Faye Pyles Completes Pacific Partnership Mission

Faye Pyles is a pediatric nurse practitioner from Norfolk, Virginia, a four-time Project HOPE volunteer and retired after 25 years service with the U.S. Navy. During the Pacific Partnership 2010 mission, Faye served as HOPE’s Chief Nursing Officer and Operations Officer in Vietnam, Cambodia and Indonesia. Even as the rest of the HOPE volunteers returned home in August, Faye stayed on, working with those in need in Timor Leste. Here is a blog she wrote before leaving the USNS Mercy on August 31.

The trip from Darwin began as the trip from Guam. Calm seas, new faces, new roommates, and a new sense of anticipated adventures. However, as I walked around the decks of the Mercy there was a sense of something being missing. The ever present Project HOPE T-shirts, the usually smiling faces and the always entertaining company at meal time was absent. The stories of where they had been and how their days had gone were now silent. Just as Team One had left a little of their spirit behind so did Team Two, and for this I am grateful. I know we all have some pleasant memories that elicit smiles as we think of one of our unique team mates and their entertaining stories. My first mission as a Project HOPE operations officer was blessed with some extraordinary volunteers who made even the most trying days worthwhile.

As the Mercy left Project HOPE Team Two in Darwin to experience their own Australian adventures we pressed on towards Timor Leste. The crew has become aware that there is now not a full PH team. I now have heard many versions of the same phrase. Many people have commented to me that Mercy is left with little HOPE, minimal HOPE, just a small ray of HOPE, and soon will be HOPEless. I am trying to catalogue all the different versions of the same joke, if for nothing else then at least for my own amusement.

The first MEDCAPs in Timor Leste were exciting. I finally was able to see patients and actually do what I usually do on these missions. Though the site was dusty, and hot I was thrilled to be finally in the field. I felt a sense of coming home as I turned to the first patients in Timor and as I introduced myself asked, "How can I help you today?" The children and their parents were a pleasure to see.

The only drawback was one all providers wrestled with on this mission, CHIMES. I do not even text message, much less have a Black Berry or a Palm Pilot. So needless to say I spent more than a little time trying to get a sense of how to actually look at the patient rather than the little screen and how to manage to actually send the prescriptions to pharmacy without exiting the program twice before that was accomplished. I am pleased to say that I overcame CHIMES to actually have a great experience in the two days I was out in spite of technology. I was not the most productive provider, but that has never been a major concern of mine in these settings.

Never the less by the end of the first day I had elicited smiles from some of our many crying little children (at one point the count was six small screaming children in the pediatric room at the same time, quite a chorus) and expressions of relief from their parents as I assured them their child's heart sounded strong and their lungs were fine, and that their concerns had been heard. At the end of these long days the smiles we receive and the words of comfort that we provide are to me the essence of why we come on these missions. I look forward to the end of the week when I have three more days at another school. The adventure continues.


Faye Pyles, HOPE’s Chief Nursing Officer and Operations Officer during the entire Pacific Partnership 2010 mission.

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Providing Care in Moratai

When three of our first-time Project HOPE volunteers boarded the USNS Mercy on July 3rd, they had no idea that they would also be spending three nights on a much smaller Australian boat, traveling to Moratai, Indonesia. Our Australian partners provided all that was necessary to support the Moratai MEDCAP team, including transportation, lodging and meals. Although unconfirmed by independent sources, the HOPE team claims that Kiwi amenities included a chef that served roast lamb, garlic cream prawns, fresh fruit salad and ten different marinates for barbecue.

There was another charming aspect to the voyage that made up for our volunteers sleeping in what was essentially a shipping container or out on deck in the rain. Instead the traditional Navy reveille each morning, all MEDCAP providers were summoned each morning with the announcement, “Wakey, Wakey, time for breakfast!”

Among those sleeping in the converted shipping container was HOPE’s Dr. April Kranz. April worked in a Mayan Village in Belize during her fourth year of medical school, and it was there her passion was ignited for international medicine. During her first Project HOPE mission, April has seen patients in the ship’s sick call, and worked on one day MEDCAPs. But she found her foray to Moratai most exciting. “We saw a lot of lumps and bumps,” she said, “but I also saw a case that a really cool local doctor help me diagnose as probable leprosy, not something I’m likely to see at my hospital in California.”

Sleeping out on the deck was Brian Cox, who after six years of training, is just weeks away from being a full-fledged pharmacist. It seems the pharmacists on this mission work harder than anyone, because virtually every patient seen by every provider stops by the field pharmacy before leaving. In Moratai, Brian worked alongside two Indonesian pharmacists and a Navy technician to fill approximately 1,000 prescriptions a day. If Brian’s plans for the future pan out, he’ll be wearing a US Public Health Service uniform, working to promote the health of American Indians.

Dawn Horowitz is also completing professional requirements for an advanced degree on this mission, that of a nurse practitioner (FNP.) “We’ve seen a lot of untreated broken bones,” says Dawn. “People fall out of trees while harvesting coconuts, and without access to appropriate treatment, they suffer a deformity for the rest of their life. These remote areas present a huge challenge for health care.”

