---------------------------------------------------------------- The Navy Public Affairs Library (NAVPALIB) A service of the Navy Office of Information, Washington DC Send feedback/questions to navpalib@opnav-emh.navy.mil ---------------------------------------------------------------- Department of the Navy Policy Paper "...From the Sea" Update NAVY MEDICINE - "SHAPING THE CHANGE" Spring 1994 The Navy - Marine Corps white paper "... From the Sea" set a new course for U. S. naval policy. It foretold a fundamental shift away from global war and open ocean warfare to a focus on regional conflicts and joint operations conducted in littoral regions, from the sea. Today's naval forces must prepare for unique operations including humanitarian assistance, disaster relief and peacekeeping as well as conventional wartime contingencies. This change affects the entire Navy, including Navy medicine. "... From the Sea" served as the foundation for significant changes in doctrine, organization, operational requirements, education, training, and acquisition involving the entire naval force. Navy medicine is prepared for the challenges of the post- Cold War era and the special requirements of the Naval Expeditionary Forces in particular. The following health care initiatives will shape Navy Medicine's operational role into the 21st century. HEADQUARTERS ORGANIZATION Operations envisioned in ". . . From the Sea" require a highly responsive, flexible, and well-trained Navy Medical Department. As new joint military missions occur, the Navy must adapt and size its health care delivery system to fit the particular contingency. To improve organizational effectiveness, three changes have been implemented at the headquarters level: - At the Pentagon, the Medical Resources, Plans, and Policy divisions on the Navy Staff have been consolidated into one division to more effectively interface with the Office of the Secretary of Defense, the Joint Staff, and other agencies within the Department of the Navy. - At the Bureau of Medicine and Surgery, the Plans Analysis and Evaluation (MED-08) code was established to coordinate the execution of operational health care planning initiatives with the peacetime health care delivery system. - In the fleet a Navy medical augmentation unit is being planned. This initiative will create a "standing" health care cell that can be activated to advise operational commanders on health care issues, and provide Navy input at the Unified Command headquarters. OPERATIONAL HEALTH SERVICE SUPPORT Responding to crises requires great flexibility and innovative approaches to providing prompt access to quality health care while limiting the drain on logistics, personnel and other resources. Anticipating the requirement for a lighter, more mobile fleet hospital, Navy medicine has developed the concept for a 100-bed modular, self-contained unit. The modular design feature will provide the Joint Task Force commander with a tremendous degree of flexibility in tailoring the hospital's size and capability to the requirements of the mission. Two 100-bed fleet hospitals are planned; they will be assembled from the existing fleet hospital inventory and pre-positioned on each coast. Navy medicine is evaluating the primary casualty receiving and treatment capabilities on board existing and future amphibious ships, to ensure quality health service support to our operational Marine Corps forces ashore. Planning has begun to develop incremental staffing packages for the hospital ships for capacities ranging from 250 to 1,000 beds in support of both wartime contingencies and unique peacetime tasking. With the increased likelihood of providing health care for humanitarian assistance and disaster relief operations, Navy Medicine continues to train it's fixed medical treatment facility staff in the management of mass trauma. These training exercises are designed to enhance the responsiveness of our health care team in dealing with the wide range of medical and dental problems our active duty force and local civilian communities may encounter. The relief effort following hurricanes Andrew and Hugo gave Navy medicine the opportunity to quickly respond to emergent health needs and provide support to civilian providers. Additionally, humanitarian Mobile Medical Augmentation Readiness Team (MMART) medical equipment and supply kits have been developed to provide specialized health care required in remote or isolated locations. Navy medical research and development is focusing its efforts on medical problems that constrain operational forces involved in regional and littoral contingencies. The Joint Forward Laboratory significantly enhanced the effectiveness of preventive medicine in Somalia during Operation Restore Hope by keeping the disease rates of our forces to an absolute minimum. The many important research areas being explored include advanced wound healing, cholera and malaria vaccines, and freeze- dried blood. Navy medical research is on the cutting edge. EDUCATION AND TRAINING Education and training is an integral part of our ability to meet all operational health service support requirements. Strong graduate medical education programs ensure that the Navy will have a sufficient number of needed specialists to support both operational and peacetime health care missions. Using Navy trained specialists, we can keep CHAMPUS costs down in peacetime, minimizing the risk of paying for health care benefits with readiness funds. Navy medicine is continually re-evaluating every element of the health care system, especially as new expeditionary warfare concepts evolve. Innovative training approaches, such as computer simulation technology, are being explored to maximize training opportunities. Joint operations are a key element of military missions. Navy medicine is making a concerted effort to include a sufficient number of medical department officers in the Joint Staff Internship and other Joint Staff training courses. Representatives from each of the Navy medical corps are being enrolled in various Service Staff and War Colleges to gain greater understanding of military science and help develop a more balanced health care perspective. Navy Hospital Corpsmen play an important role in Navy health care support. Corpsmen are being provided with greater opportunities for clinically supervised, hands-on training in medical treatment facilities. This develops the proficiency and personal confidence needed to provide the best care for sailors and Marines in the fleet. NAVAL RESERVE Naval Reservists continue to play an important role in providing enhanced health care for Naval Expeditionary Forces. Medical and dental Reserve personnel contribute by: - Providing active duty training back-fill, which improves access to care, and further reduces CHAMPUS and supplemental care costs. - Supporting humanitarian assistance and disaster relief operations. The Reserves accomplish this while maintaining a readiness posture in support of mobilization requirements with the Fleet Marine Force, in fixed medical and dental treatment facilities, and in fleet hospital operations. NAVAL MEDICAL DOCTRINE In 1993 Navy medicine established the Naval Medical Doctrine Center to develop guidelines to use medical and dental assets. The center is scheduled to become part of the Naval Doctrine Command and to work closely with the Marine Corps Combat Development Command and the Joint Doctrine Center to optimize joint mission capabilities of Naval Expeditionary Forces. Also, the center is developing ways to effectively employ the fleet hospitals and hospital ships to meet the needs of operational commanders. CONCLUSION Navy Medicine is a key element in the strategic vision of "... From the Sea". The primary mission of providing health care to Navy and Marine Corps forces has not changed. The environment and the threat our forces face, is varied and constantly changing. Navy medicine remains vigilant, keeping pace withforce requirements and the needs of operational commanders. As wartime requirements change, our mechanism for providing health care must change. For example, we must be prepared to respond to the use of weapons of mass destruction by our adversaries. Reserve health care professionals will continue to augment our active duty forces in times of war and will provide maximum contributory support during peacetime. Navy medicine plays a vital role in naval warfare strategy. Despite end strength reductions and challenging fiscal restraints, Navy medicine will continue to provide quality health care to our operational forces and their families back home. Our warriors can fight with the peace of mind they need to face the nation's mission head on. Navy medicine is assisting now "... From the Sea." For additional information or to arrange an interview with a Navy expert on this issue, call CHINFO Media Operations, (703) 697-5342. -USN-