|HISTORY OF MILITARY MEDICINE
|Year : 2017 | Volume
| Issue : 2 | Page : 146-150
Submarine medicine in indian navy: A 50-year Odyssey
GD Bhanot1, Parthasarathy Gokulakrishnan2, MI Reddy3
1 Base Medical Officer, INS Vajrabahu, Mumbai, Maharashtra, India
2 Fleet Medical Officer, Western Fleet, Mumbai, Maharashtra, India
3 NS Shishumar, Mumbai, Maharashtra, India
|Date of Web Publication||13-Feb-2018|
Dr. Parthasarathy Gokulakrishnan
Western Fleet, c/o FMO, Mumbai - 400 005, Maharashtra
Source of Support: None, Conflict of Interest: None
The Submarine arm of the Indian Navy is in its Golden Jubilee year, celebrating 50 glorious years of service to the Nation. From a small force of Foxtrot class, it leapfrogged into high technology boats in just 25 years of its coming into being. Forays into operating a nuclear Submarine have brought the Navy into the fold of of modern Submarine powers. In this journey, it has also graduated from acquiring Submarines from foreign nations to the present day indigenous construction of both conventional and nuclear boats. Submarine Medicine has been an inseparable part of strengthening the Naval capability throughout this endeavor. This article briefly describes the tale of Submarine medicine in India since its origin, highlighting significant milestones.
Keywords: Military medicine, Naval medicine, Submarine medicine
|How to cite this article:|
Bhanot G D, Gokulakrishnan P, Reddy M I. Submarine medicine in indian navy: A 50-year Odyssey. J Mar Med Soc 2017;19:146-50
“Of all the branches of men in the forces there is none who shows more devotion and faces grimmer perils than Submariners”
- Winston Churchill
| Introduction|| |
Indian Navy (IN) today stands at the cusp of Submarine glory. The silent arm that runs deep celebrated its Golden Jubilee on December 8, 2017, after 50 years of glorious service to the Republic of India. The journey from evolving the concept of the underwater force, developing and operating Submarines with understanding of matters medical in the sub-surface realm, to the present day of veritable expertise accrued after operating eight different classes dieso-electric and nuclear boats, is recounted in this paper.
| Preindependence Era|| |
The beginning of the IN's underwater service traces back to preindependence years. As the World War II came to a close, the plan for the development of the Navy to be inherited by Royal IN upon independence was stated in the Godfrey plan of 1944. The second phase of the plan envisaged acquisition of aircraft carriers and Submarines. The “Outline Plan for the Reorganisation and Development of the IN” of August 1947 specifies a minimum of four Submarines for the Navy were to be acquired in 10 years.
| Consolidation of Indian Navy Postindependence|| |
The era soon after independence saw Indian reliance on Royal Naval ideology and training. While the outline plan remained in letter, mainly due to the reluctance of the Royal Navy to transfer its Submarine assets to India, the next decade saw IN engaging in parleys not only with UK but also with the USA and USSR to work out modalities of building IN Fleet, including Submarines. It was only in 1958 when Vice Admiral RD Katari took over as the first Indian to assume the post of Chief of Naval Staff that the Navy earnestly re-looked its force levels and pursued afresh its aspirations for the Submarine arm. In keeping with the efforts to acquire Royal Naval Submarines to augment IN, the decision to train Indian Naval personnel by the Royal Navy was taken in 1960. However, this team did not include any Medical Officers (MOs).
