Global RN

Resurrecting Global RN for "X24 Europe"

2011-03-23T23:17:00.000-07:00

After a very long hiatus, and many twists and turns like a lot of us these days, I've finally gotten back to what I love. Talking about global healthcare, humanitarian assistance, and disaster response. I want to apologize to my followers for not getting back to this column, and wanted to thank them for their insight and comments.

Please feel free to send stories, comments, whatever you can do to share knowledge in this field, whether you are civilian, government, non-goverment, or just an interested individual.

I am excited to report that I will be going to Montenegro for participation in an international on-line disaster exercise next week, utilizing social networking capabilities such as Facebook, Twitter, Ushaidi, and many more, to get people engaged in sharing their knowledge and ideas for humanitarian assistance and disaster response. X24 Europe is an outgrowth of X24 which was our first online disaster exercise which was highly successful. We had 89 countries check in and over 10,000 messages from texts to Twitter messages. It is open to all to view or participate. You can find the information on Facebook under "X24 Europe" It will be conducted March 30-31. I will hopefully be posting pictures from the drill as we go along, or, if it gets too busy, I will catch up when I get back. Take care all,

Call for stories

2010-01-27T22:48:00.000-08:00

I would really like to hear stories from the field, so if you are there, please send us your experiences.

Our local DMAT team meeting was tonight, the house was packed, we even had several new people who came to apply to join. We went through the health and security issues involved in deploying to Haiti and heard bits and pieces of our sister team CA-6 who was one of the first teams there. They had to sleep out in the open for nine days. That's rugged.

I've been getting more communications about doctors and nurses who spontaneously went there and are having problems because they are expecting some agency or organization to put them up or have an assignment for them. Or, they are getting overwhelmed. Evacuating them takes up air time, flight space, fuel, manpower, etc. Don't do it!

Passion and Good Intentions are Not Enough

2010-01-23T20:32:00.000-08:00

Great article from MSNBC the other day regarding the hazards of unsolicited help, and the burden it can put on a response. Every unnecessary person, politicians included, takes away resources needed from victims who so desperately need them. I know first-hand how resources get diverted for some unplanned arrival of volunteers, politicians or military officials that have neither the self supporting resources for their purpose, or have no good reason being their other than morbid curiosity and the chance to say they were there. This includes security, transportation, health care, billeting, etc. Enough of my rant, here's the article.

http://today.msnbc.msn.com/id/34958965
If the link doesn't work, I apologize.

Watching out for "Responder Envy"

2010-01-22T17:02:00.000-08:00

It's been said before, that disaster responders are the type of people that when something happens, they run to a situation rather than away from it. I very much agree. Whenever a disaster happens we automatically go into alert mode and watch for an opportunity to be called upon to help. Once you've been to a few disasters, and another disaster happens, friends and family automatically ask if you are going, most expect you will. When you don't they may ask "Why not, don't they need help, isn't that what you guys do?" With the DMAT teams, there is an order and process to go through in order to have an effective response. Sometimes these regulations make sense and sometimes they don't. As I may have explained earlier, each team is "first up" to respond during certain months of the year. When a disaster happens and your team doesn't deploy, it is easy to become a little envious, frustrated, or disappointed. I half-jokingly refer to this as "Responder Envy", "Non-Deployment Depression, or "I Can't Deploy Blues". It can be hard for people who have good skills, experience and willingness, to sit back and wait for the call to go. We are an ingenious bunch and can often figure ways to get in on a response through other NGOs or agencies. Each person does what he or she feels best, but this may not always be the best choice. I like deploying with my DMAT team as we train together, and have the resources and protocols to keep ourselves safe and render more effective aid. Whether or not I will be able to deploy through DMAT is in question as I was trained by the CDC to help with H1N1 issues if needed. The commitment is through August, so I'm not sure if I will be released by one agency to serve with the other. Frustrating but the reasoning behind it does have some logic. We cannot send all of our resources to one disaster. As I speak, here in Southern California we are having torrential rains, trees toppling on to cars and buildings, we had at least one woman lose her life due to a tree coming down on her trailer. So, we must keep some resources here in case of a domestic emergency.
When I feel that angst at not being able to go, I have to check myself out. Is it my ego? Or, is it a genuine frustration at circumstances beyond one's control? Maybe a little of both. What I do know, is to be careful of what you pray for. I'm learning to find out how I can contribute to the response in ways other than hands-on nursing care, thus avoiding those "I Can't Deploy Blues". This time I've become involved in monitoring communication and logistics efforts on-line, and helping connect resources through different networks via the university and the National Institute of Urban Search and Rescue. Small efforts, but it helps me learn more about all the things that go into and behind my nursing care in the field.

The following was written by my friend Sam Bradley (links on side). She captured so much of what I wished to say. I feel about my DMAT team and our commander the way she feels about hers.

A week ago Tuesday I was driving from Northern to Southern California to meet with a representative from Washington DC to work on a national training project. Car travel for me generally assumes being firmly entrenched in the iPod zone. I actually look forward to long drives as it’s an opportunity for me to catch up on my favorite podcasts and audiobooks. That might explain my complete mystification when I dropped into the hotel bar at 7:30 to see news footage of the Haiti earthquake on the TV. Me: “So, when did that happen?” Bartender: “Oh, about 3:00 this afternoon.” That’s when my iPhone came to life with e-mails from the team speculating about a possible deployment. Deploying to Haiti would be our first international mission. So, there I was, sitting at the other end of the state with an all day meeting scheduled the following day. The next morning we met for breakfast and guessed that my team would probably not be deployed before the end of the week. International travel creates a whole new set of complexities to the already daunting task of sending multiple teams of thirty-five people into a disaster area. We were wrong. DMAT CA-6 and other teams were moving out by the end of the day. Even though I wasn’t on the current roster, I was disappointed about being left behind. Disaster medical people are a unique bunch and thrive on working in the worst of circumstances. The extremely austere conditions in Haiti would provide an especially challenging opportunity.
Who are these people? In 2008, I was doing an article for JEMS magazine that was ready to go when my (then) employer decided I wasn’t high enough in the food chain to author the article. The magazine liked it, but it didn’t see print. In the process of creating it, I interviewed some of my team members to try and explain what drives them to do what they do. This is a chance for their thoughts to come off my hard drive and to be shared with you.
David Lipin went from being a partner in a computer networking business to joining DMAT CA-6 as an EMT. Within a few years, he became the commander of our team. In our opinion, he’s the best in the system. (No bias, here!) I asked Dave what attracted him to disaster medicine.
“I got into disaster work because it's so different than my ‘day job’. It works a different part of my brain, is almost like a vacation, and ultimately, is just so darned satisfying. The best part is the grateful responses of patients we treat at disasters. No bills, no insurance, no worries -- just medicine”. Dave devotes himself to this work full time now, and states that he’s “living his dream”. When asked about his best memories of deployments, he told me: “Watching a baby girl being born at the Superdome, and seeing my wife at the airport upon returning from Ground Zero”. I’m anxious to hear what experiences he brings home from Haiti.
Annie Bustin is an experienced RN who is a triage nurse in San Francisco, and the Disaster Coordinator for her hospital. In my opinion, she exemplifies what a nurse should be. (No bias here, either!) She is also the Operations Chief for DMAT CA-6. When asked what attracts her to disaster work, Annie said, “Being an RN in the emergency department allows me to use my critical thinking skills. I can be creative, go outside the box, and actually do something for a patient to make them feel cared for. It’s incredibly satisfying. Disaster work is that same feeling, but a thousand fold. It’s knowing that you're right where you're supposed to be, that you can give your blood, sweat and tears to a stranger without them ever knowing it; without the world ever knowing it.”
Annie is motivated by the fact that she has the skills to make a positive difference in someone’s life during the worst of circumstances. “I can give back to the human race. I can give a piece of myself to healing the injured, ill, broken and destroyed victims of a disaster. I can give hope where there is none. How can you turn down a job like that?” Deployments aren’t always easy, and Annie described her most memorial moments of Katrina as too private to share. “It's an emotional moment that’s as strong now as it was then.” But, she’s treating people in Haiti as we speak. Her words reflect beautifully how many of us feel, “At the end of the day, when you can finally lay your head down somewhere, a sense of peace and mercy falls upon your breaking heart. And you know then, that you've come home”.
A DMAT or any disaster medical team is not just about the medical personnel. The team can’t function without a place to practice and sleep; the use of electricity, water and sanitation; and certainly, communications. Critically important team members include the logisticians or, as we affectionately call them, the “loggies”. In answer to the question, “Why do you do this”, a loggie told me; “Because I have a screw loose in my head. Who in their right mind pursues a career and a hobby where you run toward a situation that other people are screaming and running away from? The best part is the feeling of accomplishment that you've done something to help, that you gave them your best shot, and you got people through it. It’s the satisfaction of having to improvise and create something that helps the team or a patient, by using non-standard thinking and a creative skills set to make a piece of chewing gum and a Band-Aid into a heart monitor. It’s what “loggies” do best.” He’s right … loggies are the most creative and resourceful people on the planet.

