Project HOPE Medical Volunteers Complete Latin America Mission--Watch the Video!

More than 60 Project HOPE volunteers provided basic health care, health education and humanitarian assistance to more than 61,000 children and adults who often do not have access to care.

The mission, Continuing Promise 2008, sent two U.S. Navy ships, the USS Boxer to Guatemala and El Salvador in May and June, and the USS Kearsarge to Nicaragua, Colombia, Haiti, the Dominican Republic, Trinidad and Tobago and Guyana from August to November.

Project HOPE volunteers, alongside Navy medical personnel and other NGO volunteers from Operation Smile performed 219 surgeries and conducted 46 health professional training classes for more than 27,000 local health care professionals.

Project HOPE also delivered nearly $2.5 million of donated medicines and medical supplies during Continuing Promise 2008.

Support future volunteer missions to provide health care and lifesaving heath education to those in need around the world.

Project HOPE Volunteers Finish Rotation in Guyana

I’ve been without a reliable connection to the Internet for a few days, so I apologize for the delayed update.

I wanted to give a final recap on HOPE activity in Guyana. While in Guyana’s interior, Project HOPE and the Continuing Promise personnel saw over 4,000 patients at three different clinics across the country. Optometrists handed out glasses, dentists cleaned teeth and medical professionals supplied medication to those in need. And there is a lot of need.

I also visited Georgetown Hospital to learn more about the surgery team’s activities, something I hadn’t had the opportunity to do while living on the Kearsarge. The HOPE volunteers had been training nurses and midwives while a urology team performed approximately six surgeries a day for the past two weeks. When I finally saw them in action on their last day in the operation room they were joking with each other and, literally, operating like clockwork. They understood each other and had a system worked out to make sure their patients were not under any longer than they needed to be. Their time together had formed a cohesive unit that was functioning at maximum efficiency. This group of volunteers came together from Alabama, Virginia, California and New Jersey to help the Guyanese people. It’s great to see a group of strangers from across the USA working together to help the rest of the world.

The visit to Georgetown Hospital also brought home closer to me. In a strange coincidence, the hospital’s scrubs were stamped with “Kettering Medical Center” – the hospital in my hometown of Kettering, Ohio. I’m guessing the scrubs were donated to a philanthropic organization, and by some twist of fate ended up in the cross-equatorial hospital I happened to visit while in Guyana. One of the nurses told me it was a sign that I should visit, so I’ll see you all for Thanksgiving.

The day after my visit to the OR, I stopped by the hospital ward to make rounds with Rob, HOPE’s urologist on this mission. The ward would best be described as a giant open room with wooden floors and rows of beds. While there I asked Anne, a pediatrician that had spent time in other developing nations, how this hospital compared. She said it was about the same and that hospitals like this were a glimpse into the past. It looked like something straight out of period piece set in a British colony. Despite its dingy look, those admitted were up and in good spirits. Some of the patients that underwent prostate surgery were without a catheter for the first time in three years. I can’t imagine the relief those people must feel.

And we were relieved that everything went well. With a day left for tourist activity, some of the HOPE team went out to Kaieteur Falls – an amazing site to behold. Over a celebratory dinner, I had a chance to see the joy on the faces of the medical team and hear the highlights of their trip. Everyone was happy to lend their services and was looking for future volunteer work.

For me, I was happy to visit another part of the world and use my professional skills to help others – something public relations representatives do not usually get to do. I enjoy photography and Project HOPE gave me the opportunity to make good use of my hobby. I would also like to thank the Navy personnel that helped shuttle me around Guyana, in particular Mass Communication Specialist 1 Crawford of the Public Affairs Office. I hope I wasn’t too big a pain in the neck.

I’ll read your comments when I get back and hope you’ll continue to follow the HOPE blog. You never know when I’ll have more entries.

Photos and Blog Entry by John Bobosh

Project HOPE Volunteers Helping Patients Understand their Health

Today I visited the Mabaruma clinic on its closing day. I watched three of the Project HOPE members help patients. One of our staffers, Rachel, spent three days on location and was happy to have spent a few nights in the community. That opportunity allowed her to meet the locals and get a feel for the problems they faced. Supplies and food options are really limited in the area, and asking a person with high blood pressure to radically change their diet might not be an option.

Just like the Santa Rosa site, the doctors were doing their best to treat any ailments with the supplies available, and diagnosed over 300 people while there. A lot of the people came in with skin infections we don't see in the United States. Apparently this is really common in developing nations, as living conditions may not be optimal and medicine to treat these problems is not readily available. The doctors on site were doing their best to treat any ailments with the supplies available, and saw over 300 people in the three days there.

I was told the hard part comes after the patients leave. Just like in America, getting the people to stick to their doctor's recommendations is hard to do. Most of the locals have no formal health education and have trouble understanding the impact of their eating or hygiene habits on their well being. High blood pressure and diabetes seemed common with this population, but these people tended not to stay the doctor's recommended course of action. The locals seemed to think that one dose was enough to cure their problems. They do not realize that they need to continue taking their medication, filling prescriptions or make a behavior change to cure their ailments. The HOPE staff has been working hard to explain that people need to stick to the health plan provided by their doctors.

Low literacy in outlying areas of the country also contributes to poor health education. Teaching proper diet and health maintence activites requires a person to be on location. Medical professionals cannot hand out pamphlets to the people because many of the people cannot read the information. This creates a huge challenge, as the Guyanese Government cannot afford to send out people to talk to every individual in the government.

Tomorrow Project HOPE is donating several tons of medical supplies to the Guyanese Government. I'll be on hand to take pictures and hear what the Guyanese officials say.

Project HOPE Volunteers Help and Bond with Children in Guyana

I finally made it out to one of the three Project HOPE sites in Guyana. It was great, maybe because I haven’t seen dry land in five days or maybe because it was really good to finally see the people we were here to help.

The day started at 0500 with a quick breakfast before mustering in the ship’s hanger bay at 05:45. By 0600, I was on a 45 minute helo (the military is wearing off on me) ride to Santa Rosa - a small, remote area in the northern part of the country. When we arrived on location, all the local children, were gathered to watch the helicopter land. Anne, a pediatrician, was only other HOPE volunteer at this site today.

Anne used to work in international health training and programs with the World Health Organization and USAID, so she has plenty of experience with treating patients in developing nations. I watched her interact with patients, mostly children, for the better part of the day. She treated over 60 patients in 6 hours. A lot of patients had skin infections, dietary problems, chronic pains and other things common in developing nations. Most of these things were treatable on the spot, but more serious maladies were taken back to the Kearsarge for surgery or, unfortunately, turned away because the necessary treatments were unavailable.

I’ve been hanging out with the medial staff, military and HOPE, on this trip on the ship and finally saw them in action. I am truly impressed with their dedication to treating patients. These are wonderful people that are truly out to better the world, one patient at a time. I’m proud to say that many of these people come from America.

At the end of the day, the people not spending the night gathered on the airstrip for our return trip to the Kearsarge. The local children again came out to watch the helicopters come in and pick us up. The boys, all under 12, began to play marbles. I started talking to these guys about the rules of the game. They were all really shy and soft spoken. I sometimes have a hard time understanding the Guyanese Creole they speak, partially because some of their colloquial phrases are foreign to me and partially because I they speak in a near whisper.

After talking to Vivian, a young boy that lived near the hospital we were visiting, I pulled out a deck of cards and asked him if he knew any card games. A short while later I was teaching 40 children how to play a card game.

