NMCP Group Reflects on African Medical Mission

Navy News Service

Story Number: NNS121106-12
11/6/2012

By Rebecca A. Perron, Naval Medical Center Portsmouth Public Affairs

PORTSMOUTH, Va. (NNS) -- Naval Medical Center Portsmouth staff participated in Africa Partnership Station 2012, and spoke Nov. 1 about their experiences providing humanitarian assistance for two months in seven West African countries.

Approximately two dozen Navy Medicine East providers - the NMCP contingent and personnel from naval hospitals in Jacksonville and Pensacola, Fla.; Charleston, S.C.; Rota, Spain; and Naples, Italy - left Rota on board the Military Sealift Command High Speed Vessel Swift, a hybrid catamaran primarily used for fleet support and humanitarian partnership missions. They sailed down the West African coast, visiting Liberia, Ghana, Nigeria, Cameroon, Republic of Congo, Benin and Togo, before sailing back to Spain.

The 35-person team included nine civilian volunteers from the non-governmental organization Project HOPE, who collaborated with APS. The naval and NGO providers trained medical students and local military and civilian health care workers, and cared for patients in the host nations.

The visit to each nation lasted five to eight days. The team treated more than 9,000 patients, conducted 13 Medical Civic Action Programs, 13 military-to-military trainings and 10 optometry outreaches.

Nearly half the patients took advantage of the optometry outreach, and the providers wrote about 2,000 prescriptions. Almost 120,000 pairs of sunglasses donated by the Lions Club were distributed.

Four Seabees assigned to the group lent their support and led two civil affairs projects, one at an orphanage and another at a school, and were assisted by some of the medical and Swift's personnel.

Developed by United States Naval Forces Europe-Africa in 2007, APS works with U.S. and international partners to improve maritime safety and security in Africa.

The program builds the skills, expertise and professionalism of African militaries, coast guards and mariners and is delivered in many forms, including ship visits, aircraft visits, training teams and Seabee construction projects. APS activities consist of joint exercises, port visits, hands-on practical courses, professional training and community outreach with coastal African nations.

"Each contingency has a slightly different mission, but the main medical focus is capability building and mentoring the host nation medical providers, whether military or medical students, nurses or midwives," said Cmdr. Matthew McLean, an NMCP pediatrician. "We matched our specialties with theirs - we had two family practice docs, two pediatricians, two optometrists and an obstetrician - and we worked with them to first find out their knowledge base and train them, and second, to provide acute medical care."

McLean compared the MEDCAP mission component to that of USNS Comfort (T-AH 20) or USNS Mercy (T-AH 19), but on a smaller scale. The Swift mission provided much greater host-nation provider/Navy provider interaction and collaboration. McLean said they learned just as much about caring for tropical diseases with limited resources as the host-nation providers learned from us, and that it was a truly joint experience.

"We were a much smaller contingency than the Comfort or the Mercy, but based on lessons learned from those missions, [we] still kept mostly one patient with one complaint to one provider," McLean said. "However, our size allowed us to be more flexible, so in some locations, patients were able to see multiple providers because the tribal leaders asked us to support them this way. So, we adapted to the needs of the communities.

"Another example is how our obstetrician worked with the midwives in Ghana," McLean said. "Capt. Copenhaver worked collaboratively with the midwives of the clinic we were operating out of to see 100 percent of the obstetric patients enrolled to that clinic. She provided important patient care and staff training that directly benefited their specific population."

Additionally, Copenhaver taught midwife skills that could be carried on after the Swift left. This has not usually been done on large ship missions.

Lt. Cmdr. Rommel Flores, NME Operations, Future Operations associate deputy chief of staff, served as the mission's officer in charge, leading the providers, corpsmen and volunteers from Project HOPE.

"As medical OIC (officer-in-charge), my job was to oversee day-to-day coordination of security and logistics, translation support and facilitate host nation interactions, but I did that with the help of everyone in the team," Flores said. "A lot of the focus medically is showing the 'soft power' of our Navy, thereby contributing to the overall AFRICOM and Naval Forces Africa mission and vision."

Some of the training consisted of health promotions and preventive medicine, as well as military-to-military training to improve the African nations' shipboard readiness. The providers also assisted their host nation counterparts in doing rounds at local hospitals. They shared best practices and ways to stretch limited resources. The team even brought mannequins for realistic hands-on training and simulation.

