Restoring Sight in Antigua

One of the anesthetists showed a video at last night’s Confirmation Brief. It was an interview with an elderly woman who had 2 cataract surgeries this week and had been blind for 5 years. She spoke with gratitude of how she was able to see her grandson for the first time onboard Comfort. There were many moist eyes in the audience.

Project HOPE volunteers serving in Antigua.

--Tom

Project HOPE Volunteers Experience Record Breaking Days and Technical Breakthroughs

Monday and Tuesday saw record-setting days at the clinics on shore and a technical breakthrough onboard Comfort, and were packed with special events. Where to begin?

The breakthrough was a video conference of a surgery on the Comfort that linked to doctors at Walter Reed. I’m told this is the first-ever ship-to-shore real-time video conference. There was only a 0.5 second delay between what the surgeon on Comfort was seeing and what the doctors at Walter Reed saw. This opens the door for some exciting possibilities. When the medical department on the ship needs a specialist who isn’t onboard, all they have to do is get the specialist to a video room. It will also make surgical screens at the mission clinical sites more efficient by allowing the doctors on the ship to “see” the candidates at the sites one minute, and still be able to get the OR the next minute to do surgery. This will cut down on a lot of the “dead” time getting from the ship to the clinic and back.

The special events – it’s Nurses’ Week. Our educators have been doing training with the Antigua Nurses Association and with student nurses. Many local nurses and students came aboard Comfort in the afternoon for a tour of the ship and some cake and ice cream on the mess deck, and then a group got together for a church service and opening ceremony last night.
Another special event was a visit from the Governor-General of Antigua & Barbuda – the Queen’s personal representative – as well as the Prime Minister and other high government officials. When they toured the ship, they greeted many of the patients by name. It’s a small island, after all!

And finally…the numbers. On Monday, our medical providers set a record for the number of patient encounters on the mission to date, and then on Tuesday broke the record. I didn’t get ashore either day, but I saw everyone come back in the evening, with faces that showed how pleased and proud they were of the work they’d accomplished…and they were tired! Same goes for the providers onboard. We have a total of 150 surgeries booked for the mission, so they are very busy, too! We sent a team by helo to Barbuda on Tuesday. The island has a population of only 1500, and we saw 500 of them that day. And…for the mission we passed the 100,000 health care encounter milestone yesterday.

So Continuing Promise 2009 is on a crescendo…looking to wrap up in Antigua & Barbuda this Friday on a high note!

--Tom

Volunteers Continue Work in Antigua

Myriads of poor, medically underserved Antiguans crowded the two medical sites to receive basic care. HOPE’s volunteers, working at the Multicultural Center and St. John’s School improvised health centers continued delivering excellent medical care to a wide variety of patients. Simultaneously, our ship-based colleagues assisted as the first surgeries were done. Our education team moved ahead with their ambitious professional development program – now teaching Advanced Cardiac Life Support at St. John’s University

-By Dr. Ken Iserson, serving as Project HOPE's volunteer medical director in Antigua

A Note from Project HOPE volunteer Kenneth V. Iserson, M.D.

Dr. Iserson is serving as Project HOPE's Chief Medical Officer onboard the USNS Comfort


Project HOPE's dedicated and experienced volunteer healthcare professionals have fully integrated into the complex workings of the USNS Comfort. We are helping to provide primary health care, surgical services, professional healthcare education, and the necessary administration for the project. The last involved helping other senior officers prepare the materials so that our healthcare professionals could have temporary Antigua licensed.

Our Project HOPE team has become a well-liked and well-respected part of the Comfort's community. Yesterday, for example, we provided 2/3 of the pediatric care at the Multicultural Center, the site of our major on-land ("beach") activities in Antigua.

On a personal note, everyone has been extraordinarily helpful, not only in making us a part of the team at every level (I, for example, am in the Division Head's briefing every morning that I am on the ship), but also helping all of us orient to this enormous ship. While seemingly simple, just figuring out whether you are going forward or aft can be a challenge, until you get oriented.


We're all looking forward enthusiastically to the additional sites we'll visit and, of course, the liberty port, Cartegena, Columbia.

Best wishes, Ken

Photos of Volunteers at Work in Antigua

Linda, Sandy, Tom and Kelly are joined by the "Three Amigos" -- Captain Ware, Commodore Lineberry and Captain Finger -- at the ceremonial turnover of gifts in kind in St. John's, Antigua

Ken, Kelly, Elie, Linda, Sandy, Jan and Darlene muster in CASREC, going ashore in Antigua.