“What we do medically during a three-day encampment is limited,” says April, a doctor who plans a career in international medicine. “We have to keep remembering that the MEDCAPs are just one small piece of a broader initiative to build infrastructure and relationships.”

Thanks for your interest in Project HOPE -- Kathryn Allen, HOPE Public Affairs Officer

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Third Continent for Fourth-Time HOPE Volunteer

It all started at a kitchen table in Seattle, almost as far from the Katrina disaster as one can get in the United States. Gabrielle Seibel and her husband, Mike, were, like so many Americans, frustrated at the lack of help being provided to the flooding victims. “And then it came to us," Gabrielle says, “We can do something.” The couple rounded up their three children and had a talk how their family could make a contribution. “We concluded that my nursing skills would be most directly beneficial to the Katrina situation,” says Gabrielle, who recently completed her fourth Project HOPE mission in Indonesia.

Gabrielle’s qualifications make her extremely well suited as a HOPE volunteer. She’s a nurse practitioner with two decades of experience, most of it working with children of immigrants, the underserved and minorities. But she also has a masters in public health that has given her the skills to support Project HOPE's commitment to education and infrastructure development. “What I love about Project HOPE is that they don’t just go into an area for a short term assignment and then leave. They are all about sustainable relationships and partnerships that result in better local health care. Everything was gone after Katrina,” says Gabrielle. “We had to pull a medical site together from scratch, while also seeing patients, all of whom where suffering from traumatic stress."

In Indonesia, Gabrielle assessed and treated hundreds of children in a variety of locations and conditions. In Ambon, at a site that was almost shut down because the crowds were on the verge of getting out of control, she saw a two-year-old boy whose arm and hand had been severely burned several days earlier. With no treatment, the child was in pain, the wound was infected, and his hand was contracting. Not content to just treat the pain and infection, Gabrielle took photos of the injury and discussed the case with both a plastic surgeon and a dermatologist. Arrangements were made to bring the child onto the ship, where state-of the-art burn care was provided. “The boy should regain full use of his hand," says Gabrielle. “There’s a lot of satisfaction when we can do something concrete like that.”

Gabrielle also had an opportunity to mentor two HOPE volunteers on this mission, both RNs who are just completing their final requirements to become nurse practitioners. During a MEDCAP, Gabrielle was able to demonstrate for them the many ways in which pediatric assessment differs from adult assessment. “You can hurt the child if you don’t hold the otiscope a certain way,” says Gabrielle. Dawn Horowitz, one of the NP students, took the initiative to write notes on every pediatric patient they saw together that day. Later, Gabrielle and Dawn reviewed the list and talked about standards of care that are feasible “in the field” as opposed to standards of care in optimal conditions.

“I also learn on these missions,” says this HOPE veteran. “In Ghana, they have a beautiful system for baby clinics. They bring in all the prenatal patients on one day, as a group; then all the well-babies and their mothers on another day.” She explains further that each clinic begins with a prayer, then songs, then dancing. Once everyone is relaxed and feeling good, the clinical care commences. On well-baby days, the mothers walk their infants through a series of stations, where they are weighed, measured and otherwise evaluated. “They don’t have the same concept of privacy that we do,” says Gabrielle. “But they also don’t have post-partum depression.” The mothers of her small patients in Seattle are often isolated, and she feels they could benefit by some Ghanian wisdom about scheduling and program design.

Gabrielle has now treated patients on Project HOPE missions in the United States, Liberia and Ghana in Africa and throughout Indonesia. “The medical care we provide can change lives,” says Gabrielle, certainly thinking of her recent burn patient. “But truly, the medical clinics just scratch the surface. The education and infrastructure piece is huge for us to meet the goal of local sustainability.”

Note to my non-medically trained readers, which may be most of you! Inside the world of health care, we love code words like infrastructure and sustainability. For the rest of us, those words boil down to something we can all understand: people, equipment and buildings that provide health care over the long run.


Thanks for your interest in Project HOPE -- Kathryn Allen, HOPE Public Affairs Officer

Help Support Project HOPE's Humanitarian, Health Education and Volunteer Programs Around the Globe.

Project HOPE's Dr. Nasar Sheldon Visits Pacific Partnership Volunteers in Indonesia

Project HOPE has a history of medical missions within Indonesia spanning 50 years, but it was the relationships forged during the 2004 Tsunami response that lay the groundwork for Project HOPE’s continuing presence in Indonesia.

During Project HOPE and the USNS Mercy’s recent stop in Ambon, the Director of HOPE’s Indonesia Operations, Dr. Nasar Sheldon, visited the ship and went on MEDCAPS with HOPE volunteers. During his time on board he shared news with us of the exciting work being done in his country, day in and day out. It’s a common feeling for volunteers to leave MEDCAPs frustrated by their inability to follow up with their patients, so it was heartening for the team to hear about Project HOPE’s contributions to sustainable health care systems in Indonesia. Many people still associate Project HOPE primarily with “the big white ship,” but, in fact, the majority of work done by Project HOPE worldwide is conducted in land-based efforts.

