Great Britain | Operation Bolus

[Jamie]

OPERATION BOLUS MINISTRY OF DEFENCE ROYAL NAVY

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OPERATIONAL DIRECTIVE
APRIL 1995
TOP SECRET​

[1] OVERVIEW

[1a] BACKGROUND​

[1b] OPERATIONAL OBJECTIVES​

[1c] CASUALTIES AND LOSSES​

[2] BELLIGERENTS
[3] ORDER OF BATTLE
[4] OPERATION STAGING AREAS
[5] CAMPAIGN REGISTER

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[1] OVERVIEW

[1a] BACKGROUND
The Republic of Madagascar has experienced a outbreak of a new and deadly form of Ebola with a death rate reaching 70%, this has led to a state of emergency been declared by officials within the country which has seen the deployment of troops to help contain the current situation.​

[1b] OPERATIONAL OBJECTIVES

1. Provide support to the Republic of Madagascar through humanitarian efforts to compartmentalize, treat and prevent the growing outbreak of Ebola.
2. Assist the Malagasy Air Force with the resupplying of affected communities.
3. Establish a constant line of communication with the Republic of Madagascar to contain the situation.

[1c] CASUALTIES AND LOSSES DEC1995 - DEC1996

BLUFOR	OPFOR	NON-COMBATANT
		Atsimo-Andrefana Region 976 Killed 5,323 Registered Cases

[2] BELLIGERENTS

Blufor United Kingdom Madagascar Opfor Ebola

[3] ORDER OF BATTLE
DEC1995-DEC1996

[1] HMS Albion (Albion-class Landing Platform Dock)

[325] Royal Navy Personnel
[137] Fleet Air Arm Personnel
[150] 55 Commando Forward Surgical Group
[3] Westland Lynx HMA.8 (700 Naval Air Squadron, B Flight)​

APR1995-DEC1995

[1] RFA Argus (Argus-class Casualty Ship)

[130] Royal Navy Personnel
[137] Fleet Air Arm Personnel
[200] Commando Logistics Group Medical Squadron
[4] Westland Sea King HC.4 (874 Sqd, A Flight)​

[4] OPERATION STAGING AREAS as of DEC1995

DESIGNATION	LOCATION	STATUS
RFA Argus	RFA Argus	Operations Suspended
Camp Morombe	Morombe, Madagascar	Operations Suspended
HMS Albion	HMS Albion	Operations Suspended

[5] CAMPAIGN REGISTER

Campaign	Location	Objective(s)	Dates	Status
Operation Bolus I	Madgascar	RFA Argus Deployment to help tackle Ebola in West Africa.	APR1995 - DEC1995	Concluded
Operation Bolus II	Madgascar	HMS Albion Deployment to help tackle Ebola in West Africa.	DEC1995 - DEC1996	Concluded

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The Vessel was boarded and fully supplied prior to departure. Ensuring everything was accessible, it had already been granted a re-supply (if needed) at Gibraltar, Cyprus and/or Diego Garcia on it's way down to Madagascar.
Following Route IO>IN>IM>JM>KM>KL>KK>LK>LJ>LI>LH/LG, it'd resupply as needed which included refueling and once closer to Madgascar, would request access to their waters to begin it's operation.

 

[Jamie]

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ARRIVAL
Pennant Number R4, otherwise known as RFA Argus is the one and only casualty ship utilized by the Royal Navy that was fitted in 1991 with a complete refit to fulfill its role as a fully functional hospital, it was now embarking on the next struggle of it's life which was to support the Madgascar Government in the fight against Ebola; operating the fleet air arm and medical staff from the Royal Marines to provide what aid they can on behalf of the British Government. Having resupplied at a couple of stops along the way, it was arriving on the coast of Madagascar at the Western Side. Closest to the last reported affected regions of Menabe, Melaky and Atsimo-Andreafana. Onboard the ship, all those involved in Operation Bolus were focused on setting up the hospital area with quarantine zones for any casualties that do need to be brought aboard, all personnel wearing the appropriate preventive measures which include what is essentially full HAZMAT suits with the current method of transmitting the disease focused on direct contact through fluids. The four Westland Sea King Helicopters were to be the primary asset for the operation to support the local government. With that in mind, in the command center on-board Argus, a call was requested with a senior member of Staff from Madagascars Government or Armed Forces to be the liason for British Operations in the area. Confirming they were on scene and ready for tasking based on requirements. @Nathan

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[Jamie]

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COMMAND
With the government of Madagascar handing command of the fight against Ebola over to the British Armed Forces for the Atsimo-Andrefana region, by default this would allocate RFA Argus to been the command center with senior British Officials on-board to direct efforts for the rarea. Multiple Briefings had occurred to establish the affected regions, best plan of action and any recent news regarding operations on the ground. Officials from Madagascar have since been invited to RFA Argus; whether in person or via video call, to be aware of the situation for that location.

