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Today's social infrastructure, e.g., transportation, medical services, energy supply and distribution, may become temporarily unable to provide functions due to the damage to buildings or excessive congestion resulting from threats, such as natural disasters, rising sea levels, pandemics. Maritime-based responses, typified by hospital ships, are drawing attention as a method to mitigate these effects. However, while designing emergency infrastructure, it is necessary to consider not only the value of these systems in emergencies but also during normal times. This study adopts the systems approach, a set of methods to conduct decision-making when complex stakeholders' relationships are involved. We focus on medical functions and propose a conceptual design for a flexible hospital ship with dynamic capability during emergencies as well as normal times. Specifically, we examine the optimal combination of ship type, size, navigation range during normal times, operations during emergencies, and contract approaches. Quantitative evaluation of utility during emergencies and economic efficiency are considered in tradeoff. In addition to the conventional cost-based study, we examined benefit-cost through ship sharing, in which ships are leased to the private sector as merchant vessels during normal times to generate revenue.
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En Cuba, el primer departamento de rayos X se inauguró en el año 1907 por Francisco Domínguez Roldán. Poco se divulga un contacto previo durante el siglo XIX, en la guerra hispano-norteamericana. Este artículo describe el uso de los rayos X en la guerra hispano-cubano-norteamericana y su importancia en la historia de la Radiología. Para esta contienda, la parte norteamericana preparó sus barcos hospitales. El ejército habilitó el Relief y el Missouri, mientras que la marina lo hizo con Solace. También se convirtieron en buques hospitales el Olivette y el Bay State. Todos contaban con equipos de rayos X. El capitán Borden publicó un libro en 1900 "El uso de los rayos Roentgen por el departamento médico de la armada estadounidense en la guerra con España (1898)" que marcó un antes y un después en el uso de los rayos X. Este fue un hecho trascendental para la historia de la Radiología y favoreció un avance considerable en la sanidad militar y civil.
In Cuba, the first X-ray department was set up in 1907 by Francisco Domínguez Roldán. Little is reported about a previous contact during the 19th century in the Spanish-Cuban-American war. This article describes the use of X-rays in the Spanish-Cuban-American war and its importance in the history of Radiology. For this war the American side prepared its hospital ships. The Army fitted out the Relief and the Missouri, while the Navy did it with the Solace. The Olivette and the Bay State also became hospital ships. All were equipped with X-ray equipment. Captain Borden published a book in 1900 "The Use of Roentgen Rays by the Medical Department of the U.S. Navy in the War with Spain (1898)" which marked a before and after in the use of X-rays. This was a transcendental fact for the history of Radiology and favored a considerable advance in military and civilian health.
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From June 28 to November 22, 2018, the Chinese People's Liberation Army Navy - PLA(N) - Peace Ark hospital ship had conducted Mission Harmony 2018, providing humanitarian medical assistance and carrying out international cooperation, in 4 Pacific island countries and 6 Central and South American countries. Compared with its application only in onshore outreach medical teams in the previous Mission Harmony, portable ultrasonography was used both onboard and onshore in Mission Harmony 2018. The purpose of this study was to assess the performance of onboard portable ultrasonography in PLA(N) Peace Ark hospital ship during Mission Harmony-2018, share our onboard working experience, and provide a reference for humanitarian assistance missions in the future. A retrospective review was performed on a cohort of patients checked by onboard portable ultrasonography. Patients' gender, age, the distribution of examined organs, and multiple applications of the portable ultrasonography were analyzed. Some limitations of portable ultrasonography on the mission and possible improvements in the future were also discussed. A total of 5277 cases (mean age: 43.74 years; range: 2 months-105 years) of ultrasound examinations were performed during the mission; among them, 3126 (59.2%) cases were performed by portable ultrasonography, including 3024 onboard cases and 102 onshore cases. The portable ultrasonography had been applied in many scenarios, for example, onboard emergency triage process, onboard bedside medical support, and onshore outreach medical service, which had become one of the indispensable auxiliary examination methods for its compatibility, portability, and flexibility. The onboard deployment of portable ultrasonography played a versatile and irreplaceable role in the humanitarian medical assistance and medical cooperation carried out by the PLA(N) Peace Ark hospital ship, and will contribute to such kind of missions in the future.