We see an amazing number of people in the few weeks we’re in a disaster area. We suture, hydrate, cleanse and salve their wounds. We comfort them the best we can. What makes a deployment difficult is never having closure on the stories of the people we treat: parents separated from kids; loved ones floating away after a hurricane or flood; people missing under the rubble of an earthquake; the loss of beloved animals and everything they own. We can’t tell them, “It will be all right” because we know it won’t be. We don’t know where the homeless will go or whether they’ll ever see their families again. We can tend to their wounds and replace their meds, but we can’t repair the psychological devastation that will remain long after we’re gone. It almost leaves us feeling guilty for having an intact family and home to return to.
Yet, we love to remember the moments when something happens that brings a little light to the darkness: a family is reunited, a baby is born, or a life is saved. At Ground Zero we met the family of a lost FDNY firefighter that we still remain in contact with. I wrote about Christian Regenhard in the story about my Ground Zero experience in the book, “To the Rescue, Stories of Healthcare Workers at the Scene of Disaster.” After Katrina, CNN profiled a story about a woman whose mother still hadn’t been located many months after the hurricane. Dave recognized the missing woman as one they had seen when the team was trying to make their way to the Superdome and some people were pushing her up the freeway on a gurney-like device. The team stopped and attended to her then provided for her evacuation. Even though the prognosis for her was certainly not good, Dave was able to provide some much needed closure for that family … all recorded on CNN. Now the team is back in the lights of the CNN cameras doing the good work that they do. They are there with the USARs, religious and non-governmental organizations; the American military, and the Comfort hospital ship to name just a few.
Okay, here comes the rant … It’s my blog, I can say what I think. Every time I hear negative comments about the US response to Haiti being too slow or not good enough, it annoys the crap out of me. To those people: before you criticize, know the facts. First of all, there is no mandate for us to be there. We are a humanitarian nation and choose to be there. When the call comes, team members have to get off work and prepare their families, while the government processes a deluge of travel orders. They have to determine how to safely get them into the disaster area, especially when there are issues like damaged ports, lack of aircraft fuel, and a semi-functional and overloaded airport. Then, there are the issues of security for the personnel and getting huge caches of equipment to the teams. News flash: There is no means of instantly transporting people and equipment and have them land in a light beam in an affected area an hour after a disaster … end of rant.
So, am I going to Haiti? I don’t know. If the call comes, I’ll be ready as will many of us who missed the boat ... or plane, the first time. I’ll remove the down jacket and fleece I packed for a trip to Alaska and replace them with bug spray and mosquito netting. If I don’t go to Haiti, there will always be another disaster somewhere ... sometime …

I'm hoping that I can focus my next posts on updates from the field and ideas regarding what to take and how to prepare for a disaster response. Take care and stay safe.

2010-01-20T22:11:00.000-08:00

Short post tonight, but I did want to introduce a colleague of mine from our sister DMAT CA-6 out of Northern California, Sam Bradley, responder extraordinaire. She's recently published a book about disaster responders, detailing their experiences at disasters such as Ground Zero and Hurricane Katrina. Well worth checking out.

"To the Rescue - Stories of Healthcare Workers at the Scene of Disaster" at Barnes and Noble, Amazon, etc. There's also a summary at

http://books.simonandschuster.com/To-the-Rescue/Nancy-Harless/9781427799722

http://www.totherescuestories.com/

thesambradley@blogspot.com.

Hopefully the military issues with security will be satisfied soon so that aid teams can get in there and do their job! I'm too tired to go on my tirade about the lack of interagency collaboration, agencies culture clashes, civ/mil culture class, administrative turf wars, etc. Great warriors trying to manage a humanitarian mission without a whole lot of life experience or training in that field. There has to be more civ/mil research in to lessons learned or at least really put the lessons learned from past missions into effect instead of starting from square one each time. The Israeli's had it down. Set up and operational in 48 hours. Mmmmm....

Notes from the field

2010-01-19T23:43:00.000-08:00

Tonight I'm posting a field report from Steve Hailey passed on to me from Lois Clark-McCoy, President of the National Institute of Urban Search and Rescue.
Steve was the Emergency Services Director for American Red Cross in Austin TX.
He has over 50 Disaster Response assignments plus 6 international deployments.
His note below. He is currently working as a contractor (Technology and communications response) for a group of doctors from Orlando FL.

-----Original Message-----
From: Steve Hailey
Sent: Monday, January 18, 2010 11:00 PM

Just a quick update. I made it to Haiti and am supporting doctors at the main general hospital as well as an International Red Cross team who have setup a mobile hospital on the general hospital grounds to help with the overflow. Without going into all the gory details I guess I can only say that with all the disasters I've been on this is 1000 times worse. It is really bad here the people need help and I fear it will only get worse. I'm just glad I am able to help. My family is doing well back home thanks for asking.

Let me give you just few highlights from my first 24hrs.:

1. Flight over was a chartered jet and the air traffic control was so overloaded that my plane was not able to reach ground control at Port au Prince for nearly an hour and we had to basically fly in a circle to get them to recognize us. So we were flying by the seat of our pants. After landing I paid a local with a truck to haul people and personnel to the hospital and had him drive right up to the plane on the grass and didn't go through customs or anything. Very interesting.

