Tuesday, June 30, 2009

Volunteers Stay Busy on Floating Hospital Ship

While some Project HOPE volunteers are running the remote triage sites ashore, many more are engaged in helping to keep the USNS Comfort’s six operating rooms(OR) up and running. Some nurses are in Casualty Receiving (CASREC), the first place a patient will go once she lands on Comfort’s flight deck. Some, like Addy Wakeman, keep the pre-op ward, where patients stay the night before their surgery (as it is affectionately called “The Hotel”), running efficiently. Still others help in the OR, or in Post-Anesthesia Care Unit (PACU), where I found HOPE volunteers Amy Bream and Elizabeth Roughead today, or in (Intensive Care)ICU, where patients are moved after coming out of PACU, which is where I tracked down Elie Malloy.

I moved backwards through the flow today, meeting Elie in ICU first. Elie’s main patient was an El Salvadorian woman who underwent a hysterectomy yesterday. Her husband was always close at hand, especially when Elie moved her or shifted her position with the help of the other nurses in the ICU. When it was removed, her uterus was about twice the size of a normal woman’s, and filled with fibroids. Now, everything is tracking well and she is scheduled for normal discharge tomorrow.

In PACU, I found Amy and Elizabeth bringing a patient up from anesthesia. He had come in to have his cataracts removed, and was just a step away from moving down to visit Elie at the ICU. His body temperature was 96.5—0.3 degrees lower than the regulations consider manageable enough to move away from the OR (PACU). Cataracts usually come in pairs, so the floating hospital will usually do the surgeries over two days (to keep the patients from having to undergo two surgeries in one day), so Jose Diaz and his wife will be with us through the weekend.

I then went to the front of the patient flow (and, incidentally, the front of the ship—Comfort was designed to streamline the receiving process: CASREC is in front of the Hotel is forward of the OR’s are forward of PACU, and all on the same level. Only ICU and Discharge are one floor down, but patients will only go there after time has ceased to be critical). At the Hotel, I found Addy Wakeman holding down the fort. A Medical Telemetry (post-op) nurse by trade, she’s just getting the feel for the rhythm and needs of the Comfort pre-op ward. The Hotel was only about half-full today, though the nurses there have seen a patient in every rack, plus as many cots as they could put out as well. That week, the surgeons operated on 241 people in 10 days—a record even by Comfort standards.

Thanks for reading-Jacob

Monday, June 29, 2009

HOPE Volunteers Saving the World—One Coloring Book at a Time

Today found Project HOPE volunteers Sarah Angelo, Carrie Reichert, Elise Chamberlain, and Tina Weitkamp heading for the Jose Pantoja Hijo School, the current main site for Continuing Promise ’09.

Sarah quickly found work tag-teaming the front door of the General Adult Medicine room with HOPE volunteer Marley Gevanthor. After their initial screening process, patients are sent to the appropriate specialists—Pediatrics, Ophthalmology, Dentistry, OB, Adult, or whatever the case may be.

Outside of the specialty room, though, the screening continues: “Are you in pain? Where? How badly?” Prescription sheets must be filled out correctly. All of the patients information must match on each piece of paperwork. Marley and Sarah saw to it that all these details were smooth, getting each patient to see their provider that much quicker—which means more patients were seen today.

In the meantime, Carrie, Elise, and Tina set up a preventive medicine/health information booth near the initial triage area, and began teaching dozens of children how and how often to brush their teeth and wash their hands—using crayons and colored chalk as their lesson plan. By the end, I don’t know how many little artists put their masterpieces in Project HOPE’s coloring books, and everyone seemed happy: the educators saw the children learning, the kids were having a blast, and the mothers worrying over sick loved ones had one less thing to worry about for a few hours. Sarah even got a Spanish lesson or two from some 5-year-olds. What better way to teach a child than to have them teach you?)

Thanks for reading-Jacob

Saturday, June 27, 2009

Health Education in El Salvador Proves Timely

I spent most of the day today with Project HOPE volunteer nurse educators Meg Candage and Tina Weitkamp. Together with two U.S. Navy nurses, they took over a classroom at the military secondary school located on the Naval Base in La Union, El Salvador.