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Military Personnel , Relief Work , Adult , Humans , International Cooperation , Ships , UltrasonographyABSTRACT
Royal Navy Operating Department Practitioners are employed in a number of different roles, during peacetime, humanitarian aid operations and periods of war. In recent times, Royal Navy Operating Department Practitioners have deployed on active operations in addition to working in NHS hospitals at home in the United Kingdom. This article will explore the different avenues and experiences of Operating Department Practitioners who are currently serving in the Royal Navy. The reader will then also gain an insight into the different echelons of care provided by the Defence Medical Services to the United Kingdom Armed Forces and Allied Nations. The article will then consider the unique experiences available to Royal Navy Operating Department Practitioners in this multi-faceted role which offers the opportunity to explore work patterns in different environments.
Subject(s)
Hospitals, Military/standards , Military Medicine/standards , Operating Rooms/standards , Perioperative Care/standards , Practice Guidelines as Topic , Ships/standards , Adult , Female , Humans , Male , Middle Aged , United KingdomABSTRACT
Objective To analyze the characteristics of “Mission Harmony” overseas medical services and medical consumable requisitions, so as to provide reasonable and scientific advice for preparing future “Mission Harmony”overseas medical consumables and to scientifically and reasonably design the proportions of the medical consumable for each department. Methods A retrospective analysis was made on the person times of medical services, medical consumable requisitions and distribution proportion of medical consumable for each department based on “Mission Harmony-2017” overseas medical services in eight countries and “Mission Harmony-2018” overseas medical services at 18 service sites in 10 countries. Results A total of 110 983 patients received diagnosis and treatment, 587 patients received surgical treatment, and 454 patients were hospitalized during the two missions. Department deployment before departure of the hospital ship was the peak period of medical consumable requisitions (43.80%, 241 543/551 510). The basic medical consumables were mainly applied during the overseas medical services (49.72%, 274 225/551 510). Specialized medical consumables were mainly applied during the department deployment period (11.43%, 63 046/551 510). The medical consumables were mainly applied by the General Department of the Outpatient Department (42.39%, 233 811/551 510), Operation Room (22.99%, 126 784/551 510), and the Ward (9.67%, 53 319/551 510), while Imaging Department was the main auxiliary department to apply (4.19%, 23 085/551 510). During the periods of department deployment and overseas medical services, there were significant differences in basic medical consumables and specialized medical consumables in the General Department, Stomatology Department, Ophthalmology Department, Gynecology Department, Laboratory Department, Special Examination Room, Imaging Department, Sterilization and Supply Department, Operation Room, Ward, and others (all P<0.01). During the department deployment period, the General Department, Gynecology Department, Laboratory Department, Special Examination Room, Operation Room, Ward, and others mainly applied for basic medical consumables, while Stomatology Department, Ophthalmology Department, Imaging Department and Sterilization and Supply Department mainly applied for specialized medical consumables. During the period of overseas medical services, the General Department, Stomatology Department, Ophthalmology Department, Gynecology Department, Laboratory Department, Special Examination Room, Sterilization and Supply department, Operation Room, Ward, and others mainly applied for basic medical consumables, while the Imaging Department mainly applied for specialized medical consumables. Conclusion Different departments have different requisitions on medical consumables at different task stages. It is necessary to strengthen the management of consumables and improve the pertinence of requisition and distribution of consumables. The consumption and distribution proportions of medical consumables in each department can provide reference for the preparation, requisition and distribution for future tasks.
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INTRODUCTION: Global health engagement missions are conducted to improve and protect the health of populations worldwide. Recognizing the strong link between health and security, the Armed Forces have increased the number of global health engagement missions over the last decade to support force health protection, medical readiness, enhance interoperability, improve host nation capacity building, combat global health threats (i.e., emerging infectious diseases), support humanitarian assistance and disaster relief efforts, as well as build trust and deepen professional medical relationships worldwide. These missions additionally support the US Global Health Security Agenda, US National Security Strategy, US National Defense Strategy and National Military Strategy.Although global health engagement missions are conducted by armed forces with numerous military units and geographical locations, military healthcare personnel assigned to US Naval hospital ships also perform a wide range of these missions. These missions comprise some of the largest global health engagement missions conducted, encompassing hundreds of subject matter expert exchanges, community health exchanges, medical symposiums, and side-by-side partnered healthcare in countries around the world. Military healthcare personnel who have completed past missions possess valuable knowledge related to ship-based global health engagement missions. Capturing and transferring this knowledge to future deployed personnel is important for future successful missions, but has remained a significant challenge. The purpose of this study was to capture and examine first-person accounts of experiential learning among active duty physicians, nurses, and hospital corpsmen who had participated in recent hospital ship-based global heath engagement missions. MATERIALS AND METHODS: We used the interpretive, ethnographic method of interviewing and data analysis described by Benner. Interviews elicited detailed, narrative examples of experiences from military health care personnel who had participated in previous global health engagement missions aboard hospital ships (N = 141). Our approach to gaining meaning from these narratives was guided by three central strategies: (1) identify paradigm cases, (2) identify themes within and across participant narratives of meaningful patterns, and (3) identify exemplars to represent common patterns of meaning and common situations. Additionally, we collected demographic information. RESULTS: Our findings provide firsthand descriptions of five essential elements to prepare military healthcare personnel for shipboard global health engagement missions. These essential elements are mission clarity, preparedness, experiential knowledge, lessons learned, and flexibility/adaptability. CONCLUSIONS: Widespread dissemination of the lessons learned from military global health engagement missions is crucial to shaping forces that operate effectively in a rapidly changing global environment. Sharing lessons learned increases efficiency, adaptability, and agility, while decreasing variance in processes and the need to relearn mission-specific lessons.