In Indonesia, Dr. Sheldon directs a staff of 32, most of whom are Indonesians working in areas in which they have a network of relationships. Most of their work has been in Nagan Raya, the province just south of Banda Aceh, and the area hardest hit by the tsunami. In 2005, Project HOPE and local health officials agreed on two goals: Establish basic and referral services, and restore and improve health care services for mothers and children in the Nagan Raya Province. The challenge was enormous. Even before the tsunami, the area’s health care resources had been ravaged by thirty years of conflict and war.

Nasar shared some results from Project HOPE's work in Indonesia:

•1,3oo community health volunteers have been trained

•229 village midwives have been trained

•200 health care providers have been trained in the World Health Organization's Integrated Management of Children’s Health Illnesses protocols.

•400 Elementary school teachers in 127 schools are implementing a health education program geared to 5th graders, designed to make children and families more aware of health care resources in their communities.

I hasn’t been easy, but five years later, the successes in NR are many. Millions of dollars have supported facility and equipment development, resulting in the establishment or upgrading of 247 Posyandrus (health clinics.) They’ve served 122,000 people, including 25,000 women of childbearing age, and 17,000 children aged five years or less.

Dr. Sheldon is a native of Indonesia, and has experienced the country’s decade-long emergence from totalitarian rule to democracy. The ability to communicate openly and directly has been essential to the forging of strong relationships between Project HOPE staff and district health officials.

Our medical mission is winding down, and the opportunity to meet this key player in Project HOPE’s worldwide reach has been fascinating for those of us who care so much about Health Opportunities for People Everywhere.

The Engine Room

I didn’t really want to go on the tour of the USNS Mercy engine room, but my fellow Project HOPE volunteers kept raving about how awesome it was so I finally caved to the peer pressure. After all, life on the ship has been a huge part of our experience here in Indonesia. And ship-based medical missions are an integral part of Project HOPE’s history, going back to the SS HOPE’s maiden voyage in 1960. To Indonesia, exactly 50 years ago!

As a group of us walked to the far aft end of the ship to start the tour, we admitted all we know about ship engine rooms comes from disaster movies. Titantic came up first, of course, with its scenes of sweaty seaman desperately trying to crank down hatches to forestall invading ocean water. Some of us also remember The Poseidon Adventure, in which the ship actually turned over, and Shelley Winters swam through flooded engine rooms while Karen Carpenter crooned in the background.

Our tour started off calmly enough with affable Chief Engineer Joe Watts giving an overview of the ship while pointing to various places on a large framed schematic. With an accent hinting of his home in Boston, he told us the Mercy runs 894 feet from stem to stern, 105 feet across at its widest point, and 116 feet high. We’re just a speck traveling through the vast expanses of the Banda Sea, but if the ship were to be dry docked, it would take three high school football fields to contain it.

Once we nodded our agreement that this is a really big boat, Joe gave us a mini- history lesson. In 1958, Project HOPE founder Dr. William Walsh persuaded President Eisenhower to donate a U.S. Navy hospital ship, and the concept of ship-based volunteer-staffed medical missions was born.

We are not in that same ship, today, of course. The SS HOPE was retired in 1974. In the early 1980’s bids to build two floating hospitals from scratch went out. The National Steel Company in San Diego came back with a crazy idea to retrofit existing oil tankers into hospitals. It would save millions, they argued, and they were awarded the contract. The hospital berthing units and wards were built “prefab,” then lowered by sections into the discrete vertical “slices” of the ship’s hulls.

Joe could write a book about the mechanics of the ship’s engines, and with a few months at sea, I could probably write a chapter. But this is a blog, so I’ll just share a few highlights: the ship’s propeller is 26 feet wide, and has five blades instead of four, for smoother sailing should surgery be required while underway. Also, the OR is placed dead center of the ship, where the least motion can be felt. (Nonetheless, I’m happy all the surgical patients have been discharged. Today, as we are underway to Australia, the waves are 7-9 feet high, and we are all weaving like drunken sailors.

Finally we pushed orange foam plugs into our ears and encountered the deafening noise in the actual engine rooms. We trudged through rooms as toasty as 118˚, and then computer and repair rooms as sweetly cold as meat lockers. The main room is vast and tall enough to make one dizzy looking up, but other spaces are so tight we had to make ourselves skinny to avoid touching grimy, hot machines. Joe shouted out information along the way, and we all nodded along as if we heard and understood every word.

I did catch this: Enormous boilers that bring to mind Dante’s Inferno produce our water for drinking and washing by heating salt water to 170 degrees. Then they apply some engineering mojo involving vacuum pressure. The sucked out salt sludge is returned to the sea, and more seawater is taken in. No water shortage here, salty or not.

Our tour wound down when Joe opened a hatch and ushered us onto a small balcony featuring fresh air and blinding sunshine. He showed us the gun that shoots a line over to an oil tanker, which ultimately results in a cable that connects the two ships. A hose as big a boson’s arm and then pumps 10,000 barrels of oil from the supply ship to the Mercy, as the two ships remain sailing at the exact same speed for three hours.