There, they met 20 doctors and nurses from local hospitals and clinics in the La Union area (some from nearly 2 hours away) to train on ACLS (Advanced Cardiovascular Life Support) and CPR. Working through translators (I even got to jump in to translate at one station!), they set up four different stations—defibrillation, CPR technique and airway opening, types of arrhythmia, and tachycardia—and began training.

The Salvadorian medical personnel were quick to catch on—and equally quick to point out where U.S. procedures and regulations differed from those in their hospitals.

By the end of the day, these nurses who were just now getting portable defibrillation devices in their hospitals, were able to demonstrate exactly how to diagnose and use the portable defibrillator on a cardiac patient safely and quickly.

I was also able to sneak in a tour of a Navy project site with Capt. Jim Hudson, the man in charge of all ashore transportation. He showed me around the project site of the Navy Construction Battalion (CB—or SeaBee’s). They’re partnering with the El Salvadorian SeaBees to completely redo a local playground—right now it’s a prime hang-out of some distinctly non-family people once the sun goes down. New roofing on the toilets and main picnic area, new basketball hoops and backboards, and some 660 feet of new fence, topped by concertina wire to keep the place safe for kids after sundown are all in the plan. It’s an amazing project, and just one of the ways that NGO’s, the U.S. Military, and foreign militaries are all working together towards a common goal.

The training and that side-stop took most of the day—but we were able to get back to the ship while there was still daylight. It was the first time I’d really seen El Salvador in the sun, and it is an amazingly beautiful country. The jungle, mountains, and ocean all come together in exactly the same spot. All in all, a great day.


Friday, June 26, 2009

Volunteers Work Busy Medical Sites in EL Salvador

Within five minutes of our arrival at Jose Pantoja School, now converted into the staging area for Continuing Promise 2009, Project Hope volunteer nurse Peggy Goebel had canvassed the site, finding out where the Pediatrics, Radiology, Dental, Ophthalmology, General Medical and Pharmacy were located (all in rooms that, until two days ago, had been elementary school classrooms), found what was needed at each station, and began filling in the gaps. She sent a translator here, a triage nurse there, a corpsman to yet another area, and then began seeing to patients herself. A trained labor and post-natal nurse, she naturally gravitated to pediatrics.

The patients she saw had already been screened from the thousands still waiting outside the gates. She began to further prepare them to see a primary care provider—in this case, Project HOPE volunteers Ken Iserson (PH’s Medical Director) and Faye Pyles. She made sure their paperwork was filled out correctly, asked deeper screening questions that would speed up their process, and—with the help of their parents—generally kept dozens of children occupied, entertained, and mostly under control.

There were a lot of unusual Pedi patients today—a girl with probable cerebral palsy, another wheelchair-bound girl with two dislocated hips, a boy with a club foot. I followed Mirare Andrades and her mother from her initial screening to the end of her time at the triage area. Mirare, a 7-month old girl, has syndactilism—an extra thumb on her left hand which, though now is merely strange to look at, could cause her significant problems down the road. After coming through initial screening, she saw Doctor Iserson almost immediately, who sent her to Radiology.

At X-ray, Project HOPE volunteer Marina Rivera got her to sit still for just long enough to take 3 X-rays of her tiny hand. She checked the images—yes, the sixth digit was clearly visible. Back to Doc Iserson, and then the case had to be forwarded up to higher authority.

Because Mirare is less than a year old, she cannot be operated on aboard the Comfort. However, because of the partnership and cooperation in place between the U.S. and El Salvadorian governments, we were able to forward her on to the El Salvadorian Ministry of Health, and she is scheduled to be operated on in the General Hospital at La Union on Monday.

More tomorrow on health education training-Jacob

Thursday, June 25, 2009

Project HOPE Volunteers Get to Know the Comfort

More Project HOPErs streamed in late last night, and this morning, as the patients rolled in to Casualty Receiving (CASREC), the main staging area for incoming patients, our new volunteers began to get the lay of the land.

