29 May 2019 The overall c lassification of this brief is UNCLASSIFIED//FOUO

1. Regional Impact of U.S. Navy Hospital Ship Comfort (T-AH 20) Deployment in Support of Enduring Promise Initiative 29 May 2019 The overall classification of this brief is UNCLASSIFIED//FOUO

2. USNS Comfort (T-AH 20) Flight deck & Casualty Receiving 12 Operating Rooms 20 Post Operative Acute Care beds 80 Intensive Care beds 900 Ward beds CT Scanner (4) X-ray rooms Laboratory Blood bank (up to 5000 units) Pharmacy Physical Therapy Dental clinic Optometry lens fabrication lab (2) Oxygen-producing plants (4) Distilling plants to make 300,000 gallons drinking water from sea water/day Length: 894 ft(273 m) Beam: 106 ft(32 m) Speed: 17.5 knots

3. USNS Comfort Deployment History PLANNED MISSIONS EMERGENT RESPONSES 2010 – Earthquake Response - Haiti, 49 days, 871 outpatients, 843 surgeries 2017 – Hurricane Response - Puerto Rico, 53 days, 1,625 outpatients, 290 admissions and 191 surgeries

4. Humanitarian Crisis Response International Organization for Migration Sept 2018

5. Scheme of Maneuver (SOM) 5 In conjunction with Partner Nations, supply humanitarian assistance during a time of unprecedented movements of migrants in order to alleviate stress on HNs and continue to foster strong relationships in the region. (SOURCE: OPORD) 4 3 VZ 1m SOM 1. Esmeraldas, ECU 2. Paita, PER 3. Turbo, COL 4. Riohacha, COL 5. Trujillo, HND 1 200k 400k 2

6. Force Composition ALL NGO DURING EP2018 Partner Nations

7. Deliver First Rate Patient Care What was provided? • Summary of Medical Care • Esmeraldas, Ecuador • Paita, Peru • Turbo, Colombia • Riohacha, Colombia • Trujillo, Honduras • General Surgery • Ophthalmologic Surgery • Basic Medical Evaluation and Treatment • Preventive Medicine • Dental Screenings and Treatment • Optometry Screenings • Eyewear Distribution • Public Health Training Why? Relatively simple, speedy, huge quality of life impact “The gift of sight is a huge economic multiplier.” Captain Kevin Buckley, MTF CO, in Miami Herald 14,554 26,706 3203 Medical Patients Total Patients Dental Patients 8335 599 Optometry Total Surgeries $2.4 million Patients in medical donations Miami Herald, 29 Nov 18 Most common operations by numbers Providing the Right Procedures Met the Needs of the People and the Mission 7

8. Surgery

9. USNS Comfort Patients Four year old girl prepared for corrective eye-lid surgery 3 month old, former preemie transported for pediatric ophthalmology consult 80 year old man after cataract removal Eight year old boy receives cleft palette surgery

10. Partnerships, Interoperability, Future Leaders • Implement whole of government approach by integrating collaborative efforts of local/national stakeholders to achieve unity of effort • Mission planners prior/during each stop work with State Department, country teams, local host governments, local/national police, ministries of health, partner nation militaries/coast guards, NGOs • Experience in inclusive, cooperative planning allows for future HADR efforts. e.g. Rapid creation of medical clinics on shore • Increase in medical interoperability with partner nation medical providers • Subject Matter Expert Exchange (SMEE) • Casualty drills • Daily lectures for translators Argentina Brazil Canada Colombia Costa Rica Chile Honduras Mexico Ecuador Peru U.S. U.K.

11. Summary of Care Provided