With the plan to develop underwater capability gathering momentum, the Medical Services invested its efforts to acquaint with the subsurface domain, including its health and medical issues. These efforts preceded the actual acquisition of Submarine platforms. In 1960 Surg RAdm Malhotra and Wright, a renowned physiologist published the first scientific article from the niche specialty. He was a pioneer who dedicated his efforts to habitability on-board Indian Naval Ships.
| Naval Medical Research and Training Centre|| |
It was perceived in 1964 that, with the aspirations of IN to operate underwater, there is a need to support this endeavor with medical and scientific basis to render these operations safe and healthy. Naval Medical Research and Training Centre was established in 1964 for the conduct of research and training in IN. This Centre later translated into the current Institute of Naval Medicine (INM).
| Acquisition of The first Submarines|| |
By early 1964, the Defence Plan 1964–1969 had crystallised, including a renewed case for the acquisition of Submarines. Sensing the Royal Navy's reluctance to part with their assets, the Government of India explored the Soviet offers. Post the Sino-Indian war of 1965, the balance firmly turned into a viable defence partnership with the Soviet Union, and on September 1, 1965, an agreement was signed for the acquisition of four Submarines and a Submarine depot ship.
The special branch of underwater medicine was already in the forefront of activity, providing medical and diving support to Shri Mihir Sen's feat of swimming across the Palk Strait in April 1966.
| Indian Navy's Maiden Submarine – the Kalvari Class|| |
The first Submarine, KALVARI (NATO designation: FOXTROT class) was commissioned at Riga in the erstwhile USSR on December 8, 1967 – [Figure 1] and [Figure 2]. The decision to base these boats at Visakhapatnam was taken mainly to protect the eastern coast from threats, and the Submarine base, INS Virbahu, was established at Visakhapatnam in 1967.
|Figure 2: Vice Admiral AK Chatterjee, Chief of Naval Staff, with the crew of Kalvari|
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Around this time Marine Medicine as a specialty took rapid strides forward with the first Indian Symposium on Diving Medicine conducted at Cochin in 1968. This conference was attended by eminent experts from INM UK. It is with these initial interactions with Submarine operating nations that IN developed its own competence in this niche specialty.
| Naval Medicine Course|| |
In 1971, Surg Lt Cdr AK Chatterjee designed and imparted training to MOs to meet the basic demands of shipboard medicine, diving and Submarine arms. This paved the way for the Naval Medicine Course that all Naval MOs undergo to-date.
The inclusion of medical problems of divers as well as other naval personnel widened the scope of this specialty. The First Naval Medical Symposium to deliberate on medical problems peculiar to the Submarine and diving environment was held in September 1973 at Bombay and was truly the first comprehensive Marine Medical Conference to be conducted in India.
| Submarine Escape and Rescue Training|| |
An important aspect of Submarine Medicine is to look into procedures and methods to rescue crew from any ill-fated disabled Submarine. One of such methods is escape from a sunken Submarine by its crew. To train the Submariners for any such eventuality, a water-filled tower is used to simulate the escape. The 30 m Submarine Escape Training Tower at INS Satavahana, Vishakhapatnam came up in 1975 and was built with the help of the Soviet technical team under the overall supervision of Surg Lt Cdr AK Chatterjee. This was in keeping with the fact that the MO on board the Submarine is also the professional advisor to the command on medical matters pertaining to Escape. At the time of it becoming operational, this was only the third 30 m escape training tower in the world, ahead of most experienced Submarine operating nations.
To advance research in the field of assistance to sunken Submarine, Comex Industries at Marsilles, France was chosen in 1979 to supply an advanced deep-diving chamber. This Recompression Chamber with the capability to sustain saturation diving with gas mixtures was installed at INM under the supervision of Surg Cdr Idicula and became operational on March 1, 1983. A full range of diving experiments was conducted in this chamber, which included operational research with validation of saturation diving tables and imparting saturation diving experience to Indian Naval divers for assistance to distress Submarine. IN's tryst with actual operational depths that were envisioned and achieved subsequently, were met only with the help of experience gained from the chamber dives at INM.
| Postgraduate Diploma in Marine Medicine|| |
In 1979, based on an augmented syllabus, including shipboard medicine, University of Bombay accorded approval for the INM to conduct a postgraduate course in Marine Medicine (Diploma in Marine Medicine). This is the only institution in India where such a course is conducted. The first batch of specialists qualified from this institute in 1981.