I tagged along with the Project HOPE nurses as they got the lowdown on all of the equipment in CASREC that they will be working with for the next four weeks. Even though it floats, Comfort is still a hospital—and every hospital has its own quirks, routines, and regulations. And though all of our nurses had worked with similar equipment before (IV monitoring devices, for example, or heart monitors), its tough to use a device if the “On” button is in a totally different place than what you’re used to.

Some of the equipment I recognized—the EKG and defibrillator—but it was a learning experience for others. The “bear hugger,” for instance, which is used to get post-op patients’ body temperature back to within manageable range—above 96.8F—or a Doppler ultrasound pulse reader, used to check fetal heart rate, or the pulse of patients with lots of swelling.

More tomorrow-Jacob

Wednesday, June 24, 2009

Project HOPE Volunteers Arrive in El Salvador

Jacob Steele, a former Public Relations Officer for the U.S. Navy, is serving as Project HOPE’s public affairs officer during the final leg of Continuing Promise 2009. Here are his first impressions :

Early flights, delayed connections. Bus schedules in turmoil. Planes, trains, automobiles, and ferries to get where we’re going—a floating hospital anchored in the Pacific Ocean, miles off the coast of the remote El Salvadorian city, La Union.

Yet all of the commotion of getting here was worth the journey—and was clearly anticipated by the staff and crew of the USNS Comfort. Captain Tom Negus, the Mission Commander, was at the ferry landing to greet the 18 new Project Hope volunteers coming onboard, and actually rode the shuttle back out to the hospital ship with us.

“I’ve been in the Navy for twenty-five years,” the Commodore told the doctors, nurses, dentists, and assistants that had gathered around him. “And I’m telling you now, this is easily, easily the most important mission I’ve ever been on. Welcome aboard—it’s an honor. I’m not blowing smoke when I say that this mission could not be conducted without each one of you.”

Captain Ware, the head Medical Officer, also greeted us and gave us the lowdown on the upcoming mission, our role, and how things had been going in previous ports.

The Project HOPE volunteers (or “Hopies,” as our lead medical officer, Dr. Iserson, affectionately calls us) were joined by 3 other organizations Sunday in checking onboard—from dental students at UCSD to the Dutch Army Medical Corps—to team up with the kaleidoscope of NGO’s and US Agencies that make up Continuing Promise 2009. Today was spent in gathering ourselves together, getting our bearings, and preparing to hit the ground running.

What is happening here (and has evolved only in the last five years) is something entirely new. Non-governmental agencies from across the globe are integrating cooperatively with one another—and with the military!—in order to do more than any organization could on its own. The doctors are ready. The nurses and educators are ready. The ground has been prepared by three months of hard work and experience gained. It's awesome and humbling to be part of what is bound to be a strong finish to such an amazing mission. Let’s get to work.


Tuesday, June 23, 2009

Help Project HOPE Today

Project HOPE is funded from the grassroots by caring Americans like you. Our financial year is ending on June 30th and we need your help to continue providing lifesaving health education and humanitarian assistance to those in need around the world, especially children. You’ve been following our important work online and know about our lifesaving programs around the globe as well as our inspiring volunteer doctors and nurses now working in El Salvador. Can you help today. Donating online is the fastest and most efficient way to help Project HOPE continue saving lives. Donate now.

Meet the Project HOPE Volunteer Team for El Salvador and Nicaragua

A new group of Project HOPE medical volunteers began working in El Salvador this week. Get to know them here and check back each day for new stories on their inspiring work.

Sarah Angelo, a nurse from George Washington University Hospital in Washington, D.C., is a first–time volunteer for Project HOPE. She is working as a medical/surgical nurse onboard the USNS Comfort.

Charity Braden is a first-time volunteer for Project HOPE. A nurse from George Washington University Hospital, Washington, D.C., Charity is using her Spanish speaking skills while working as a medical surgical nurse during the last leg of the Continuing Promise 2009.

Amy Bream, a nurse from Swedish Medical Center in Englewood, Colorado, is volunteering on her second mission for Project HOPE. In 2008, she worked in Liberia at the JFK Memorial Hospital in Monrovia. Onboard the Comfort, Amy is working as a PACU nurse.

