Friday, July 24, 2015

Pacom Chief: China’s Land Reclamation Has Broad Consequences

By Terri Moon Cronk
DoD News, Defense Media Activity

WASHINGTON, July 24, 2015 – China’s land reclamation in the South China Sea could have far-reaching U.S. security and economic consequences by disrupting international rules and norms that have supported the global community for decades, the commander of U.S. Pacific Command said today.

In a security forum panel discussion in Aspen, Colorado, Navy Adm. Harry B. Harris Jr. said China’s assertiveness in the South China Sea is an issue the American public must know about and the United States must address.

“While Vietnam, Malaysia, the Philippines and Taiwan have also conducted land reclamation in the South China Sea, their total -- approximately 100 acres over 45 years -- is dwarfed by the size, scope and scale of China’s massive buildup,” Harris said. “In only 18 months, China has reclaimed almost 3,000 acres.”

Each year, he noted, more than $5.3 trillion in global sea-based trade relies on unimpeded sea lanes through the South China Sea, adding that the Strait of Malacca alone sees more than 25 percent of oil shipments and 50 percent of all natural gas transits each day. This is made possible through the regional countries’ adherence to longstanding customary international law, which protects freedom of navigation, he added.

Fundamental to Global Economy

International recognition and protection of freedom of navigation are fundamental to the global economy and the U.S. way of life, Harris said, and unilateral attempts by any nation to disrupt freedom of navigation place the international system and global economy at risk.

“The South China Sea is front and center in the tug-of-war between the majority of regional nations that want to maintain the status quo and China that wants to change it to suit its narrow self-interest,” he said. “This is why Deputy Secretary of State [Tony] Blinken recently compared the aggressive actions of China in the South China Sea to Russia’s actions in Crimea. They both demonstrate desire by individual actors to change the status quo.”

China Not Using Diplomacy

Rather than pursing diplomatic actions to address their disputes, China is changing tactics “through aggressive coercive island building without meaningful diplomatic efforts toward dispute resolution or arbitration,” the admiral said.

Harris said China is building false sovereignty as it builds man-made islands on top of coral reefs, rocks and shoals, which destroys surrounding underwater environment.

“That severe environmental impact is one aspect of China’s land reclamation that I don’t believe has received enough attention, because protecting our fragile environment is a global responsibility,” he said. China’s has actions have led to “the most rapid rate of permanent loss of coral reef area in human history,” he added, citing University of Miami marine biologist John McManus.

And while President Barack Obama is designating an additional 490,000 square miles as marine sanctuary in the Pacific, “China’s destructive activities will result in the permanent loss of coral reef in one of the most important reef systems in the Pacific,” Harris said.

China’s Destruction Exceeds Environment

But more damage is taking place because of China’s land reclamation, the Pacom commander said. The shared principles that ensured security and prosperity in the region for decades also are threatened, he noted.

“Secretary of Defense [Ash] Carter stated at last month’s Shangri-La Dialogue that China is out of step with both the international rules and norms that underscore the Asia-Pacific’s security architecture, and the regional consensus that favors diplomacy and opposes coercion,” Harris said. “These are the reasons that the U.S. has called for peaceful resolution of South China Sea disputes, an end to attempts to unilaterally change the status quo, and an immediate halt to land reclamation by all claimants.

“We call on China to use the mechanisms of international dispute resolution in good faith,” he continued, “and to abide by those decisions as so many of its regional neighbors have already done.”

China’s actions are inducing its South China Sea neighbors to build stronger relationships with each other and with the United States, the admiral said, “driven not by a sudden U.S. effort to increase stability and security within the region, but by China’s conspicuous failure to do the same.”

Military Hospital’s Surgical Care Ranks Among Best in Nation

By Elaine Sanchez
Brooke Army Medical Center

WASHINGTON, July 24, 2015 – The San Antonio Military Medical Center here ranks among the top hospitals in the nation for surgical care, according to a recent report from the American College of Surgeons.

SAMMC earned an exemplary or average rating in 180 different surgical quality variables, placing the facility in the upper half of hundreds of esteemed hospitals throughout the nation.

