Wednesday, June 30, 2010

Students Teach Malaria Prevention

As 1000 people onboard the USNS Mercy for Pacific Partnership 2010 continue their work on behalf of the people of Vietnam and Cambodia, malaria is one major consideration and a frequent topic of conversation. Everybody has been advised to use appropriate prophylaxis, such as with Doxycycline or Malarone, but questions remain.

The ship presented a formal session on malaria by Project HOPE volunteers for any Mercy personnel who wished to attend. “Nursing students from University of San Diego and pharmacy students from Shenandoah University will discuss prevention, recognition and treatment of Malaria,” the notice read.

The well-prepared students gave a practical and professional presentation to a large audience consisting largely of doctors, nurses, and other health care professionals. The students’ answers to the substantial questioning at the end were especially well regarded. After being congratulated by a number of people including the ship’s chaplain, the students asked their faculty members to identify themselves and come forward for a picture.

The presenters from Shenandoah University (who won a competition at their University for this opportunity) were Kristina Angelone and Renee Summerson, mentored by Earl Rogers, Pharmacist. The presenters from University of San Diego were Abigail Chua, Catherine Chung, Will Flores, Kimberly Fong, Jacqueline Iseri and Patrick McNichols, precepted by faculty members Kathleen Templin, RN and by Peggy Holt, RN. Clearly the students are benefiting from the clinical and educational opportunities at the same time as the hospital ship is benefiting from their services. Together we are improving our preparedness to give humanitarian and civic assistance.

Thanks for reading - Mary Hamill, Ph.D., Project HOPE PAO

Tuesday, June 29, 2010


Project HOPE volunteer Renee Summerson says what she liked best in her work on the Pacific Partnership Cambodia mission was “seeing the people and being able to help them.” Renee is referring not only to the people in the port city of Sihanoukville but also to those in remote Kampot Province.

She is now back onboard USNS Mercy after a five day MedCAP(Medical Civic Assistance Project) which provided medical care to the rural people who live near the Ang Sophy School. The expedition began and ended with a 45-minute helicopter trip along the Cambodian coast. When the helicopter first landed in a clearing in front of the school, Renee and the doctors and nurses and other care providers unloaded their gear and set themselves up in tent cots so that they would be able to sleep without concern about mosquitoes.

Renee is a pharmacy student at Shenandoah University who worked in Kampot with one pharmacist and one other pharmacy technician to fill 5,809 prescriptions, more than 2,000 of them on the last complete day at the site. Renee found that they saw more adults than children, many of them with skin infections, many requiring antibiotics. A large number of dental extractions were carried out as well.

Among the patients were several monks from the adjacent Buddhist temple and pagoda and meditation caves. When Renee was invited to go inside the caves, she saw golden statues and unique rock formations for which the monks had specific names. She was happy to have extra translation services through a member of the Peace Corps teaching at the local school.

Thanks for reading - Mary Hamill, Ph.D., Project HOPE PAO

Monday, June 28, 2010

HOPE Volunteers Help Mother with Young Twins

Preparing to leave the USNS Mercy today is a mother with young twins who remains the focus of substantial help from several Project HOPE volunteers. Both of her five-year-old boys are ill and malnourished, living on her breast milk; she does not have the means to provide them either solid food or a set of clothes.

To get to the Sihanoukville Provincial Hospital for the Medical Civic Assistance Project (MedCAP), the three journeyed from the remote Cambodian countyryside more than one hour by bus. The stronger twin came to the pediatrician with such a large oozing abscess on his forehead that he needed to be brought to the ship for surgery, now successfully completed. His twin brother, the tinier Voeng, was the most anemic child ever seen by the doctor. He was found to have blood cells whose shape suggests very serious illness. For diagnosis and treatment, he needs further lab tests than the ship can provide; but the family lacks the money to obtain these. Unfortunately the family also lacks access to any refrigerator and so cannot go home with the preferred antibiotic; the mother is being taught to mix an alternative powdered one instead.

The family will be discharged in somewhat improved health and spirits; they will have a helpful set of paperwork and a precise referral to a hospital near their village. Clearly more is needed, and so a set of connections has been made with social service agencies by way of USNS Mercy Navy Chaplain Horne. While the Mercy has been at anchor in the port of Sihanoukville, he and the other chaplains have overseen substantial community service work by Project HOPE volunteers and others; and the chaplains have also facilitated charitable donations of goods to groups that care for the needy, including those with a profile like this family. Especially because his family has no money, no address, and no phone, getting Voeng the help he needs will be a great challenge.

