Your Grace Archbishop Tutu, Your Excellencies Ambassador Nolan and
Distinguished Leaders of the Government of Botswana and the University,
colleagues, students, and friends. It is a deep honor to be with you all
today and lead this afternoons keynote session. I am honored and
privileged to follow Archbishop Tutu's outstanding presentation
this morning. To take part in this special conference with such
distinguished leaders whom I have long admired is certainly one of the
highlights of my naval career. Thank you for inviting me and for asking
me to be part of this important conference.
I am a firm believer that events like this provide each of us with
an opportunity to help advance our shared goals and interests.
Today's exchange allows us to speak openly about where we are and,
more importantly, where we want to go. As a result, there is a lot of
incentive for us to share our opinions and ideas today. Even more
importantly, we are here because we want to celebrate a significant
milestone for the university and for Botswana.
The University of Botswana has enjoyed a long and distinguished
history from its remote origins in 1950, through the establishment of
diverse movements a decade later, to the place of honor that the
university holds today in this region. You indeed are an amazing
community of scholarship and learning.
I am deeply aware of the immense responsibility you continually
undertake to serve those who suffer from disease and illness. We are
kindred spirits in this partnership as we share an abiding commitment to
stretch hands across the water in the solidarity of healthcare. I am in
admiration of your leadership to stave off various infectious diseases
such as HIV, malaria, cholera, tuberculosis and others. As a physician
and as a healthcare leader, I am very conscious of our mutual bond to
defend against disease in every nation and every culture, and to bring
to everyone not just prevention or intervention, but the joy that comes
with quality human living.
In our mutual mission of healthcare, our efforts are achieved when
we bring to others a sense of enrichment that touches individuals, their
families, their communities, their nations--and in doing so--the world.
We are joined together in this common mission. And this joint
mission is why I feel privileged to join you this week and into the
years to come, to build with one another a world filled with love, hope,
and security founded on the premise of compassionate care for all.
In this uncertain world, the United States, as well as other
nations, has continued to forge greater bonds of trust and cooperation
with people and countries around the world to contribute to the common
good. It is a common good symbolized by this medical convention--a first
of its kind here in Botswana, a truly remarkable gathering of
government, military, and industry leaders.
This past August, the university's commitment to medical
leadership has taken on a new and profound depth as it has welcomed its
first class of medical students. I salute you. I welcome you. I cannot
tell you how wonderful it is to be here as a physician and a witness to
the passion for healthcare education and leadership as it takes root
here. You are delivering this university as a community of hope.
Creating this atmosphere of "Hope" is what I would like to
speak with you about today.
As the United States Navy Surgeon General, I have the unique
opportunity to serve not only my nation, but also humanity. This service
is manifested most dramatically in the notion of humanitarian
assistance. Because in humanitarian assistance we lend assistance to
those people around the world in need. We help them--we bolster security
and stability--and, most importantly, WE CREATE HOPE.
Navy Medicine, along with the rest of the United States Department
of Defense, realizes that the promotion of world peace is dependent upon
more than weapons and/or political alliances. World peace is also
dependent upon security and stability. Where there is security and
stability, we also find hope. And hope is the essence of what fires our
souls and provides light in our world. Hope becomes the beacon that
shows us the way from darkness and desolation (abandonment) to light and
The United States Navy's Cooperative Strategy for 21st Century
Seapower serves as an example of this light/beacon. This strategy is a
beacon that shows just how important are military forces and trained
health professionals around the globe to the international order.
This strategy promotes security and stability; but it also serves
to establish hope and prosperity by emphasizing "soft
power"--the power of humanitarian assistance that serves to provide
training, education, and security for all and in so doing establishing
an infrastructure of health, wellbeing, and contentment that are the
necessary ingredients of hope. For only in hope can we build the
foundation of respect and tolerance that becomes crucial in establishing
and maintaining world peace. If you will allow me, I would like to serve
as the catalyst for that discussion, by giving you my perspective on the
First and foremost, our people expect their military forces to
remain strong. They want us to protect them and our homeland, and they
want us to work with partners around the world to prevent war.