Photos and Entry by John Bobosh

Project HOPE Volunteer Reports from the USS Kearsarge

Unfortunately, I haven't been off the ship yet. But Project HOPE volunteers and their lifesaving work continue to be covered in the local Guyanese media. I've included a couple media clip links below.

I think I will be on the ship one more day before making landfall. Then, I'll be able to provide more details on HOPE volunteers’ activities. Over the next 10 days I'll be in Mabaruma, Georgetown, Port Kaituma and Santa Rosa - all Guyanese locations where Project HOPE volunteers are working. I'll send more detailed information and pictures once I meet up with HOPE volunteers that have been in the field the past couple days. I'm sure they have some amazing stories to share.

Life on the ship continues to impress me. The people on board are quite diverse. The Navy's Continuing Promise Mission to Latin America, which Project HOPE is a part of, involves service people from all branches of the US military. Canada, France, Brazil and the Netherlands also lend medical staff from their military to support the mission. During my free time I've had the opportunity to get to know the military staff much better.

The Kearsarge crew has all been really friendly. Any time I get lost below deck, which happens a lot, they point me in the right direction. In my exploration, I've seen most of the ship. Several of the crew asked for Project HOPE t-shirts which I was happy to provide.

-John Bobosh

http://www.guyanachronicle.com/topstory.html#Anchor-Presiden-50883

http://www.stabroeknews.com/news/us-warship-set-to-tackle-enemy-diseases/

http://www.stabroeknews.com/news/operation-%e2%80%98continuing-promise%e2%80%99/

http://www.stabroeknews.com/news/region-one-to-benefit-from-us-navy-medical-mission/

http://www.gina.gov.gy/archive/daily/b081112.html#6

Project HOPE Participates in Media Event in Guyana

We are currently off the coast of Guyana. Today I met with the local Guyanese media. There was a press conference held aboard the Kearsarge, and all the groups participating in the Continuing Promise 2008 Mission, including Project HOPE, to Central and South America gave brief summaries of their activities in the region. I may have even been on a TV newscast in Guyana. Scan the web for any updates on Project HOPE in Guyana. Tomorrow the President of Guyana will visit the ship. I hoping for an opportunity to meet with him!

-John Bobosh

Project HOPE Volunteers Arrive in Guyana

I, along with other Project HOPE volunteers arrived on the USS Kearsarge by helicopter this morning to begin our mission in Guyana. Some of us will be will be based on the USS Kearsarge during our two week mission, while other medical volunteers will be based in Guyana itself.

As we approached the ship from the air, I noticed its size. The ship itself is huge; when we landed there were several other helicopters, all with adequate spacing, also on the flight deck. I was curious about the name of the ship, so I searched the net for Kearsarge. According to Wikipedia, Kearsarge is a mountain in New Hampshire and comes from a word that means “notch-pointed-mountain of pines” in the local Native American language. Somewhat appropriate, as this titan of the sea is covered in radio antenna and other pointy objects that could be taken for a mountain covered in pine trees from a distance.

The transition to Navy life has been a good one. I have yet to lean over the railing to check out the name of the ship. But it seems, just as I’ve established my sea legs, I’ll be headed back to Guyana. The HOPE volunteers on the ship will start surgical and clinical rotations tomorrow, helping diagnose locals and perform treatments not available from local doctors. Many of the surgeries are simple outpatient procedures that we in the United States take for granted, such as hernia surgeries and cataract removal. All seem excited and eager to start work. Some of my

Project HOPE shipmates will be shuttled to remote locations in Guyana for several joint missions with the Navy over the coming weeks.

But before we start our mission we have a celebration to attend. The Marines celebrate their birthday today and we’ve been invited to dine with the Commodore. I’m told this is a quite the honor. I’ll let you know how it goes.

-John Bobosh

A Project HOPE Volunteer

As some of our Project HOPE readers know we don't just recruit medical volunteers for our missions. We often try to have a volunteer communications/public relations volunteer to serve as our Public Affairs Officer (PAO) on board too so they can provide us with images, stories and capture the moments on these missions. Below is a blog entry from our newest PAO John Bobosh. He will be aboard the Kearsarge as it works in Guyana.

Happy Reading!

-Marisol

Hi.

Allow me to introduce myself. My name is John Bobosh, and I’m the communications liaison for Project HOPE’s current mission in Guyana. Over the next two weeks I’ll do my best to relate to you what I’ve seen and share stories from the various members of our medical staff. My goal is to provide insight into Project HOPE’s operations in other countries and maybe even inspire some of you to volunteer or donate to this wonderful cause. While I attempt to do this, I’m also going to try to fill you in on Guyana’s history and current situation so you all have a better understanding as to why organizations like Project HOPE are needed around of the world.

Current location: My apartment, Washington, DC.

I just wrapped up a two year stint in the Johns Hopkins University Zanvyl Krieger School of Arts and Sciences. I went in angry (at the price of a credit hour) and came out a lean, mean communication master ready to ruin anyone’s poorly conceived public relations strategy. I currently work for a public relations firm in the District, as the locals call it.

Like any good student, I did a little research on my destination. Guyana passed through the hands of several sovereign nations throughout its history. First the colonized by Dutch in the 1500s, it eventually became apart of the British Empire before receiving its autonomy in 1966. Because of this chronology of imperialism in Guyana, it is the only South American country that speaks English as its primary language. What luck I’m in, because it is my first and, despite my Spanish teachers’ best efforts, only language. It seems most of the Guyanese people also speak a form of Creole. I’ve read up on Guyanese Creole and it seems like I should be able to pick up a lot of what the locals are saying – in theory anyway. In practice, I’ll likely have to ask everyone to repeat themselves three times. I’ll figure out if I’m a capable linguist on my arrival.

To this day it remains part of the Commonwealth of Nations, a group of former British colonies that adhere to a common standard of civil liberties. Because of its history, the demographic makeup of the country is quite diverse. Approximately 43% of the population is of Indian decent (as in from the country India), 30% come from the African Diaspora, followed by people indigenous to the region (20%), and finally a very tiny percentage (less than 1%) of are Chinese or Caucasian. In short, people in Guyana descend from all parts of the globe.

I also looked at other census information. According to the CIA’s World Fact book, Less than 800,000 people live in the country. The infant mortality rate in Guyana is approximately 30 deaths for ever 1,000 live births. To put this in perspective, it is five times higher than in the United States of America – meaning that medical standards are not considered the most modern. The gross domestic production totals something near $1 billion US, mostly from the mining of minerals and precious stones, a fraction of a percent compared to America’s $14 trillion. While the average family income is less than $3000, literacy in the country is very high, at 99% literate.

After reading all these, my mind is at ease. The country itself seems rather peaceful and pro America (something you have to worry about these days). I’m still a little apprehensive about living on a Navy cruiser for a couple weeks, but I figure it will be an experience I wouldn’t have otherwise.

Project Hope Medical Volunteers See Patients in Dominican Republic

A team of 10 medical volunteers from Project HOPE contributed their time and skills in October, in the Dominican Republic, as part of Continuing Promise 2008. A humanitarian initiative with the US Navy and other humanitarian organizations providing health care and health education to communities in need in Latin America.

Temporary clinics were set up at several locations in the country, including in Dominican Republic Naval bases and sports complexes. Each morning, hundreds of people lined up, some before dawn, to be screened and treated. Dentists, ophthalmologists, and optometrists treated some people on site.

Other personnel included pediatricians, dermatologists, general surgeons, family practitioners, nurses and nurse practitioners, medical educators, a midwife, and for four-legged patients, veterinarians. Several of the HOPE volunteers were also fluent in Spanish, which greatly facilitated the treatments.