Pictured here is the family among many hard-working Project HOPE volunteers on the Pediatric Ward. The nurses and University of SanDiego nursing students here are: Fran Bauer, Peggy Goebel, Kimberly Fong (student), Kathy Templin, Will Flores (student), Peggy Holt, and Jacqueline Iseri (student).

Thanks for reading - Mary Hamill, Ph.D., Project HOPE PAO

Friday, June 25, 2010

Volunteers at Work in Cambodia

SIHANOUKVILLE, Cambodia (June 21, 2010) A Project HOPEvolunteer looks on as a girl blows bubbles at Ohtres Chas Primary School during a community service event. U.S. Navy photo by Mass Communication Specialist 3rd Class Matthew Jacks.

SIHANOUKVILLE, Cambodia (June 20, 2010) Cambodian children play games with Sailors and Project HOPE volunteers during a community service event at the Enfants du Cambodge orphanage. U.S. Navy photo by Mass Communication Specialist 2nd Class Jon Husman.

SIHANOUKVILLE, Cambodia (June 20, 2010) The USNS Mercy anchored off the coast of Sihanoukville, Cambodia. U.S. Navy photo by Mass Communication Specialist 2nd Class Jon Husman.

SIHANOUKVILLE, Cambodia (June 16, 2010) HOPE volunteer Catherine Chung checks the blood pressure of a Cambodian patient. U.S. Navy photo by Mass Communication Specialist 2nd Class Eddie Harrison.

Thursday, June 24, 2010

Volunteers Use High Tech PDAs in Humanitarian Effort

The first thing a visitor sees at a typical MedCAP (Medical Civic Assistance Project) site in Vietnam or Cambodia is the iron gate of the building complex swung wide open, with hundreds of local people moving in and out. Inside the walled courtyard is a crowd roving among security personnel, and then a line of people waiting for their turn at one of the tables with a smiling intake staff person holding a high tech device. That would be the PDA for the CHIME system: it is the symbol and the reality of step one in a patient’s long-awaited day of accessing health care providers from the Pacific Partnership 2010. The automated system provides patient tracking at triage, assessment, diagnosis and treatment stages.

Initially, basic information is collected; and the patient is given a wristband with a unique bar code. At subsequent steps, the barcode is swiped so any data can be read and used. And after the patient is seen, new data gets entered. For example, a nurse weighs the patient and enters the weight on their handheld PDA. When the patient reaches the doctor’s office, the data gathered so far are used to help with the diagnosis and treatment plan, each of which is also entered.

Any medications prescribed are entered as well; and, in the best case, these can be waiting at the pharmacy area all ready with translated labels. The aura of the highly visible technology at each step seems to work a little magic of its own as it heightens the credibility of the service providers.

CHIME is among the newer of the many acronyms that pervade life on a Navy ship: Civil and Humanitarian Information Management—Expeditionary. At the MedCAP site the central piece of the technology is an In-field Server that collects data from the separate units: Triage, Primary Care, Dental, Optometry, Physical Therapy, Surgery, and Radiology. Pacific Partnership 2010 is a beta test site for the CHIME system, which was previously tried by NGOs in Haiti, by the American Red Cross at Hurricane Katrina, and by Continuing Promise 2009 among others.

From a managerial perspective, the system standardizes data collection and sharing in a paperless way. Beyond that, it also makes possible the consolidation of the information in “real time” for planning purposes locally or at a distance at a higher level in the command. The information gathered can be used for evaluation and planning, duly combined with qualitative and financial and other types of data. CHIME assists with one set of considerations about the impact of the mission on the people of the region.

When a tired doctor makes it back to the mess hall of the USNS Mercy at the end of a long day at the MedCAP and talks about the pros and cons of having seen 110 patients, the facts are a matter of record.

Thanks for reading - Mary Hamill, Ph.D., Project HOPE PAO

Wednesday, June 23, 2010

Volunteers Waste No Time Getting to Work in Cambodia

As opening ceremony speeches were taking place onshore in Cambodia, an extensive set of medical outreach activities were already emanating from the USNS Mercy, many of them including Project HOPE volunteers.

