President Obama’s announcement yesterday that the U.S. Government would use the American military to help fight the Ebola epidemic in West Africa distresses me greatly. I am not dismayed because the case for action is weak, and I certainly am buoyed by the fact that the President justified the decision as a matter of national security instead of “just” a humanitarian exigency. The calamitous Libya escapade, remember, was justified as a humanitarian intervention; as a rule, liberals are hard-pressed to use force for “selfish” national security reasons. So the President’s locution is refreshing in this light, doubly so in tandem with a slow-moving but apparently real intention to use at least a dollop of wallop against ISIS in Syria.
No, the reason I am peeved goes deeper than that: Whenever the U.S. Government has a choice between doing nothing and sending the cavalry in a non-vital national security contingency, it is a sure sign of an antecedent failure of imagination, usually of the structural design sort. Why on earth should we use a strapped and splayed military to do something that is not essentially a warrior mission? Answer: Because our policy toolbox is otherwise empty, and it’s empty because our political class is composed on balance of a bunch of narrowly self-interested dullards with the foresight of myopic toads.
What we need for situations like this—long predicted and widely understood in the analytic and even academic communities—is an U.S. Expeditionary Medical Corps. That would be a specialized and larger version of USAID “dart” teams, which are small but effective and highly mobile first-on-the-scene responders when there is a humanitarian emergency (earthquakes, floods, volcanic eruptions, and so on) somewhere that U.S. assistance is requested. “Dart” stands for Disaster Assistance Response Teams.
Leaders of “dart” teams are trained a little like a Coast Guard “captain of the port” is trained—in other words, to be someone who can get various civilian and security functions to coordinate and work together in an emergency. (In case you were in any doubt, this sort of thing does not happen spontaneously.) We don’t have many of these teams and they are underfunded, but beyond that they lack the technical and professional ability to deal with the threat of a pandemic.
Understanding this, and anticipating in a globalizing world the increasing danger of planetary-scale pandemics, a trove of commissions and studies—some government, some private; some large-scale, some by individuals—have been warning for years that the U.S. Government is not properly designed or prepared to deal with such contingencies. There are ongoing, semi-permanent institutions at various U.S. universities and policy think-tanks devoted to global health and medical issues, and many of them do excellent work, to very little practical avail. One of the functional organizations of the United Nations is the World Health Organization, and it too has issued a stream of recommendations over many years—all of which have pretty much been ignored by the U.S. government. The WHO is also poorly funded and varyingly staffed thanks to UN patronage corruption.
The closest the U.S. government has come to doing anything serious on this front came about a decade ago when Dr. Bill Frist, then a Republican Senator from Tennessee, prepared a bill calling for the creation of a U.S. Medical Expeditionary Corp. As a medical professional, he understood the issues. He understood above all that it is no act of charity for Americans to want to be able to get to and deal with a potential pandemic at or near its source, wherever it may be anywhere in the world. Rather, it is highly self-interested to want to do so, because once something like Ebola spills beyond the containment capacities of weak states—and they are all fairly weak in West Africa, as we have seen in recent weeks—the problem grows exponentially. There is no effective “Fortress America” strategy against pandemics.
I cannot remember if the bill was actually introduced, but it had no chance of passing anyway. This is the sort of foresight that regularly fails to capture any attention in our Legislative Branch. If it costs money but cannot be shook to yield near-term campaign contributions from lobbyists, no idea is going to get very far just on its merits.
So push comes to shove, as it usually does, and the President has no choice but to send the military to do something it’s not really trained to do, that strains its budget, distorts its operational tempo elsewhere, and diffuses its core warrior ethos. Nothing new here; it happens a lot, whether it’s “nation-building”, so called, painting school buildings in Peru as a gesture in public relations, or eavesdropping on drug dealers from an offshore submarine.
In my proposal for a large-scale voluntary national service program based on a “baby bond” concept (you can read it in chapter 14 of Broken, my March 2013 TAI ebook), one of a dozen categories I listed for national service is precisely in a national medical expeditionary corps.
Young Americans who wish to use their baby bonds to help them become doctors, nurses, physical therapists, lab techs, and so on would be perfect volunteer service apprentices for what I envisage as a fleet of hospital ships and M-Dart Teams (Medical Disaster Assistance Response Teams). Their mission would be to improve health as an integral part of U.S. development assistant efforts and be dual-hatted as early-warning stations against pandemics. For public diplomacy as well as a host of other reasons, I want these U.S. ships sailing into foreign ports not with guns on view but flying the flag of the U.S. Medical Expeditionary Corps (USMEC):
As things stand now, the United States has but one hospital ship—the Mercy—and one private ship from the old Project Hope. This is woefully inadequate to the point of really inexcusable. It’s not just the Legislative Branch that is at fault here: no President in recent decades has had the foresight to do anything about this deficit, and no President since Dwight Eisenhower has really understood that, given how large organizations function, if you want government to do something new and necessary, you have to redesign its structure to have any hope of getting it right.
So off will go the U.S. military to do battle with Ebola. I wish the men and women assigned to this mission the best. I know they will do their best. And my heart just aches at the very thought that multiple sins of omission over decades has mandated this obscene mismatch of national assets and obligations.
Mr. President, in the time left to you in office, will you act so that no successor has to face the same sort of awkward choice you have had to face? This will not be the last pandemic that constitutes a national security threat to the United States. Be a leader, please.