2. Driving around is by far the most dangerous activity. You can get shot, a telephone pole came within feet of fallling on the car I was riding in. Note to self...stay off the street because its dangerous.

3. Now I know what wartime medicine is. Its dirty, nasty, and that is all I can say right now.

4. Provided comms for Intl. Red Cross Hosp. AND the main general hospital.

Not bad for the first 24 hours. I need to turn the genset off now take care and please pass this on if you wish.

I hope to post more field reports from various teams as more teams get up and running.
Kudos to the Israeli team for such quick and efficient hospital set up. Take note emergency response administrators, we could learn a thing or two.

Bits and Pieces

2010-01-18T21:16:00.000-08:00

A case in point about helping responders: Yesterday I was trying to do chores amongst e-mails, blogging and all of the assorted bits and pieces of what we do. I was chagrined to say the least, to find out that I absent-mindedly used bleach instead of detergent in my load of dark clothes. Of course, some of my favorite things were in there. Oh well, I'd rather goof on my laundry than actions related to the response. Tonight my daughter-in-law cooked a fabulous dinner while I played a short game of monopoly with my granddaughter. We need to take those breaks, most of us are a very driven bunch when it comes to disaster response.

As far as Haiti, situation reports have been from one extreme to the other. Reports of a communication team trying to set up a communication system, being attacked and having to retreat into Santo Domingo. While on the other end, I got a message of a hospital that wasn't in the damage area which was able to take patients, but no one knew because of the lack of communications. This was great news, and in this area things were calm and the community trying to help as much as they could. The beauty of the networking, social and technical, is they were hooked up with people on the ground in Haiti who need to know this. Fuel is still very difficult to obtain and anything that runs off of a generator, from lights to communications is affected. This alone slows the process. It is diligently being worked on by a number of people from all over the world. People wonder why the heavy equipment isn't getting there, if they could only have a fly on the wall perspective they would understand the numerous logistical issues involved, the ports heavily damaged, roads damaged or impassable, or no roads at all, and poor communications. However, it is getting somewhat better as we speak, thousands of people communicating through various networks to come up with solutions.
Meanwhile medical personnel are trying to manage the best they can as supplies trickle in. Last night on 60 Minutes they showed doctors having to use a hack saw for amputations and vodka for sterilization as that is what they have at hand.
Hopefully tomorrow I can post a little of what responders are encountering if I can get some reports from the field from one of our teams that just arrived in Port Au Prince today.

One of the security issues they are dealing with is the escape of several hundred felons from their collapsed prison. Port Au Prince has had a long history of gang violence. Haiti is one of the main portals for cocaine to the U.S. Fighting for turf is going to be an issue especially with the escaped criminals many who were in for drug or violence charges. Couple this with people not being able to get food, water, and medical care and it all contributes to the risk of violence. When I responded to the Nias earthquake, a helicopter was shot at trying to deliver food. Who is responsible for establishing security? Especially with a collapsed government. While the UN may send in some peacekeeping forces it is not enough. The U.S. while trying to help may be perceived as trying to take over. So many political, administrative, logistical issues that slow these responses, yet, I still see the progress of Civilian/Military and International cooperation better than it has been in previous responses. I think the world finally realizes we are all on this planet together and we better help each other, as what happens in a disaster affects everyone. Take care all.

Ways to help responders

2010-01-17T14:13:00.000-08:00

Sitting here awash in e-mails, and situation updates regarding the tremendous logistical and communication challenges that are trying to be solved, in order to provide water, food, shelter and medical care; I pined for someone to attack the pile of dishes in my kitchen, and the laundry that needs to be done, and the bills that need to be paid. It dawned on me that there is so much that people can do to help this whole response even if they are not directly involved.
Many people want to help but either don't have the skill set needed, or money to contribute, or for some other reason cannot be directly involved. It would be a tremendous help to those who are responding, and I'm not just talking about medical providers, or search and rescue teams, I'm talking about those behind the scenes, to have a little help with common chores or everyday needs. There are thousands of people who sit at computers all day and night, sometimes for days on end, providing solutions to a myriad of problems out there. It would be extremely helpful to them for family, friends, or neighbors to offer a little help. Some ideas might be:

* Do their dishes
* Fold that pile of laundry
* Walk their dog
* Feed their cat
* Clean their fish tank
* Take out the trash
* Take them over a bowl of soup for dinner
* Wash their truck
* Shovel their snow
* Give them a neck and shoulder massage
* The ones that do have to deploy: make sure their bills get paid, many have to leave on short notice, they shouldn't have to come back to no lights or water.
You get the idea. What you do may not make the news but it is an essential part of all of us working together for the best outcome.

Preparing team for send off

2010-01-17T00:04:00.000-08:00

Today was spent repackaging medicines and medical supplies on the loading dock of a hospital, getting ready to send a medical team from International Relief Teams off to Haiti. Some of us who belong to our local DMAT teams also volunteer with other organizations, so it really is a sense of camaraderie helping each other to deploy, whether it a government, or non-government response. I can't say enough about the people of all different walks of life and disciplines who I encounter doing this kind of work.

Reports from different sources indicate that fuel supplies on Haiti are extremely low and that will affect the ability for responders to continue operations. No fuel = no generators, motor transportation, etc. Incredible collaborative efforts are being made through both civilian and military channels, government and non-government alike. Increasing violence is being reported as victims wait for aid, most not having any idea of the supplies that are there but unable to distributed because of the lack of roads, the lack of fuel and the lack of communications. This puts first responders in an extremely vulnerable position, another reason for not spontaneously volunteering without support and security with legitimate agencies.

Communications are always the most difficult component in a disaster response, especially with the infrastructure being destroyed. Again many partners are trying to develop collaborative networks to solve this problem in Haiti. Not an easy task when you have differing technologies, differing systems and capabilities, not to mention the multitude of languages.

A lot of people are working endlessly around the clock to stem the massive suffering and try to give them a chance at rebuilding their lives, which in Haiti, historically, has been a challenge at best.

So you want to volunteer.

2010-01-15T22:58:00.000-08:00

For some of us, especially nurses, when disaster strikes we want to help. We see the need, we have the skills, and we are willing to put up with hardship and donate our time, so why can't we just go? Disaster response takes training and immense coordination. Sure you may be able to get yourself to the site, but unless you are volunteering with a legitimate response agency or non-government organization, you will most likely be a burden to the response and do more harm than good. We see the need, we can't understand why more isn't done, and so we take it upon ourselves. Let's say you get your way to the response area. Where will you stay? Who will provide your security? What will you eat? Where will you get your drinking water? Who will you go to if you need medical care? Do you know the politics, language and culture of the area? If you show up unannounced and unplanned all of your needs will detract from limited supplies needed for the rescue effort. More on this later.