The report is issued by ACS’ National Surgical Quality Improvement Program, or NSQIP, a voluntary program that gauges the quality of surgical programs across the nation. The aim is to help surgeons better understand their quality of care compared to similar hospitals with similar patients, according to the program’s website.

“The largest and best hospitals in the U.S. are part of this program, and our percentages place us in the top half of those hospitals,” said Air Force Col. Joseph Brennan, chief of SAMMC’s Department of Surgery. “We are very proud of that.”

Data Collection is Key

Data collection is key to the program’s success, Brennan noted. At SAMMC, a surgeon oversees the program and two nurses are dedicated to inputting preoperative through 30-day postoperative data into a secure, web-based platform. ACS analyzes rates of mortality and morbidity, such as pneumonia, surgical site infections, urinary tract infections, sepsis and readmissions.

“Blinded” information is then shared with all participating hospitals, offering a snapshot of how hospitals rank according to surgical outcomes.

This data offers priceless insight, noted Army Maj. (Dr.) George Kallingal, surgeon champion for NSQIP at SAMMC.

“NSQIP foremost offers us an internal metric to ensure our surgical quality outcomes continue to progress at SAMMC and sets in motion the process of continual analysis and improvement,” he said.

SAMMC’s surgical outcome data has been increasingly positive over the past three years, Brennan noted, an uptick he attributes to SAMMC’s care providers and infection control, quality and process improvement teams.

Improvements to Surgical Processes

“As a result of the data, we’ve made multiple improvements to our surgical processes,” he said, citing efforts to improve operating room preparations and catheter use. “And our exceptional staff did a great job pushing initiatives focused on better patient care.”

While NSQIP provided the framework for analysis, “the dedication of SAMMC personnel and their commitment to quality improvement is what fostered meaningful change,” Kallingal said. “It will continue to be an important tool to provide the framework for improving surgical quality outcomes in the future.”

The program is an easy sell at SAMMC, added Mariea Shelton, process improvement coordinator. The aim, she said, is to always strive for “great outcomes in surgical procedures.”

With an eye on further improvements, Brennan hopes to add a third NSQIP surgical clinical reviewer soon to enable more data to be inputted and more feedback to be gained. “The more numbers we can track, the better off we’ll be when it comes to gauging our strengths and weaknesses,” he said.

While the program is voluntary, the Defense Department requires all military hospitals to participate in NSQIP. SAMMC has been a voluntary member of the program since 2009.

“Participation in NSQIP means there is a total commitment to deliver the highest quality surgical patient care,” said Marilyn McFarland, a NSQIP surgical clinical reviewer.

Multiple Recent Successes

"Quality patient care is [the] priority here and it shows,” added Laura Van Dyk, surgical clinical reviewer.

Brennan praised the hospital’s exceptional care, citing recent successes on The Joint Commission reaccreditation survey, Level I trauma center reverification, and a Commission on Cancer silver designation for SAMMC’s cancer program.

“Our focus has always been on providing the best patient care,” the colonel said. “That emphasis has never wavered. This is just a great organization, from the leadership on down.”

Undersea Rescue Command Completes ORE; U.S. Navy Returns to Deep Sea Rescue

By Mass Communication Specialist 2nd Class (SW/AW) Kyle Carlstrom, Commander, Submarine Squadron 11 Public Affairs

SAN DIEGO (NNS) -- Crew members from Undersea Rescue Command (URC) and contractors from Phoenix Holdings International (Phoenix) completed an operational readiness evaluation (ORE) July 19, re-certifying the Navy's deep sea submarine rescue capability.

The submarine rescue system had undergone an extensive refurbishment period. The ORE, a component of crew certification, was the final step in a multistage process that enabled the URC-Phoenix team to become rescue-ready for worldwide submarine rescue.

"This was a tremendous effort by our rescue team, Naval Sea Systems Command (NAVSEA) and Commander, Submarine Force U.S. Pacific Fleet (COMSUBPAC) in restoring this unique capability," said Capt. Gene Doyle, commander, Submarine Squadron 11 (CSS 11), who is responsible for administrative and operational oversight of URC. "Whether it's a U.S. submarine, or a partner nation submarine, URC is ready to respond if called upon."

