Base Both U.S. Hospital Ships in the Pacific

As the Navy prepares for a potential maritime conflict in the western Pacific, it will need every available asset. That should include basing both hospital ships and their eventual replacements in the Indo-Pacific theater and employing them in ways that develop key strategic partnerships. Having them in the Indo-Pacific also would position medical resources for either foreign humanitarian assistance or combat trauma support, should there be a rapid transition from peace to conflict.

Wide-Ranging Value

Every year, the hospital ships USNS Mercy (T-AH-19), based in San Diego, California, and USNS Comfort (T-AH-20), based in Norfolk, Virginia, take part in theater security cooperation missions, such as Pacific Partnership or Continuing Promise. Through these missions, the Navy demonstrates a commitment to providing humanitarian assistance following natural and man-made disasters. This is a key element of soft power that complements U.S. diplomatic efforts and shows allies and partners that the United States is their “friend of choice.” In 2018, the USS Carl Vinson (CVN-70) made history as the first aircraft carrier to return to Vietnam since the end of the Vietnam War in 1975. This was made possible in large part thanks to the Mercy making multiple trips to the country in the years prior to the Carl Vinson’s arrival.¹ The strategic use of hospital ships has resulted in foreign port access for Navy warships and strengthened partnerships in Southeast Asia.

Hospital shipsalso have repeatedly de------mo--nstrated their humanitarian assistance capabilities on a global stage. For example, in January 2010, the Comfort deployed in response to the 7.0 magnitude earthquake that rocked Haiti. The ship arrived from Baltimore in only 77 hours and began receiving critical patients immediately. The ship treated 871 patients and performed 843 surgeries during the 60 days she was dedicated to Operation Unified Response.²  

In addition to their capability to care for combat trauma patients, the Mercy and Comfort also have tremendous logistical utility to support distributed maritime operations. Both ships can produce potable water and store 300,000 gallons of it on board. They both have two oxygen-production plants and can refill depleted cylinders. They can carry 42,000 barrels of DFM/F76 ship fuel and hold 90,000 gallons of JP5/F44 aviation fuel.³ They also can carry massive stocks of medical material and, if properly resourced, can provide general area support for medical resupply. These ships are often seen only in terms of beds and casualties, but they also should be considered part of the larger global prepositioning effort to get supplies and consumables in position to support a wide range of operations.

Closer Access to the Western Pacific 

Getting the Mercy and Comfort in place to bolster fleet operations is time consuming. They are converted supertankers that plod along, not swift warships that can quickly steam to where needed. If a crisis unfolded in the western Pacific today, such as a natural disaster or military conflict, the nearest hospital ship—the Mercy—would take up to three weeks to get to the theater (see Figure 1). In that time, U.S. and allied forces would be without this important capability. Time and distance are real factors that must be considered.

China also has a hospital ship and a penchant for using it to project soft power for strategic influence. The Peace Ark, based in Zhoushan in the South Sea Fleet, provided humanitarian assistance following Super Typhoon Haiyan that devastated the Philippines and routinely supports Beijing’s theater security cooperation missions to countries in Africa and South America.⁴ If a humanitarian crisis unfolded today in the western Pacific, China would have the jump on responding. This should change.

To maximize both hospital ships’ ability to reinforce the nation’s strategic goals relative to China, the United States’ primary adversary, and support distributed maritime operations, the Navy should support Military Sealift Command in:

•  Assigning the Comfort to the Indo-Pacific theater. Bringing the Comfort to join the Mercy in the Pacific would be a strong strategic message of U.S. preparedness and resolve.  

•  Basing one of the ships in Guam, Japan, or Singapore. In the event of a conflict or disaster, the ship’s medical staff could “surge” forward from the continental United States to embark rapidly. Staging one hospital ship west of the International Date Line could cut 10–14 days from the time required to bring logistical and casualty-receiving resources to bear, and would provide commanders a tool to rapidly support partners with humanitarian assistance and reduce risk to the force during the early days and weeks of a conflict. The Navy obviously sees value in forward-basing forces in Japan, Guam, Bahrain, Spain, Diego Garcia, and Singapore, for example. Positioning a hospital ship forward should be viewed through the same lens. 

• Rehearsing hospital-ship integration as part of Indo-Pacific theater sustainment plans for Class VIII (medical) supplies. The hospital ships would provide an opportunity to preposition Class VIII supplies in the maritime environment. However, Navy medicine needs to practice line-item resupply of medical materials for joint warfighters in the Pacific. It will be too late to identify friction points when patients are on the surgical table. Better coordination with the theater lead agent for material management in the Pacific would ensure these ships are prepared to support the larger theater sustainment efforts.

Some would view basing both hospital ships in the Pacific as a slight to European allies. However, such a move would not foreclose bringing a hospital ship back to the Atlantic or anywhere else when needed. It does shift the risk associated with long transits from the Pacific to the Atlantic, but the United States and its NATO allies already have far more medical resources in the European area of responsibility and near the Africa Command area of responsibility than exist in the western Pacific. The need is greater in the Pacific, and the hospital ships’ homeport assignments should reflect that.  

Hospital ships will always be one of the first assets to respond to humanitarian crises or maritime conflict. As large-scale maritime conflict in the western Pacific grows increasingly possible, having both hospital ships permanently based in the Pacific would send a strong signal to allies, partners, and, most important, China that the United States is increasing its commitment to the region.