Haiti Response

2010-01-15T11:24:00.000-08:00

I've finally decided to reactivate this blog in light of the terrible tragedy unfolding in Haiti right now. My DMAT team is low on the response priority, but I know of several other DMATs that have been deployed, they have got an extremely difficult job ahead of them.
Part of me of course wants to be there immediately, that is our nature, but the reality is that this will be a prolonged response with a need for many hands as the days, weeks and months go by.
Meanwhile, there is much to do behind the scenes. Communications is of course the most important and difficult to do with the infrastructure being wiped out, but already folks from SDSU's VizLab, InStedd, NIUSR, Google, and many more are trying to get the social networking up so people can see that even though they have not received help yet, that much is already there awaiting transportation to the affected areas. This will hopefully help avert some of the ensuing violence that is starting to happen.
This is a short entry for now, but I would like to make this a venue for communications with responders that are involved with this response, especially nursing, and to hopefully educate those interested in the different aspects of disaster response. Please feel free to contribute your stories, pictures, needs, etc.
Stay safe and take care of each other.

Australia

2008-07-30T01:47:00.000-07:00

Well, I'm finally off the ship. The last day I just stayed on when we hit Darwin as it was a circus trying to get a thousand people off the ship and a couple hundred on.
In Sydney now, I just got back from taking the ferry across Darling Harbor to Manley Beach. It was so beautiful! This harbor probably is the most beautiful harbor in the world. After getting off the ship I stayed a day in Darwin and wished I could've stayed more. Very peaceful and quiet. Spent the day just walking around town picking up a few souvenirs, took a quick dip in the pool and went downtown for dinner. Ran into some of the women I worked with on the ship at a bar and grill called the Hog's Breath, they were having a few and one of them asked me to play my harmonica. I used to be just so shy about playing in front of people, now two different women have asked me to teach them what I know. I'll probably not see them again but got a few tips in. Last night was a challenge, after getting off the plane I had to wait in line for about an hour to get a taxi. It took me to the other side of town and into a hotel that the cab driver didn't even want to drop me off at. No internet, my cell phone wouldn't work so I called work and they had the agency correct things. So,now I am staying in a very nice hotel in the middle of downtown Sydney, walking distance to almost everything I need or want to do. It's winter here so it's a little cold but not bad at all. Just wish I had brought a nicer jacket than my DMAT jacket, but hey, I didn't have any idea I'd be coming here in the first place. Trying to soften the edges before I get back home. Wish I had more time here, there is so much to do, so much I'd like to explore about Australia. I'm hoping to meet up with one of the Australians I talked with on the ship to discuss international civ/mil collaboration. Funny thing, I ended up sitting next to two Aussies I worked with and one of them got the guys' phone number for me. How's that for luck? More pictures when I get home. Take care.

Timor Leste

2008-07-22T05:10:00.000-07:00

The past few days have been pretty busy. Operation Mercy Wrap was a huge success,we had a lot of people on the mess deck with needles and thread, from the Commodore on down. I was surprised how people got into it. They had media up there filming and doing interviews. It was great to see everyone getting involved, even our partner nations, Australia, India and Canada pitched in and sewed up towels for blankets and shirt sleeves for hats. One pharmacist brought her really nice sewing machine and made some very nicely done bath bags. She also brought a lot of fleece and made about 14 blankets out it. The hard part now is getting them back up to the clinic up in the mountains where they are needed. Roads are practically non-existent and it takes several hours up a mountainside to get there. A lot of other places could use them but we want them to go where the need was noticed first.

Got to go to Mass at a Catholic Church in Dili on Sunday. Went with a group of about 30 people, it's the first time I've been off the ship since opening ceremony. It was very nice, and interesting. It's the first time I've ever gone to church and saw a soldier (Aus) with a semi-automatic rifle hanging off his shoulder as he was doing the standing, sitting, kneeling that we do in Mass. The congregation was large and international with the UN Peacekeeping Force still there. It was all in English and the choir was wonderful. I liked the chiming bells they ring at communion, just like it was when I was a kid. The priest asked everyone from the Mercy to raise their hands and the congregation applauded, it seemed they were happy to have us there.

Got my first helicopter ride today and it was awesome! I thought it would be more rough, but it was so smooth, we even had the doors open so I got some videos and pictures. When we landed these kids came up to greet us and there was this wonderful elderly lady who was just smiling, I asked if I could take her picture, she nodded yes and just as I pressed the shutter she reached out her hand in greeting. I shook her hand and she just hugged me and kissed me on both cheeks, she was so happy to see us. We went to a clinic (Clinic Timor)run by the coffee cooperative. They grow coffee for places like Starbucks. It is apparently run by some Cuban doctors. I met a nice young man from Cuba who was translating for us. They even had coffee and buns for us in one of the rooms. People were lined up outside the fence and the waiting room was filled. It is a beautiful area, in the not too far distance there were these very tall trees with a big canopy, just lovely. The coffee cooperatives and the cattle cooperatives are helping to fight the pervasive poverty in that area. Hard job to do for a whole country, but I think it is being done, little by little.
We picked up a young man to take back to the ship for cleft lip/palate surgery. He's 15 and he didn't have anyone with him. Imagine being whisked away by some large caucasians, probably never had been in a car much, only to be flown away to a white ship in the middle of the ocean, then having your first ride in an elevator! Can't imagine what is going through his mind. Operation Smile from Australia is doing the surgery, they've done some incredible work on this mission. The sad part of this mission is seeing the disease states in 20 and 30 year olds that we were seeing in 60 and 70 year olds in the Philippines. The result of years of instability. Hopefully that will change with some persistence and international collaboration.
Only a few more days before all of this part ends and I will be off the ship. Then the next phase of this, taking it all back to San Diego, begins. So many stories, so little bandwidth! Just tried to post pictures of all of this and can't so will do when I can.
Take care all.

The Shirts Off Our Backs Sewing Bee

2008-07-16T03:54:00.000-07:00

At last night's Operation Brief (where we discuss all of the activities we've done and discuss upcoming plans) we were told about a clinic up in the mountains where it actually gets pretty cold. The doctor up there said that many babies get sick and eventually die because they don't have baby blankets and caps to keep them warm. The people are so poor they cannot afford material to make them. So, Jan Kline, a nurse with Project Hope, and I put our heads together to see what we could come up with. We cannot use government supplies without going through the proper authorization, and we don't have time for that process before we leave, so we tried to think of what we could do with what we have on hand until we could find a better solution. We found out that we could use items that were going to be thrown away, so we wondered if there were any old blankets, towels etc. that might be around. The laundry happened to have some old towels they were just going to incinerate so we asked if we could use them. They're not very pretty, they're a worn out brown, but would definitely keep a baby warm. So, we cut some triangles and took a sewing repair kit, the kind you would keep in your purse, and sewed them into the corners of the towels to make some hoodie type bath blankets. We called them "Mercy Wraps". Then I cut the sleeve off of my "I Love Nursing" t-shirt, put a basting stitch through one end, pulled it up, stitched it together and made a little baby cap. Looked kind of funky but serviceable. Jan came up with the idea of going down to the pediatrics ward to try it on one of the babies. Fit great. Well, things took off from there. We got permission from the Commodore to announce at the Ops brief that tomorrow night we wanted to have a "sewing bee" to make some of these up to take to the clinic until we could get some proper ones acquired, it takes a long time to get things shipped here sometimes. So Jan went off to make the powerpoint and I stayed in the ward room to finish sewing our prototypes by hand. As I was sitting there a couple about my age came in and sat down and we were sort of watching the television. We started talking and it turned out to be a gentleman and his wife who work here, they were waiting to take a boat back to shore after touring the ship. When he found out what we were doing he offered to transport the caps and "blankets" to the clinics for us. So, there we had supply and transportation taken care of, all we needed now was some buy-in from the staff. The ops brief went well and the Commodore said to make a special announcement tomorrow for folks to bring a t-shirt and help sew these things. I told the surgeons to "show their stuff!" Then the Commodore said "Suppo (the supply guy) we will have ice cream for those who sew won't we?" Great! Then I had a pharmacist tell me she has a sewing machine, and maybe some extra fleece for blankets, so that will make it even better.
Jan and I are going to try and visit a couple of orphanages that this gentleman knew about. He said the nuns there would be so grateful for anything, these people are probably the most impoverished in SE Asia. Hopefully we can help set something up to help them long after we leave. They really need it.
Now if I can only find some thread around here!