One team including nurse Dawn Gaynor began day one of surgeries for Cambodians in the Mercy’s Operating Rooms.

The pediatric group onboard welcomed children brought in by boat; it included nurses Fran Bauer and Peggy Goebel.

Student nurse Abby Chua was quizzed by the visiting Rear Admiral Christine Bruzek-Kohler on a patient’s diagnosed condition while fellow student nurse Patrick McNichols helped a three-year-old girl and her father cope with a ringworm infection of the head and face.

On the ICU ward on a very long shift were nurses Cherri Dobson and Chelsea Spindel.

Nurse Diane Sperenza was at the intake spot on the hospital ship called “Casualty Receiving.”

Janna Tamminga was providing Physical Therapy onboard.

On the Medical Surgical ward for the night shift was nurse Terry Tucker.

Nurse Kathy Templin was working onboard while colleague nurse Peggy Holt had a day of “liberty” in town along with students.

Another team undertook the first full day of seeing new patients at the Sihanouk Provincial Hospital; it included Project HOPE volunteer hospitalist Betsy Trefts, MD, family nurse practitioner Mary Levitz, and Medical Assistant Catherine Chung. A contingent of twenty people including pediatrician John Neale, MD, brought supplies and activities to the children at the Goodwill Center in town. Pharmacist Earl Rogers along with student Kristina Angelone were working in the dispensary, while their colleague Renee Summerson went off by helicopter for a five day Medical Civic Action Project in Kampot, rural Cambodia. Other doctors and nurses flew as far as Ratanakiri to deliver the medical care needed there.

Thanks for reading - Mary Hamill, Ph.D.,Project HOPE PAO

Tuesday, June 22, 2010

Opening Day in Cambodia

The Opening Ceremony for the Pacific Partnership 2010 in Cambodia took place June 16 on the pier in Sihanoukville, which is the country’s only port. This marks the first time in its five years that a US Pacific Fleet humanitarian team has come to Cambodia, bringing a range of medical, dental, veterinary, and engineering service. Providers come from Australia, Canada, France, Japan, Singapore, and the United Kingdom, as well as the United States.

The event to launch this Cambodian portion of the civic assistance project was resplendent with military regalia and was intensely covered by dozens of reporters and photographers.

Dr. Marshall Cusic, M.D, retired Navy Rear Admiral, was in attendance and represented Project HOPE as director of the current rotation. As pictured here, he made the journey between the ship and the land via a local wooden boat along with uniformed servicemen from all four military services.

On the pier which is used for fleet landing and where the Japanese ship JDS Kunisaki is now docked, an orange tent was erected adjacent to a formal stage of wood and granite. As the temperature rose to 97F and the humidity rose to 96%, the brass band from the USNS Mercy played on.

The array of dignitaries as photographed were: Carol Rodley, the US Ambassador to Cambodia; Commodore Lisa Franchetti, USNS Mercy, Pacific Partnership 2010 Commander; General Neang Phat, Secretary of State Defense Minister of Cambodia; Commodore Shunyo Susaki of the Kunisaki; and Masafumi Kuroki Japanese Ambassador to Cambodia. Their speeches emphasized the fact that Cambodia’s people eagerly want and need the assistance which this humanitarian exercise brings.

During the afternoon, tours of the hospital ship were provided to many people who had made their way over from land, including the two Ambassadors and the many reporters from Cambodia, Japan, Australia, the US, and beyond.

Thanks for reading - Mary Hamill, Ph.D.,Project HOPE PAO

Monday, June 21, 2010

"Partner Ship" Kunisaki

The “Partnership” in Pacific Partnership 2010 refers to many kinds including national ones with Australia, Canada, France, Japan, New Zealand, Portugal, Singapore, and the United Kingdom. Most visibly prominent among these at the moment is the partnership with Japan, because the JDS Kunisaki, a large ship of the Japanese Maritime Self Defense Force, has been positioned right next to the USNS Mercy, at anchor or underway.

Also Japan is currently providing the most support of any of the partner nations. Their medical team includes more than 30 professional providers who work side by side with the Navy and Project HOPE and other Non-Government Organizations (NGOs).

