapped synergies of civil-military collaboration in providing humanitarian assistance.