Volcano!

2008-07-11T04:32:00.000-07:00

Heading for Timor Leste. Today off the starboard side of the ship we passed an active volcano. I don't know the name of the little island but it sure was spouting off smoke. This is the "Ring of Fire" after all, and one of the most geologically active places in the world. Even though it is exciting seeing something like an active volcano it makes you think about where you are and the hazards you face on a mission like this. Being on the ship I thought "what if that thing blew" What types of risks would we be facing"? Even if it wasn't catastrophic, exposure to the ash and sulfur dioxide could cause respiratory issues. That's something to consider when dealing with health-care issues of the citizens of this area. Not only from volcanoes, but more from the pollution caused by burning off the forests for cash crops, what they use for cooking fuel and the exhaust from the ubiquitous motorcycles. It has become a real problem in this part of the world and the wind can carry it to other countries. Last time I was here I could see the rising smoke from the airplane.
Timor Leste is a new country that claimed it's independence from Indonesia in 2002. There's been a lot of instability and much of the infrastructure has been destroyed in the struggles, so there is great need here. TB and dengue fever are problems here. They Xray the patients before coming on board, but at the in -country medical sites that is not so easy. Stress is put on the importance of using deet to keep the mosquitoes at bay as there is no prophylaxis for dengue. We take medication to prevent malaria, but that doesn't protect you from dengue. Other risks are possibly getting parasites, some which don't present with any symptoms. Most are easily treatable if caught early, but we have seen some interesting and heartbreaking cases. One, a 17 year old boy in Vietnam had been a normal teenager until about a year ago. When he came to us he was on a stretcher, couldn't walk and had other neurological problems. Upon having a CT scan, it was discovered that he had a pork tapeworm in his brain causing encephalitis. We were able to help him get treatment through the Vietnamese government, but it is a sad case.
We'll spend about two weeks here doing medical and civic projects like building a community center, then it's off to Darwin where I'll start my journey home.
Take care

Leaving Singapore

2008-07-06T05:34:00.000-07:00

Back on the ship. Came in a little early to miss the rush of people tomorrow morning. I sure needed that break. The Botanical Gardens are a must-see if you come to Singapore. I walked from the hotel and wasn't sure if I was going the right way or not some of the time but I eventually got there. Hot and so humid you literally drip all day when you are outside. Totally worth it though, very peaceful and incredibly lush. I also ventured out on the MRT which is incredibly busy and crowded but at the same time clean and super efficient. Something we could learn from. They place a high value on public safety, health education and just plain courtesy and kindness. I enjoyed reading their newspapers to see more of the international news than we can easily get in one paper back home. Wished I had more time to visit the hospitals and health clinics but I guess I'll just have to come back for that. I watched Malaysian, Korean, Chinese, Indian, English, German and French TV. One of my favorite things was hearing the band in the lounge playing "Okie from Muskogee", they really love 70's music here and play reruns of Macguyver. Great food here also.
The next stop will be East Timor, I don't know how long it will take to get there but at least a few days. We are anticipating much more need there as those folks have been through a lot in the past several years.
We are supposed to have a crossing the equator ceremony in a few days for those of us who this is their first time crossing, and I heard it's not for the faint-hearted.
Take care all.

Singapore

2008-07-03T06:40:00.000-07:00

In Singapore, starting to feel human again. Yesterday was a challenge trying to get off the ship, the room I thought was confirmed was unavailable and all of the phone lines were down on the ship. The internet has been notoriously slow so there I was, stuck on the ship, everyone had left for liberty and I had no communication with the outside world. I was not a happy camper to say the least. I decided upon the advice of someone who said "you just need to get off the ship!", to take a cab and try and find a room. Self-sufficient as I think I am, it was a daunting task to tackle finding a room in a foreign country by myself. It was hot, I was tired and I didn't know if I would have to go back to the ship or not. I ended up sharing a cab with two other people from the ship and ended up getting a room at the hotel I was originally booked at. There was also the issue of how I was going to use this time, could I afford it, and what was I going to do by myself in Singapore? I decided to just take it easy and not try to do and see everything. I got a bite to eat at this great little Japanese restaraunt where the gentleman that owns it gave me his and his wife's phone number in case I found myself needing help while in Singapore. It was quiet and the food was great. Did some channel surfing and watched a Mayasian version of Punked! called Watanabed! Funny, same premise. Today I slept in, had a late breakfast walked down the street exploring a bit,found a grocery store and got a few thinngs and then came back and decided to lay out by the pool. It was great, did a little swimming which felt good and got a little sun. There's tons of shopping around here, I guess that's the main attraction. After the pool I got some acupressure done on my neck and back then had my hair cut. Just a day to take care of all those little things. After that I went on a big adventure and took the bus to Plaza Singapura to try and find a b-flat harmonica. I was told there was a Yamaha music store there. Found the store but they only had C and G harps, got a C one anyway. Got a couple of hang ten shirts for a really good price, no wonder people like to shop here. Tomorrow I hope to go to the Botanical Gardens to see the Orchid Garden and then maybe to Little India. Didn't even take my camera today so maybe tomorrow I'll bring it to get a few shots of Singapore.
One of the things I love about Singapore is the mix of cultures, it's wonderful. And, easy for me, most people speak English and it's very safe for a single woman to travel. It is an incredibly clean city and very green and lush. I know it's going to be difficult going back to the ship after this! Grateful for a much needed break. Take care all.

