The Tinian Deployment

On April 16, 1999, in response to an Executive Order issued by President Clinton, the National Security Council directed the U.S. Coast Guard to interdict a boatload of 147 Chinese migrants from Guam to Tinian, Commonwealth of the Northern Mariana Islands (CNMI). The purpose of the interdiction was to attempt to stop the smuggling of human cargo by a Chinese underworld organization. Overall responsibility for the operation was assigned to ICE with coordination and support from many Federal and local agencies. As ICE´s medical authority, the Division was able to deploy Medical Officers to provide for the health care needs of the migrants. Over the course of the next two months, the operations required the deployment of PHS officers for tours of duty ranging in length from 21 to more than 30 days. Health care was provided to a total of 523 Chinese migrants who arrived on five vessels. PHS officers, who were included as members of the Coast Guard boarding party, were confronted with the most vile, repulsive and unsanitary conditions imaginable, as they sscreened patients and tended to life threatening conditions. In the initial hours and days of the operation, PHS officers played significant roles in advising the on-site ICE officers in dealing with a myriad of hygiene and health-related issues. These ranged from development of appropriate meal menus to procurement of hygiene items and clothing suitable to the climate, to establishment of portable showers and hand washing stations for staff and migrants. The creation of a MASH-like working clinic in a tent from a "blank slate" took incredible foresight, cohesive teamwork, professional flexibility, disregard for personal comfort or complaints, and the knowledge and experience of seasoned PHS Officers. This functional clinic, which changed location several times, was developed in a military tent on the airfield from supplies that were brought, bought or borrowed. Officers were required to work long hours (in some cases 36 hours without rest) to provide 24-hour coverage amidst torrid environmental conditions including intense tropical heat and humidity, rain, insects and rodents. They placed themselves in harms way considering the very real hazard of contagion. At one point, five migrants were under treatment for active tuberculosis.

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