The next morning we actually witnessed this process, one of hundreds of wonders, big and small, we’ve experienced these last five weeks.


Thanks for your interest in Project HOPE -- Kathryn Allen, HOPE Public Affairs Officer

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FIU Professor, HOPE Volunteer, and Expolorer

Randy Roark just might hold the record among all Project HOPE volunteers for the number of years spent in graduate school. He has acquired five – count them – post graduate degrees. He’s also had the smarts to billet himself in beautiful places with great weather: PhD in nursing (Hawaii); MS Adult NP (San Francisco); MPH Epidemiology (Miami); and MA in Exercise Physiology (Berkley, CA.) His law degree (NYC) does seem to be an outlier, both in subject matter and location, but Randy says he “just thought it would be fun.”

So what’s driving this educational marathon?

“Well, it took me a while to figure out what I wanted to do when I grew up,” Randy says sheepishly. “But nursing has been central to everything I’ve done.”

In Indonesia, Randy had a real opportunity to put his nursing skills to use during a 7-day, 6-night MEDCAP in Jailolo, a town near our Ternate stop.

“I expected to see exotic cases, and I did see active TB, malaria, and even an eel bite,” says this first time volunteer. “But the real eye opener was that people here suffer so needlessly from hypertension, diabetes and strokes; diseases that are treatable. It’s really tough to send them on their way.”

Randy now teaches at Florida International University, and the academic year allows him to volunteer for Project HOPE.

“I’ve wanted to do something like this for a long time, but wondered if I have the mettle to do it. After Jailolo, I’m happy to say that I do. I’ll definitely be doing more medical missions.”

On this mission, Randy is also mentoring two FIU nurse practitioner masters students. He is charged with ensuring they receive appropriate training on the mission.

“Vanessa (Doorasamy) was with me in Jailolo, and she just jumped right in,” says Randy. “Dawn (Horowitz) is so smart and so thorough, but she wanted to feel more confident. I think her trip to Moratai took care of that.”

Randy is several oceans away from his roots in Indiana, where he was the first in his family to graduate college.

“My family calls me a vagabond, but I prefer to think of myself as an explorer. Indonesia is just a first stop.”


Thanks for your interest in Project HOPE -- Kathryn Allen, HOPE Public Affairs Officer

Help Support Project HOPE's Humanitarian, Health Education and Volunteer Programs Around the Globe.

Small efforts can make huge impacts in a child's life

The previous story on Club MEDCAPs was on the light side, and humor is an important tool in the skill set of any volunteer who works a medical mission under somewhat adverse conditions. But laughing aside, the work our Project HOPE volunteers do is hugely important to thousands of lives; lives that are changed one, by one, by one.

Hope Pediatrician Alan Jamison had nothing but positive stories to tell about his recent seven days in Jailolo, Indonesia. “I thought we’d be in tents out in a field. They gave us nice rooms in one of the hospital wards.” If this doctor’s army cot kept him awake at night, there was no mention of it.

When asked if one visit with one patient can make a different, Dr. Jamison nodded his head affirmatively. “There was one toddler I saw who had a dermoid on her cheek that was 2” long and quite thick. She would have had a terrible time in life with such a disfigurement.” Dr. Jamison was able to refer the child to a mission dermatologist, who with some local anesthesia, was able to exise the dermoid that very afternoon. This story made me think of Syarif, our recent adult patient who had to wait until his twenties to have the very large nevi removed from his face, with much more extensive surgery and a many-day stay on our hospital ship.

Dr. Jamison has nothing but positive comments about Indonesian parents. “The mothers here do a great job of taking care of their children. I saw no diaper rash or evidence of the sometimes limited resources people have for staying clean.” But our pediatrician did see many children suffering the effects of birth trauma, including children with cerebral palsy. Fortunately, our HOPE providers also had the support of mission physical therapists, and Dr. Jamison referred several children for PT. “The physical therapists are able to teach the parents exercises that will help their children maintain flexibility, avoid strictures, and even strengthen cognitive development.”

What one medical provider does for one mother and child might seem like a small thing. But it can make a huge difference in the future of that child, and those who care for him or her. And speaking of one child, our first little patient in the yellow dress is now back home in Jakarta. Santi’s vision dramatically improved by having corrective surgery for congenital cataracts in both eyes. Because of Pacific Partnership 2010, and the many individuals who have volunteered their time and expertise, Santi’s life has transformed from shadows to sharp vision. That is no laughing matter, but it is occasion for a huge smile.

Thanks for your interest in Project HOPE -- Kathryn Allen, HOPE Public Affairs Officer

Help Support Project HOPE's Humanitarian, Health Education and Volunteer Programs Around the Globe.

Club MEDCAP

Ah, Club Med: exotic locations, sparkling ocean water, comfy beds, and all meals and drinks included. Nothing against hedonistic pleasures, most of us have done our share of beach time. But here on the USNS Mercy? The hot ticket is to Club MEDCAP.

