Medical Planning for Liberty and Working Port Visits

Department of the Navy
Bureau of Medicine and Surgery

Port visit medical planning requires early staff preparation and verification with the executive officer, operations officer, and supply officer as well as medical staff aboard ship. The following checklist can assist in providing an organized approach to medical planning for port visits.

• Obtain medical intelligence on the port and locale that will be visited by the ship. This information can be obtained from Armed Forces Medical Intelligence Center (AFMIC) and the regional Navy Environmental Preventive Medicine Unit (NEPMU): See the intelligence officer for the AFMIC download.

• Locate message traffic from earlier U.S. Navy ship visits. This should be obtained before the deployment. Ask the ship's operations officer for the port surveillance report message (this includes a medical section).

• Access information from other resources. Internet websites provide additional information that can be helpful in filling in the gaps with port visit planning.

• WHO - http://www.who.int/

• United Nations - http://www.un.org/

• CIA Factbook - http://www.cia.gov/cia/index.html

• State Department - http://www.state.gov/

• Ensure a written plan is in place for the management of snake bites and rabies prophylaxis. Verify the availability of anti-venom, Rabies Immune Globulin (RIG), and Human Diploid Cell Vaccine (HDCV) in the local area. Become familiar with onboard vaccine reagents and the expiration dates. Reorder well in advance of underway deployment periods.

• Frontline all medical education and training at the Planning Board for Training (PB for T) meetings. Prepare a medical brief for the ship’s crew with an honest assessment of sexually transmitted diseases (STDs), and other infectious diseases and environmental risks (heat, UV, dog/monkey bite, food, and water quality). Prepare a video tape presentation and make this available for on-site TV.

• Coordinate the following taskings with the supply officer:

1. Logistical flights supporting your ship during your stay (can be used for MEDEVAC lift of opportunity)

2. Rental vehicle(s) to transport patients to and from airport and local hospitals.

3. Communication for medical in port (pagers, cell phones).

4. REMEMBER IF YOU DO NOT ASK YOU WILL NOT GET IT, SO ASK EARLY!

• Plan ahead for medical support. Write a medical SOP if you are designated as the medical guardship. Content should address medical duty, what to do in an emergency, and watches for intoxicated crewmembers.

• Plan to set-up a corpsman rotating watch if a shipmate is hospitalized in a foreign hospital. Ensure the corpsman has a reliable means of contacting the ship. Many nations lack adequate nursing care and as a result, care falls onto family members (feeding, bedpans, and changing sheets).

A good relationship with the husbanding agent is key to the overall success during the port visit. This person arranges translators, settles all medical bills, and arranges for your survey of the local hospital(s). Ensure a binder is prepared and maintained for the in-port watchstanders. This should include the husbanding agent’s business card with phone number and all information gathered about the local medical system to include at a minimum, ambulance, local emergency departments, and the husbanding agent. DO NOT TAKE LIBERTY UNTIL YOU HAVE VISITED THE LOCAL HOSPITALS AND CREATED THIS PASS-DOWN BINDER.

How do I pay for the medical care at foreign hospitals? The husbanding agent will pay the bill in local currency and present a bill at the end of your stay. Work with the ship's disbursing department to handle the payment of foreign hospitalization(s). BUMED issues a message entitled CENTRALLY MANAGED ALLOTMENTS. This annual message is released in general distribution to all fiscal officers/comptrollers and this contains accounting data that can be used by the ship's disbursing officer to pay for any and all services a foreign hospital provides. DO NOT DEPLOY WITHOUT THIS MESSAGE. Further questions may be addressed by contacting the BUMED Accounting Division (MED-14) at DSN 762-3576 or (202) 762-3576. All copies of the hospitalization and medical care provided (even if written in a foreign language) should be mailed to MED-14 at BUMED using the following address:

Bureau of Medicine and Surgery
MED-14
2300 E St. N.W.
Washington, D.C. 20372-5300

Finally, maintain a copy of all records.