One strong Japanese NGO for this kind of medical mission is HuMA, Humanitarian Medical Assistance, directed by Norifumi Ninomiya, M.D., Professor at the Nippon Medical School. The members of HuMA are among the many friendly Japanese people who welcomed us aboard the JDS Kunisaki for a gala evening celebration of our mission. Three of their members whom we have repeatedly encountered on land while working on our joint mission are pictured here at the party along with Faye Pyles, who is retired Navy captain, nurse, and HOPE volunteer helping to direct our group.

The party was a gala event with sushi brought in from Japan. It was held in the hangar area of the ship, transformed by vertical bands of red and white fabric blanketing the walls as well as by ceremonial sword fighting. Decorative fans for all the guests were eagerly welcomed to help with the oppressive humidity.

Tonight there will be another party on the Kunasaki, this time at the pier in Sihanoukville as shown here. The Japanese hosts will be serving sake to the guests, including seven people from Project HOPE. Each volunteer has the opportunity to attend one major party, and the Kunasaki has become the most favored spot—at least for today.

Thanks for reading - Mary Hamill, Ph.D.,Project HOPE PAO

Friday, June 18, 2010

Dr. Betsy Trefts Brings Health and Smiles to her Young Patients

On the Pediatric Ward on the USNS Mercy many children and adolescents are treated for many different diseases.

Often it is Project HOPE volunteer Dr. Betsy Trefts, who is doing the treating. Betsy is both a pediatrician and a hospitalist and brings to the ship her skill sets from both specialties. She also brings much good cheer to her patients.

Here she is seen examining the eyes of a Vietnamese boy lucky enough to be getting help while still a pre-schooler.

By contrast, adolescents who find their way to Betsy’s care have typically struggled for several years. Pictured here on the Ward with his mother is such a 17-year-old, namely Vansi Huyng, who had long endured the combined problems of a cleft palate and a heart murmur. He was helped by Betsy and also by Mercy Navy surgeons, HOPE student nurse Abigail Chua and HOPE nurses Peggy Goebel and Peggy Holt, among others.

Thanks for reading - Mary Hamill, Ph.D.,Project HOPE PAO

Wednesday, June 16, 2010

Long-time Volunteer Continues Work in Vietnam

Earl Rogers says he began volunteering with Project HOPE in 1972 because he felt “a need to give back something,” having been fortunate enough to have the kind assistance of many people in his own life. Those who work with Earl on the USNS Mercy say that he is giving back in spades.

Earl is working as Pharmacist and also as mentor/sponsor/teacher to two advanced pharmacy students from Shenandoah University thanks to a program he helped facilitate in concert with Dean Alan McKay there and with Matt Peterson at Project HOPE. His students, Kristina Angelone and Renee Summerson, bring a splendid combination of professionalism and enthusiasm; and Earl finds that their perspectives enrich the humanitarian efforts onboard this military hospital ship.

Earl is happy to have young students learning in different cultures, having long prized such opportunities in his own development.

Initially he responded to a newspaper advertisement for serving with Project HOPE and became a part of the original mission to Brazil. As part of the exploration, he met his wife Lois Hofstra, who was serving as translator. More recently he has been a volunteer with Project HOPE in a range of places: Russia, Lithuania, and the Ukraine in 1992; the JFK Memorial Hospital in Monrovia, Liberia, in 2008; and in Ghana aboard the USS Nashville in 2009. He has helped to support effective pharmacies in developing countries through a number of Subject Matter Expert Exchanges (known as SMEEs).

During the current mission Earl has worked many days in the pharmacy onboard ship and many in the clinics set up in Binh Dinh province in Vietnam. In one picture here he is seen at the Phouc Hoa clinic using a high-tech system for prescribing and filling and labeling-in-translation the medications needed for each person; patients’ needs are recorded and tracked as they move from the room with the intake personnel, to the room with the diagnosing/treating doctors, to the room with the dispensing pharmacists.

Among the hundreds of families he saw was this set of grandmother, mother, and twin girls, who had minor treatable ailments of the stomach and the skin. (Top photo)

Thanks for reading - Mary Hamill, Ph.D., Project HOPE PAO

Tuesday, June 15, 2010

Donations of Medical Equipment Continue

Project HOPE presented a donation of durable medical equipment to the Binh Dinh General Hospital.