Project Hope volunteer Maria Morris, a nurse educator and current student in the University of Texas-Houston Nurse Practitioner program, had the opportunity to teach CPR to medical students at the Universidad Autonomo de Santo Domingo, the oldest university in the Americas. Speaking to about 100 students in the university physiology classes, plus an interested number of doctors, Maria was able to give the latest live-saving techniques, using both adult and infant dummies.

“Many had no experience in modern CPR so this was a good class for them. After giving them some basics, they practiced on the dummies for most of the time,” she said. “This is valuable knowledge that they could take away from the lesson. We did several scenarios, such as choking and being injured in a car accident. The students were so enthusiastic about learning; it made it fun for everyone.”

Licensed midwife Lillian Sanpere of Tallahassee, Florida counseled several pregnant women who came to the Bayaguana Sports Complex for treatment, about healthy eating and good prenatal care. “In general, they seem to be well-cared for and like most women, just want some added assurance or vitamins,” she said.

Because volunteers were living and at times working on the USS Kearsarge they had to quickly became accustomed to life aboard the a ship, including climbing steps and ladders to various levels, sleeping in narrow berths, and getting their ‘sea legs’, often during the choppy seas of hurricane season.

Linda Rothery, a family nurse practitioner, summed it up this way. “I never thought I would ever get to do something like this. I’m so glad I came. I wouldn’t have missed it for anything.”

-By Inga Kimple

Project Hope Volunteers Visit HOPE Clinic in the Dominican Republic

Several Project Hope volunteers, participating in the 2008 Continuing Promise campaign, were able to visit one of the nonprofit’s clinics in the Dominican Republic in October. Doctors Lydia Segal and Nancy Foote, PACU Nurse Julia Taylor, Midwife Lillian Sanpere, Family Nurse Practitioner Rena Rovere, and Public Affairs Officer Inga Kimple, made up the team. As part of a joint mission by US armed services, the US Public Health Service, several foreign countries and other non-government agencies, the group flew the first leg of the journey in a US military helicopter, and then were driven from Bayaguana to Monte Plata by van.

“Maternal Child Clinic of the Order of Malta, one of two such clinics supported by Project Hope and the religious order in the Dominican Republic, has been offering services since August 2003. First begun as a facility for mothers and children, prioritizing the most vulnerable, the facility now also sees the general, underserved population three days a week,” said Teresa Narvaez, Project HOPE Dominican Republic Country Director. “Here in Monte Plata we have a great need for our services.”

To commemorate the visit by the U.S. volunteers, a health fair was held. Patients were able to see both the visiting doctors and regular staff, have some general health questions answered, and receive printed health literature.

The clinic, which typically sees from 80 to 100 patients a day, is actually able to process up to 300 lab tests in its state-of-the-art laboratory. With its clean, open and airy waiting rooms and examination areas, everything is cheerful and efficient. The facility also has dental and optometry offices and a well-stocked pharmacy. Patients are asked to pay on a sliding scale for prescriptions and supplies. But there are no doctor fees.

“The doctors live about an hour and a half away in Santo Domingo,” said Clinic Coordinator Angela Alban. “They want to help and generally stay a year or two. Then the long drive gets to be too much and we have to replace them. But we use them a lot while they’re here. We also have an endocrinologist who comes in on a regular basis.”

As part of its original mission the clinic offers general medicine, pediatrics, obstetrics and gynecology, childhood vaccinations, and sonograms. Health education, home visits and various types of follow-up in the community are also an important part of the routine.

During lunch, the visiting Project Hope volunteers were treated to a sampling of Dominican Republic typical fare: seasoned chicken, potato and carrot salad, rice and beans, and a visit from the clinic’s major donors. Señor Cesar Medina, a cattle rancher and farmer, along with his wife, Francia, gave the plat for the clinic and continue as major benefactors, Alban said. In the near future, Medina will also develop a housing project and various businesses behind the clinic.

“When they built the clinic, there was nothing here. Now the government has put in the new street and bridge and the sports complex across the street,” Alban said. “It has really added to the area.”

The volunteers also met Ruben Ottenwalden, another Project Hope volunteer, who returned to his native Dominican Republic after living 30 years in the United States. Ruben, whose real name is “Bienvenido” or ‘Welcome’ in Spanish, has, along with his wife, adopted several children and feed about 35 more, several times a week.

“People thought I was crazy to return here. But, sometimes what we feed them is the only food they have all day,” he said. “We just try to do what we can.” A few days later, the volunteers were able to meet with Ottenwalden again in Santo Domingo, to pass on several bags of clothing and supplies, as they lightened their luggage for the return trip home.

-By Inga Kimple

Project HOPE Volunteers With U.S. Navy in the Dominican Republic

Ten members of a Project HOPE volunteer medical team were recently deployed for a mission to the Dominican Republic, only one of several countries in Latin America that was chosen for the U.S. Navy’s 2008 Continuing Promise Campaign.

The doctors were housed aboard the USS Kearsarge, as were medical personnel from the Netherlands, Canada, Brazil, and France. U.S. military and uniformed services taking part in the Dominican portion of Continuing Promise aboard the Kearsarge were the Navy, Air Force, Marines, Coast Guard, Army, and Public Health Services, along with another non-profit agency, International Aid. In another aspect of the campaign, the Army Corps of Engineers built washed out bridges and playgrounds, and veterinarians vaccinated domestic animals.

Cmdr. David Damstra, M.D. the officer in charge of the surgical team, said that the deployment at the height of hurricane season was “by design” to better assist those Caribbean nations who might suffer from the storms’ impact. “Project HOPE is an integral part of this team,” he said. “If need be, we can give immediate relief by helicopter.

Because Dominican Republic was not severely damaged by hurricanes this year, several secondary sites on the island were established to screen and treat patients. Surgical patients were taken aboard the Kearsarge for treatment.

Three of the Project HOPE team, PACU Nurse Julia Taylor of Tucson, Anesthesiologist Dr. Enrique Abreu of Portland, and General Surgeon Dr. Sharon Weintraub of Baltimore, were aboard as part of the overall surgical team. Drs. Abreu and Weintraub spent the first several days in Santo Domingo, at Dominican Naval Base 27 de Febrero, identifying prospective patients for the surgeries which were carried out on the latter part of the mission. Dr. Weintraub also performed an emergency appendectomy on a crew member.

“I’m very pleased by the unity of purpose during this mission. Everyone has melded together as a team,” commented Capt. Frank Ponds, the Commodore of the U.S. Navy’s Southern 4th Fleet, who is aboard the Kearsarge for the mission. “Sea spray is a great equalizer.”

Cmdr. Ponds said that Continuing Promise is planned as an annual campaign in Central and Latin America, as part of the Navy’s humanitarian campaign, after this year’s success in integrating other services and non-profits.

Other Project HOPE team members include Dr. Hilary Warren, a pediatrician from Boise; Dr. Lydia Segal, a family practice doctor from Washington, D.C.; Rena Rovere, a family nurse practitioner from Albany; Lillian Sanpere, a licensed midwife from Tallahassee; Linda Rothery, a family nurse practitioner from Florida; Maria Morris, a nurse educator from Houston and the project medical director, Dr. Nancy Foote, a family practitioner from Seattle.

-By Project HOPE Volunteer Inga Kimple

Project HOPE Volunteers Help in Haiti

Just before the USS Kearsarge continued on its way to the Dominican Republic three of Project HOPE's volunteers had the opportunity to join the US Navy in offering aid to the people of Haiti. Haiti was not originally scheduled as a stop but hurricanes forced the USS Kearsarge to change route in order to help the country whose washed out roads had made it impossible to get aid to certain regions. At the time Project HOPE only had three volunteers aboard as all the other volunteers had been originally scheduled to join the Kearsarge in Panama but due to the change they were diverted to the Haiti just in time to join the crew as it departed for the Dominican Republic. Below is an account of the team's work in Haiti.