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Health Personnel/trends , Military Personnel/education , Global Health/education , Health Personnel/education , Humans , Military Personnel/psychology , Military Personnel/statistics & numerical data , Naval Medicine/methods , Naval Medicine/trends , Relief Work , Ships/statistics & numerical data , United StatesABSTRACT
When providing medical services in infectious disease high-incidence areas such as Africa becomes a routine, the prevention and control of infectious diseases has become an indispensable part of hospital ship mission.“Mission Harmony-2017” provided a 155-day medical service in seven African countries (Djibouti, Sierra Leone, Gabon, Congo [Brazzaville], Angola, Mozambique and Tanzania). We successfully completed the mission through active preparation before the departure, including carefully studying the prevalent trend of infectious diseases in these countries, disease screening and compulsory vaccination and drug prevention, and critical prevention and control during the mission (staff training, health and epidemic prevention and graded precaution). At last we achieved “zero” incidence of infectious diseases among mission personnel during the task. The prevention and control strategies for infectious diseases in this mission can provide experience for all kinds of personnel in areas with high-incidence of infectious diseases in the future.
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Objective To analyze the clinical efficacy of cataract phacoemulsification combined with implantation of artificial lens for patients with cataract in seven African countries during“Mission Harmony-2017” task. Methods We retrospectively analyzed the data from 51 cataract patients (52 eyes) receiving cataract phacoemulsification combined with implantation of artificial lens between Aug. 2017 and Nov. 2017 on Ark-peace Hospital Ship. The preoperative and 1 d postoperative best-corrected visual acuity and astigmatism were compared, the postoperative ocular recovery was observed, and the intraoperative and postoperative complications were analyzed. Results One day postoperation, 4 (7.7%) of 52 eyes had a best-corrected visual acuity ranging from 0.06 to 0.3, 26 (50.0%) 0.4 to 0.6, and 22 (42.3%) 0.8 to 1.2. Slit-lamp examination showed that 48 eyes (92.3%) had corneal hyaline on 1-3 d after operation, 4 eyes (7.7%) had corneal edema, and 50 eyes (96.2%) had round pupil with diameter being 2.0-3.0 mm, and posterior corneal deposits and Tyndall effect were negative in all eyes. The mean astigmatism of 52 eyes before operation was significantly higher than that on 1 d after operation ([1.13±1.02] D vs [2.67±0.87] D, t=2.365, P<0.05). Posterior capsular rupture and vitreous prolapse occurred in 2 eyes (3.8%), prolapse of iris in 1 eye (1.9%), and progressive pupil reduction in 2 eyes (3.8%) during operation. Corneal edema occurred in 4 eyes (7.7%) on 1 d after operation. Conclusion Cataract phacoemulsification combined with implantation of artificial lens can be safely and effectively performed on Ark-peace Hospital Ship.
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“Ark Peace” is a modern hospital ship for marine medical rescue, and is taken as “the tertiary academic hospital floating on the sea”. It plays an important role in the ocean-going medical support and military diplomacy of the Chinese Navy. Ultrasound diagnosis, as an indispensable part of hospital ship, provides a solid guarantee for medical services. We summarized our experience on the equipment configuration, staff preparation, reporting system improvement, quality control management and introduction of new technologies on hospital ship during “Mission Harmony-2017” task, and put forward some suggestions for improving the comprehensive diagnosis and medical treatment ability and carrying out diversified military tasks in the future.