Nothing threatens world security and prosperity like war. Our new
strategy says that it is as important to prevent war, as it is to win
To prevent war, we must attack the seeds of instability and
hopelessness where they exist. Human suffering moves us to act, and the
expeditionary character of our maritime forces uniquely positions them
to provide assistance as the vanguard of interagency and multi-national
efforts. While we still train our forces to fight and win our
nation's wars alongside our allies, we have adopted a serious focus
on humanitarian assistance and disaster response to help those in need
to attack instability and insecurity, so that we help our partner
nations create conditions where hope can flourish.
This recognition has resulted in the increased focus on the
importance of proactive humanitarian assistance operations. Yes, we have
been involved in these types of missions since our beginnings, but they
were done in a rather ad hoc manner. As a result of our newest maritime
strategy, we now have elevated these important missions to the same
level of importance as war fighting. We now actively train and equip our
maritime forces to perform this important mission that brings about
partnerships as well as fundamental and meaningful relationships
resulting in hope.
Our Navy-recruiting slogan reflects the importance of this new
course we have set for ourselves. We refer to our Navy as a "Global
Force for Good," and we have found this message has resonated among
our nation's youth.
You see, the ultimate mission of our United States Navy is simple:
To defend those who cannot defend themselves. Arising from this spirit,
United States Navy vessels over the centuries have been the mechanism
that the American people have used to extend themselves outward to help
others in need. Wherever there has been poverty, famine, disease, war,
injustice, or danger, the people of the United States have launched Navy
vessels to provide protection, food, clothing, healthcare, and the
compassionate care of young Sailors lending a helping hand and heart to
those in need of safety and security. Whether it has been in Indonesia
after the tsunami, or helping the people of New Orleans after Hurricane
Katrina, this is the platform of selfless service from which Navy
Medicine will always build its mission around the world. This is the
meaning of humanitarian assistance--protecting others even when it
places us in harm's way--extending ourselves for the benefit of
those in need.
As Surgeon General, I lead Navy Medicine every day in putting a
human face on the words "humanitarian assistance." Navy
Medicine is not only willing and able to participate in these missions;
we do so enthusiastically. Our healing hands symbolize soft power, which
forges stronger relationships with other nations and lessens the chances
of armed conflict. By doing this, humanitarian assistance missions
enhance the protection of our homeland and way of life.
Let me illustrate my point of the importance of these missions by
relaying a story from the devastating earthquake that hit Pakistan in
2005. Thirty days after the Kashmir earthquake hit the isolated,
mountainous region of Pakistan-administered Kashmir, an injured man
hobbled into a United States disaster relief hospital near Muzaffarabad
*, approximately 12 miles from the quake's epicenter.
He said he had followed the "Angels of Mercy," the local
Pakistani-nickname for the U.S. Navy helicopters that were making
countless runs every day--day after day--to provide food, medicine and
supplies while shuttling people back and forth to safety. Somehow this
man got down off the mountainside, hobbled in and walked past all the
other hospitals to get to us. He had a compound fracture of his leg and
our doctors could not believe that this man could travel so far with
this injury. They immediately took him into surgery; they were there for
hours just trying to cleanse his bones. I am pleased to report that he
survived, with his leg.
That is just one story in a calamity that claimed the lives of more
than 75,000 men, women and children while leaving another 100,000
injured and 3.5 million homeless in one of the most isolated and
desolate areas of Pakistan.
This was certainly an area where hopelessness was flourishing.
Our naval forces arrived there within 48 hours after the earthquake
hit and got to work to help alongside other United States and
international agencies under the guidance of the United States
Ambassador to Pakistan.