Jane Bower a nurse from Advance Nursing in Tucson, Arizona, joined the Continuing Promise 2009 mission in Antigua in May. She is serving as the lead nurse educator and will continue to educate patients and local health professionals through the completion of the mission in July. Jane speaks Spanish.

Meg Candage, a nurse from University of Cincinnati in Ohio has 17 years of experience in ICU, ER, PACU and FLIGHT nursing and currently works as a Flight RN with University of Cincinnati AirCare. A first-time Project HOPE volunteer, Meg is working as a nurse educator during Continuing Promise 2009.

Elise Chamberlain, from St. Francis Hospital, Federal Way, Washington, has more than 5 years experience as a public health and ER nurse. She has traveled throughout Central and South America and spent 3 months studying Spanish in Guatemala. A first-time volunteer for HOPE, Elise joined the Continuing Promise mission in Panama in May and continues to serve as a nurse educator.

Dr. Robert Coleman is the Chief of the Department of Surgery at the Illiana Veterans Hospital in Danville, Illinois. He is a first-time volunteer for Project HOPE but has participated in mission trips to Honduras and Costa Rica. Dr. Coleman is performing general surgeries onboard the USNS Comfort.

Marley Gevanthor, a nurse with 28 years of experience from San Francisco General Hospital in San Francisco, California is participating in her fourth volunteer mission with Project HOPE. She served onboard the USNS Comfort in 2007 working in Belize, Guatemala and Panama. In 2008, she traveled to the West African countries of Ghana and Liberia, working on the USS Swift. Later in 2008, she traveled to Papua New Guinea and Micronesia onboard the USNS Mercy. Marley joined the Continuing Promise 2009 mission in Panama, and is working as a triage nurse through the mission’s completion.

Dr. Peggy Goebel holds a Masters and Ph.D. in Maternal and Child Health and is currently employed as a professor at the Dominican University of California & Santa Rosa Junior College. She is participating on her second volunteer mission for Project HOPE. In 2007, she served on the USNS Comfort working in Belize, Guatemala, Panama. On Continuing Promise 2009, Peggy is working as a triage nurse.

Dr. Kenneth Iserson joined Continuing Promise 2009 in Antigua and will continue through the end of the mission, serving as Project HOPE’s Medical Director. A first-time Project HOPE volunteer, Ken is a Professor Emeritus of Emergency Medicine at the University of Arizona in Tucson. He has more than 40 years of experience in delivering prehospital and emergency medical care. He has traveled and taught in many countries around the world, including Argentina, Peru, Mexico, Guatemala, Panama, Zambia, Israel and England.

Elizabeth Johnson is a Doctor of Pharmacy Candidate at Shenandoah University in Winchester, Virginia. She is a first time volunteer for Project HOPE. Elizabeth is working as a pharmacy technician onboard the USNS Comfort.

Tracey Kunkel is an operating room nurse from Pittsburgh, Pennsylvania. She retired from the U.S. Navy after 21 years and has specialized in areas such as Mother/Baby unit, Labor and Delivery, Orthopedics and Podiatry, General Surgery and Pediatrics. Her Navy experience also includes humanitarian assistance deployments on both the USNS Mercy and the USNS Comfort. She joined the mission in Panama and is serving as Project HOPE Operations Officer for the remainder of Continuing Promise 2009.

Jamie Lummis is a recent Animal Science graduate from Novato, California. She is a first–time volunteer or Project HOPE. Jamie is assisting the veterinarians during Continuing Promise 2009.

Kelly Magee a nurse from Maimonides Medical Center in Brooklyn, New York is a first-time volunteer for Project HOPE serving on the entire four-month long Continuing Promise 2009 mission. She is working as a perioperative nurse on board the Comfort.

Elizabeth Malloy is a registered nurse from the University of Utah Medical Center in Salt Lake City, Utah. A first-time Project HOPE volunteer, Elie has been onboard the Comfort since it departed from Miami in April and is working as an ICU nurse until the completion of the mission in July.