The 70 s and early 80 s were the days of glory for INM. Surg Cdrs Joe Idicula (1976–1980), AM Madhwal (1980–1983), and AR Gokulnath (1981–1983), the pioneers of Marine Medicine trained abroad, were posted to the School of Naval Medicine, wing of the INM. In 1980 a 30 bar Research Recompression Multiplace Chamber for primary research in diving physiology was sanctioned resulting in “quantum” leap for INM. Many young and talented MOs joined the fold due to the rapid induction of-of diesel Submarines and submarining blossomed into a career option for many, merging IN's operational need to send doctors in the Submarines and the parallel growth of Marine Medicine as a specialty.
| Sindhughosh and Shishumar Class submarines|| |
In 1983, Surg Cdr AK Chatterjee inspected and assessed the escape system of the Shishumar Class Submarines under construction at Howaldswerke Deutsche Werft, Kiel, West Germany. Modifications to the Submarines to include the conning tower and torpedo tube escape options were made in keeping with the philosophy and training gathered over years of operating Kalvari class Submarines in the Indian context.
With the arrival of Project 877 (Sindhughosh Class) Submarines and Type 209 (Shishumar Class) Submarines commencing 1986, the Submarine Medical branch grew in size and capability with more MOs undergoing conversion to Submarine service than ever before. The initial MOs trained in each of the newer class of boats, namely, Surg Lt Cdrs DK Wasunkar and AM Joglekar, who commisioned Shishumar and Shankush and Surg Lt Cdrs B Sudarsan and George Verghese who commissioned Sindhughosh and Sindhudhvaj, brought in a paradigm shift in understanding of Submarine Escape and Rescue modalities of the Eastern and Western Boats, which was a rare mix at that time, operated only by IN.
The extensive training imparted to these MOs was encapsulated into the standardized training curriculum for Basic Submarine Course conducted at INS Satavahana, Vishakhapatnam. This includes special training on habitability, environmental control, and professional subjects of interest to the underwater domain.
After many decades of operating diesel-electric Submarines IN was at the pinnacle of profound domain experience in Submarine medicine. The MOs of Submarine specialization formed the backbone of the specialty of Marine Medicine thus cementing the bond between underwater warfare and undersea medicine.
| The first Nuclear Submarine – ins Chakra|| |
While the deal for the Navy's first leased nuclear Submarine was underway in the early 1980s, the crew had to be selected and readied for training. Psychological aspects of assessment of the suitability of personnel have also had its beginning as an organised scientific tool among Submariners, with the use to shortlist crew for the First Nuclear Submarine, INS Chakra. A Soviet team arrived in 1983 for medical and detailed psychological assessment and was set up at INS Hamla. Surg Capt SN Samarth, a Psychiatrist and Surg Cdr AK Chatterjee were associated with this screening. The MOs selected for the nuclear Submarine were Surg Cdrs PP Bellubbi, and A Ahuja and both received intensive training in the USSR following which they served on board INS Chakra, the first nuclear Submarine operated by IN. Surg Lts VRG Patnaik and Rahul Ray also served on the Submarine later.
| Era of Nuclear Submarines|| |
In the meantime, Russian Federation offered to lease their 971 class nuclear-powered Attack Submarines (Akula class) to India in 2004. Surg Lt CdrsPGokulakrishnan and Vishal Kansal were selected to train for these latest generation Nuclear Attack Submarines. Their training at the Military Medical Academy, St. Petersburg, in the years 2005–2006, included attachments at various clinical departments to hone their skills for prolonged deployments. The maiden return passage of the Submarine to her home port was the longest uninterrupted maiden underway passage of any Naval vessel in IN, which was achieved in the coldest of Northern Winters without any detriment to the crew health or compromising operational stealth.
| Disaster Relief Efforts|| |
During disasters or mass casualty situations, Submarine MOs with their background of underwater medicine have been deputed to render special medical aid at site – for example, the Samastipur railway accident in 1981; Godavari floods at Rajahmundry in 1986; medical assistance to divers during oil pipeline leak at Mumbai in 1981 and the floods in Bihar and Bengal in 1999. IN continues to provide Recompression Therapy at Port Blair in the event of civilian recreational diving accidents.
