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Coast Guard 

To Win Hearts and Minds, Give Coast Guard New Hospital Ships 

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Commentary By Craig Hooper and Jim Dolbow 

Long before it became fashionable to “win hearts and minds,” the U.S. Coast Guard was rescuing people regardless of nationality.

Humanitarian missions are a perfect match for the Coast Guard’s lifesaving ethos. That is why the Coast Guard needs to acquire both large and small hospital ships.  

Hospital ships would be a welcome addition to the Coast Guard’s fleet of cutters. Recent Navy deployments of the USNS Mercy and USNS Comfort have demonstrated their ability to project a caring image of the United States around the globe.   

The Coast Guard operates in a diplomatic space that the Navy is unable to replicate, and offers the United States another avenue to engage in politically sensitive disaster response and medical outreach projects.

Hospital ships are, by design, multi-use vehicles that are capable of serving in command and control, educational outreach, or as virtual sea bases.

The Coast Guard’s modernization plans — under the Deepwater program — already are under stress and budgets are strained. So new hospital ships would be best drawn from tested hulls found in the inventories of both the U.S. and allied navies as well as the private sector. No need to reinvent the wheel.  

A future hospital ship should be tied into some sort of modularized container system that may mirror the modules used by the Navy’s Littoral Combat Ship. A ship that might be charged with high-tempo combat trauma care will need a flat deck that is able to withstand the heat and weight of large helicopters. A well deck also would be recommended, although it could be passed over if the ship is able to dock or maintains an organic docking system.  

Under a two-tier system, smaller, cheaper ambulance-like platforms could work in tandem with a larger, more expensive command-and-control “trauma” platform or aid ship tenders where the crew of a smaller, low-endurance craft can take a breather or swap out crews.  
For guidance on doctrine, Coast Guard planners can look to World War II, when small ambulance ships often worked as primary receiving platforms.  

A floating trauma center requires a large platform that is capable of supporting a hospital and of providing sufficient electrical, water, crew-surge space and stability, as well as comprehensive organic decontamination facilities and the ability to receive contaminated or infectious casualties and aid workers either from the flight deck or well deck. A natural solution would be the LPD-17 class of amphibious ships, which offer a 25,296-ton displacement and 23-foot draft. The chief drawback, however, is the LPD’s billion-dollar price tag and crew of 360.  

If the Coast Guard can’t afford a medically-dedicated LPD-17, there are cheaper, more versatile vessels on the world market. Options include France’s built-to-commercial-specifications Mistral helicopter carrier (displacement 21,500 tons, draft 20 feet), Japan’s smaller Oosumi (14,000 ton displacement, 21 foot draft) or any other member of the emerging global fleet of flat-deck/well deck amphibious ships — as long as the flight support facilities can be modified to handle large military helicopters.

Of all the flat decks, the Mistral would be a top choice because France seems likely to remain an active and enthusiastic partner in maritime outreach in the coming years. France also maintains many islands and remote territories. Of the countries that have the most to gain by building a set of active maritime alliances, France is it. By picking the Mistral as a standard for an aid vessel, the Coast Guard would be creating a longer-term tie to a valuable seaborne ally.

As a super-cheap dark horse, a modified Lewis and Clark cargo/logistical support ship might be worthy of consideration. It is already built to handle small-ship support and logistical needs, and offers ample cargo handling and sorting capabilities. It would require shedding some of the “support” vessel characteristics and move hospital/residential modules into the ship’s hold while also adding additional rotary-wing support facilities.  

As far as smaller-scale aid ships go, the Coast Guard would be wise to consider one of the existing ferries that have been designed for the Navy’s soon-to-be-announced Joint High Speed Vessel. These “navalized” auto ferries can get in close to shore and are capable of deploying a containerized hospital or operating limited outreach in degraded ports.

Another option is the Gen. Frank S. Besson Jr. class littoral support vessel. A throwback to the LST (landing ship, tank), the LSV has considerable potential for niche missions. A modified LSV (4,265 ton displacement with a 12 foot draft) hauling up to 2,280 tons of cargo might fit the needs of medical outreach. The chief drawback to the LSV is that it is slow and sails like a brick.  

Catamarans and trimarans are hampered by a far smaller payload (500-700 tons) and are less fuel efficient, but they are tough to beat in speed.

A compromise candidate between the large and small platforms is Denmark’s commercial Absalon class. It is essentially an armed (6,300 ton displacement, 21 foot draft) roll-on/roll-off cargo ship with a small flight deck and hangar. Like the U.S. Coast Guard’s smaller Bertholf class National Security Cutter, the Absalon is a modular, long-legged craft, ready to operate in hot climates, and is affordable. It has enough going for it that it can, with the help of some deft shifts in the medical mission module set, become everybody’s floating hospital.