We brought a hospital with medical capabilities--including
orthopedic, general surgery and internal medicine assistance--and worked
with the government of Pakistan to provide food, supplies and medical
assistance. We also sent another self-sustaining land-based hospital and
125 engineers from Naval Mobile Construction Battalion 74 (Seabees) who
immediately cleared roads, set up shelters, and built schools.
Prior to this earthquake, more than 80 Pakistani healthcare
facilities existed in this area; however, the event destroyed all but
two, and they could barely operate.
The villagers were not used to the quality and scope of American
medical care. Among other things, we brought in a Navy hospital from
Okinawa. We had 2 surgical suites, 24 intensive-care-unit beds, 36
medical-surgical beds and 60 medium-to-minimal-care beds.
Humanitarian assistance is so important because it has a powerful
impact on people, on relationships and an understanding of our American
values. According to estimates, our relief and follow-up efforts saved
half a million lives in Pakistan during this mission, which led to
overall improved relations and trust with the country itself. Through
our humanitarian assistance missions, we learn about one another, and in
so doing we develop relationships--relationships on a personal level,
professional medical relationships, military-to-military relationships,
and relationships between our governments.
From relationships comes the concept of trust--a reliance on
integrity, strength and surety--and the ability to have confidence in
Trust is vital. While our naval forces can be surged, trust cannot.
Trust is built over time, through dialogue and working together on
common goals. Cooperation and trust built in times of calm become the
major building blocks for effective crisis response when it is needed.
Many of us saw this first hand during the tsunami relief effort in South
East Asia over three years ago. We were able to have a tangible impact
on human suffering arising from that horrible and devastating event.
Ships designed for battle provided help to people in need as our forces
responded without hesitation, with the kind of enthusiasm that arises
when the mission involves rendering assistance to fellow human beings.
Responses such as this require an unprecedented level of
integration among our military forces and enhanced cooperation with the
other instruments of national power, as well as the capabilities of
non-governmental agencies and others. By sustaining dialogue and
understanding, we can build confidence and trust, whether in formal
alliances, partnerships or simple exchanges of information. This is the
essence of providing care and assistance and enduring security and
stability. This is the foundation of establishing world peace.
Today, our ships and Sailors are engaged in proactive humanitarian
aid missions all over the world--from South America to the Pacific to
the West Coast of Africa. These humanitarian engagements are now part of
our normal routine, and Navy Medicine is a vital part of this mission.
We support regional humanitarian operations by providing preventive
medicine services, healthcare training, and other similar efforts, while
always respecting the host country's culture and customs. From our
experience, we have developed a successful model of healthcare education
and training for host country providers. This will lead to local
sustainable activities that will provide long-lasting benefits to help
overcome healthcare barriers in resource poor communities.
Please allow me to highlight a few of our recent missions:
1. In 2007, the amphibious ship, USS Peleliu, conducted a 4-month
humanitarian mission called "Pacific Partnership," visiting
the Philippines, Vietnam, Solomon Islands, Papua New Guinea, and the
Republic of the Marshall Islands. During this mission, Peleliu provided
a variety of medical, dental, educational and preventive medicine
services to more than 31,600 patients.
2. In 2008, the hospital ship, USNS Mercy, also participated in
"Pacific Partnership," serving as a platform for military and
nongovernmental organizations to build and cultivate relationships with
the Republic of the Philippines, Vietnam, the Federated States of
Micronesia, Timor-Leste, and Papua New Guinea. This mission treated more
than 90,000 patients. Among those treated were more than 14,000 dental
patients and more than 1,300 surgery patients in various locations
throughout the Western Pacific.
3. Our other hospital ship, USNS Comfort, deployed this past April
to participate in "Continuing Promise 2009," a 120-day mission
to South and Central America. The ship traveled to Haiti, the Dominican
Republic, Antigua and Barbuda, Colombia, Panama, E1 Salvador and
Nicaragua, spending between 10 to 12 days in each port. During the
course of the deployment, our medical teams treated more than 100,000
patients, completed 1,657 surgeries, dispensed 193,961 prescriptions,
30,785 pairs of glasses and 11,940 pairs of sunglasses. The dental
department extracted 4,444 teeth and treated more than 15,000 people.