This is how they got ashore. The Coral Ark is easier to embark and disembark but she is SLOOOOOOOOW. Gives us more time to work on tans and enjoy the ever-changing colors of the water.

Lynn, Susan, Michele and Jane good to go for the first day of medical education and training in Antigua.

Dr. Darlene Lee consults with a pediatric patient and her mother in Antigua.

Dr. Ken Iserson and a family in Antigua.

Kelly Magee kept schoolkids smiling at the main clinic site in Antigua.

Jan Auerbach triaged hundreds of patients per day in Antigua.

Sandy Larson with a happy patient.

The Prime Minister and Minister of Foreign Affairs of Antigua & Barbuda gives the opening declaration for the Continuing Promise mission in his country.

Project HOPE Volunteers Begin Work in Antigua

Greetings from Antigua!

The mission here officially began on Wednesday with an opening ceremony in the Multicultural Center. The Prime Minister, the country's Chief Medical Officer and a representative from the Ministry of Health, Social Transformation & Consumer Affairs spoke and then toured the clinic, which was already up and running. A plaque near the entrance of the Center says it was partly paid for by the People's Republic of China...this underscores the diplomatic aspect of Continuing Promise. The Center is just across a channel from the BLZ (boat landing zone). I could throw a baseball from the BLZ to the parking lot, but there's no bridge across, so we take a 5-minute bus ride through the shopping district. Also interesting about the Center...it could be unprecedented in HOPE history as a clinic site...it's air conditioned!!! After the opening ceremony, the AF Band performed outdoors, and the crowd got loose when to Bob Marley songs. The educators, vets and Seabees also began work on Tuesday. The were no big lines for the training like in the Dominican Republic (yet) but the students were very receptive. Yesterday, several Hopies attended the GIK turnover ceremony, met many people from local humanitarian organizations, and stayed on shore to work in the clinic. We enjoyed a leisurely cruise back to the Comfort on the good ship Coral Ark. I stayed aboard Comfort today. As I type this, I can hear the mess hall filling up, so the first group must be back from shore. Have a good weekend everyone!

--Tom

Volunteers Complete Health Education and Care in the Dominican Republic

Happy Cinco de Mayo!

We finished the mission in the Dominican Republic on Friday. Everyone worked incredibly hard to the very end. On the last day alone, there were almost 1,400 patient encounters. While it’s not about the numbers, everyone can be proud of the fact that we saw more patients and taught more students -- in less time -- than in Haiti. The unofficial totals for the country were:

• More than 11,000 patients triaged – including a case of leprosy in early stages
• 206 surgeries in 7 operating days – 30 per day in the 5 OR’s
• 1917 dental encounters
• 4780 students taught in 213 sessions

On Saturday night, Captain Ware sang the praises of all the educators…students had lined up all week for the sessions like it was a Hannah Montana concert (whoever she is)…and one of our own, Project HOPE volunteer Michele Okamoto, was honored as the ship’s Person of the Day.

On Sunday morning, we were visited by the Robert Peary – a refueling ship. The Navy term for refueling at sea is UNREP, or underway replenishment, and it’s simply an amazing thing to witness two huge vessels going side by side in perfect sync for more than two hours. The Comfort took on 500,000 gallons of fuel and the Witch Doctors executed a flawless VERTREP, moving 182 pallets of supplies from the Peary’s flight deck to ours. The ship’s Master, Captain Finger, said he’s done these for 30 years and hasn’t seen a better one.

On Monday, we steamed for Antigua. Most of the crew got the day off, sleeping in and enjoying brunch. In the afternoon, there was a Steel Beach Picnic on the flight deck that was a lot of fun. The highlight was the rain-shortened AF Band concert. The horns were tight and Keisha, the singer, should be on American Idol. She is that good!

Well, we “dropped hook” in St. John’s Harbour in beautiful Antigua about an hour ago, and we just went to flight quarters. The first “serial call aways” have begun, summoning the crew members who are moving our stuff to the sites on shore, and the first helo is taking off as I type. The table and walls are shaking, so I’ll sign off for now!

--Tom

Photos of Project HOPE Volunteers at Work in the Dominican Republic

Elie Malloy charting in the ICU onboard the USNS Comfort

Elie Malloy and Lisa Boatright in the ICU

Lisa Boatright with an ICU patient aboard the Comfort

Dr. Knaster's farewell speech

Boatswain Butch escorts Harry, Lisa, Jan and Judi to the boats

Bon voyage dinner for NGO volunteers. Hopies on right: Harry Knaster, Suzie Piperno, Lisa Boatright, Emily Desrosiers, Jan Eames; on left (next to Big Daryl): Judi Knickerbocker

Enjoy--Tom

An Interview with Project HOPE Volunteer Medical Director Dr. Harry Knaster - Onboard the USNS Comfort

Last week, I sat down with Project HOPE’s on-board medical director, Dr. Harry Knaster, to reflect on the mission in Haiti and take a deep breath before doing it all again in Santo Domingo. Here are some excerpts from the interview.

