UC San Diego

Introduction: Global health diplomacy is important in mitigating disaster severity through collaboration. Complex health emergencies resulting from rapid onset disasters frequently rely on international stakeholders to alleviate suffering of an affected population. The United States Government possesses a unique medical capability to provide humanitarian assistance within Department of Defense (DoD that conducts proactive healthcare-capacity building Maritime Humanitarian Civic Assistance (mHCA) missions. Linking HCA proactive healthcare-capacity building activities to efficiencies in reactive disaster responses is a desired outcome for the DoD.

Methods: Through examination of peer-reviewed and “grey” literature yielded (a) the manner in which HCA missions are referenced, as health-related activities or a strategic security tool; (b) identified mHCA missions process outcomes through structured web searches; and (c) the author professional affiliations referencing mHCA missions. A comparative case study of DoD military medical resources during complex disaster responses was undertaken. Disaster-affected nations where mHCAs had been conducted during 2006-2013 were systematically selected utilizing disaster risk trend and disaster tracking databases to define the unit of analysis; and (b) conduct thematic analysis of key stakeholders’ post-disaster reports documenting foreign militaries’ medical resources impact on disaster responses and associations with mHCAs.

Results: The literature review identified 800 citations regarding mHCA missions with 126 meeting inclusion criteria. Documents identified as grey literature represented 58% of the results and focused on national security agendas while describing maritime HCAs as a strategic security tool. No mention of mHCA mission impact on host nation health status was noted. Several themes emerged: a) pre-disaster health engagements with foreign nations are not identified with improvements in disaster responses; b) the benefit of establishing a formalized international disaster response and preparedness framework integrating military resources is acknowledged; and (c) ongoing disaster management education of military personnel is needed.

Conclusion: This dissertation contributes to the understanding on the utility of military medical assets providing purposeful global health resources in disaster management. By examining the literature on proactive mHCAs and developing a comparative case study, the DoD’s strategic perspectives in disaster mitigation are better understood to inform the design of policy solutions to synergize DoD efforts in disaster-risk-reduction through healthcare-capacity building