ASSIGNMENT: Medical Supplies Requested in Mandronarivo
British Forces have been provided the assignment to deliver much needed medical supplies to the Western Village of Trangahy, located in the region of Melaky. This region had seen a spike in cases of Ebola with up to 200 cases on record. Due to this, extreme caution has been advised with one of the Sea King Helicopters, specifically ZN105, has been tasked. Resupplying on Argus and complimented by 8 personnel from the Commando Medical Squadron, all those involved were covered in CBRN attire to maximize their safety. On-board the helicopter was multiple crates of medical supplies that would be used to assist and help the local population. The medical staff that were going would be able to provide additional assistance whilst on site. It was a small flight but to the opposite side of the region.

ASSIGNMENT: Establishing a Response Base
The Argus Casualty Ship is somewhat limited to easy transport due to it been out in the ocean, it's based of the coast from Morombe, a city in the designated region. With that in mind, two Sea Kings compiled of 25 Commando Medical Staff each. They were to be lifted to the cities airport named the Aeroport de Morombe and use this as a staging area for deliveries between Argus and any Ebola victims. On board were medical tents, the two helicopters, once delivered their payload, were to move back and fourth to receive extra medical equipment and shelter. Building of the makeshift camp made away from the runway.

@Nathan

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[Jamie]

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ASSIGNMENT: Medical Supplies Requested in Mandronarivo
ZN105, a Westland Sea King Commando HC4 had arrived at the small western village of Trangaghy, one of the remote areas which have confirmed cases of Ebola and hundreds on record. The crew and medical staff on-board were all suited with HAZMAT attire for their own protection. The aircraft descended into a vacant field within proximity of the village, allowing the medical staff to exit and were promptly greeted by the village elders. The Chief Medical Officer took the role of spokesperson and begun to converse whilst the other medical staff opted to off-load the medical supplies. This providing oxygen, fluids and electrolytes, blood pressure medication, blood transfusion equipment and general treatment for other infections. This would allow the local doctors to manage the symptoms of the disease. Once unloaded, a general review took place of by the Royal Marine Medical Team to provide an apt evaluation of the situation and identified it as a village requiring more involvement from British Troops. A report they would need to fill out following their return to RFA Argus which the journey began shortly after.

ASSIGNMENT: Establishing a Response Base
Both Seaking Helicopters arrived at the airport in Morombe and begun to set up the medical tents, shelter and generally an environment that could be used as a camp. Ensuring all tents were secured to prevent the helicopters causing disruption to the stability of them, and in general, setting up the interiors to be configured for medical outreach. Any British Personnel in the camp was required to be in full protective gear. A few more deliveries from the Royal Navy Aircraft would soon see the camp, named 'Camp Morombe', put into active service and begin managing outbreak cases.

@Nathan

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[Jamie]

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CAMP MOROMBE: Operations at Work
With Camp Morombe classified as 'Active', it was now the turning point in the region for the fight against Ebola. This becoming a paramount service across the Atsimo-Andrefana region, with hundreds turning up to be checked and confirmed clear. Anyone that was considered 'at risk' or 'affected' by the virus was isolated within one of the medical tents. The focus was containing those affected to prevent it spreading further. The more people with the disease that were isolated, reduced the chance of it spreading and eventually kill it even though no vaccine was yet discovered; a number of treatment options were given:

• Rehydration with Fluids and Body Salts (given orally or intravenously).
• Targeting specific symptoms such as:
  • Low Blood Pressure
  • Vomiting.
  • Diarrhea.
  • Infections.

With the opening of the facility, 100 personnel were delivered from RFA Argus to the camp as their new station whilst they continued to work. Leaving 50 on Argus to work from there and give direction. It had almost been 6 months since 54 Commando Surgical Group was deployed to Madagascar which has proven to be up for the task. Working continuously to minimize efforts. The Royal Navy personnel that are in the region were informed via the chain of command that in December, a furhter two months away, their mission will be reviewed to determine if it will be suspended or exchanged with another unit.

ASSIGNMENT: Sick Person report, Ambatomilo
The moment any emergency call came in that sounded similiar to the affects of Ebola, it wasn't long until the Royal Navy was informed and in this scenario, deployed to retrieve the casualty. The small village of Ambatomilo hadn't had any cases of the virus yet but getting ahead of this sickness could be the difference between further cases or prevention. ZN0108, or informally known as COMMANDO004 was tasked with the support of 6 Medical Staff to deploy to Ambatomilo, further down the coast, to confirm if the situation was Ebola. Suiting full protective gear, the Seaking helicopter departed safely and begun to make its way south to investigate further.