Happy reading,
Marisol
_______________________________________________

Working with the United States Navy in Operation Continuing Promise in Latin America, Project Hope volunteers on board the USS Kearsarge were diverted from humanitarian projects in Columbia and Panama to bring food, water and other relief supplies and emergency medical care to Haiti after the island of Hispaniola was the target of four major hurricanes: Fay, Gustav, Hannah, and Ike.

After an initial rapid assessment of Haiti’s needs by the Navy, areas cut off by washed out bridges and roads were targeted for aid. According to the Navy Officer in Charge, Captain Tim Shope, M.D., many of the villages had no lines of communication open and were accessible only by helicopter. “We evaluated the sanitation, medical, and food needs at each site, which then allowed us to work with the non-government agencies and the other military branches to set up emergency clinics,” he said.

One of the first Project Hope volunteers to see patients was Dr. Hilary Warren, a pediatrician from Boise, Idaho, who worked alongside medical personnel from the United States Public Health Service (USPHS) and the Canadian Forces. U.S. Coast Guard, Marine Corps, Army, and Air Force medical services are also present for this mission, as are members of the Brazilian and Dutch armed forces.

After landing on a mountaintop in a Navy CH53 heavy lift helicopter, Dr. Warren, a veteran of Peruvian and Honduran medical missions, was greeted by the Gros Morne mayor and a large group of enthusiastic citizens, including many children and animals. The colorful parade walked some two miles to a makeshift clinic, where over several hours the three doctors saw 206 patients, while veterinary teams administered basic animal care and vaccinations.

“We used one room of the school and turned around the wooden desks to make examination tables,” Dr. Warren said. “One of the Canadians served as a French interpreter and one of the locals translated Haitian Creole, when needed.

“Most of these people were living in a shelter in Gros Morne because they were displaced by the storms, but in general, although there was some malnutrition, this particular village was in pretty good shape. Because clean water was being provided, there was little diarrhea.”

With the overall hardship in the country, Dr. Warren said she saw many cases brought on by what she termed ‘the pain of poverty.’ “Adults often complain of non-specific pain saying they ‘hurt all over’. This is common in populations that spend their lives in backbreaking farm work, or other chores such as drawing water from wells and carrying it for miles on their heads,” she said. “Life is not easy here and by the time they’re middle-aged, their bodies break down.”

Family Practitioner Dr. Nancy Foote and Family Nurse Practitioner Linda Rothery worked nearby in the village of Terre de Negre. Along with another USPHS physician they established their clinic in a church that doubles as the village school, and were able to see about the same number of patients as the other site.

Both women bring a wealth of experience and compassion to their service. Dr. Foote, a family physician from Seattle spent over two years in the bush in Zimbabwe with the American Friends Service Committee. The Operations Manager, Medical Director, and Chief Education Officer for the Colombia, Haiti, Dominican Republic and Trinidad and Tobago portions of Project Hope’s current mission, Dr. Foote spent most of her career caring for migrant and seasonal farm workers in eastern Washington and most recently worked as a Spanish medical interpreter for the University of Washington Medical Center.

Ms. Rothery, now enrolled in a doctorate nursing program at the University of Florida, is a former care flight nurse who was often sent to rescue injured coalminers in the mountains of Virginia. Upon graduation she plans to serve in international mission work.

After the Haiti mission was complete, Captain Frank Ponds, Commodore of the Kearsarge which is operating under the Southern Command Fourth Fleet, gathered the medical teams together for some well-earned praise. “This mission was seamless with a high degree of professionalism. Your passion and compassion resonates,” he commented.

-By Project HOPE Volunteer Inga Kimple

Project HOPE Volunteers Continue Continuing Promise '08 Mission

Volunteers from Project HOPE are participating in their fourth humanitarian assistance mission with the United States Navy this year. Embarking the USS Kearsarge in Haiti, there are currently 10 volunteers from across the United States aboard to provide health care and health education as part of Continuing Promise 2008 to Central and South America. In all nearly 50 Project HOPE volunteers will join colleagues from non-governmental organizations and Navy medical personnel to provide basic health care, health education and humanitarian assistance to children and adults who often do not have access to care.
-Marisol

Meet the Project Hope Team Currently Aboard the USS Kearsarge

Julia Taylor, PACU RN
Residing in Tucson, AZ, Julia is a former teacher, and civilian computer scientist for the federal government. Julia enjoys reading, camping, and biking. She will remain on the ship most of the time in Dominican Republic, as cases are brought into the operating room.

Lydia Segal, MD
Lydia is a family practice doctor. She is a former journalist, who went into family practice, then integrative medicine, and is back to family practice. She grew up in the Bronx, attended college and medical school in Arizona, and now lives in the Washington, D.C. area with her husband.

Rena Rovere, MS, FNP-C
Residing in Altamont, NY, Rena is a family nurse practitioner who regularly volunteers with Compassion in Action. She has 25 years as a clinical nurse specialist in the emergency room and has seven years experience as a family nurse practitioner. She enjoys biking, swimming, walking, reading, and is practicing her Spanish. She and her husband have three grown children.

Sharon Weintraub, MD
Sharon is a general surgeon at a hospital-based trauma/critical care/acute care practice in Baltimore. Born and raised in New York, she moved last year from New Orleans where she studied public health at Tulane University. She also worked with Doctors Without Borders last year at a project in West Africa. Sharon was able to perform an emergency appendectomy on one of the crew members assigned to the USS Kearsarge.

Hilary Warren, MD
Raised in Kansas City, Hilary works in a large pediatric practice in Boise, Idaho. After training in the Midwest, she participated on medical missions in Peru and Honduras. The youngest member of our team at 33, Hilary enjoys the many outdoor activities of Idaho, and keeps fit in the USS Kearsarge gym while on board.

Linda Rothery, FNP
Linda is a family nurse practitioner and is currently enrolled in the doctorate program at the University of Florida and is using her Project HOPE experience as an elective independent study course. A breast cancer survivor, she worked in post-Katrina clean-ups and was a volunteer at the 2004 Summer Olympics in Greece. She plans international mission work after graduation.

Maria Morris, RN, MPH
Maria, who grew up in New York, was a nurse educator at UC-Berkeley “many years ago”. Now she is a student at the University of Texas-Houston in the nurse practitioner program, and has worked in women’s health in the Middle East and in Venezuela. Her husband is a petroleum engineer currently stationed in Saudi Arabia, where Maria spends six months of the year. She and her husband have two sons. Maria makes one of a kind character dolls for fun and speaks fluent Spanish “thanks to my Puerto Rican parents.”

Nancy Foote, MD
Nancy is the Medical Director, Operations Manager, Chief Education Officer, and everything in between for the Project HOPE team. With her great energy and enthusiasm, she makes everything easier. A family physician, she currently resides in the Seattle area. Her areas of service include over two years in Zimbabwe with the American Friends Service Committee, working with the migrant workers of the Northwest, and most recently a position as a Spanish medical interpreter for the University of Washington Medical Center. She has two grown children.

Enrique Abreu, DO
Enrique is an anesthesiologist who belongs to a large private practice in Portland, Oregon. Of Cuban descent, Enrique has cousins in both Puerto Rico and Dominican Republic. In the last three years, he has been on eight medical missions, mostly with ROTOPLAST, traveling to Venezuela, Mexico, and Brazil. He is a fluent Spanish speaker who enjoys taking photos with his Nikon, listening to a large variety of music, and at home, kiteboarding.

