Hostname: page-component-76fb5796d-qxdb6 Total loading time: 0 Render date: 2024-04-25T17:09:38.788Z Has data issue: false hasContentIssue false
  • English
  • Français

Hospital Ships Adrift? Part 2: The Role of US Navy Hospital Ship Humanitarian Assistance Missions in Building Partnerships

Published online by Cambridge University Press:  04 December 2013

Derek Licina ,
Sangeeta Mookherji ,
Gene Migliaccio  and
Cheryl Ringer
Derek Licina*
Affiliation:
Department of Global Health, The George Washington University, Washington, DC USA
Sangeeta Mookherji
Affiliation:
Department of Global Health, The George Washington University, Washington, DC USA
Gene Migliaccio
Affiliation:
Department of Global Health, The George Washington University, Washington, DC USA
Cheryl Ringer
Affiliation:
Department of Defense – US Navy, Bethesda, Maryland USA
*
Correspondence: Derek Licina, MPH, DrPH The George Washington University Department of Global Health 2175 K Street, NW, Suite 200 Washington, DC 20037 USA E-mail derek.j.licina@us.army.mil
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction

US Navy hospital ships are used as a foreign policy instrument to achieve various objectives that include building partnerships. Despite substantial resource investment by the Department of Defense (DoD) in these missions, their impact is unclear. The purpose of this study was to understand how and why hospital ship missions influence partnerships among the different participants.

Methods

An embedded case study was used and included the hospital ship Mercy's mission to Timor-Leste in 2008 and 2010 with four units of analysis: the US government, partner nation, host nation, and nongovernmental organizations. Key stakeholders representing each unit were interviewed using open-ended questions that explored the experiences of each participant and their organization. Findings were analyzed using a priori domains from a proposed partnership theoretical framework. A documentary review of key policy, guidance, and planning documents was also conducted.

Results

Fifteen themes related to how and why hospital ship missions influence partnerships emerged from the 37 interviews and documentary review. The five most prominent included: developing relationships, developing new perspectives, sharing resources, understanding partner constraints, and developing credibility. Facilitators to joining the mission included partner nations seeking a regional presence and senior executive relationships. Enablers included historical relationships and host nation receptivity. The primary barrier to joining was the military leading the mission. Internal constraints included the short mission duration, participant resentment, and lack of personnel continuity. External constraints included low host nation and United States Agency for International Development (USAID) capacity.

Conclusion

The research finds the idea of building partnerships exists among most units of analysis. However, the results show a delay in downstream effects of generating action and impact among the participants. Without a common partnership definition and policy, guidance, and planning documents reinforcing these constructs, achieving the partnership goal will remain challenging. Efforts should be made to magnify the facilitators and enablers while developing mitigation strategies for the barriers and constraints. This is the first study to scientifically assess the partnership impact of hospital ship missions and could support the DoD's effort to establish, enable, and sustain meaningful partnerships. Application of the findings to improve partnerships in contexts beyond hospital ship missions may be warranted and require further analysis. This unique opportunity could bridge the rift with humanitarian actors and establish, enable, and sustain meaningful partnerships with the DoD.

LicinaD, MookherjiS, MigliaccioG, RingerC. Hospital Ships Adrift? Part 2: The Role of US Navy Hospital Ship Humanitarian Assistance Missions in Building Partnerships. Prehosp Disaster Med.2013;28(6):592-604.

Keywords

disaster responsehospital shipshumanitarian assistancepartnershipsqualitative research
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 28 , Issue 6 , December 2013 , pp. 592 - 604
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Licina, D. Hospital ships adrift? Part 1: a systematic literature review characterizing US Navy hospital ship humanitarian and disaster response, 2004-2012. Prehosp Disaster Med. 2013(3):230-238.CrossRefGoogle ScholarPubMed
2.Green, J, Thorogood, N. Qualitative Methods For Health Research, 2nd ed.Los Angeles, CA, USA: Sage; 2009:304.Google Scholar
3.Boydell, LR, Rugkasa, J. Benefits of working in partnership: a model. Critical Public Health. 2007;17(3):217-228.CrossRefGoogle Scholar
4.Pawson, R, Tilley, N. Realistic Evaluation. London, United Kingdom: Sage; 1997:235.Google Scholar
5.Ulin, PR, Robinson, ET, Tolley, EE. Qualitative Methods In Public Health: A Field Guide For Applied Research, 1st ed.San Francisco, CA, USA: Jossey-Bass; 2005;318.Google Scholar
6.Yin, RK. Applications Of Case Study Research, 2nd ed.Thousand Oaks, CA, USA: Sage; 2003:173.Google Scholar
7.Baxter, P, Jack, S. Qualitative case study methodology: study design and implementation for novice researchers. The Qualitative Report. 2008;13(4):544-559.Google Scholar
8.Yin, RK. Case Study Research: Design And Methods, 4th ed. Los Angeles, CA, USA: Sage; 2009:219.Google Scholar
9.Miles, MB, Huberman, AM. Qualitative Data Analysis: An Expanded Sourcebook, 2nd ed.Thousand Oaks, CA, USA: Sage; 1994:338.Google Scholar
10.Stake, RE. The Art Of Case Study Research. Thousand Oaks, CA, USA: Sage; 1995:175.Google Scholar
11.Boex, JR, Henry, RC. Principles to guide AHC-community partnerships. Acad Med. 2001;76(2):151-152.CrossRefGoogle ScholarPubMed
12.Kumar, N, Scheer, L, Steenkamp, J. Collaborative communication in interfirm relationships: moderating effects of integration and control. Journal of Marketing. 1995;32(3):20-115.Google Scholar
13.Welling, DR, Ryan, JM, Burris, DG, Rich, NM. Seven sins of humanitarian medicine. World J Surg. 2010;34(3):466-470.CrossRefGoogle ScholarPubMed
14.RAND Corporation. Developing a prototype handbook for monitoring and evaluating department of defense humanitarian assistance projects. 2011: http://www.rand.org/pubs/technical_reports/TR784.html. Published 2011. Accessed May 4, 2013.Google Scholar
15.Department of the Navy. Guiding principles for conducting monitoring and evaluation (M&E) for medical stability operations (MSOs). 2011:1-102.Google Scholar
16.Center for Strategic and International Studies. The Defense Department's enduring contributions to global health: the future of the U.S. Army and Navy overseas medical research laboratories. 2011. http://csis.org/files/publication/110615_Peake_DoDOverseasLabs_Web_0.pdf. Published 2011. Accessed May 4, 2013.Google Scholar