@Nathan

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[Jamie]

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APR95 - NOV95 Review
The Personnel of RFA Argus and currently deployed on Operation Bolus were approaching their 8th month of operations in November, with their initial deployment taking place in April. The work they have been carrying out in one region of Madgascar has been warmly welcomed back in the United Kingdom and the Prime Minister himself who identifies the Ebola issue as the 'potential to be a global catastrophe'. It had been confirmed by the Ministry of Defence that RFA Argus' operation would cease mid-November and Operational Command handed over to HMS Albion which had begun to depart from the UK, following the same route as Argus on its journey.

[1] HMS Albion (Albion-class Landing Platform Dock)
[325] Royal Navy Personnel
[137] Fleet Air Arm Personnel
[150] 55 Commando Forward Surgical Group
[3] Westland Lynx HMA.8 (700 Naval Air Squadron, B Flight)

ASSIGNMENT: Sick Person report, Ambatomilo
Approaching the small village, the Sea King Commando Helicopter kept on the border, beginning its descent in a safe open area. Allowing the medical staff to get off and meet with the Elder of the village who escorted them to the sick individual. No one else in the village had yet been affected but it was their job to confirm if this was Ebola and he would need isolation, or whether it was symptoms indicating another issue. The medical staff got closer and begun to do their standard checks on the casualty. A Frail man, at least 80 years old. After about an hour of conducting checks, they had given him the all clear and confirmed it was a general illness, likely related to his age. Signing him off, the personnel were able to leave via the Sea King and return to base.

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[Jamie]

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DEC1995 Hand Over
Several days had passed which the primary focus had been an official handover from RFA Argus to HMS Albion; with officers from both vessels coming together to establish the situation as it current stands, the trend in which way the Ebola Outbreak appeared to be progressing and the plan that RFA Argus had been following until that time. Following the conclusion on those days, HMS Albion became the official commanding vessel for Operation Bolus and concluded Argus' involvement. Departing fully crewed, supplied and ready to return to their families. It had been 8 Months since the original deployment and the new personnel were expected a similar duration of deployment. Based on the official handover, the current non-combatant casualties are held at 706 Killed and 2,123 Registered Cases. The current trend indicates that in the region managed by UK forces, the amount of registered cases is decreasing as the fatalities increase. However, as the UK Mandate is to minimize the risk of it spreading, it's predicted that the fatality rate will continue to increase with the hope that less and less cases occur each day. Due to a heavy reliance on aircraft, the officers of HMS Albion had pitched a request to the Ministry of Defence to request ground vehicles to support the operation due to the limitation of aircraft.

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Argus Returns Home
During the end of December and into January, RFA Argus had begun it's departure from the area of operations (AO) and begun it's journey home following the same route it was authorized to use on the way into the mission. Abiding the humanitarian access that was kindly offered by the Egyptian Authorities. A desperate journey back saw the pennant number 'R4' in the distance of HMNB Devonport; the home-base for the casualty ship. Across the harbour walls amassed hundreds of people, from family and friends, to those just wanting to see and support the return of the Royal Navy's Personnel who had spent 8 months away supporting the people of Madagascar. The event was presented live on local media news stations and the BBC.

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[Jamie]

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Ministry of Defence, London
Confined to a private conference room, ministers involved in the deployment and procurement departments within the MOD had begun to process the request pitched for ground vehicles to be deployed to Madagascar to reduce the strain on the Fleet Air Arm in which currently only 3 Lynx Helicopters are providing air support for the full region. The meeting, headed by Minister Wright, seemed to be going in the direction of rejecting the request. They were working through vehicle options and reviewing the currently deployed force to contemplate whether this was viable. During this time, statistics were released to them of the progress in the area which appears to be indicating that although deaths are rising, the number of new cases daily is rapidly decreasing as the containment seems to be working. As a result of this, the request from HMS Albion was rejected under the statement: "Although understanding the need for additional equipment, the work conducted by RFA Argus and now HMS Albion is indicating that the current presence is making a big impact. The use of helicopters is also limiting contact between British personnel and those affected by Ebola.

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Bolus Command Center
Disgruntled by the prospect of additional support been rejected, it was down to HMS Albion to ensure the containment remains valid. They have outlined a three-phase plan which works on top of the briefing that took part with RFA Argus.
Phase 1: Containment
This resulted in a specific area provided by the Government of Madagascar in which the Royal Navy would contain the outbreak too. Preventing it from spreading outside of that region with an intention of stopping it from impacting others.
The containment phase was practically achieved, with the British Forces only focused on one particular region.
Phase 2: Identify & Isolate
The goal for P2 was to identify those effected from the Ebola outbreak and isolate them. The issue is at the moment there is no vaccine so those who pull through are released, providing they don't test for it.
The key was to prevent it spreading to more people within the effected area, and the isolation tents at Camp Morombe was the main area. Transporting those who needs isolating via helicopter. After each trip, the helicopters were giving thorough cleans and the Lynx Crews were in full HAZMAT attire.
Phase 2 was still underway, whilst the cases were rising, it was at a lower average then before.
Phase 3: Recover
Thousands had died, and it was a big recovery operation for the region to recover long term. Though it was promised the Royal Navy would support them however possible.