We pause here for yet another acronym debriefing A MEDCAP is a Medical Civil Action Program, and in straight talk, that means that lots of medical providers camp out for a day, three days, or in some cases, a week in one place and set up shop. Then hundreds or thousands of people show up, because for many of them, it’s the equivalent of the Mayo Clinic coming to town.

While anchored near Ternate, six Project HOPE volunteers participated in two different MEDCAPs. Three worked a 5-day MEDCAP in Moratai: Dawn Horowitz, Brian Cox and April Krantz. Alan Jamison, Vanessa Doorasamy and Randy Roark did a 7-day encampment in Jailolo.

All six volunteers worked at a pace unheard of in most American settings, many seeing more than one hundred patients a day. It seems impossible, but when people have waited hours or days to see a doctor you just do what you have to do. At the end of the day, our volunteer doctors, nurses, and pharmacists are beat, and ready to check into Club MEDCAP.

Chow at the Club? A dizzying array of choices, if you don’t mind your food entombed in plastic, and brown cardboard. MREs, or Meals Ready to Eat are available three times a day. Meat loaf for breakfast, anyone? Military intelligence has designed nifty little heaters for the food that are activated by just a few ounces of water, but a lot of people just dive into the candy, crackers, cheese whiz and peanut butter that require no technology. Did you know that there is an iPhone app to let diners know which treats are included in each MRE?

(In full disclosure, it is true that local food is often foraged, and there are more hits than misses there.) After dinner, and maybe a rousing game of gin, our intrepid volunteers are ready to turn in. To get a feel for the accommodations, remember the worst pullout couch you ever slept on. Imagine it one-third the width, and without a mattress. The middle support bar that will press against your spine remains. Then cut some bamboo poles to stretch the mosquito over it. Add a sheet and you are good to go until the cock crows.

We’ll spare you the details of la toilette. Let’s just say there are no six-jet showers, and a bucket of water is provided for flushing.

Our volunteers come home (did I just call a Navy ship ‘home’?) and their rack in berthing suddenly looks like a suite at the Waldorf. They are grizzled, gritty and ready for a long, hot shower. But they are beaming from the experience, and all they want to know is, “Am I scheduled for the next MEDCAP?”

Thanks for your interest in Project HOPE -- Kathryn Allen, HOPE Public Affairs Officer

Help Support Project HOPE's Humanitarian, Health Education and Volunteer Programs Around the Globe.

Community Service in Indonesia

The Navy loves acronyms, and COMMSERV is fast talk for “Community Service.” On their days off, staff and volunteers on the USNS Mercy can sign up to participate in activities designed to foster new relationships between people of different countries. The fact many more people sign up than can go is a sign everyone here is excited to be an ambassador.

Yesterday, Project HOPE’s Sheila Cardwell, a surgical nurse, and HOPE ICU nurse Laura Schlansker, visited with forty or so teenagers who live in an orphanage in Ternate. Some live there because they have no parents, and some are from poor families who have found a sponsor for their child to live where he or she can be educated. All of them basked in the attention of the group in which Sheila and Laura participated.

Sheila is a rare breed of American who actually grew up in an orphanage, so she was particularly interested to see how this one compared. She saw some parallels. “There’s a religious component to both; mine was Catholic, this one is Muslim. And the children are very well-mannered, just as we were taught to be.” “And then,” Sheila continued, “There is the lack of ‘stuff’ in their lives. That felt very familiar.”

The children were lively, friendly, and anxious to talk with the first Americans they had ever met. Sheila brought a cache of inexpensive beaded bracelets and necklaces, and the girls took a long time looking them over, chatting with each other about them, and deciding which ones they wanted to select.

For Laura, it was her first chance to really experience Indonesian culture. “It was hard to communicate with words,” she said, “But we colored and used sign language, and laughed a lot anyway.” Laura was particularly touched when the children sang for them at the end of the visit. “I found out later that the lyrics were about children missing their parents,” she said, shaking her head.

About a week ago, I visited an orphanage in Tidore. I’d been on the waiting list, and at the last minute got the green light. I took along a Slinky and an Etch-A-Sketch, and the organizers brought bubbles, crayons, puzzles, Play-do, and soccer balls. I’m not sure who had more fun, the kids or visitors. I especially connected with three teenage girls –Adi, Tihi, and Veni - who after laughing with me over my attempts to speak Mahasa - gave me a tour. The stucco buildings were clean, and the grounds were lush with vegetation and flowers. But just as Sheila had noted, there was a startling absence of “stuff.” The girls’ bedroom was pleasant but stark, and there were no visible closets or places to store clothing. Despite the lack of things – or maybe because of it? – the children here seem happy, inquisitive, and engaged. Each one has a dream for the future, as do our children everywhere.

Thanks for your interest in Project HOPE -- Kathryn Allen, HOPE Public Affairs Officer

Help Support Project HOPE's Humanitarian, Health Education and Volunteer Programs Around the Globe.

