After A Near Disaster, USNS Comfort Returns Home And Navy Faces New Questions

After a near-catastrophe off Haiti, where 19 sailors and civilians narrowly escaped with their lives, the Navy faces a slew of “get real” and “get better” questions over how it is managing their two obsolete hospital ships, the supersized USNS Mercy (T-AH-19) and USNS Comfort (T-AH-20). The hulking 69,390-ton vessels, built as San Clemente class oil tankers in the mid 1970’s, are just too big for most ports to handle, and suffer well-known and long-standing defects in safely getting personnel aboard while at sea.

The limitations don’t seem to matter to the Navy. Ignoring the operational challenges, the Navy insists upon using America’s floating hospitals like they are fully-functional amphibious vessels rather than the aged, fragile and increasingly mission-limited civilian platforms they actually are.

The accident on the USNS Comfort, the latest of several disturbing Navy misadventures, occurred at night in a calm sea off the earthquake-damaged Haitian port of Jeremie. As personnel on a small utility boat were coming aboard the USNS Comfort, a tie-down or some rigging used to lift the shuttle vessel gave away, very nearly dumping the little water taxi—inexplicably packed with 19 sailors and civilians—some thirty feet down into the water.

The accident is a symptom of the Navy’s long-standing disinterest in managing basic and widely-known operational challenges. Given the port conditions, the unwieldy hospital ship should never have been dispatched to Jeremie, an austere port normally used to ship cement. Even worse, to get around the ship’s inability to safely operate under the prevailing conditions, the crew may have taken some dangerous operational short cuts. And, frankly, the Navy accepted all this. After several fatal accidents over the past few years, the Navy suffers a systemic inability to address widely known operational shortcomings both ashore and at sea. Problems are simply allowed to fester until they kill sailors or become too big to ignore.

But now, after decades of real-world hospital ship experience and a near-catastrophe, it is high time to refresh the Navy’s strategic medical support playbook, supplementing Mercy and Comfort with smaller or more utilizable hospital ships.

America’s two floating hospitals are impressive. They’re massive, floating, 1000-bed trauma centers, but, unless the ship is tied up at a pier someplace, there’s no real way to operate it. Offshore, there’s no workable plan to get 1000 wounded people on-board these vessels in any timely fashion. The ships have big flight decks, and aircraft are the safest, fastest way to arrive on the vessel. But, in the frequent event that aircraft are unable to land on the vessels, the two ships are terrible at receiving people from the waterline. As a visitor, you are either hauled up the hulking hull, climb up a thirty-foot ladder, or are brought in via a hatch near the waterline.

The Navy’s sullen reluctance to replace their oft-criticized big hospital ships with something more effective—and less operationally fraught—reflects the Service’s unserious approach to the bloody realities of modern warfare. Slavish service-wide devotion to an operationally hollow “Warfighter” ethos has systemically whittled away at the influence of Navy medical, diplomatic and logistical professionals. While China and others rush to develop and deploy a scalable fleet of hospital and ambulance vessels, the U.S. Navy has stuck with their obsolete and dangerous “White Elephants.”

After Haiti, this all must change.

Operational Work-Arounds Nearly Killed People

Two videos detailing the incident, first reported by maritime watcher Sal Mercogliano, are harrowing, and each end with a personnel-packed small boat pitched over and dangling, some thirty feet above the water. It is clear the accident could have been far, far worse, and the Navy is darn lucky only two sailors were injured.

Like any maritime accident, this latest naval mishap started as a mundane accretion of avoidable risk.

First, the USNS Comfort should never have been used at the Haitian port of Jeremie. Planners knew Jeremie’s single pier could never moor the big hospital ship, and they knew that the USNS Comfort would be forced to anchor at sea while personnel worked on shore.

That solution has worked fine at other ports. But the Navy also knew that Jeremie’s port and offshore anchorage is “quite exposed” to the east. According to port descriptions, the harbor “is likely to experience considerable swell,” preventing the deployment of a small landing “barge” along the side of the ship, allowing easy access to the water-level entry hatch.

Operators also understood that, without an alternative boarding method, the high swells would make safe personnel transfer a complicated, time-consuming process, where personnel must painstakingly clamber aboard via a ladder or rope, timing their transfer with the waves.

The timing of the port visit was bad as well. USNS Comfort was on the final leg of a two-month long “Continuing Promise” deployment through Southern Command, having previously visited Guatemala, Honduras, Columbia, and the Dominican Republic. As one of the last overseas stops for the ship, a tired home-bound crew aboard an unreliable ship with a tight schedule was far more likely to manage the complex anchorage by falling back on unsafe operational short-cuts.