This is one of Vietnam’s largest hospitals, serving not only the city of Quy Nohn but the entire province of Binh Dinh and beyond—more than a million people. At the time of the visit approximately one thousand outpatients were being treated. There are many feeder clinics in the Hospital’s catchment area, and one of the nearest is Quang Tung Ward Clinic, to which Project HOPE made last week a coordinated major contribution of furnishings and equipment.

At the General Hospital the Intensive Care Unit was the specific site where the equipment was presented by Marshall Cusic, MD(retired Rear Admiral) and Faye Pyles PNP (retired US Navy Captain), director and operational director respectively for the Project HOPE team currently on the USNS Mercy. Receiving the equipment with thanks were Dr. Nguyin Hoang Minh, Vice-director of the Hospital and Dr. Nguyen Phan Auh Ngoc, Vice-director of the ICU.

The donation consisted of two types of items: 1. Pulse oximeters, for measuring heart rate and oxygen level; and 2. Syringe pump devices, for delivering controlled small quantities of fluids or medications such as pain-killers to adults or children. The equipment incorporated upgrades in the level of technology beyond the items the ICU previously used for these purposes.

The Project HOPE volunteers met also with members of the Pediatrics Division, namely Dr. Phan Van Dung, Vice-director and Dr. B.S.Minh, GPD. They explained the history of the unit, which has grown from a small entity and has had its own building since 1977. The focus was on the particulars of care for some of the children’s illnesses seen at our MEDCAPS (Medical Civic Assistance Projects) and onboard the Mercy, e.g., deafness and cardiac conditions.

The session ended with all present installing batteries in the new pulse oximeters to get them operational so we could test them on ourselves. We enjoyed measuring our individual resting pulses while speculating on reasons for the differences, cultural and otherwise. Throughout we were ably assisted by Ms. Nguyen Phuong Hoa from Hanoi and our young student translator from Hue University, Khuong Duy.

Thanks for reading - Mary Hamill, Project HOPE PAO

Monday, June 14, 2010

From Shore to Ship, Volunteers Continue to Treat Patients

Each day of our mission in Vietnam, health care providers travelled by boat and by van to clinic sites they had established throughout the greater Quy Nhon region. During the eleven days of work they treated 19,600 patients for a wide range of ailments. Some of those whose needs were most compelling were then brought on board the ship for surgery.

Serving last week at one of these sites known as Medical Civil Assistance Programs was Project HOPE volunteer pediatrician Dr. John R. Neale, who has treated as many as 60 patients in a single day here. One local man came in with his somewhat apprehensive seven-year-old daughter named Kieu Trang and described her case by saying at the outset that it was time for her to have surgery. She had an obvious left-sided mandibular mass present since birth and, according to her father, had initially had relatively simple surgery at the Quy Nhon General Hospital in 2005. Now she was old enough for more. So Trang was next seen by the Mercy’s dental unit and came to the pediatric ward on the ship for a CAT scan and treatment under the care of HOPE volunteer hospitalist Dr. Betsy Treft among others. Once the tumor was excised and the pathologist had declared it non-malignant, Trang was given a bone graft and substantial post-operative care.

Trang’s grateful father was with her throughout, because patients who come on board during humanitarian missions are encouraged to bring a family member. The two slept in adjacent “racks” (beds). Trang’s father, like her mother, earns his living as a rice farmer, and they have an older son living at home as well. While the father and daughter were on the pediatric ward, they were assisted regularly by HOPE volunteer nursing student Kimberley Fong. She says that one day Trang is likely to be a doctor or a nurse. During Trang’s stay on the ward she shadowed Kimberley, using her own borrowed stethoscope to listen to the heart beat of any person or stuffed animal that would comply.

Trang and her father were the last to dissembark from the USNS Mercy before the ship’s departure from Vietnam. Now minus the disfiguring tumor, she seemed relieved to be heading back to shore wearing a bright orange striped sun hat that helped minimize the still-visible closed incision from the surgery.

Thanks for reading - Mary Hamill, Project HOPE PAO

Friday, June 11, 2010

Shenandoah University Pharmacy Students Blog From Vietnam

First time Project HOPE volunteers Kristina Angelone, a Doctor of Pharmacy student, and Renee Summerson, a fourth-year pharmacy student, both from Shenandoah University in Winchester, Virginia are blogging about their memorable experiences in Vietnam. Both students are working onboard the USNS Mercy and ashore, providing pharmacy support for the medical care and health education mission.

Read Their Blog