Goodbye Vietnam

2008-06-29T00:21:00.000-07:00

Well, we pulled anchor a little after eleven this morning after a small closing ceremony on the pier. Went through the receiving line shaking hands with all the dignitaries. We had to stand for a group photo with all of the dignitaries from both sides, me being in that group reminds me of Forrest Gump where you see him in all of these historical photos. That's about how I felt, like who me??? Just to be there and witness the event was incredible enough. The coastline as we were leaving the bay was absolutely beautiful with these undeveloped beaches, rocky islands jutting up off the shore and the colorful fishing boats going by. I can see coming back here. I know we got to see the nice side and there's still a lack of freedom so all is not roses but I really feel we made some progress with this trip. The best part is the relationships built with the doctors and nurses and the people one on one. I was wishing I could have seen the two nurses I talked about earlier (pictured)when I was coming back from my last day ashore, I had such a good time with them, when as I was going down to my berthing I saw a whole tour of Vietnamese coming up the stairs and one stopped and looked at me. It was Phuong, one of the nurses and right behind her was Phuc (pr.fook). We all squealed and hugged each other and promised to e-mail each other, that was pretty cool.
Friday (your Thursday) night I went to the farewell reception and that was pretty amazing. I met Admiral Crowder who is head of the Navy for the whole Pacific, and his wife, also Dr. Julie Gerberding Director of the Center for Disease Control, the Counsel General of the Embassy in Hanoi, the Chair of the People's Committee, and several high ranking medical and military Vietnamese. What a huge honor. The band played extremely well as usual and a few people got up to dance. Of course I was one of them, I think I take after mom with that.
Not everyone enjoyed being here so much. I talked to one of the civilian mariners who had been here during the war and didn't think it would affect him but it did.
At one of the medical sites there was a Vietnamese elderly man who was in a sort of tricycle device, he had been injured by a blast in the war, he was fighting for the north. He couldn't make it inside the clinic and one of our nurses saw him sitting under a tree so she had one of the docs come over and see him. He left but then came back later in the day to give us a piece of his mind. He shouted amongst the crowd that "The Vietnamese and Americans are brothers, and diplomacy was helping the lowest man who had the least and not the guys higher up shaking hands (I'm paraphrasing) and he presented a letter to the doc for the Medical Corps along with the third highest medal awarded from the North Vietnamese that he had received himself. Incredible. I wonder what will really happen from all this. We also saw a draft dodger who had cut off his index finger so he wouldn't have to serve in the war. Some things are just the same wherever you go. We are human beings first. I want a shirt that says that.
Found a local surf shop but the only thing they had with their logo on it were the T-shirts they wore as a uniform and they were not for sale. Lots of stories, not enough time.
In a couple of days we'll be in Singapore, then after that we go to Timor Leste, they really need the help.

Happy Birthday Freddy! Love, Mom
Happy Birthday Freddy! I have to get a link to his website.

Shipboard living

2008-06-26T02:23:00.000-07:00

Some days you're just plain tired. I was supposed to go out on a DENTCAP (Dental Civic Assistance Program)so I got up at 0400 after a rough night of bad sleep, but had to be in on a conference call at 0600 so I missed out on going out to the site today which was disappointing as it is headed by Capt. Craft from USPHS, working with the East Meets West Foundation. Incredibly nice person.
From reading the blog it all sounds so adventurous and exciting but the majority of the time is spent dealing with living on a ship. The constant noise from engines, exhaust, loudspeakers, and people is a chronic stress on your system, you sort of adapt, sort of. Just imagine cramming 1,000 people on an approximately 950ft converted oil tanker with patients, doctors,nurses, military, civilians, all having to eat, sleep and work in a shared space. In our berthing, as I mentioned, there are seven women, all with different schedules. For example, the other night someone went to bed at 9:00, someone came in at 02:00, then someone got up at 04:00 to work out. Not much in the way of sleep. Everyone tries to be respectful and quiet but that's extremely difficult with metal lockers and drawers. Sometimes the steam pipes clang all night from condensation. The first time it happened I got up to make sure all the lockers were secured and looked inside to make sure there wasn't any loose metal making that clanging sound, I just couldn't figure out where it came from. Then I went down to the bathroom to make sure the metal stall doors were secured open because when you are out to sea they can bang open and closed if they are secured. I didn't find out for a couple of days that is was the pipes. All that running around in the middle of the night ticked off for nothing.
Tonight the air conditioning gets cut down so they can clean the condensers, this makes it extremely hot in some parts of the ship. They try to keep the patient areas and berthing cool but in a country where the heat index hits 113 degrees outside it can get quite hot and stuffy in the ship. Then the smell of PineSol and stinky feet and other lovely odors are just the rule of the day. Not so exotic.
The folks in the engine rooms and the galley just drip sweat all day, they have really hard physical labor to perform, I don't know how they keep it up. They were camelbacks to drink water all day, but I know how it affects me just being in the heat!
Breakfast is usually from 04:30 to 06:45 then there's muster, then usually what dad used to call "field day" where everything is swept and mopped, cleaned etc. Patient areas are also done with the addition of all the complications of having patients and family members that don't speak English. Around 16:00 the same routine. In between lunch is served from 11:00 to 12:45, dinner from 16:30 to about 18:00. If you miss the meal, tough. It's very easy to get into stress eating.
You can only do laundry on certain days, and when you do you are lucky if you can get an empty washer or dryer. In all of this shipboard living you have to remember which stairwell leads to which area of the ship. It's easy to get turned around and end up opposite of where you want to go. Imagine carrying your laundry and soap, getting lost and it's hot and you are tired and maybe not in a good mood.
It's 65 steps from my berthing up to the mess decks where we eat or have the operations briefs every night. Lots and lots of going up and down stairs. The last time I was on this ship in 2006 my berthing was on the 5th deck below, I got really sick and literally had to crawl seven decks up to sick call.
The absence of privacy and all the above factors coupled with a lack of phones and a slow, limited internet service can lead to a lot of stress. Activities are planned such as kareoke night, movie night on the flight deck, or bingo, but sometimes you are just too tired or it's too hot or you just aren't in the mood. It seems like most people have a meltdown or get down at some point. The chaplains are kept very busy around here. The military are taught to not show emotion so when you mix civilians in the mission who are not trained to hide their emotion it can lead to some misunderstands and conflict. Then there's the generational difference, situations where an older experienced person has to answer to someone who is younger but of a higher rank.
Thank goodness most people look out for each other, but not always. I think everyone experiences a sense of isolation at some time and it's not fun, but where are you going to go on a ship. Some folks play guitar, I take my harmonica out on deck, one guy in the office has a ukele.
One of the cool things I've experienced here are the workouts (if I'd only go more!)such as the kickboxing, one led by this young female sailor who is soooo fit! The fun part is seeing this mix of people of all different ages,sizes and abilities, some who probably never work out much at home, working out together to the music in the patient receiving area or the hallway of the ship. Sometimes a game of ping pong is set up in the hallway or a spontaneous game of hallway soccer. Oh, by the way, India won the first International Australia/India Cricket match yesterday. I guess a bunch of Yanks formed a team and had a spontaneous game and did pretty well.
Well just thought I'd tell a little about shipboard living. There goes my workout, see what I sacrifice to keep you posted! It's dinner time and I gotta run. :)
Take care,