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Objective To research the location,composition,zoning,flow and combination form of medical system of Model 920 hospital ship, and to provide theoretical support for the design of the hospital ship. Methods The layout of medical system of the hospital ship was constructed based on the theories of ship engineering design,hospital architecture design and naval health service as well as the requirements for height and internal environment of medical system.Results The mode combining multi corridor and single column was used to design 8 operating rooms and accessories in the midship of No.01 deck.Conclusion The multi-corridor single-column combination operating area occupies less ship space resources and the surgical treatment of wounded and sick patients is efficient, which is suitable for the platform of the ship and is worthy of reference for the design of the medical system of the large-scale rescue platform on the sea. [Chinese Medical Equipment Journal,2018,39(5):39-43]
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Peace Ark Hospital Ship of China and Mercy Hospital Ship of U.S.had their current statuses introduced,and then were compared from the aspects of technical parameter,personnel allocation,running mode and etc.The advantages of Mercy Hospital Ship were described in safety,details and rationality.It's pointed out the hospital ship in China minimize cost of medical resources,optimize medical treatment and nursing as well as maximize medical efficacy.
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Objective To explore the medical equipment management to facilitate the medical support in the hospital ship.Methods The influences and the ship-mounted equipment on medical equipment were analyzed,the requirements of sea conditions for medical equipment management were explored,the hidden risks and present situation of medical equipment were introduced,and some countermeasures were put forward accordingly.Results The problems of equipment management were analyzed in hospital ship,and some countermeasures were brought out including bringing into better balance the relations between various sectors,enhancing personnel,introducing professional talents,trying for the support from the director and etc.Conclusion The safety of hospital medical equipment is of great significance to the hospital ship itself and the patient.Only to strengthen medical equipment management while focusing on the qualified personnel contributes tobetter fulfilling its mission.
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Through the experience of being stationed on the USS Mercy hospital ship (T-AH19) and a preliminary comprehension of the personnel and material arrangements, processing and functional formats, and the multi-platform contributions of US Navy hospital ships, we briefly introduce the characteristics of US hospital ships regarding medical support, emergency rescue exercises, communications and training, international humanitarian aid, etc. We discuss the function and responsibility of Chinese hospital ships, focusing on the investigation of the construction mode and positioning in the navy.
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OBJECTIVE: From November 24 to December 10, 2013, the Chinese People's Liberation Army Navy [PLA(N)] hospital ship Peace Ark was deployed to the Leyte Gulf in the Philippines to provide humanitarian medical relief in Tacloban after Typhoon Haiyan. The purpose of this study was to assess the radiological services aboard the ship to provide guidance for future missions. METHODS: A retrospective review was performed on a cohort of 109 patients who underwent digital radiography (DR) and 59 patients who underwent computed tomography (CT) scans during a 16-day period during a humanitarian medical relief mission to the Philippines. Patient demographics, DR findings, and CT findings were analyzed. RESULTS: The mean age of the 109 DR patients was 39.7 years for the 64 males and 43.7 years for the 45 females. A total of 148 DR examinations were performed of the chest (n=109), extremities (n=35), and spine (n=4). The mean age of the 59 CT patients was 43.8 years for the 32 males and 49.1 years for the 27 females. A total of 72 CT scans were performed of the head and neck (n=36), thorax (n=24), abdomen (n=5), spine (n=4), and extremities (n=3). The imaging findings mainly included disaster-related and non-disaster-related fractures, pulmonary tuberculosis, pulmonary infection, acute brain infarction, intracranial hematoma, and occupying lesions. CONCLUSION: Analysis of radiological services during a humanitarian medical relief mission to the Philippines provided meaningful information for future humanitarian medical relief missions.
Subject(s)
Altruism , International Cooperation , Military Personnel , Ships/methods , Adolescent , Adult , Aged , Child , Child, Preschool , China , Cyclonic Storms/mortality , Female , Humans , Infant , Male , Middle Aged , Philippines , Radiology/methods , Radiology/statistics & numerical data , Retrospective StudiesABSTRACT
Objective To summarize the characteristics of medical service patterns at Grenada station of Mission Harmony-2015 so as to provide reference for future overseas services in similar island countries .Methods After detailed analysis of actual conditions of the countries visited and efficient communication with host country health organizations , we made an appropriate adjustment of the medical service pattern , which involved multi-site screening of general patients , followed by intensive checkups and treatment aboard the hospital ship .Results The procedure of diagnosis and treatment was streamlined and the efficacy of medical services was significantly enhanced to meet the maximum medical demand of local residents.Grenada became a station with the largest number of patients who received top-quality fee-free healthcare during Mission Harmony-2015 .Conclusion Adjustment of medical service patterns according to the actual conditions could deliver a desired effect during overseas missions .