Indian Naval Submarine MOs have regularly represented IN in expert group discussions in international Submarine distress assistance exercises conducted abroad and on many instances, embarked on rescue ships of foreign navies, acting as ambassadors of IN and Armed Forces Medical Services.
MOs of the Submarine Branch had been associated with the deep submergence rescue vessel project which is a state of the art system for the rescue of disabled Submarines.
| Achievements|| |
Submarine MOs have been involved in the indigenization of the Submarine escape systems (SES), environmental and radiation monitoring systems and countermeasure medications for tackling radiation exposure and contamination. Much of the work underwater remains silent in keeping with the ethos of the service and is bonded by mission secrecy. However, it is a proud moment to recall and reminisce the historical achievements where Indian Naval Submarine medicine fraternity has given an excellent account of itself by constantly providing solutions to events underwater. The discovery of a new ailment of divers by Surg Lt Cdr J Idicula, who, along with Lambertsen and Idicula described a new gas lesion syndrome in man induced by isobaric gas counter-diffusion  is in itself a first for the IN Medical Services. The efforts of Submarine MOs to devise and improvise methodology pertaining to escape from distress Submarines, including assistance in indigenisation of SES and formulate the policy relating to human safety in radiation environment are singular examples of the development of durable and tangible results in a specialty that is uniquely Navy.
The achievements of Submarine MOs have occurred in a domain of limited expertise outside IN, in an operational role where none other than the Submarine MO himself could be deployed and with extensive assimilation of technological improvements from other nations, many of which have been converted into indigenous homegrown replacements.
| The Spirit of Adventure|| |
The paramedics of Submarine arm have not only been astute and trusted members of the Submarine crew but have also shown remarkable enthusiasm in participating in Indian Naval adventure activities. They have been members of expeditions to Mt Everest and South and North Poles. Vikas Kumar, MCPOM I and Rakesh Kumar, POM (Retd) were part of the first all Navy team to summit Mt Everest in May 2004. Following this, these two Submarine paramedics went on to successfully to conquer the South Pole in December 2006. A team including the two paramedics undertook an expedition to the North Pole in April 2008. This successfully culminated the quest of historic proportions-the “Three Poles Challenge,” with the Submarine paramedics achieving a first for the Navy. For this rare distinction, these Submarine paramedics were awarded Nao Sena Medal (Gallantry). In addition to these decorations, Surg Cdrs A Abraham and PP Bellubbi have been awarded Vishisht Seva Medal for meritorious service, and Surg Capt Anil Ahuja has been awarded Nausena Medal for Gallantry.
| Conclusion|| |
Submarine medical fraternity continues to bridge the warfighting aspirations of the IN and the challenge of incorporating modern medical practice in an enclosed and constrained environment. This is only possible with the understanding of the engineering peculiarities, tactics in the deployment of Submarines further and deeper, and by keeping up-to-date with recent developments in medicine and remaining steadfastly attached to the niche specialty. Today with the commissioning of the new INS Kalvari, the arm has completed a cycle of creditable five decades of service to the nation [Figure 3]. That this service has maintained impeccable standard of professional competence is borne out by the fact that the Indian Naval Submarine arm has maintained a high degree of safety of human life throughout its 50 glorious years of operations. The branch has limited scope for flair and exuberance, and the achievements underwater remain unknown to many and unsung. The medics who serve deep have reasons to rejoice this moment of rare glory by tracing their glorious path over the last five decades, in this Golden Jubilee year of Submarine Service of IN!
|Figure 3: Launch of indigenously built INS Kalvari on April 6, 2015. INS Kalvari was commissioned on 14 Dec 17|
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Conflicts of interest
There are no conflicts of interest.
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Lambertsen CJ, Idicula J. A new gas lesion syndrome in man, induced by “isobaric gas counterdiffusion”. J Appl Physiol 1975;39:434-43.
[Figure 1], [Figure 2], [Figure 3]