As the two remaining U.S. hospital ships face retirement, the Coast Guard has an opportunity to step up by offering Congress a compelling case for funding hospital ship construction and integrate hospital ship operation into top-line increases to the Coast Guard’s annual budgets. A cash-strapped Navy can then focus on its own modernization projects.

Craig Hooper is a visiting assistant professor at the Naval Postgraduate School in Monterey, Calif. Lt. Jim Dolbow, USCGR, is an M.A. candidate in statecraft and world politics at the Institute of World Politics in Washington, D.C.
Reader Comments

Re: To Win Hearts and Minds, Give Coast Guard New Hospital Ships

This thread is probably dead, but if someone like me reads it...after seing the comfort sail away to Haiti, I do wonder why there is no one out there funding a modern hospital ship.What about that Virgin guy...Sir Richard Branson or something...why is the public sector not involved in funding such a venture. I can see a Mistral with the Virgin logo (same colors)red and white doing what the comfort is doing but with worldwide doctor's, nurses a crew manning the ship...a more United Nations approach with private money.

benoit forcier on 01/18/2010 at 21:34

Re: To Win Hearts and Minds, Give Coast Guard New Hospital Ships

Why not use a decommissioned ship that can be modified cheaper then building new or purchasing a foreign built ship.
My suggestion would be the decommissioned USS FORRESTAL AVT-59.
This ship had a large medical area, has a very large flight deck for helos and other aircraft. The deck edge elevators machinery spaces can be converted to patient areas along with the squadron rooms & ready rooms. There is more then enough storage areas. There were 2 mess decks (forward & aft). This ship would have everything that you would need for a very good Hospital Ship & can be shared with the Coast Guard and PHS.
The new hull no would be
USS FORRESTAL T-AH 59

Marc on 12/09/2009 at 11:58

Re: To Win Hearts and Minds, Give Coast Guard New Hospital Ships

leesea,

If the hospital ships are built, the USCG and PHS would be sized and structured for T-AH operations.

Jim Dolbow on 11/23/2008 at 16:50

Re: To Win Hearts and Minds, Give Coast Guard New Hospital Ships

The article strongly suggests that these notional aid ships be used for other Coast Guard purposes when not committed to an aid mission. There's no reason to change the present surge manning model required to deploy the current set of hosptial ships--keep the medical surge a Navy/USPHS/NGO mission. But allow the Coast Guard to use newer vessels for other activities when they're not needed for aid/medical diplomacy missions. So enough of the hand-wringing about manning--as long as a Hamilton Class Cutter sails the sea, the Coast Guard certainly has enough people to man and operate a Mistral.

Now, don't get hung up on the complexities of granting a vessel "hospital ship" status. That's a canard. Plenty of vessels work the medical aid/medical diplomacy mission without being formally certified as a "hospital ship." Frankly speaking, there isn't a missle out there that can actually distinguish between white or grey hulls!

Springbored on 10/26/2008 at 13:49

Re: To Win Hearts and Minds, Give Coast Guard New Hospital Ships

As someone who helped introduce the Hosptial Ships to MSC, I think I can say conclusively that the USCG is completely under manned and not set up to operate them. What the authors fail to appreciate is that the hospital ships' crew alone ranges from 25 in ROS to 125 CIVMARs in FOS. The Medical Treatment Facility aka hospital, ranges from 40 to 1200. MSC provides all the ships’ crews, while large MTF/hospitals and the naval reseves provide all the needed medical and support personnel. The USCG & PHS are simply NOT sized or structured for large or even mulitple smaller T-AH operations.
While there is serious discussion about building more or replacement ships, using a warship as a model does not fit the authors good ideas about modular medical facitlities. Perhaps they should become familiar with the USN Expeditionay Medical Faclity which is just that?! Most who have actually managed T-AHNs realize several smaller ships with additional functions & capabilities are what is needed. For instance, the Mercy had to add two utility boats since they were needed to transport crew, staff and patients to/from shore. The flght deck had to be improved to support helos for longer periods. There are no cargo holds to support the Seabees which are not seen as essential elements in a T-AH mission. While the Mistal and Absalon designs are very attractive, multi-mission ships, their cost may be as unaffordable as the LPD17 which is far too much to spend on medical diplomacy. I serioulsly doubt a T-AKE naval auxiliary could be modified cost effectively to be a T-AH? The modifications fwd of the house alone would be significant.
P.S. its not just the white hull which is required by international treaty, it is also the removal/abscence of military systems which a hosptial ship must conform to.
I have a concept paper which addresses these problems, just email me.

leesea on 10/24/2008 at 13:39

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