Faye Pyles, a pediatric nurse practitioner from Norfolk with more than 30 years experience, is on her third mission with Project HOPE. She first volunteered in Ghana and Liberia in 2008 and later the same year she served on the USNS Mercy in Southeast Asia. Faye recently retired after 25 years from the Navy where she served in a variety of roles in both the US and overseas. Currently she is working part time in private practice and volunteering with a variety of nonprofits. She is volunteering as a pediatric nurse practitioner aboard the USNS Comfort.

Carleen Qualantone, a nurse from Memorial Health System in Colorado Springs, Colorado has 16-years of experience in emergency and cardiac Cath Lab care. A first-time volunteer for Project HOPE, Carleen is working as an ER /Trauma nurse onboard the USNS Comfort.

Carrie Reichert, a nurse from Johns Hopkins Hospital in Baltimore, Maryland is a first time volunteer for Project HOPE. Carrie’s previous volunteer experience includes work with the Phu My Orphanage and Tam Binh Orphanage in Vietnam. She also recently graduated from Johns Hopkins University with a Master of Public Health. Carrie is working as a NICU nurse onboard the USNS Comfort.

Marina Rivera is on her third volunteer mission for Project HOPE. An X-Ray technician from Colorado Springs Health Partners in Colorado Springs, Colorado, Marina brings more than 20 years of experience in radiology to the mission. She also is retired from the U.S. Army. Marina worked in Liberia for Project HOPE in 2008 and just returned from her second mission to West Africa to Ghana in March of 2009. She joined the 2009 Continuing Promise mission in Panama in May and is serving as an advanced X-ray technician onboard the Comfort for the remainder of the mission.

Elizabeth Roughead is a recent biology graduate of Middlebury College in Middlebury, Vermont. A first-time volunteer for Project HOPE, Elizabeth is working in an administrative role onboard the USNS Comfort. Elizabeth is from Washington, D.C.

Ann Russell, a certified nurse midwife from Planned Parenthood in Seattle, Washington is a first-time volunteer for Project HOPE. Ann brings more than 25 years of midwifery experience and Spanish speaking skills to her role as a midwife onboard the USNS Comfort.

Diane Speranza is on her fifth volunteer mission with Project HOPE, previously serving onboard the USNS Mercy in 2005, following the Indian Ocean Tsunami. In 2006, she returned to Southeast Asia onboard the Mercy to work in Indonesia and also the Philippines. In 2007, Diane volunteered onboard the USNS Comfort in Central and South America and in 2008, she again volunteered on the Mercy working in Vietnam and East Timor. A nurse from Helen Ellis Hospital in Tarpon Springs, Florida, Diane is also a member at large for the Project Hope Alumni Association. She is serving as a triage nurse during Continuing Promise 2009.

Jacob Steele, from Atlantic Beach, Florida, is a first-time volunteer for Project HOPE. A former Public Relations Officer for the U.S. Navy, Jacob transitioned out of the Navy in June 2009, and is now focusing on peace building in Latin America. He is serving as Project HOPE’s public affairs officer onboard the USNS Comfort.

Susan Troll, a registered nurse from Ellis Hospital in Schenetady, New York is participating in her fourth volunteer mission for Project HOPE. In 2005, she served onboard the USNS Mercy during Tsunami relief efforts. In 2006, she volunteered in Biloxi, Mississippi following Hurricane Katrina and in 2007 she worked in Southeast Asia onboard the USS Peleliu. Onboard the USNS Comfort, Susan is working as a medical surgical nurse.

Adeline Wakeman is a nurse from Harborview Medical Center – University of Washington in Seattle, Washington. A first-time Project HOPE volunteer, Adeline is working as a medical surgical nurse onboard the USNS Comfort.

Tina Weitkamp is participating on her third volunteer mission for Project HOPE. She worked in Southeast Asia onboard the USNS Mercy in 2006, and served in Latin America onboard the USNS Comfort in 2007. The Director of International Affairs and Associate Professor of Nursing from the College of Nursing, University of Cincinnati, Ohio, Tina is volunteering as a nurse educator during the final leg of Continuing Promise 2009.

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