This week, the White House announced its intentions to deploy 3,000 troops and spend about $500 million to combat the worsening Ebola epidemic in Liberia. The news comes amid reports that the suspected infection rate and death toll in that country has nearly doubled in the past month, making it the worst Ebola outbreak in history, with more people killed by the disease than in all other previous cases combined. As American troops get ready to head over, I'd like to offer some insight into what the military’s operation might look like based on my experience deployed on a similar mission.
The upcoming troop deployment will mark the largest single-mission deployment of US forces to Africa since 1992-3’s Operation Restore Hope. In that case the military was sent as part of an international relief operation in Somalia that eventually saw U.S. forces combatting Somali militants in the streets of Mogadishu, a battle famously depicted in the movie Black Hawk Down. Despite misgivings from critics of U.S. foreign policy in Africa, this mission in Liberia is likely to look less like Mogadishu 1993 and more like the U.S. military’s response to the 2010 Haiti earthquake. It may be military-led, but the operation will likely integrate with ongoing efforts from NGOs and the Liberian government.
In 2010-11, I was assigned to the U.S. military task force based in Comayagua, Honduras, that conducted disaster relief and humanitarian assistance missions throughout Central America. We ran medical assistance training missions with local forces on a monthly basis, and our offices contained hundreds of contact cards for each country: NGOs, USAID representatives, local government, host-nation military leaders, and other organizations that played a role in disaster relief.
These medical missions were practice runs for the real thing. If the U.S. ambassador to an affected country made an official request for disaster relief, the process began in earnest: setting up flight routes, identifying landing zones, palletizing equipment, packing aircraft, identifying security forces and staging everyone on the airfield’s flight line. In Liberia’s case, a force of 3,000 troops will likely include many physicians and nurses, additional medical professionals, and equipment used to support hospital operations. It will also include shipping container handlers, logistical professionals, field sanitation personnel—the unlucky and wholly essential troops who deal with the porto-johns and medical waste—and a security force, the service members who guard the doctors and nurses while they work.
Organizations like Doctors Without Borders operate in a similar way, deploying a “hospital in a box” when they hit the ground in a disaster area. Once assembled, relief organizations create a secure area with controlled entry and exit points. They set up an area for patient triage and identification to help them prioritize. That way they can treat the sickest patients immediately but still hand out preventive medical information to the healthy people who invariably show up for the valuable free visit with a doctor. An article in The New York Times gives a detailed rundown of the process. But for all the undeniable good that those facilities in Monrovia have done, they are completely overwhelmed.
For better or worse—and there are vocal arguments against the re-purposing of military forces as aid providers—the U.S. military can scale up relief operations very quickly, in ways other organizations can’t match. After the 2004 Indian Ocean tsunami, the aircraft carrier USS Abraham Lincoln provided purified water from its on-board desalinization plant and delivered more than 2 million pounds of food and over 700,000 pounds of medical supplies.
One obvious difference between the tsunami mission and the upcoming Ebola deployment is the danger of contamination and the risk of exposing troops to the deadly disease. But the military can mitigate the risks simply by virtue of its enormous logistical reach. This operation will likely include offshore medical vessels with quarantine capabilities, as well as standby aircraft that can immediately transport critical cases to facilities in Western Europe or beyond.
Although similar outbreaks have taken place in neighboring Guinea and Sierra Leone, the U.S. has chosen to focus its resources on Liberia. This decision likely draws from two factors: first, Liberia is faring the worst of all affected nations, and second, Liberia has a significant recent history of military cooperation with the United States.
In fact, it is entirely possible that the Liberian military will handle a large amount of the security requirements in this mission. The DoD has spent over $300 million in the past decade to train and equip Liberia’s armed forces, which it effectively created from scratch (using defense contractors and, later, uniformed advisers) in the aftermath of the 2003 Liberian civil war.
Building on its ongoing military mentorship program with the U.S., in 2006, Liberia was the sole African country to volunteer its soil for the newly created United States Africa Command. Owing to either logistical advantages or geopolitical concerns, the DoD instead opted to base AFRICOM at Kelley Barracks, a small facility in the German state of Baden-Württemberg.
There are serious problems with using the military as a stopgap in emergencies but this type of humanitarian deployment has a precedent in recent decades. It is quite frankly the definition of militarized aid, but the aid is real—and so are the victims who need it.