While an investigation into the incident is certainly underway, an unsafe operational shortcut seems likely. Videos of the accident show how the ship used a crane to lift a crowded utility boat some thirty feet up in the air, hoisting it from the water and up to the USNS Comfort’s main deck. The personnel aboard are acting like the operation is routine, moving about with little or no evidence that the exercise was unusual or potentially unsafe. Suddenly, rigging or one of the boat’s attachment points fail. Out of balance, the utility boat careens, nearly capsizing in mid-air.

At least two people fall from the boat, where, given the height, they likely impacted the water at about 25-30 miles an hour.

Had more lifting points or cradles on the utility boat given way, the outcome—two sailors injured—would have been far, far worse. Put bluntly, the mishap had real potential of becoming one of the largest losses of life in the Navy since at least 2020, when eight U.S. Marines and one sailor died in an avoidable amphibious assault vehicle accident.

Institutionally, this incident is not a good sign, and somebody, somewhere in the Navy needs to heed the warning signs. After a month of close calls—an onboard fire on an aircraft carrier, an operational “near-miss” in San Diego Harbor and a surprise leak of firefighting foam at the troubled Red Hill Bulk Fuel Facility in Hawaii, the Navy is stumbling along.

Without accountability and, maybe, some new leadership at the top, the Navy is headed towards a very serious and very avoidable mishap. It’s just a matter of time.

Build New Hospital Ships

USNS Mercy and Comfort are certainly useful. But a smaller, more nimble craft could enter more harbors, tie up at more piers, and, if designed with modern amphibious ship technology in mind, a newly designed hospital ship could arrange to receive patients via a well deck or via other, safer small boat launch-and-recovery systems.

Casualty care is an important enough of an issue that hospital ships should be a part of any new fleet laydown or amphibious force study.

Hospital ships are also strategically valuable. In our failure to look at afloat medical services as a strategic opportunity, America is losing an opportunity. Over the past several decades, the United States Navy has been content to make do with two imperfect super-sized hospital ships. But China, after thinking out a comprehensive medical support strategy, has put it into action, and, today, the country supports a fleet of nine oft-deploying hospital vessels. Every port call is another win for China.

The change has been impressive. Since 1976—back when the future USNS Comfort was launched—China has gone from wielding no afloat medical support to fielding a comprehensive and modern armada of floating hospitals. Today, at the top of China’s hospital ship pyramid are two Type 920 Anwei class hospital ships of around 26,000 tons. Unlike America’s Mercy Class ships, they are both modern, purpose-built vessels. The first big “Peace Ark” was launched in 2007, and a second is currently fitting out. Two mid-sized 4,000-5,000 ton Type 919 Anshen class hospital ships entered service two years ago, and they are all supported by five small Ankang class ambulance ships.

In contrast, the U.S. is set to procure two hospital/ambulance variant Expeditionary Fast Transports (EPFs), a small, fast-moving hospital ship that would be perfect to engage degraded ports like Jeremie. But there’s no need to wait until 2027 or 2028. As I wrote two decades ago, a mobile field hospital, embarked aboard an EPF, could easily deploy ashore, doing much of the same work the USNS Comfort did in Haiti. But, again, neither the Navy nor the Army seem eager to try out the concept.

But, with the Pacific becoming a far more contested area, the military need for more forward-deployed, operationally relevant, and strategically-useful hospital ships is undeniable.

There’s no better international engagement and training tool than a hospital ship. Pier-based support does work, and it all can be done on a relative shoestring. Mercy Ships, a religious medical support organization, offers a great example of what pier-dependent hospital ships can offer. In Africa, the organization operates two hospital ships, a 16,572 ton vessel and a brand-new 37,000 ton hospital ship, for little more than $133 million a year (ship operations cost about $100 million, with administrative and fundraising costs taking the rest).

They treat and train thousands.

American hospital ships could do this. But, in the Pacific or in other areas with degraded or small harbors, more “right-sized” EPF-based hospital ships would be particularly useful, while a mid-sized hospital ship with a well-deck—just like one of America’s big amphibious vessels—would be a real operational boon.

The ability to safely receive large numbers of personnel is a critical operational feature for military hospital ships, and the USNS Mercy and Comfort cannot safely do the job. Unless the Navy really wants to suffer a major disaster, they must stop dragging their feet and “get real” and “get better” about developing, deploying, and operating America’s oft-overlooked medical fleet.