Dermatology Aboard the USNS COMFORT: Disaster Relief Operations in Haiti After the 2010 Earthquake

On the 12th of January 2010, Haiti was struck by a 7.0 Richter magnitude earthquake that devastated its already fragile capital region. Approximately 230,000 people died immediately or during ensuing weeks, mostly due to acute trauma. Countless others suffered significant life- or limb-threatening injuries. As a part of the United States’ response to this tragedy, eventually named Operation Unified Response, the United States Navy deployed hundreds of physicians and other medical response individuals on a hospital ship. Operation Unified Response was a military joint task force operation augmented by governmental and nongovernmental organizations. Its mission was to bring medical and logistical support to the region.

On the 12th of January 2010, Haiti was struck by a 7.0 Richter magnitude earthquake that devastated its already fragile capital region. Approximately 230,000 people died either immediately or during ensuing weeks, mostly due to acute trauma. Countless others suffered significant life- or limb-threatening injuries. As a part of the United States’ response to this tragedy, eventually named Operation Unified Response (OUR), the United States Navy deployed hundreds of physicians and other medical response individuals on the USNS Comfort , a US Navy hospital ship based in Baltimore, Maryland. OUR was a military joint task force operation that was augmented by both governmental and nongovernmental organizations (eg, US Agency for International Development, Project HOPE, and Operation Smile). Our mission was to bring urgently needed medical and logistical support to the region. I had the distinct privilege to serve as the dermatologist for this mission.

The Comfort ( Fig. 1 ) is one of two Mercy class hospital ships operated by the US Navy. The Comfort and its West Coast counterpart, USNS Mercy , participate in biennial humanitarian missions that bring health care to many developing nations in Central and South America and along the Pacific Rim. In addition, these ships are on perpetual standby as part of the national response to natural disasters, both in the United States and abroad. Recent disaster-related missions have included deployments to New Orleans after Hurricane Katrina and to Indonesia after the 2004 tsunami. Although most missions render humanitarian assistance or disaster relief, the Comfort also provided combat medical support for Operation Desert Shield and Operation Desert Storm. In this instance, most of the reporting personnel received less than 24 hours notice to prepare for deployment, get to Baltimore, and report aboard. The Comfort set sail on January 16, 2010, with more than 1000 medical and support staff. It arrived in Port-au-Prince and was receiving her first patients within 7 days of the earthquake.

Commissioned in 1987, the Comfort ’s capabilities are impressive. It was originally built and launched as an oil tanker, the SS Rose City , in 1976. At 892 feet, almost as long as an aircraft carrier, it boasts a 50-bed trauma emergency room, 12 operating rooms, a 20-bed recovery room, a 30-bed intensive care unit, 400 intermediate-care beds, 500 minimal-care beds, and full radiologic and laboratory support. For this mission, the ship was staffed with many medical and surgical subspecialty physicians ( Table 1 ).

Table 1

Breakdown of physician/staff specialties aboard USNS Comfort for Operation Unified Response Haiti

*USNS Comfort* for OUR Haiti—2010** ^a
Physician Staff
Anesthesiology	11	Neurology (pediatrics)	1
Cardiology	1	Neurosurgery	2
Critical care	3	Obstetrics/gynecology	2
Dermatology	1	Opthalmology	3
Develomental pediatrics	1	Oral/maxillofacial surgery	1
Emergency medicine	5	Orthopedic surgery	12
Emergency medicine (pediatrics)	1	Orthopedic surgery (pediatrics)	1
Endocrinology (pediatrics)	1	Otolaryngology	1
Family practice	4	Pediatrics	4
Gastroenterology	1	Plastic surgery	1
General surgery	2	Psychiatry	1
Infectious disease	2	Radiology	4
Internal medicine	2	Urology	2
Nephrology	2	Vascular surgery	1
Neurology	1	Wound care	1
Nonphysician Clinical Staff
Dentist	3	Optometry	2
Nurse anesthetist	13	Clinical psychology	2
Family nurse practitioner	3	Social worker	2
Medical/surgical nursing	165	Wound care nurse practitioner	2