At the moment, Phase 2 was the focus given the success that Phase 1 had received.

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Lynx Helicopters at Work
The small flight of 3 Westland Lynx HMA.8 helicopters were consistently busy. This particular airframe was a welcome one due to it's ability to go into more secluded spaces in comparison to the Seaking which meant the crews were busier than before. Participating in 10's of sorties each day to deliver the sick to the isolation pods, this obviously came at huge risk to the air crews but they maintained their HAZMAT equipment and ensured the lynx's were properly decontaminated after each one. The average start time for the air crews at 4am and finishing around midnight that night. Having to alternate pilots with reserve pilots to prevent them getting fatigued. After each sortie, they were to return to the camp for refuel and re-supply.

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[Jamie]

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Ministry of Defence, London
The fight against Ebola seemed to be diminishing in the aspect that the disease was becoming controlled and the Ministry of Defence have announced a withdrawal plan that seeks to bring Operation Bolus to a sustained end by December, having the crews back in the United Kingdom in time for Christmas. The final couple of months was to isolate any remaining strains that were crossing over the population, and begin to support the recovery of the region. Something that HMS Albion was to lead. Answering to the press, the British Prime Minister has classified the deployment a 'Success' despite the amount of deaths that have occurred. Urging the public to "recognize the good done by those in the Navy to put their lives at risk to prevent the spreading of such a disease."

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Phase 2
Phase 2 continued with the combined efforts of Lynx Helicopters continuing back to back flights, delivering supplies, medics and even casualties between Camp Morombe and their homes. It was a particularly busy time for the Fleet Air Arm who only had a limited amount of aircraft on scene. Nonetheless, working to their best ability, the duties remained the same to test and separate those with the symptoms or have been confirmed.

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Phase 3
Although the second phase was still in process, the Royal Navy forces deployed begun their preparation for the final part which would be assisting in the recovery. Providing troops to assist where people were scarce due to the amount of deaths, and providing supplies to villages just beyond the regional border. It was hoped that the Government of Madagascar would confirm their plans to recovery from the crisis, which would only justify the withdrawal of British Forces come December. Until then, the Royal Navy continued to act in the best interests of those living in the area.

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[Jamie]

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Phase 3
HMS Albion was fast approaching its end of deployment for Operation Bolus, having spent 11 months in the region providing medical and transportation support in the fight against Ebola. If all goes to plan, the vessel will be returning back to its home port at the beginning of December. Since their deployment, the Albion has actively commanded three Lynx Helicopters who were operating in the region, delivering supplies to those that required it or providing medical assistance and isolating those that have been confirmed to have symptoms of Ebola. Fortunately, for the UK's deployment, the region it was tasked to has seen a major improvement and has stabilized. Phase 2 had officially concluded and Phase 3 had begun to ramp up, during split shifts, personnel from the Navy begun to take down Camp Morombe which had been put up as a British Camp for treatments, whilst the Lynx Helicopters support recovery efforts to re-supply depleted villages, towns and cities that had been effected by the outbreak.

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[Jamie]

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Phase 3 Conclusion
It had been a considerably long tour of duty with the crews of HMS Albion, 55 Commando Forward Surgical Group and the aircrew from 700 Naval Air Squadron, B Flight, who had spent a year deployed on the coast of Madagascar as part of Operation Bolus, an ongoing effort that was designed to locate, identify and isolate those with Ebola since the outbreak begun in the poverty-induced country of Madagascar. With two individual deployments and hundreds of personnel involved, it had been foreseen that the Royal Navy would conclude its operation in December of 1996 which had just hit. The Phase 3 part of the operation resulted in a couple of months focused on recovery for the region, the removal of the existing camps utilized by British Forces and resupplying the villages and towns that had been hit badly. With all resources returned to HMS Albion, the Lynx Helicopters safely secured and the crew all aboard, it was marking the end of Bolus as the final British Flag was lowered in Madagascar. HMS Albion with her 612 personnel begun their journey back to the United Kingdom via the same journey they took to get to the Area of Operations initially.

Families and friends of the personnel on board were made aware of the intended arrival in the next few days and would be welcome to the home port to welcome their loved ones.

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