"One important educational need is to help them learn neonatal resuscitation," McLean said. "In the Republic of Congo, we worked with four hospitals and had an entire day of resuscitation education for midwives, pediatricians and general medical officers. In Cameroon, at a single military hospital, we worked with medical students. They do a lot of theory, but don't have the equipment to do hands-on. So we brought the mannequins in so they could practice their techniques."

While the doctors spent the mission training their counterparts and seeing patients, the 12 corpsmen also contributed to the mission.

"My job was to medically assist the officers and set up the site," said Hospital Corpsman 2nd Class Edward Lopez, one of five NMCP hospital corpsmen on the mission. "We put in place the plan to locate and categorize patients and set up fencing to efficiently and safely direct patient flow. I worked with different providers, managed supplies, took vital signs and helped patients get from point A to point B to get treatment. We also worked with our enlisted counterparts at the different sites to help them give proper and accurate treatment."

According to McLean, the hospital corpsmen were the face and backbone of the mission, spending more time with the patients.

"I tried to learn the language of each nation to communicate with them and tried to keep them happy and entertained while they were waiting," said Hospital Corpsman 2nd Class Terron LaSalle, another NMCP corpsman. "I helped the medical providers and did a lot of hands-on training with them. We taught them Basic Life Support and Tactical Combat Casualty Care course standards. We also came up with ways to speed up patient care and make it more efficient as we went along."

While LaSalle and Lopez spent the mission in each country ashore, some of the hospital corpsmen worked with medical teams aboard African naval ships.

"Some of the [hospital] corpsmen did shipboard training, where they trained them on their ships so the environment would be the same," Lopez said. "They showed them how to take care of patients at sea, including treating steam injuries, placing a spine board and properly using splints. [While carrying a stretcher,} they were taught how to navigate small, confined spaces, go through hatches and deal with the boat rocking while they were on ladderwells and not lose grip."

The training was well-received by the local navies and increased their overall medical readiness. When the team was not providing medical care, they participated in the Seabee projects.

"The orphanage in Cameroon was a new building and the Seabees were there to help finish the building," Lopez said. "After they did the sanding, I helped with painting, and they trained me to measure for windows."

There was also time for a little competition between the U.S. and host nation naval forces.

"We played soccer with them and lost every single game - we did win the volleyball games, though. We laughed together, and we had fun," LaSalle said. "I loved the interaction with the people, the liberty calls and exploring the country that is actually pretty beautiful.

"I have a very different viewpoint of Africa now than before," LaSalle said. "They drive the same cars, they have beautiful houses and they are just as intelligent and friendly - they just don't have the same resources as we do. We did see the poor side, as well. From this experience, I came out a different person with a very positive perspective of Africa, appreciating more what I have in my life. I would love to do it all over again if given the chance."

"Leaving Africa was bittersweet," Lopez said. "I loved every part of the mission. I would play with the children: laughing, clapping, singing, playing tic-tac-toe, entertaining them. We cracked jokes, laughed, some asked me why I speak funny. Many of them had scars on their faces that is a form of tribal identification. I asked them about the marks, and they asked if I wanted one. I said no, that my uniform is my tribal mark and that my tribe is the Navy."

Lopez enjoyed the African restaurants and said the food everywhere was amazing.

"And the arts and crafts," LaSalle said, and then pointed to Lopez. "He brought back a lot of stuff."
Lopez nodded in agreement. The sense among the group was one of camaraderie.

"We didn't know each other at the beginning, but we became a family at the end," Flores said. "I was blessed with the finest [hospital] corpsmen, doctors, Seabees, Swift's crew and Project HOPE personnel. It was a really good mission. My favorite part was in creating this incredible team. There were a lot of challenges in creating an efficient team focused on the mission, but we were able to set aside rank, egos and just work together and have quite a memorable summer at the same time."

Flores said they left each location with a positive image of the Navy and of America.

"That to me was the most important part, especially using providers and corpsmen to do that - show how generous and caring Americans truly are," he said.

In December, Flores begins a new assignment in Naples with NAVAF/NAVEUR/6th Fleet and plans on future APS medical missions. He is looking forward to the challenge and continuing the enduring partnerships that they created there.

"Overall, it was a very rewarding and unforgettable experience," Flores added. "I hope to get the next set of deployers there well prepared, but I would love to go again, especially if it was with the same team."