Life-altering Surgery in Indonesia

Two days ago we anchored near Ternate, and our surgical teams went ashore to screen local patients for surgery on the ship. Ternate is a large city with many open-air markets and mosques. But the largest mosque, one easily spotted from the ship, sits cheek-to-jowl with a big box store that looks suspiciously like Wal-Mart. And signs announce that KFC is on its way. I love fried chicken, and I have nothing against KFC. But I’m so grateful we got here before the Colonel.

At the hospital, a crowd of people in the lobby waited patiently to be deemed appropriate candidates for surgery. Upstairs, our Project HOPE anesthesiologist somehow scored the only air-conditioned room. Dr. Patel is a man with a sense of humor he hides behind a face that, at rest, looks morose. One of his potential patients that morning looked equally glum, so Dr. Patel said to the interpreter, “Tell him we will take good care of him.” At that, the briefest of smiles flitted through the patient’s face. The smile got slightly bigger when he was cleared for surgery, and then pointed to the scheduling table. There, HOPE OR nurse Linda Crowell assisted him with the paperwork and the logistics of getting onto the ship. At her elbow was a one-page sheet of Indonesian words and phrases that she valiantly employed in her deep Southern accent.

Patients began arriving at the ship within hours of being admitted, and the operating rooms have been going full tilt for two days. Today, I was given the opportunity to observe a toddler’s cleft palate surgery, a case in which both Dr. Patel and Linda Crowell participated. The toddler is fortunate, a child who will never know the heartache surely experienced by another cleft palate patient who came to us as a young man. When he arrived on the ship two days ago, I had to look away. It hurt to think how he has suffered from this deformity his entire life.

After leaving the OR this morning, I stopped by to say hello to HOPE’s discharge nurse Vicki Bryant, and who was she discharging but our adult cleft palate patient! The transformation is nothing short of stunning. With a virtual wave of the USNS Mercy magic wand, he is now a handsome young guy, one who will certainly see the world – and be seen by the world – in a life-changing way.

Thanks for your interest in Project HOPE -- Kathryn Allen, HOPE Public Affairs Officer

Help Support Project HOPE's Humanitarian, Health Education and Volunteer Programs Around the Globe.

Work in Ternate Begins with a Ceremony

A palace and a chance to meet a real Sultan! Representing Project HOPE at the opening ceremonies for this stop of our mission in Ternate were Lynn Bemiller, our medical director, and Ellen Fernando, one of our nurses who had a day of liberty from her responsibilities in the ship’s pediatric ward. Your blogger went along, too, excited for yet another opportunity to connect with the gracious people of Indonesia.

The American Consul General Kristen Bauer opened the ceremony, speaking entirely in Indonesian. She began her job here only five days ago, and her fluency seems symbolic to me of the extreme courtesy and warmth demonstrated amongst the people who represent the countries participating in the Pacific Partnership.

Resplendent in a traditional palace uniform - electric blue velvet and a thick, woven cap - a spokesman for the Sultanate talked movingly about the historical friendship between the U.S. and Indonesia. U.S. and Australian forces assisted in the safe removal of the Sultan who ruled during WWII and our assistance during the pending Japanese invasion is still remembered nearly 70 years later. A 92-year old former aide to that Sultan was present at the ceremony, and afterwards, explained to us the meaning of the large, gold, two-headed bird called “Zohba” that dominates the pavilion in which the ceremony took place. “It has two heads to represent the many Indonesian people,” he said, “And one heart to show that we are united.” When asked why the heart is upside-down, he said that it indicates that people remember their ancestors and their history.

The Mercy’s Captain Franchetti spoke about how the Pacific Partnership began with the joint relief efforts after the Tsunami of 2004, and how our continued relationships prepare all involved countries for responding to natural disasters.

After all the speeches were done, and gifts exchanged, we were given the opportunity to view the sultan’s jeweled crown, kept under glass and behind heavy velvet drapes. After everyone oohed and aahed, the drapes were again drawn shut, and one of the guards then faced the wall, head down. I wondered if he were saying a prayer of some sort, perhaps required after opening the crown to public display. But no, when he turned, I had to laugh at myself: He was talking on his cell phone. PS. Two cell phones went off during the ceremony, making me grateful that our American phones don’t work here!

Each of the Indonesian leaders who spoke this morning opened his remarks with “Good morning and peace be with you.” Many in the audience responded, “and peace be with you.” Despite the stiffness of all the uniforms, and the formality of these types of ceremonies, the intention and hope inherent in that exchange felt all warm and fuzzy.

We are seeing thousands of patients with medical needs on this trip, yet all that happened this morning reminds me that our mission is so much bigger. We are waging peace, and this morning it seemed that peace among nations gained new ground.

Thanks for your interest in Project HOPE -- Kathryn Allen, HOPE Public Affairs Officer

Help Support Project HOPE's Humanitarian, Health Education and Volunteer Programs Around the Globe.

Teaching - An Important Part of Clinic Work

It’s a classroom on most days, and in the way of classrooms around the world, wooden desks are lined up facing a chalkboard, and colorful posters identify numbers and letters. But today, six of this school’s classrooms in Soasio, Indonesia were arranged and provisioned as medical offices, staffed by an international contingent of medical providers, including Project HOPE volunteer, Dr. Lynn Bemiller.