Lillian Sanpere, LM, CPM
Lillian has a birthing center in Tallahassee, FL where she takes care of pregnant women, births babies and trains new licensed midwives. Born in Miami, she was raised in the Caribbean. While on liberty in Puerto Rico, she was able to visit with her two sisters who she hadn’t seen for several years. Lillian is a strong person who after her last chemo treatment for colon cancer, made plans to walk the Camino de Santiago in the Pyrinnes Mountains in Spain. She walked nearly 400 miles and the following year, walked another part of the trail for over 500 miles.

Inga Kimple, BSJ
Inga is the Public Affairs Officer for the trip. Now residing near Cincinnati, she has lived in eight states and is a semi-retired journalist and freelance writer. When not writing, she spends a good deal of time in the Yucatan, working with the Maya, and in Ohio works with the Hispanic population and as an English as a Second Language tutor. She was on four post-Katrina trips in Mississippi. She also enjoys living near her family, especially her two young grandchildren.

Project HOPE Volunteers Don't Slow Down Their Pace

This is the last blog entry in the series "Snap Shots from the Field" written by Project HOPE volunteer Lynne S.

Lynne, a freelance writer from Oregon, was HOPE's volunteer Public Affairs Officer (PAO) on the USS Kearsarge while it was in Nicaragua. Thanks for your hard work Lynne!

Happy reading!

-Marisol

Snap Shots from the Field... "Everyone will be this day."

Project HOPE volunteer nurse Michelle Pena listens through a stethoscope, then tells another woman that her heart sounds good. Pena’s eyes lift when the woman hands her a foil packet of medications she was told to take. Pena and a military doctor carefully scrutinize the packet, trying to determine what kind of medication it is.

A cooling breeze flows through the open windows of the classrooms. Shadows disappear and the lines outside slowly dwindle to a few dozen people.

As the day winds down, medical providers are acutely aware of people still in line, many of whom have waited all night to see someone.

Most of the doctors and nurse practitioners see an average of 50 patients each day. They are exhausted, yet no one slows down their pace.

There are just too many people who need help. Fortunately, everyone will be seen this day.

Project HOPE Volunteers Dispense Education Not Just Medication

In this excerpt from Lynne's notes she writes about the different ailments, sometimes uncommon in the US, Project HOPE volunteers see on these missions. She also writes how volunteers also try to dispense education to their patients while treating them.

Thanks for reading!
-Marisol

Snap Shots from the Field... "Every contact with a patient is an opportunity to educate."

The mother is clearly proud of her son. He’s a handsome boy with bright eyes and hair neatly brushed back from his forehead. Her hand drifts over his shoulder and her fingers gently alight on his back as Project HOPE volunteer MD Dale Rai quietly asks him questions. The boy, maybe about 12 years old, appears to be in good health.

The mission offers doctors like Rai the chance to tackle cases not normally seen in a standard practice, like malaria and dengue fever. But for the moment, another patient arrives and the man in front of him is complaining of a sore back. To the bemusement of his patient, Rai drops down to his hands and knees and slightly arches his back to demonstrate an exercise that will relieve back pain.

For many people, this is their only chance to see a doctor. The Project HOPE volunteer doctors and nurses who have descended on the school are some of the best in their field. But even so, health care this day comes in a bare bones classroom with rough cement floors, no private rooms and only the instruments carried on shore by doctors and nurses. People plagued by problems for months, even years, are hoping doctors can do something, anything to help them.

Inside another classroom, Christopher Truss listens as a translator tells him the woman in front of him is complaining of worms that have crawled up her GI tract. He’s seen it many times before. “They block your intestines and you pass worms in your stool,” the gastroenterologist says matter-of-factly. Worms are endemic within the local population and de-worming for parasites is one of the most common problems encountered by medical providers.

“Many people are the walking-well,” says Truss, “people with chronic problems but no access to care. He admits that not every problem can be dealt with, “but even some suggestions can make a huge difference,” he says. Every contact with a patient is an opportunity to educate; telling patients to frequently wash their hands or to clean food with boiled water is just as significant as dispensing medications.

All day a Navy combat photographer weaves in and out of the various clinics set-up in classrooms. One moment he’s assisting an injured man through a door, the next, snapping compelling photos of the people who have come here this day. “This is the best work I’ve ever done while in the military,” he says proudly.

And so it goes throughout the day. Teams of translators, medical providers and support staff work their way through a maze of problems hour after hour. They sit without complaint, listening, questioning, and utilizing the best of their expertise.

“Easy, easy, does it hurt?” Rai asks while scraping a benign tumor from one man’s scalp.

Project HOPE Volunteers Offer Care to Women and Children

Lynne S. accompanied Project HOPE volunteers day in and day out as they headed back and forth from the USS Kearsarge to shore to provide care for the people of Puerto Cabezas. Below she recounts what she sees and hears in Puerto Cabezas, Nicaragua.
-Marisol

Snap Shots from the field...Life in Puerto Cabezas

In Puerto Cabezas’s grinding poverty is awash in contradictions. One Nicaraguan woman familiar with Puerto Cabezas tells me how air conditioned taxis wait down by the docks for returning lobster fishermen whose pockets are loaded with cash. Lobster divers squander their hard-won cash on drugs, prostitutes, and air-conditioned taxis that drive them around all day. Little money reaches their families, she says.

Nonetheless, poverty is extreme and it’s the women and children who bear the brunt of it. Lack of working infrastructure means garbage is heaped everywhere you cast your eye: on sidewalks, streets, around the tiny wooden shacks that serve as unofficial stores. At the local hospital, buzzards feed on medical waste left on the ground. Piles of moldering garbage are scattered throughout the hospital’s boundaries, crowding the walkways that one worker swabs with a wet mop and some kind of disinfectant. Her efforts seem utterly useless.

What’s even more striking is that, despite the poverty, locals show up at the clinic in clean shirts and dresses, obviously their very best clothing. Little girls arrive in flouncy princess-style dresses that bring out the cameras. It could be a sign of respect for the volunteers at the clinic, or it’s simply customary to dress in your best when seeing a doctor.

Indeed, there is no mistaking the importance of the moment. People listen intently to the visiting U.S. medical personnel, leaning forward, absorbing every word spoken, whether it’s in Spanish, fluently spoken by many of the doctors and nurses, or through Miskito translators.

A Project HOPE T-Shirt is a Symbol of HOPE

In the excerpt below Project HOPE volunteer public affairs officer Lynne S. recounts how the hundreds of patients waiting to be seen by the American doctors and Project HOPE volunteers mistake her for a health care provider as she walks around the clinic in Puerto Cabezas, Nicaragua and what a enlightening experience it is to realize that her Project HOPE t-shirt is much more than just a uniform to the people waiting in line.

-Marisol

Snap Shots from the Field...“Excuse me, miss, can you help me?”

Leaning over the wire fence and dressed in a white ball cap, open-neck shirt and jeans, Roy Fredrick, 27, has spotted me in my “Project HOPE” t-shirt. As I turn, a broad smile spreads out over his smooth-skinned face. “My grandmother needs help,” he says, gesturing to a nearby elderly woman sitting on a fold-up chair. Her eyes are blurry and in pain, he says, hoping that I will somehow fast-track her inside.

The screeners have heard every story possible from people who are desperate to get to the head of the line. Lines begin to form around 3 a.m. as locals wait for the Continuing Promise teams to arrive each morning. Many say they have walked 7 or 8 miles to get to the clinic.