Dr. Knaster is living his dream on this mission. His career began in Boston, where he provided primary care in a community clinic while working on his master’s of public health degree at Harvard. His plan was to move next to New Zealand and teach epidemiology while pursuing his PhD, but he and his wife decided to stay in the U.S. when they were expecting their first child. He became a residency director in Northridge, California, and later went into private practice in Monterey. Once his children were grown, his wanderlust resurfaced and he began traveling by single-engine plane to Baja California to provide services to remote villages there. When the Indian Ocean Tsunami struck, he journeyed to Aceh and worked in the emergency room of the only remaining hospital facility. He saw the USNS Mercy in the harbor, took a tour of the ship and learned about Project HOPE. Last year, he served as the Project HOPE medical director on the USNS Mercy and visited Port Moresby, New Guinea and several islands in Micronesia.

What attracted you to Project HOPE and your first mission with the Pacific Partnership 2008?

I really liked the philosophy underlying the mission, the idea and expectation of the Navy and NGOs working together to provide a safer and healthier place for people in need.

And so you came back for more of the same on this mission?

I met (Project HOPE's) Dave Eddy and (U.S. Navy's) Captain Ware during the Pacific mission, and enjoyed working with them and knowing that they were dedicated to the same vision as I had formed while on board the Mercy.

Could you describe your duties as medical director?

First, there’s the need to oversee that quality of care is provided and that everyone on the team is doing the job they’re trained/expected to do. It’s also very important to make sure no one is working beyond their physical and emotional capacity. I’m their representative and voice at various levels of decision-making on board as the mission proceeds. And I am also facilitating communication between the caregivers and the non-professional community to insure that care giving needs are being met. And I do some educating when the opportunity is there.

You personally saw hundreds of patients in the six days you were ashore at the clinics in Port-au-Prince, Haiti.

Yes, and I have to say that there has been a major emphasis on this mission in ensuring quality encounters, as well as seeing as many patients as possible.

Did any of your encounters stand out as especially rewarding?

My translator, Joselyn, and I were seeing our last patient at Cite Soleil. She was in her mid-twenties and appeared thin, however, not especially ill-looking. As we had been doing with all our other patients, I introduced myself, as did Joselyn and asked the young woman what was the reason she was seeking medical attention. Her answer was not unlike so many other patients- “I have backache, my stomach aches and I have headaches”. Joselyn and I looked at each other and then looked again at the patient and saw something that didn’t feel right. This woman had something wrong……but we weren’t sure what it was but we both knew it wasn’t related to her initial complaints.We asked some more questions that gave us information about her home life and soon learned that she was the only person cooking, cleaning and caring for at least four other younger siblings and was married to an older man who literally kept her a prisoner threatening her with physical harm if she did not do his bidding. Tears finally came to her eyes as she described her tormented and helpless life. Upon hearing this, Joselyn took out her cell phone and called an agency that protects abused women. She was not able to get through to them, so she took her name and phone number, promising to call her to insure the referral.

Though I do not know the outcome of this encounter, I was fortunate to have the opportunity to work with a bright and empathetic translator who was able to uncover information that would in other circumstances be lost ‘in translation’.

Thanks very much for these insights.

--Tom

Distinquished Guests Visit, Volunteer Work in Dominican Republic Continues

Distinguished Guests and Project HOPE Staff in Dominican Republic Visit with Volunteers onboard the USNS Comfort

Tuesday, April 28 We had more distinguished visitors aboard the Comfort today, including the Ambassador of Ecuador, Jose Villacañas, representatives of the Order of the Knights of Malta – who have supported Project HOPE’s land-based operations in the Dominican Republic since 1996, and many staff and volunteers from the HOPE office in Santo Domingo.

Commodore Lineberry greeted the delegation in the CASREC. Dr. Knaster answered the Ambassador’s questions. The visitors were able to see the entire hospital and capped off their visit with a group photo on the flight deck.

Meanwhile, the Hopies continued their great work treating patients at several sights on the beach as well as on board.

As of April 27, Project HOPE volunteers and their Navy Counterparts have
· Treated 4,658 patients
· Total educational interactions 1,369

in the Dominican Republic

--Tom