The use of deployable military hospitals after hurricanes: lessons from the Hurricane Marilyn response.

Deployable military hospitals are frequently requested to supplement surviving local health care capabilities after disasters. Although some authors have advocated their use after mass casualty events such as earthquakes, previous reports have questioned the appropriateness of deploying these hospitals after destructive storms. These hospitals are relatively slow moving, expensive, and may require the diversion of local resources to support. After Hurricane Marilyn in 1995, a military hospital was deployed to the U.S. Virgin Islands. For a variety of reasons, the local health care community declined to use the facility once it was operational. This report is based on interviews with disaster managers and local health officials involved in the Hurricane Marilyn response. Recommendations include improving communications while requesting resources, broadening the range of available health assets to increase flexibility, positioning resources regionally or in the civilian sector, and creating clear indications for full-scale deployable hospitals when they are required.