THE CREW AND THEIR HEALTH
- establishing humanity's first, permanent foothold off Earth -

Medical: Dr. Plata describes how the medical needs could be met during each phase of development.

MEDICAL NEEDS AT DIFFERENT LEVELS OF DEVELOPMENT
There will be a need for medical care throughout the process of lunar and Martian development. However, the needs will change depending upon the number of people at the base / settlement and, more importantly, the level of health of people there. This page gives an overview of what this process might look like in order to illustrate that the medical needs of crew and settlers can be met at every stage if given some thought and planning.

INITIAL CREW OF EIGHT
In the Plan's scenario, the initial crew of eight would include one fully-trained Physician and a Biologist cross-trained in specific medical procedures somewhat more than that of an EMT. There would also be the capability to teleconsult with specialists of any medical (sub)specialty. Indeed it is a real possible for near real-time consultation by a specialist on Earth, watching medical telemetry and video mounted on the Physician and over the patient. Injured or ill crew could have immediate access to excellent medical consultation.

Prior to crew arrival, automated cargo landers would deliver equipment and supplies for the UniHab and the UniHab would have one area with certain medical equipment and supplies. The cases prepared for would include mostly emergency treatment that needed to be treated before a crew member could be returned to Earth during a three day trip. Although rather improbably, in such a scenario the Physician could attend the injured or ill crew member back to Earth. Plans would have to be made as to whether spouses would return as well or remain on the Moon. A physician from an alternate team could then be prioritized for the next crew mission in order to re-establish that capability at the base.

The initial crew would be fairly young and in extremely good health. None-the-less, a thoughtful plan would need to be developed as to what the most common and serious conditions that might occur in this setting and an extensive plan for equipment, supplies, training, and management needs to be developed for the 8-crew setting.

INTERNATIONAL LUNAR BASE
During the phase in which crew from various countries are being flown to the Moon to conduct extensive, suborbital, lunar exploration, the medical needs would change. The larger population (dozens to hundreds) of international crew means that there would be a need for more medical (and dental) personnel. It could be planned that, of the international astronauts remaining on the Moon, medical and dental personnel would be among those. Enhanced medical facilities could include a full dental set-up and perhaps a small operating module similar to those set up during disaster situations on Earth.

Diversity of specialty skills could be enhanced perhaps including, for example, a surgeon in the event of a severe accident needing definitive treatment that cannot wait three days. Along these lines, medical and rescue personnel should be on standby during an international, suborbital, lunar exploration mission. In the event of a crash (landing), the rescue personnel should be prepared to hop into a full-fueled lander with rescue equipment and immediately launch on a suborbital trajectory to the crash location. Typically, they could arrive in 15 minutes or so of the crash.

INITIAL PRIVATE SETTLEMENT
As mentioned on the retirees page, retirees are likely to be over-represented among the initial private settlers for the straight-forward reason that they are the ones who have had enough years to accumulate enough money to be able to afford to go. But, being older, retirees may well have built up chronic diseases which would place a much greater ongoing and acute medical burden upon the facilities and staff.

It may be that certain retirees with medical conditions which could not be able to be safely managed on the Moon may not be allowed to go. Certainly, elderly people too enfeebled to make the trip would not be allowed to go. The initial private settlement would be more like an active retirement community rather than a nursing home, certainly!.

But physicians and dentists tend to be over-represented among the wealthy retirement community and many of them would be very willing to serve their fellow settlers by performing medical, dental, or other healthcare services. They may be given preference for selection during the early phase of the settlement. So it seems reasonable that, along with Earth-base telemedicine, the appropriate medical personnel would be available for the medical needs of the settlers. The medical facilities should grow to include a habitat of essentially the first ward of a hospital including ICU equipment.

FULL SETTLEMENT
As the settlement grows, the number of healthcare personnel and facilities would grow. Eventually, the emergency facilities and clinics would have full hospital wards, ICUs, surgical, emergency, dental, etc sections added. Additionally, as the retirees get older, there will indeed be need for a nursing home if the retirees have not returned to Earth. Staffing would probably transition from reliance upon the settlers themselves to younger crew moving to the Moon for those jobs. Conceivably there could be an arrangement whereby a settler could borrow money to make up the difference between what they have and how much it would cost to move. They, while serving their wealthier neighbors, they could earn the money to pay back their loan. It's not indentured servitude but accomplishes the goal of allowing people to trade their services for the move.

MEDICAL FINANCING
The medical care on the Moon and Mars would be funded through health insurance and out of pocket on an individual basis. If the medical care was provided by a fellow settler the cost of medical care might not be that great. If provided by a younger worker who went specifically to provide that care, then the cost of moving them (and their family?) would have to be made up over their career so their charges could be more expensive.


If this area of a Medical Strategy interests you, and you have some expertise in this area, consider participating in the Medical Project to develop documents describing a reasonable scenario for each level of development.