Soasio is a ten-minute helicopter ride from the spot in the Halmahera Sea in which the USNS Mercy is anchored; and today this team of medical professionals flew in for the last day of a three-day clinic. Once off the helo, the team walked down a steep hill that afforded a view of the town below and the azure coastline. Children rushed to accompany the group to the clinic, and their plastic flip-flops smacked the hot macadam in a calypso chorus.

Hundreds of patients were registered to get eyes checked, teeth extracted, coughs diagnosed, and aches examined. Lynn was one of three providers in the adult medicine “office,” flanked on either side by pediatrics and the pharmacy. Also facing a packed dirt courtyard were the eye clinic, the dental clinic and physical therapy. It seemed every child of the city who was not being examined was hanging over a fence or peering through a window at the excitement.

Lynn began every patient interview in the same calm manner by saying, “My name is Dr. Bemiller, how can I help you?” A nurse/translator functioned as an effective go-between, and after a while, it seemed the language barrier evaporated. One of Lynn’s patients was a ninety-eight year old woman who described the aches and pains in her joints. Lynn elicited a smile from the woman when she said, “There’s just no way to make our joints young again,” before prescribing some anti-inflammatory medicine. So many of the day’s medical solutions were “easy fixes,” but there were too many cases in which the complexity of cases far outstripped our ability to provide care in a short visit. “That’s why this is more about teaching and building infrastructure,” said Lynn. “Working with local physicians is critical.”

The day ended with magic, and this time it wasn’t about a helo ride. As we left the site and walked back up the path, a gaggle of boys caught up and shielded me from the harsh sun with a large umbrella. At the top of the hill we hung out in a pasture waiting for our ride, and I sought the help of an interpreter to ask the boys a few questions. When I asked what they knew about America, they said, “Americans are big and tall.” I then asked if they could sing the Indonesia national anthem for us. There was a slight pause after the interpreter conveyed my request, but then one boy started singing. More kids joined in and soon a group of maybe twenty had gathered were belting out “Indonesia Rava” which I later discovered means Great Indonesia. They sang verse after verse, returning again and again to the refrain:

Great Indonesia, independent & sovereign!
My land, my country which I love
Great Indonesia, independent & sovereign!
Long live Great Indonesia!

I would give up ten sunsets here to share a photo of this with you, but I was so taken with the moment, I completely forgot to pull out my camera. But you can see the beauty in the children from other photos that day.

Indonesia is a great country, lush and beautiful. What a privilege it is to participate in Project HOPE’s mission to provide health care and health education and in turn help build stronger relationships with partner nations around the world.

Thanks for your interest in Project HOPE -- Kathryn Allen, HOPE Public Affairs Officer

Help Support Project HOPE's Humanitarian, Health Education and Volunteer Programs Around the Globe.

Supporting Follow-Up Care

Our first surgical patient, Bobitime, got the thumbs up for discharge yesterday, and the Discharge Planning team was ready to ensure that the boy and his father get home safely.

This team of nurses includes Project HOPE first time volunteer Vickie Bryant. "I wanted to go to Haiti with the California Nurses Association, but it didn’t work out. But in the end it did, because when Project HOPE called, I had all my shots up to date and even had all the necessary gear,”
she says. “This is a life-changing experience,. The exposure to different cultures - including those of partner nations, the Navy, the Army, and even those of volunteers from all over the U.S. – is simply amazing.”

Vickie is a Registered Nurse (RN) and a certified emergency nurse. She works in San Luis Obispo, California in an Emergency Room in which, “we do it all: trauma, open heart, caths, MIs, sepsis, even childbirth,” she says. Of her 10 years in nursing, seven have been spent in the Emergency Room.

Vickie came to nursing after a career in banking and finance. Her mother had been a nurse, so when Vickie was ready to change course, the world of nursing felt familiar. Soon after getting her RN, she also became politically active, rising to become the chief nurse representative for the State of California. She advocates for universal health care coverage and greater safety for both nurses and patients.

Discharge planning is all about safety, so Vickie is in the right spot on this ship. Before patients leave, she reviews their discharge instructions with them, with the aid of an interpreter. She answers any last questions, and then walks down the long ramp to the transport boat. She even takes the forty-minute boat ride with her patients, debarks with them and makes certain that they have transportation ashore to the local hospital or home.

“I love nursing,” Vickie says. “I’ll be doing this until my patients are pushing me around in a wheelchair.”

Thanks for your interest in Project HOPE -- Kathryn Allen, HOPE Public Affairs Officer

Support Project HOPE's Humanitarian, Health Education and Volunteer Programs Around the Globe.

Caring for Kids Aboard the USNS Mercy

Every bed is filled in the pediatric ward on the USNS Mercy today, or maybe I should say every bed is assigned. Walking through the ward, I had to weave between two boys playing soccer with a beach ball, a gaggle of girls coloring at a low table, and parents walking and jostling crying children. I wanted to check on Santi, our little girl in the yellow dress who boarded in Jakarta to have cataracts removed. Pediatric ICU nurse and HOPE volunteer Ellen Fernando guided me to Santi’s bed, telling me along the way that Santi is picking up English at lightening speed. Santi smiled when we crouched down to speak to her, and when prompted, proudly counted to ten in English. “What is your name?” she then asked me.

