The crew of Military Sealift Command's hospital ship USNS Comfort (T-AH 20) conducted a series of training events known as a Comfort Exercise (COMFEX) pier side aboard Naval Station Norfolk, Sep. 19-23.

The quarterly battery of drills was conducted to ensure the ship's U.S. Navy medical professionals and civil service mariners are prepared to answer any emergent crisis rapidly. The training was also critical in preparing Comfort's crew for a pending amphibious exercise, Bold Alligator 2017.

"The Comfort is a floating, state of the art medical facility which provides the same level of medical care as a high quality shore medical hospital like Naval Medical Center Portsmouth or the Boston, Maryland Trauma Center," said Capt. Lanny Boswell, the commanding officer of the Comfort's medical treatment facility (MTF). "When we deploy, we get underway with the best medical and maritime professionals. We are crewed by the top CIVMARs and military medical professionals in their respective fields."

Recently USS Batann (LHD 5) played the role of a triage support platform during a 'table-top' pre-Bold Alligator 2017 exercise. The Batann is capable of receiving wounded personnel while the Navy's hospital ships USNS Comfort and Mercy are the only platforms capable of providing full service theater hospitalization services.

"What makes USNS Comfort important for military missions is 99 percent of the world's population resides within ten miles of a waterway," said Boswell. "So if there is a conflict, influence or stabilization needed, chances are, it is going to be near the water."

Comfort's MTF is an embarked crew of medical personnel from the Navy's Bureau of Medicine and Surgery responsible for operating and maintaining one of the largest trauma facilities in the United States.

The Comfort provides emergency, on-site care for U.S. combatant forces deployed in war or other operations. The ship also provides critical medical support for humanitarian missions.

"The Comfort is categorized as a 'Ready III status," said Boswell. "We are expected to 'throw the lines' and be underway in three to five days. For us, the Comfort is always underway in three days or sooner, if possible. In a nut-shell, The Comfort is the biggest, baddest medical platform in the Department of Defense arsenal and in the world."

"The nature of a ship like the Comfort is challenging because the ship's missions requires the ability to man the platform very quickly and get underway," said Capt. David Murrin, the Comfort's Master. "As such we maintain a good, strong-core infrastructure on a daily basis so when the surge of medical professionals and CIVMARs are on station we are able to get everyone up and running to speed rapidly."

A civilian crew of up to 65 civil service mariners employed by Military Sealift Command operate and navigate the ship, load and off-load mission cargo, and assist with repairs to mission equipment.

"On the mariner side of the Comfort's crew, we are capable of getting the ship underway with the reduced crew, but the additional mariners are required for sustaining an enduring requirement. The additional crew would have to be transported to the vessel," said Murrin. "One of the aspects of the COMFEX is to shake out some of the details in terms of the time line and manning capabilities on the 'hull-side'."

Ensuring the success of a ship such as the Comfort requires special leaders and a crew of highly talented professionals. "It is very important that the CIVMARS and MTF personnel are fully aware of each other's requirements," said Murrin. "If the mariners are not ready to provide MTF required services such as power, water, refrigeration, habitability, waste management or steam the mission will fail."

"One of the purposes of the COMFEX is to ensure everyone is aware of what each aspect of the crew needs to complete their job and smooth out the activation process," added Murrin.
"The interaction between the MTF personnel and CIVMARs who crew the Comfort has to be tight," added Boswell. "There is no time to work in separate channels and everyone must be on the same page. The crew must work 'hand-in-hand' across the board to make this ship work."

Comfort's primary mission is to provide an afloat, mobile, acute surgical medical facility to the U.S. military that is flexible, capable and adaptable to support expeditionary warfare.

"When the Comfort deploys, it represents not only the people who serve in the Navy and the residents of Hampton Roads, Virginia; it represents the benevolence of our great nation," said Boswell.

"Combat support is the Comfort's primary mission. When the Comfort moves into an area, we provide a 'deterrence presence,'" said Boswell. "When an aircraft carrier strike group moves off the shore of a potential adversary there tends to be a calming effect due to the tremendous fire-power stationed off that shore. If you add a hospital ship to that presence, it sends a message to the potential adversary that we are serious and resolved to the point where we anticipate taking casualties."

"To our troops in a combat zone, the addition of a hospital ship to a theater reflects the country's promise to send them the very best medical care available to help them if they are hurt in battle." said Boswell.

This COMFEX was a 'fast cruise', with all hands living aboard, to simulate an underway period. The theme for the exercise was to recreate scenarios from the recent Bold Alligator 2016 synthetic exercise, and prepare the crew for next year's live exercise.

"There is a whole new group of people who are aboard Comfort and a big part of the COMFEX was to learn all of the processes required to meet the ship's mission," said Capt. Paul Arp, the director of nursing services for USNS Comfort's MTF. "As a group, we are learning how to 'fight' the ship and be ready to receive and treat casualties."

When the Comfort is at its normal, pier side reduced manning, there are approximately 50 personnel who crew the ship. When activated, Comfort's crew grows to approximately 1,200 personnel.

"Strong leadership and constant communication between the pier-side reduced operating status (ROS) crew and the core full operating status (FOS) activation crew are key to successfully activating the ship on short notice," said Arp.

"The COMFEX is the foundation of how we maintain our readiness but the flow of communication between the exercises is key to our success," said Arp. "The ROS and FOS leadership met once a week between the quarterly COMFEXs and collaborated about the direction the ship is going. This keeps all the key players tuned in and ready to deploy."

This COMFEX included a shipboard fire fighting drill, ship to ship patient recovery and two mass casualty drills.

"The Sailors worked directly with the CIVMARs during the COMFEX and performed a wide variety of training evolutions together," said Hospital Corpsman Second Class Quinishia Reed, USNS Comfort's command executive assistant and a year-plus crew member aboard the ship. "The crew runs 'real world' scenario based drills to ensure the crew is ready, but which we hope does not actually happen. We train to make sure we are ready for these situations should they actually occur."

Comfort will conduct quarterly COMFEXs leading up to Bold Alligator 2017. Comfort's anticipated mission during exercise Bold Alligator 2017 will be to establish an afloat patient movement system and to coordinate patient movement from point of injury to higher roles of care.

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