Since the end of the Cold War, the U.S. military's employment of health services in foreign disaster relief has expanded. While the frequency of disaster related global health engagements has risen, a method for assessing the efficacy of these engagements must be applied in order to forecast future requirements. By developing this construct for evaluation, operational planners and commanders may better understand when and how tactical medical assets should be resourced and employed in time, space, and purpose towards the achievement of strategic objectives. To this point, the underlying assumption of this research is that the efficacy of military health services in a foreign disaster environment is directly tied to its ability to provide the immediate care required until the host nation and international donors are able to assume responsibility for it. This monograph provides a framework for this assessment and recommendations derived from the analysis of policy and historical case studies. Historical analysis is conducted from two perspectives. The first historical perspective involves a literature review of disaster-related doctrine and policy across the joint-force. Although over half-a-century's documents have been reviewed, the focus of this review is on the post-Cold War. This review demonstrates that the volume and quality of planning resources for the U.S. military health systems has grown substantially for foreign disaster response. The second historical perspective involves an analysis of four case studies highlighting foreign disaster relief operations within the last twenty years. This analysis uses the principles of health service support as a means to qualitatively evaluate the efficacy of U.S. military health system involvement. These case studies portray that there has been moderate improvement in the efficacy of military health systems disaster response over the last two decades. The analysis also draws attention to areas for possible improvement.
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