“Nama Saya Kathryn,” I said, and was rewarded with another smile. “The doctors will check on the vision improvement in Santi’s left eye within the next few days,” said Ellen, “And then make a decision about doing surgery on her right eye.”

We then stop by another part of the ward so Ellen can say good-bye to Bobitime; a young boy who had a hemangioma removed from his arm yesterday, and is being discharged. Santi was our first hospital patient at this stop, Bobitime is our first off.

Ellen, a native of the Philippines, moved to New York City when she was ten and always knew she would be a nurse. After getting her bachelors of science in nursing, she tested for and received her certification in pediatric critical care. She works at the Morgan Stanley Children’s Hospital at Columbia/New York Presbyterian in New York City, but has somehow squeezed in travel to six countries in 2010, with visits to three more scheduled before the end of the year. She started looking for international mission opportunities after Haiti, and her first deployment was with Operation Smile. She wasn’t sure her supervisor would be amenable to her five-week mission with Project HOPE, but was surprised to be told, “You have to do it.”

“Living on the ship has been challenging,” Ellen says. “I didn’t know anything about the military before.” Then she paused to glance over at Santi, resting nearby. “But get me in a room of sick kids, and you’d better get out of my way. This is where I feel most at home.”

Like many of our Project HOPE volunteers, Ellen is continuing to study with an eye on a career in global medical care. She’s beginning a double degree at New York University in the fall and when finished, she’ll be both a Pediatric Nurse Practitioner and have a masters in Global Public Health. It seems a lot of people all over the world will need to stay out of Ellen’s way.

Thanks for your interest in Project HOPE -- Kathryn Allen, HOPE Public Affairs Officer

Support Project HOPE's Humanitarian, Health Education and Volunteer Programs Around the Globe.

Volunteers Begin Work in Indonesia

We dropped anchor near Tobelo, and personnel on the USNS Mercy headed off in all different directions. Advance teams left the ship early to screen between 100-150 pre-surgical patients, and our first surgeries will take place this afternoon. Project HOPE nurse Dawn Horowitz, pharmacy student Brian Cox, and Dr. April Krantz are part of teams being inserted for a five-day clinic in the remote region of Moratai. They will be sleeping and eating on two boats provided by our Australian partners; outside, under the stars and mosquito nets.

Meanwhile, down in pre-surgery, a young man who joined us in Jakarta named Syarif is waiting to be taken into the OR. He’s had a large, disfiguring nevi on his right cheek since birth that will be removed today. But with a big smile, he tells six-time HOPE volunteer Sheila Cardwell, adult NP, that he is relaxed. On hand to make sure he stays very relaxed during the surgery is Dr. Patel, our team anesthesiologist, and third time HOPE volunteer from Alabama. “I do this because I believe it is important to have a civilian counterpart to the military. Showing up and helping in this way is my way to show my flag.”

While visiting with Syarif and his wife Rusmi yesterday, Sheila discovered that they were married only two weeks ago. Sheila asks to see wedding pictures, but the only photos they have are in their phone, and their battery is dead. So she offered to take them on deck at sunset last night, and took some “honeymoon” pictures for them. They were very excited to view the photos and even happier when Sheila offered to make them some prints. At dinner tonight, Sheila reported that Syarif’s surgery went well, and that more than fifty patients are on the ship tonight, awaiting surgery over the next few days.

Dr. Lynn Bemiller, our HOPE Medical Director, was a guest at opening ceremonies in Tobelo, an event that takes place at the beginning of each mission site, and as the Public Affairs Officer, I tagged along. We boarded a small boat, and forty minutes later we were at our destination.

Our Pacific Partnership Captain Lisa Franchetti wowed the large crowd by delivering large chunks of her remarks in Indonesian. You could just feel the wave of surprise and delight among the locals. The Bupati (mayor of Tobelo and the North Halmahera Regency) was in full ethnic dress, as were many of the host city representatives, and children who danced for us. The friendly citizens of Tobelo mingled with us during the reception and even invited us to their homes. But we had to beg off; it was time for us to go.


Lynn and I were smiling at how perfect our day had been as we left the pavilion. And then…the day became even more perfect: We were told we were going home by helo! So we were driven to the town soccer field, where hundreds of children of all ages were running around. They were pretty excited about the helo, too, and when it roared toward us, they ran onto the field, waving. They were waved off by adults while we were instructed how to put on the life vest, and how to buckle in with the five point harness. We then donned very attractive helmets and goggles, ran low under the deafening propellers, buckled in and off we flew. Within a minute we could spot the Mercy, a speck in the azure sea, and then within five more minutes, we were landing.

Just another day in the salt mines.

Thanks for your interest in Project HOPE!
Kathryn Allen, HOPE Public Affairs Officer

Support Project HOPE's Humanitarian, Health Education and Volunteer Programs Around the Globe.