WASHINGTON, DC—If there is one message that Navy Lt Cdr William J Hughes IV would like to get across, it is that stability operations in the US military are to be given priority comparable to combat operations.

While DoD has a long history of involvement in disaster and humanitarian work, DoD issued a directive in November of 2005 that stated that stability operations are a core US military mission and that they shall be given priority comparable to combat operations, and be explicitly addressed and integrated across all DoD activities.

Hughes, who serves as program director for Contingency Planning in the International Health Division in DoD’s Office of Force Health Protection & Readiness, called this new directive transformational. ’To say [stability operations] is on par with major combat operations and strategic nuclear deterrence was huge.”

Conducting Stability Operations

DoD has already been involved in humanitarian and disaster responses for years, as exemplified recently in Haiti where medical personnel have treated victims injured by the massive earthquake. Hughes explained that the difference is that they are now embarking on “a whole of government approach to affect change and security … We can’t do it alone. The federal budget is tighter than it has ever been. If we want to really affect change it has come to a point now where we ask: How do we do this properly? How do we do this well? That included marketing to our people, marketing what we can do, and how we can support other US government agencies, like the State Department or USAID or even HHS. How can we market this change?”

The International Health Division, which was started in 2007 to help further this work, is aiming to strengthen healthcare delivery in stability operations by working with other entities to develop best practices and approaches.

Hughes said that his division also wants to influence change within the agency, so that line commanders consider involving DoD medical personnel in helping create courses of action and options in stability operation missions. “I don’t want a line commander to say, ‘okay, which option can you best support?’ I want the line commander to consider turning to medical ahead of time and saying, ‘get them involved in creating courses of action and options available to us.’”

Tools to Enable Stability Operations Work

Hughes said that there are several efforts within his division to help move the division’s work forward. The division is now in the process of writing and finalizing health instructions for MHS support to international stability operations and missions. ’This will be significant for us because it is our charter, so to speak. This is what sets our division going and moves us.”

The division also worked with the Defense Medical Readiness Training Institute and other government partners on the development of the Medical Stability Operations Course, which will help prepare and train DoD medical personnel to meet health requirements in stability operations. An initial offering of a Medical Stability Operations Course was planned at the annual Air Force Global Medical Readiness Symposium held at the end of April.

The division also recently released a new Guide to Nongovernmental Organizations for the Military. This guide is intended to help DoD personnel understand how to collaborate with NGOs in the field and is an update of an earlier guide originally written in 2002. There are often cultural differences between NGOs and government agencies that military personnel need to understand.

Lynn Lawry, MD, senior health stability/humanitarian assistance spe- cialist in the International Health Division who edited and co-wrote the guide, said that the guide was released online shortly before the earthquake struck in Haiti. “It wasn’t as if we planned this, but the book was put online about a week and a half before the disaster. It was hugely used and valued because this was one of those times when the military and NGOs were going to have to work together to make sure that people’s lives were saved.”

Lawry said that one reason why the NGO guide is helpful is that it details specifically how coordination should happen in a disaster, identifies the lead for each group, and explains how the UN plays into the scenario. She said that the guide is not static but will be updated as needed.

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