I speak to one of the military screeners, asking if it’s possible to get her in early. He shoots me a weary look. It’s a request he’s probably heard not once but dozens of times this morning. Everyone is sick; everyone wants to get in first.

While we wait, Roy, born in the south near Bluefield, tells me that health care is almost impossible to get. People have come today because they know the U.S. has the “best people and the best pills. It’s a big opportunity to get help.”

While talking, we are rapidly surrounded by people pressing against the fence who mistake me for a doctor or nurse. Five or six people clamor to speak to me at once. One man pulls his eye lids down, gesturing at me to take a look. Another shoulders Roy aside and speaks to me in Miskito, the indigenous language, while he pleads for help.

It’s a sobering moment. Earlier that morning, I casually slid on my Project HOPE t-shirt while dressing, giving it little thought. Suddenly it’s no longer a garment worn for work, but a potent symbol of hope.

Project HOPE Volunteers Completed Important Work on the USNS Mercy

David Eddy, Project HOPE's Operations Officer onboard the USNS Mercy Profiles Volunteer Lynne Bouffard

It was another rainy morning that turned hot and humid at the Waigani village, the primary care medical site in Port Moresby, Papua New Guinea. The local population had lined up as early as 0230 in the morning with hopes of receiving free medical care provided by the USNS MERCY health care provider teams. These teams were comprised of Navy staff, partner nation medical staff, Project HOPE volunteers and other international groups.

Project HOPE has once again supported the U.S. Navy in the Humanitarian Civic Assistance (HCA) mission, Pacific Partnership 08 to Vietnam, Timor Leste, Papua New Guinea, and the Federated States of Micronesia aboard the USNS MERCY Hospital ship. As the Operations Officer for this HCA mission I was blessed to have such a devoted and dynamic team of health care providers with me. Physicians, Pharmacist, Pediatric and Family Nurse Practitioners, Midwifes, Medical-Surgical Nurses, PACU Nurses and Nursing Educators from all over the U.S. brought a plethora of skills and talent. In all, Project HOPE brought 34 volunteers to these missions.

One of Winchester’s own, Dr. Lynne Bouffard, a Family Nurse Practitioner gave up 40 days of employment to volunteer her services to Project HOPE for this worthy cause. Because of Lynne’s expertise, she was used extensively in both the Papua New Guinea (PNG) and Micronesia medical missions that covered over 18 different sites for one to three day intervals.

Lynne’s typical day was getting up at 0430, eating a very small and limited breakfast, and reporting to the rallying point called Casualty Receiving area to muster (Navy word for accountability formation), and picking up her MRE for her lunch meal. MREs or Meals Ready to Eat are a high calorie meal in a plastic bag used on a regular basis by our military. After muster the boarding of the band-aid boats (a small Navy boat used to transport up to 20 people) would commence to transport all to shore. Transferring from one moving ship to another in the open sea can be a tricky, and it’s always a wet experience. Once ashore, all providers are moved across land by local buses to their designated work site. Everyday regardless of the site location the scene was the same. A line of people waiting in the morning rain sometimes extended more than a mile long on the muddy paths leading to the work site. Very few of the people wore shoes, but those that did displayed sandals that for the most part had been worn out some time ago. Tired and wet by the time they reached the front of the line to be treated, they always provided the greeting of the day with a big smile. More times than I can count the people would say to me and the rest of the providers, “Thank you for what you are doing for our people. God bless America”.

Respiratory illnesses in all age groups ranging from mild upper respiratory infection to tuberculosis, asthma, and pneumonia are quite common. Malaria in PNG is an enormous issue. HIV rates are high, and leprosy a disease uncommon in the U.S. is also an issue.

The team by the end of each day had seen over a thousand people. At 4:30pm, all equipment would be packed up for the return to the port to be transported back to the USNS MERCY ship. Dinner, the Commodore’s daily update, and Project HOPE's daily review meant that Lynne and the rest of our volunteers were free to shower and go to bed after 8:30PM. A long day for anyone, and certainly a long day for a volunteer that has traveled so far from home to provide medical care to a people that seldom ever see a health care provider.

As long as the days were, Lynne never complained once. Every evening when I would ask her how her day was, she would always smile and indicate “I had a great day”. While her experience was great, she and the rest of us paid an emotional price for the suffering from illnesses and injuries that we witnessed on a continual basis. You can’t help but lose a piece of your heart to these very sick children and adults. While Lynne’s stories could be many, she was humbled just to be in their presence and to assist them in their time of need.

The people of Winchester can be very proud of what Lynne and many like her do out of the kindness of their own heart. We at Project HOPE are blessed to have such professionals represent us every single day in these endeavors. They give up their jobs, vacation, and retirement to support such a noble calling. Project HOPE's credibility and legacy are a direct reflection of their absolute professionalism and the spirit of American volunteerism.

Lynne is no stranger to volunteerism. she was the first nurse practitioner hired by the Northern Shenandoah Free Medical Clinic to provide care to the working poor. She continued to volunteer at the clinic for over 7 years while working at Selma Cardiovascular Associates in Winchester . In 2006 she was awarded the Free Medical Clinic Volunteer of the Year. she presently lives in Fredericksburg with her husband David and children Jennifer and Jonathan

David A. Eddy
Pacific Partnership Operations Officer
Project HOPE

Project HOPE Volunteers Offer Comfort in Nicaragua

Snapshots from the field are notes and stories collected by Project HOPE volunteer and freelance writer Lynne. Lynne joined our medical volunteers as they worked along side the team from the USS Kearsarge for Continuing Promise '08--a humanitarian mission to Latin America involving non-governmental organizations, the U.S. Navy and government organizations. In the excerpt below volunteer Lynne recounts the story of a lobster fisherman from Puerto Cabezas, Nicaragua. Lynne spoke to the fisherman as he waited be seen for his paralysis.

-Marisol

Snapshots from the field...Fishing for Lobster

They are visible everywhere. Men with weathered faces awkwardly hobble around with canes and walkers; others manipulate curious home-made wooden wheelchairs that look like carts with levers spun around to propel the cart forward.

Robert Gilberto Mendiola looks older than his 37 years. Laboring for every breath he takes, he shuffles along with the aid of a walker. He barely covers a foot before he stops, utterly exhausted.The lobster fisherman is paralyzed on his right side. Clad in a blue t-shirt and embroidered jeans, he swabs his face with a face cloth. There is no expression on his face, or hope in his eyes. He's come here this day expecting Project HOPE to cure his debilitating injury.

A lobster diver for 20 years, Mendiola is a casualty of an industry where untold numbers of men are paralyzed, maimed, or killed as they drop to ever greater depths in search of lobster. The more lobster grounds are over-fished, the deeper they dive. Safety standards appear to be non-existent and decompression sickness is rampant.

Through a translator, Mendiola claims he can hold his breath for 30 minutes; he says he plunged to 130 feet. The dangerous work left him with a decompression injury, paralysis and a wife and six kids to feed. Five hundred men have died where he works, Mendiola says.

He jiggles one knee in agitation as he speaks. "It's the only income they have; there is no other way to survive," the translator explains while Mendiola falls silent. "No jobs in the city (Puerto Cabezas)." Lobster divers are a major source of income for the town. The temptation to take such risks is great. I learn that a lobster diver can earn $500 US and more for 12 days of work.

Many now are making less as lobster grounds are depleted and divers plunge deeper and deeper in search of them. How will Mendiola feed his family?"Only God knows," he says. He needs help to stand. He looks down towards the pharmacy set up by Continuing Promise 2008. Anyone else can reach it in a swift few steps; it will take Mendiola a good five minutes even with the aid of an enlisted man. He can't afford painkillers, but today, they are free at the clinic. He knows nothing can be done for his paralysis, but he came anyway, desperately seeking answers.