A Day in Nha Trang

2008-06-24T06:12:00.000-07:00

Yesterday I got a "liberty" day and spent the day in Nha Trang. We took the boat over to the dock and loaded on a bus for a half day tour of the local temples and a Catholic church. I know I use the word incredible a lot in this blog but that's what it was. Our tour guide was a young man whose name translated into Pine Tree. He was great, he taught us how to say "Oh my god, that's too expensive!", really funny and helpful. First we went to an ancient Hindu temple dedicated to Shiva. It's on a hill that over looks the river that empties into the South China Sea, it overlooks a fishing village. I love the way they paint their boats, much more creative and ornate than what we would have. Then we went to a Buddhist temple with beautiful dragon sculptures and a very beautiful inside temple area where people were chanting, all the monks were in a procession going past this ornate gold and red alter chanting while a huge gong was occasionally sounded. Up on the top of the hill is a huge white Buddha, but what is even more amazing is the Sleeping Buddha on the way up to the hill. Just amazing. After we went to the Catholic Church built by the French, it had beautiful stained glass, and when I was outside I could hear the women reciting the Rosary in Vietnamese. For lunch we went to the Sailing Club, a resort on the beach and had a Vietnamese coffee which was killer, and an asian dish, sort of an egg foo young stuffed with sprouts and seafood, very fresh and delicious. Ran into a young couple from San Francisco and New York. Then the girls went to the market and did some shopping for silk and trinkets, got a red Vietnam ball cap with a gold star on it, I wonder what would happen if I wore it to a Padre's game. The food markets are amazing, dried fish, shrimp and other seafood, rices, fruits, vegetables, flowers. I could have spent a lot more time there. The Vietnamese currency is the dong, and the rate is about 16,000 dong to the dollar so I did a bit of "Christmas" shopping.
Tomorrow is the first International Cricket Match between Australia and India,two of our partner nations on board, on the beach in Nha Trang. They are quite excited about it. At the Operations brief the Aussies announced it and gave a little lesson on cricket for the cricket challenged U.S. folks. The funny story about this is a few weeks ago, a couple of the gentlemen from India and Australia were talking about having their first match on the flight deck and I suggested they announce it, and have the fun boss post it so the rest of us could watch and have a little cultural exchange. Well, they got rained out that day and now it's gone really international by having the first game on Vietnamese soil. Wish I could watch but don't think I'll be able to.
Take care all,

Incredible experiences the past two days

2008-06-22T06:47:00.000-07:00

The past few days have been busy, starting with the Opening Ceremony on Friday at the pier in Nha Trang. It was extremely gracious and beautiful. To see our Commodore and Captains sitting at the same table with the Chairwoman of the People's Party and the Ministry of Defense officials was absolutely incredible. It was a small group that got to witness this special event. I took some video, hope it turned out. The best part was walking through the receiving line and shaking hands with the representatives from Vietnam. When I told this Vietnamese military official that I was a nurse from San Diego State University he broke out in a big smile and said he was the Director of the Military Medical Division and shook my hand vigorously. To see him smile was a big win for me.

Yesterday I got to work at one of the medical sites set up at a school in Nha Trang. It again was incredible! Working side by side with the Vietnamese nurses and doctors was such a great experience. These clinics are hot, crowded, there's a language barrier and all kinds of unfamiliar things but it is worth every bit of it. We saw over 400 patients yesterday. The two nurses I worked with were excellent. Education seems to be a high priority here. I learned a few phrases in Vietnamese, and had the best time with them. So many stories to tell. The guy with the "I'm proud to be an American" T-shirt on, the elderly man whose hands were messed up from the war, the elderly women who would just light up if you gave them a smile. I was helping this one elderly woman through the crowd to the next station and the other elderly women sitting on their heels waiting all smiled and exclaimed, reached out to me or bowed, just because I was showing a little respect to one of their own.
I then went down and helped the East Meets West Foundation doing a dental workshop. They had a huge crowd. Capt. Craft who is the only American dentist working with them introduced me to the staff and then let me teach some of the children about dental care using a big set of teeth and a big toothbrush while they watched a cartoon video about dental caries. He said I can come back and work with them again. They do incredible work.
Operation Smile are doing tons of cleft lip surgeries, we have 62 pediatric patients on board tonight, the ward is totally full. Plus they have their mothers and some family with them, so we have a full house tonight. I went down to the receiving area and there were babies crawling all over the place.
Tomorrow I'm going to visit some of the Buddhist temples and hope to get to the market to see what they have. I hope to post more pictures but again the bandwith is so slow it's takes a long time to download just one.

Good Morning Vietnam!

2008-06-19T07:13:00.001-07:00

I woke up this morning a little late and threw on my clothes to run up to the mess deck so I wouldn't miss breakfast, it was about 7:00. You have to eat when the meal times are set or else you are out of luck. Before going in to grab my food, I took a peak outside and saw land, so I went outside for a quick look at what my first view of Vietnam would be like. I can't explain the feeling. It was so much more beautiful than I imagined. There are a few islands where we were anchored and from the deck you can see this incredible series of low mountain ranges and the low lying beach areas. I was fortunate enough to be able to attend the opening ceremony as a representative of SDSU. The reception was very gracious and beautiful, of course there is a lot of caution but that is to be expected. There are plans for the engineering crews to work with the local Vietnamese in refurbishing clinics and schools, which I think has a lasting impact. Our doctors and nurses will be working side by side with the Vietnamese medical providers which is historic. Operation Smile will be doing about a hundred surgeries, it's just a golden opportunity to share knowledge and understanding.
There is an emotional part to those of us over 40, of course I think about my dad a lot and wonder what he would think of all of this. I bet he's up there grinning. I just got through calling my mom in Florida just to have her hear my voice from Vietnam. My son Fred surprised the heck out of her the other day. He lives in San Diego but drove out with a friend who is getting transferred overseas and he was able to drop in and give her a quick visit. That was pretty cool. Going to sign off. Take care.

Getting ready for Vietnam

2008-06-18T07:21:00.000-07:00

Well, now it's getting exciting again. Some days on board the ship are a challenge, especially when it's hot, the air conditioning isn't working and you've got seven women sharing a room with only two chairs! We've picked up a lot more people. Project Hope arrived yesterday along with some of our Partner Nation folks from India and Korea. We have about 25 Pre-Dental students from UCSD, and others I am sure I am forgetting but don't mean to. We had a presentation for the NGOs about the East Meets West Foundation which was founded by LeLy Hayslip, author of "When Heaven and Earth Changed Places". I happened to read that when I was on the Mercy in 2006. Hugely inspirational to me, it sharpened my motivation to go into global nursing. Capt. Craft, Dental Officer gave the presentation and when he started telling the story about how they got started, I thought "how lucky am I to meet someone who works with such an incredible woman." You should read the book, the movie Heaven and Earth was sort of based on the book but some artistic license was taken. We are not sure what we are going to be facing as to what types of care we will be allowed to give, but we are just happy to have the chance to be here anyway. The Navy Band will be playing at one of the sites which will make it the first time in 32 years that the Navy Band has played in Vietnam. Public Affairs has made U.S./Vietnam pins for everyone on board which when the Commodore gave me one, I almost cried as it made me think of my dad. He was here in 1969 in Quang Tri (sp?)right on the DMZ. I brought a picture of him with me and show it to people now and then, most of the comments are something like "wow! That's the real thing!" It was very special to receive that pin from Commodore Kearns, nothing official, we were just at a briefing and asked if I had one yet. I don't know when I'll be able to get onshore as there are a lot of people and only so many spots. I'm just waiting for someone to get on the intercom tomorrow and yell "Good Morning Vietnam!" Let's see what happens. I just can't believe we really get to do this! Those of us who grew up in that era I think have a special sense of gratitude about this process. Baby steps in getting along. Take care.