Dedicated and professional submariners combined with robust and redundant submarine systems ensure that submarines are inherently safe. In addition, the Submarine Rescue Diving and Recompression System (SRDRS), operated by URC-Phoenix, provides a last line of defense for the rescue of a submarine crew.

The Pressurized Rescue Module (PRM-1) Falcon, which is the submarine rescue vehicle component of the SRDRS, is capable of diving to depths up to 2,000 feet and mating with a disabled submarine trapped on the sea floor. The SRDRS is capable of being flown anywhere in the world to rescue either U.S. or partner nation submariners in distress.

The initial effort of the overall re-certification process was the restoration of PRM. Portsmouth Naval Shipyard (PNS) received the PRM in February 2013, completely refurbished the system and returned it to the URC-Phoenix team in February 2014 for final restoration.

"Without [Phoenix's] diligent and exhaustive work assembling the PRM and their exemplary operations, we would not have been able to conduct sea trials," said Cmdr. Andrew Kimsey, commanding officer of URC. "URC working alongside Phoenix was certainly key in getting past this big first step."

By late summer of 2014, URC and CSS-11 began a very deliberate re-certification process with the assistance of NAVSEA. While CSS-11 and URC focused on personnel qualification and re-certification, NAVSEA ensured material re-certification standards were met.

"The URC and Phoenix personnel went through a rigorous multistage evaluation process known as crew certification," said Cmdr. John Doney, CSS-11's deputy commander for undersea rescue. "Phase One is an intensive administration review, making sure the crew's training, qualification, material, quality assurance and internal monitoring programs were up to standards and would allow for safe, worldwide deployable operations."

The crew then began the operational certification process with Phase Two, which took place pierside aboard the rescue system mother ship, Hornbeck Offshore Services (HOS) Dominator. The two-day event ran from the safety of being pierside and involved progressing the watch teams through live evolutions and drills utilizing the installed SRDRS equipment.

"This event marked the first time the U.S. Navy submerged the PRM in the ocean since its overhaul and was an important step closer to our goal of deep sea diving," said Doney.

Overlaid into the crew certification process was NAVSEA's dock and sea trials testing to ensure the deep rescue system was materially operating as designed. Key milestones during sea trials included three deep dives, the first of which was an unmanned 2,000-foot dive to verify hull and component integrity at the crushing depth of 61 atmospheres absolute, which is more than 900 pounds per square inch.

"This critical event was successfully completed and led to the second dive, which was a manned dive to a depth of 485 feet," said Doney. "The PRM pilot and crew effectively landed and mated onto a training fixture on the ocean floor, positively testing all internal systems at this intermediate depth."

The third and final sea trials dive was a manned 2,000-foot dive in the PRM to a training fixture called "Deep Seat" to verify full system operational capability in the harshest conditions expected in a submarine rescue.

"It was during this dive that the rescue team mated PRM to Deep Seat and conducted open hatch operations simulating a submarine rescue, including having Navy divers and inspectors standing on Deep Seat at 2000 feet of sea water," said Doney. "This monumental moment was the culmination of hundreds of engineers, technicians and operators spending tens of thousands of hours in pursuit of bringing one of the Navy's most complex deep submergence systems back to 100 percent material certification."

The final phase was the ORE, which was a scenario-based event that took the entire URC-Phoenix team through a rigorous simulated submarine rescue using SRDRS aboard HOS Dominator off the coast of Santa Catalina Island in Southern California. The crew had to execute SRDRS evolutions and PRM dives, including drill anomalies, under timed constraints to conduct a simulated submarine rescue. In addition, PRM open-hatch operations were conducted at depth along with treatment of simulated medical conditions expected from those rescued.

"This was a complex and extensive process that required constant focus, teamwork and dedication," said Doyle. "Everyone involved absolutely delivered. Being certified for submarine rescue is an immense accomplishment that we're all very proud of, especially knowing that our brothers and sisters serving beneath the water can count on us."

The re-certification of PRM is not only a big step for the Navy, but for international engagements as well.

"Re-certifying the Falcon put us right back into the deep sea rescue world," said Kimsey, "Not only can we supply a deep sea rescue response for our submarines, but for anyone else in the world. We're already looking to future engagements and exercises in 2016."