The local animal population was also seen by ship's veterinarians,
who treated 13,238 animals. Both domestic and farm animals were seen for
a variety of medical issues.
4. Early in the year, Navy Medicine Reservists participated in four
medical readiness training exercises in Jamaica, Honduras, Dominican
Republic, and Guyana. These two-week deployments provided primary care
at remote locations in conjunction with the Ministry of Health of each
Each successful mission, performed with joint and coalition forces,
other U.S. government agencies, non-government agencies, and host
nations, builds strong and lasting partnerships. From the foundation of
mutual respect and understanding grow the best quality healthcare and
partnerships. This environment of trust between U.S. military services,
agencies, and our international partners is the legacy of these
humanitarian missions and helps secure our future.
Our humanitarian assistance efforts continue, with missions planned
and underway. Our hospital ships, Mercy and Comfort, have been
invaluable assets in this role as they are unobtrusive and neutral. They
are all about compassion. We offer humanitarian assistance because, when
you look at human compassion on a global scale, this is an opportunity
for us truly to help people in need.
We are now implementing a wide range of programs in Africa as well
that are preventive in nature and are designed to help build capacity in
the African nations, so that they can have a better chance of providing
for their own security, as they have expressed a will and a desire to
do. The Navy is proud to be a part of those efforts throughout the
continent. We seek to be a friend to the continent of Africa, its
nations and its institutions. All of our efforts focus on adding value
to our engagement efforts and neither disrupting nor confusing ongoing
United States government and international programs.
Many of you may have also heard of our African Partnership Station
mission that has maintained a continuous rotation of ships throughout
West African/Gulf of Guinea countries to help build capacity training
with local African forces to help bolster maritime security in this
important region. This effort has now been expanded to include countries
in South and Southeast Africa.
We take a proactive and forward-looking stance to ensure that the
partnerships we build today last well into the future and that they are
relevant for meeting the goals set by our government as we partner with
the nations of Africa. We will continue to support our U.S. government
partners and civil military activities. These activities not only
provide outstanding training and experience for those in our military
communities such as doctors, engineers, and veterinarians, they support
African humanity and capacity building and bring goodwill to the African
I am proud of this work. Our strategy focuses on opportunities--not
threats; on optimism--not fear; and on confidence--not doubt.
It recognizes the challenges imposed by the uncertain conditions in
a time of rapid change. Furthermore, it recognizes the incredible
responsibility each of us has in working together on common objectives.
We will not always agree on words; but we must always agree to talk. I
believe we have entered a new era, one in which our countries, in
forging bonds of friendship and cooperation, can lead the way to a time
of peace, prosperity, and security.
It has indeed been a pleasure to be here to recognize the
importance of Botswana and the commitment of the United States to forge
a stronger relationship with one of Africa's most important and
Thank you again for this opportunity to speak with you today.
This following is the text of the second of the opening conference
keynote addresses. This keynote was presented in the afternoon of
Monday, December 7, 2009. It was followed by three responses.
The author gratefully acknowledges the remote and proximate
contributions of CAPT Michael Krentz, CAPT Brian Dawson, CDR Joseph
Surette, and the members of his staff in the preparation of the
manuscript. The opinions represented are those of the author and do not
reflect the official policy or positions of the United States
Government, the Department of Defense, the Department of the Navy, or
Vice Admiral Adam M. Robinson, Jr., MD
Surgeon General of the United States Navy
Chief, Bureau of Medicine and Surgery
* Muzaffarabad is a town in northwest Kashmir, at the confluence of
the Jhelum and Neelam rivers. It is the chief city and capital of Azad
Kashmir, which is administered by Pakistan. Muzaffarabad is a trading
center. Much of the city was destroyed by an earthquake in 2005.