Project HOPE Volunteer Lends an Ear in Nicaragua

Below is another excerpt of notes and stories from the Nicaragua portion of the Continuing Promise mission. These notes and stories are of our volunteers and their encounters with local patients in the coastal town of Puerto Cabezas and were written and compiled by Project HOPE volunteer Lynne S. Enjoy!

-Marisol

Snapshots from the field..."It was important that someone listen to him."

Nearby in Medicina General # 2, Eddie drops his motorcycle helmet on a desk and slides into the cramped school desk in front of Project HOPE volunteer Maria Rivera, who is a family Nurse Practitioner (NP) and a certified nurse mid-wife.

Perspiring, hesitant, his face is lined with weariness. Five years ago, he slowly tells Rivera, he was robbed at gunpoint. Filled with anxiety, he can’t sleep at night. Rivera nods, listening carefully. She knows he can’t afford professional therapy, and it’s not part of the services offered by Continuing Promise this day. She gathers her thoughts, quickly debating what she can offer from the limited medications available at each site.

As she begins to speak, he leans forward, hanging on her every word. “I’ll give you Benedryl to help you sleep, but you need to seek out a family member, trusted friend, or a member of the clergy,” she urges. “Find someone you can talk to.”

Eddy looks down and away. Dozens of people wait outside for their turn, but Rivera is willing to give him the time he needs. “You were assaulted, yes, but you are here, alive and well, and that's a good thing.” He stands slowly, thanks her and leaves.

“For Eddy it was important that someone listen to him,” she later explains.

She speculates that it’s probably the first time Eddie has ever had a chance to talk about his ordeal without being criticized or questioned. The work of Project HOPE volunteers goes far beyond dispensing medicine; often, they may be the only safe place for someone to talk, especially in a culture where machismo is ingrained and feelings are kept hidden.

Not long afterwards, Rivera leads a young pregnant mother behind two white sheets draped over wire. “Can you hear that?” the maternal child health care specialist queries as she manipulates her field Doppler over the woman’s swollen abdomen. The entire room is filled with the echoes of a tiny thump thump, thump thump. The young woman smiles in disbelief. It’s the first time she’s ever heard the heartbeat of her 12-week-old baby.

Project HOPE Volunteer Provides Snap Shots from the Field in Nicaragua

While our first set of medical volunteers were on the USS Kearsarge in Latin America as part of Continuing Promise '08, Project HOPE also had a volunteer public affairs officer on board to capture moments, pictures, and stories from the field. Lynne, was aboard the Kearsarge for two weeks. She really did a wonderful job of capturing the day in life of a Project HOPE volunteer. Below is the first snap shot of a series that will be posted to our blog. Thanks for your support!
-Marisol

Snap Shots from the field... "Someone mentions it’s 122 F outside."

Or maybe it just feels like it outside Juan Amos Comenius High School in Puerto Cabezas, Nicaragua. It’s barely 9 a.m. and already shirts are soaked through. Sweat streams down faces. Puffs of red dust swirl about as dozens of feet pound back and forth.

Inside the broad courtyard ringed by classrooms, Project HOPE volunteers, military doctors, nurses---medical, dental and optical—along with support people, are scrambling to man stations set up inside various classrooms. Hammers pound and saws whine as Seabees build benches for the school library, repair ceilings and re-wire dilapidated classrooms. A CH-53 E Super Stallion helicopter clatters overhead.


Hundreds of locals, including many indigenous people, the Miskito, are lined up outside a decrepit chain link fence, waiting to be pre-screened for the clinics. Curious, patient, they watch the controlled chaos.

Babies squall. Scrawny, emaciated dogs dart underfoot searching for scraps of food. Life is hard here in this remote, difficult-to-reach town on Nicaragua’s Caribbean coast, 232 miles from Managua over barely passable roads. People...dogs...every living thing appears to face an uphill battle to survive in this environment. Women fan themselves and mop faces with face cloths brought from home. Others walk about with small towels draped over their heads to ward off the burning sun.

Project HOPE Volunteers and the U.S. Navy Work Together to Provide Care

An Inspiring Story from the USNS Mercy

While the USNS Mercy has been in Papua New Guinea the Project HOPE volunteer health care providers have seen thousands of patients, most in need of the basic of health care. However, the volunteers also see patients whose health has been ailing for many years but they haven’t had any means of getting treatment. An example of such a patient was Mary.
About 5 years ago, 44 year old Mary noticed a small nodule near the nipple of her left breast. Because she and her family had no financial resources and extremely limited medical options, she stoically watched as the nodule grew and grew. Her breast became heavy and enlarged to at least the size of a cantaloupe. The skin became eroded and began to bleed. The resultant anemia left her little strength to care for her family, including her husband and four children. She never saw a doctor because she felt that she could never receive treatment.
Recently however, she finally did seek medical attention at a local hospital. The doctors there told her that the USNS Mercy was due to arrive in port shortly, and that she should see if the doctors on board could help her. She was seen in surgical screening clinic and was referred to the ship for admittance the next day. She was evaluated and other than having a blood count of 22 (normal being from 35 to 48), she was found to be in reasonably good health and able to tolerate surgery. She and her husband, who had come on board to assist with her care, agreed for her to undergo a mastectomy which was performed after several units of blood were transfused. Led by Project Hope surgeon Ivan Shulman, along with Indian Naval surgeon Amitabh Mohan and US Naval Hospital – San Diego surgical resident Matthew Tadlock operated together to safely remove her breast which weighed 1.5 kg in an uncomplicated and timely surgery. Her post-operative recovery has been dramatic and today she feels full of hope, literally with a lightness that she has not experienced for many years.
When asked if she was afraid or scared of what was going to happen to her, she simply smiled, took her surgeon’s hand, looked directly into his eyes, and said “No, I wasn’t.”

***First name of the patient has been changed and last name omitted to protect the patient’s privacy.

Special thanks to our Special Projects Team for sharing this story with us.

A Note from a Project HOPE Volunteer on the USNS Mercy

Below is an email I received from a Project HOPE volunteer Faye Pyles. Here she gives a little insight into life aboard the USNS Mercy. -Marisol

___________________________________________________
Well it is our Monday. We are underway to Micronesia, tomorrow we cross the equator. We will be there in two more days, or so. So far the seas have not been bad, a little rolling but not significant. During the night it kicked up a little but not enough to make anyone ill, or at least not in my room. So, so far so good.


The mission to PNG finished with a little bang. We were quite busy the last day with small areas that were very needy. I went on a mission 45 minutes inland and got to see some of the countryside. It was more what I expected, palm trees, forest, mountains and small shacks and huts. We ended up on the coast with a beautiful beach.


Life on the Mercy is fine; I share a stateroom with four other PH staff and the Morale Welfare and Recreation coordinator. The staff is for the most part also good. Lots of reservist who are nice to work with, the partner nations (Aussies, New Zealand, India, Korea, Canada, Chile) are all interesting to talk with about their specialties and experiences.


Not much else, we are now finding things to do to occupy our time, it was trivial pursuit last night, and Pictionary is on for tonight. There are movies on the hanger deck tomorrow. The Mercy now travels with a helicopter detachment of two helos and crew. I am told some of us will be traveling by helo to the medical areas that we will visit in Micronesia, should be interesting.Well time to go to a steel beach cookout. The officers are cooking on the flight deck and there will be basketball and other games on the deck, the band was setting up earlier, should be a nice diversion.