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On Sept 7, 2015, Chinese hospital ship Ark Peace left its home-port in Zhoushan, Zhejiang Province, forHarmony Mission-2015, the fifth in a series of annual international humanitarian and free medical assistance endeavors by the PLA Navy.This mission lasted 142 days, involving a visit to Malaysia and participation in Peace Friendship-2015 exercise,before she was dispatched to seven countries (regions) including Australia, Polynesia, USA, Mexico, Barbados, Grenada, Peru and provided a wide range of medical , humanitarian assistance to the last four countries .A total of 12 589 patients were treated on the main platform , 4852 patients by the 29 fore-lying medical corps , 59 surgeries performed , 46 patients hospitalized ,and 7130 CT and DR et al auxiliary examinations conducted during four mission stops .We organized academic exchanges , visits and interviews , get-togethers , dynamic and static exhibitions in each country .The experience from Harmony mission-2015is of great significance for such tasks in the future .
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During the Peace Friendship-2015and Harmony Misson-2015, the medical personnel aboard the hospital ship performed extensive medical exchanges , medical service shows ,and skill training many times and visited some local medical institutions .The exchanges involved war wound , seawater-immersion wound, drill wound, common disease, infectious disease .This paper gave an account of characteristics of and specific methods used in oversea medical exchanges . The experience from these visits and afterthoughts were presented in order to contribute to medical exchanges of this kind in the future.
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During the mission of Peace friendship-2015, between September 2015 and January 2016,the Chinese Navy hospital ship respectively participated in the Harmony-2015joint military exercise in Malaysia and with the local military of Polynesia and Barbados .The article summarized the relevant background of the joint military exercise and the main practices in various stages .This article also suggests that the emergency platform be moved forward , the function of the triage area be expanded, basic life support(BLS),advanced cardiovascular life support (ACLS),and advanced trauma life support(ATLS) training programs be introduced, the training model and the test system be innovated , and realistic traumatic conditions be designed in order to guarantee the success of the joint exercise .
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OBJECTIVE: To describe how the US Navy integrates surgical resident training during hospital ship-based humanitarian activities and discuss the potential operative and educational benefits during these missions. DESIGN: Retrospective review of predeployment surgical plans, operative case logs, and after-action reports from United States Naval Ship (USNS) Mercy humanitarian deployments from 2006 to 2012. SETTING: The USNS Mercy hospital ship. PARTICIPANTS: We enrolled 24 surgical residents from different surgical specialties including general surgery, obstetrics and gynecology, urology, otolaryngology, and ophthalmology. RESULTS: During 4 planned deployments (2006-2012), 2887 surgical procedures were performed during 20 humanitarian missions conducted by the USNS Mercy in 9 different Southeast Asian countries. Of all the general surgery eligible procedures performed, 1483 (79%) were defined categories under the current general surgery Accreditation Council for Graduate Medical Education guidelines, including abdominal (31%); skin, soft tissue, and breast (21%); ear, nose, and throat (20.5%); plastic surgery (15.5%); and pediatric (12%) cases. The number of surgical cases completed by each resident ranged from 30 to 67 cases over a period of 4 to 6 weeks during the overseas humanitarian rotation. CONCLUSIONS: The US Navy's humanitarian experience provides a unique educational opportunity for young military surgeons to experience various global health systems, diverse cultures, and complex logistical planning without sacrificing the breadth and depth of surgical training. This model may provide a framework to develop future international electives for other general surgery training programs.
Subject(s)
Education, Medical, Graduate/organization & administration , General Surgery/education , Naval Medicine , Ships , Altruism , Asia, Southeastern , Humans , Internship and Residency , Mobile Health Units , Relief Work , Retrospective Studies , United StatesABSTRACT
The clinical laboratory equipment on hospital ship was introduced, whose status and common faults were analyzed during Philippines humanitarian medical rescue mission and 3 times of Mission of Harmony. The experience was summarized for the maintenance of the clinical laboratory equipment. The problems and countermeasures were proposed for the clinical laboratory equipment.