Philippines June 14, 2008

2008-06-14T00:11:00.000-07:00

Trying to catch you up on a month of what we've been doing is an onerous task, but in a nutshell:
We just finished a couple of weeks doing clinics in the Mindanao area of the Philippines. We've seen over 10,000 patients at the sites and have done somewhere between 250-300 surgeries including the story from Chief Cohen that I'll post below. In addition, they've held educational seminars at the local hospitals,civic projects such as building or re-furbishing clinics (Thank you SEABEES) and building projects such as wastewater treatment plants. Can't forget the veterinarians - this time they've sent out vets to treat different animals,everything from dogs and cats to caribao which are a type of water buffalo. All of this is being done by the local departments of health,including the Autonomous Region of Muslim Mindanao, the Armed Forces of the Philippines, the U.S. Navy, Army, Coast Guard, Marines, Australian, Philippines , Japan, Canada armed forces personnel, the U.S.Public Health Service, Operation Smile, and the 3P Foundation a local NGO based out of the U.S. which was founded and is directed by Mr. Andrew DeRossi. He's been in the Philippines for thirty years so is an excellent resource for collaboration in this area. He donated all of the medical equipment at a clinic we refurbished in Samar.
I just wished the planners of this mission would have included some of the Disaster Medical Assistant Teams (DMAT)from the U.S. as they are very well trained and experienced.
Many people will never know the sacrifices these people are making in order to participate in this mission. Missing birthdays, graduations, anniversaries are all very hard not to mention just the stress of living on a ship with a thousand other people from a bunch of different places. Some days can be pretty tough but CPO Cohen puts it very well in the following letter.

Friends and Family;

Let me take a moment of your time to tell you about my day. A few minutes ago a Marine who works for me asked me if we would get any medals or awards for this deployment, such as the Humanitarian Service Medal. I told him that we would not be eligible for the HSM, but some of us might receive something like a Navy and Marine Corps Achievement Medal or perhaps a Flag Letter of Commendation. Then I told the Sergeant that I had already received something much better than any medal they could give me. I explained how a short time ago I had stopped into the Physical Therapy room for an adjustment since I hurt my neck in a fall yesterday (not serious, getting better thanks for asking.) While I was there I saw a 15-year-old Filipino boy named Romeo. I thought he was younger than that because he is fairly small for his age. I first saw Romeo there yesterday when they wheeled him in on a wheelchair. Romeo was very excited to be in a wheelchair because for the first time in years he was able to move around on his own without having to depend on other people. When Romeo was nine-years-old he was injured in a bomb blast when his village in the Republic of the Philippines was caught up in fighting between rival factions. His legs were so badly burned in the blast that scar tissue prevented him from even straightening his leg. His legs have atrophied so much that they are smaller around than my arms. For the last six years he has been unable to walk, and his father has carried him around. When not carried, he crawls around on his hands. He is totally dependent on family members to take care of him.

As Romeo gets older, he is getting too big for his father to carry around. His father is smaller than I am, and I couldn’t imagine carrying him around all day. When his family heard that our hospital ship, USNS MERCY, was coming to Mindanao they asked if we could help. His case was accepted, and our team of doctors decided to cut away the scar tissue that bound Romeo’s leg like webbing and replace it with a large skin graft taken from his back. His father asked one of our surgeons, Commander Todd, if the boy would ever be able to ride his bicycle again. Dr. Todd said there was a remote chance he may one day be able to ride a bike - and perhaps even stand on his own – although the boy would probably never walk more than a few steps.

Today, a few days after his surgery, I saw Romeo walk on crutches for the first time since the explosion. He was surrounded by family members and his doctors, Commander Todd, Commander Tan, Commander Douglas (his plastic Surgeon), Captain Goldberg (his physical therapist) and a Navy journalist who captured the moment on video. We all watched as he climbed up on the exercise bike and rode like he was competing in the Tour de France! His father and sister watched in amazement with tears streaming down their cheeks. This is a boy who now has a chance to do things on his own. To go to school, work, play with friends, grow up and raise a family. His father shook our hands and hugged us all, then looked into my eyes and said “Salamat Po” (a sincere thank you.) I would have traded all my medals for those two words.

So that was my day. How are you all doing?

Sincerely,

Shawn Cohen

CPO, USN

Kind of says it all.

Mercy Musings

2008-06-12T04:48:00.000-07:00

Thursday June 12, 2008 - Off the coast of the Philippines

Well, I’ve been on the U.S.N.S. Mercy a month already, and since trying to e-mail everyone to keep up with what I am doing has been difficult, I’ve been talked into blogging. I wished I had started it a month ago but I was too chicken. Hopefully, I can be your eyes and ears on this adventure of a lifetime. Not easy dragging a child of the ‘50s into the 21st century, but probably a much better way of keeping in touch with people and recording some of my experiences. Some days, such as this one, it may be very lengthy, sometimes not. This will not always be grammatically correct, there will be misspellings, and I may have to eat my words every now and then but here goes.
One day I got a call at a conference. “I hope you don’t mind but I volunteered you for something”. Knowing it was my graduate advisor Dr.Frost, who has done so much, so quietly, for so many people, I had very little hesitation in accepting and answered “Sure, what is it?” “How would you like to go on the Mercy?” I couldn’t believe my luck! I had been on the Mercy to Banda Aceh and Nias, Indonesia in 2006 and really wanted to go again but was in the middle of graduate school for Global Emergency Preparedness and Response at San Diego State University. I was thinking it would be for a couple of weeks or maybe a month at the most. The Mercy was planning on going to several countries including Vietnam, Papua New Guinea and Micronesia. I was stoked! Little did I know that I would be on this venture for nearly four months. At the planning meeting for the trip I asked, “which leg of the trip do you want me to go on?” I was trying to figure out that if I had to choose between Vietnam, Papua New Guinea, or Micronesia, which would I pick? When they told me the whole thing, I inwardly gulped, knowing what a challenge it was to live on the ship for a couple of weeks much less for an extended period of time, but excited non the less. Would I have the mental and physical stamina? (We’ll find out)
To tell you the truth, I never even thought I would be a nurse, (I wanted to be an archaeologist) much less voyaging across the Pacific in a Navy ship with nearly a thousand other people. Currently my area of interest in nursing is in International Civilian/Military Collaboration for Humanitarian Assistance and Disaster Response. This was the perfect opportunity as the Navy is working with several Host Nation and U.S non-government humanitarian agencies to deliver assistance to these countries.
Well, enough about how and why I got here. We are finishing our first leg of this trip and will leave the Philippines in a few days. I’ll try and recap what we’ve done and post pictures when I can, but I just remembered I have laundry to finish, (yes, you have to do laundry on the ship) and then head to the mess deck for an ice-cream social celebrating Independence Day here in the Philippines. Looking forward to some time on the ground in Manila.