Faye Pyles is a Project HOPE volunteer on the USNS Mercy currently on a humanitarian mission in Southeast Asia. This is Pyles second volunteer mission with Project HOPE. She previously participated in Africa Partnership Station in Ghana and Liberia. Faye is retired U.S. Navy Captain and a pediatric nurse practitioner from Norfolk, VA.

Faye sees one of her little patients at
JFK Hospital in Liberia in March

Project HOPE Volunteers Take Care of Children on USNS Mercy

Diane Speranza, a nurse from Florida, recently returned from her third volunteer mission for Project HOPE, serving on the USNS Mercy as a medical surgical nurse. Here are a few excerpts from her emails while on her most recent mission in Timor Leste. --Melanie

We have been busy on the pediatrics ward...day 7 already and 7 more to go!! I am getting tired. Doing 14 days in a row of 12 plus hours a day is tough. But there is an end in sight!

We have seen a lot of hydrocephalic kids. Unfortunately we can not do any surgery on them as we do not have the capability on the ship. So all we do is CT's. It gives them a chance to spend a night or 2 on the ship, get some good food for themselves, sleep on a bed rather than floor or hammock, get their child some formula, pampers, toys and clothes. They all leave smiling and happy even if we could not' fix' their child. This goes for all the ones that we bring on the ship. I am amazed at how they all clean their plates at every meal except for Brussels sprouts. I have never seen chicken bones so cleaned off. It is sad to think that they don't have much money and there for not much food. They are all so skinny and short. I am so glad that I sent a head of time boxes of baby and kids clothes. I try to give everyone an outfit, as they seem to have nothing. When I give it to them they immediately put it on their baby or child.

I will try to describe how the process works here. Patients are screened on shore at the MedDenCaps (medical,dental civil action program) the clinics that we set up where they are seen for their problems. If those assigned to go ashore feel there is something we can do for them IE: surgery or diagnostics or PT etc then they get a hold of the ship and see if there is a bed, OR time and a physician able to take the patient Once given the ok they get them to the ship via boat or helo(copter). Each patient is allowed an escort to come with them. If it is a child both parents can come and sometimes it means bringing another of their children with them. Most families here have 6 or more kids and are young mothers......teens. So we try to encourage one parent to stay home.

We have 22 beds on each ward plus we put up cots if needed. There are the same number on top of the ones we use but because they are so high and you would need a ladder to get up we do not use them. If the children are small the escort usually sleeps with them. Otherwise we put a cot up or mattress on the floor next to them. The beds or 'racks' as they call them are only about 12 inches off the floor. That with the fact that they are very close together makes it hard to work on the patients. You either have to bend over, not good on the back or get on your knees.


The patients are usually admitted the day before their surgery and usually go home one or 2 days after depending on the type of procedure they had done. The children all get 'de-wormed' most all have worms and by doing this it gives them a few months of good nutrition. The shift I have is 0630 to 1900 but we always end up staying later. So when I get up it is dark and when I get done it is dark. When the patients are discharged they get copies of all their records, CT's etc. so that if they do get to follow up with a doctor or clinic they can pass them on.


The E. Timor people are very poor and we forget that all the comforts we are used to they have never heard of and it is all new to them. For example: All are amazed at TV, we play DVD's for them all the time. Even the parents love the children’s movies...Shrek, Little Mermaid, Indiana Jones etc. I asked a translator once if the child wanted apple or grape juice and he said it doesn't matter they have never had it! When they come in we hand out toys usually stuffed animals which they seem to know what to do with them. But we have to explain and show them what to do with coloring books and crayons. It is touching to watch all the adults sit on the beds and color. In fact I think they seem to enjoy it more than the kids.
Some come with their own food, not knowing that we will feed them. They either wear Flip Flops or come barefoot. We have a playroom set up for the kids (adults have just as much fun) but you have to show them how a lot of them work. Everyone loves to have their picture taken and then you show them in the camera after and they all just giggle. Wish there was more I could do for them.

Early mornings, dire needs and other notes from Project HOPE Volunteers on the USNS Mercy

It's 4:49 P.M. on Thursday on the east coast of the U.S. mean while it is Friday, 6:49 A.M. across the globe in Papau New Guinea and after sleeping in confined quarters aboard the USNS Mercy(we are taking bunked beds on a ship that could rock quite a bit, how many adults do you know would volunteer to sleep in a bunk bed for a month or two?) Project HOPE volunteers and their Navy counterparts are begining a new day of providing HOPE and healing to the local community. A HOPE volunteers day may begin early but it doesn't end early--the crew on the ship's day can usually go into the evening hours.


As the day begins volunteers will report to stations either working in the medical rooms aboard the ship or on shore at a local hospital. The folks who are taken ashore are shuttled there aboard a helicopter or boat. When they arrive at the hospital they are will be greeted by hundreds of people already waiting in line since about 2:30 A.M. A continous flow of people will come through the stations to be screened, vaccinated, and get other health care needs taken care of. Those who are in need of surgery, and can be helped by surgery, are then shuttled back to hospital ship.

There is a constant movement with upwards of 2,000 patients seen daily, many who are in need of the most basic health care we take for granted. The team is also providing another key component to these missions, education and training to local health care workers. Project HOPE believes in providing sustainable advances in health care. This means educating and training those can help their communities and encouring them to continue to teach others. The students who attend these training courses are like sponges, soaking up all the they can get because many of them don't have access to training and new techniques. In the U.S. we have continuing medical education, were health care professionals can stay on top of the newest advances in medicine. This is not the case in other parts of the world.

Even though the conditions for such missions can be very demanding many of these Project HOPE volunteers continue to volunteer time after time. They know it's hard work but also very rewarding. It is truly a humbling and inspiring experience.

Project HOPE Volunteers Teaching and Listening in Papua New Guinea

Jan, a Project HOPE volunteer nurse from Dallas, TX, sent me an email yesterday with a wonderful story about teaching nurses in Papua New Guinea and the common stresses nurses across the world share. The story is below--enjoy!

-Marisol
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What a great privilege to participate in an educational exchange with the nursing staff at The Port Moresby General Hospital in Papua New Guinea. After being at sea for eight days I was ecstatic to learn that I would be setting my feet on solid ground, if only for a few hours. As the two U.S. Navy nurses and I arrived in the tiny open classroom, around nine in the morning, there were already five nurses that stayed over from the night shift eagerly waiting to hear what we had to say. Soon others joined, ranging from nursing students to very experienced nurses, representing a wide variety of specialties. By the looks of the crowds waiting outside the hospital gate to be seen in the emergency room alone when we arrived, I was not surprised to learn that most of our audience was cross trained to function in multiple areas of the hospital. What followed in that modest classroom will forever elicit fond memories of my new friends and colleagues in Papua New Guinea.

I have taught continuing education courses for nursing staff in the hospital where I work in Dallas, Texas, as well as formal nursing courses in the university. In stark contrast, I have never seen such enthusiasm for learning as I witnessed that morning. Every participant listened with intensity to lectures covering topics from patient assessment to triage during disasters. The hour that we were scheduled to speak soon turned into three as we began to talk about a common bond that nurses all over the world share—work related stress. Most nurses in the U.S. prefer to label this phenomenon as "overworked and underpaid." As almost all of the twenty or so nurses eagerly shared their personal work experiences, especially those related to patient deaths, the three of us soon realized that we were in a full blown critical stress debriefing session. Coping with the severity of nursing shortages, lack of equipment, supplies, and other resources in Papua New Guinea is beyond imagination to the average nurse at home. Even though we facilitated the discussion by offering healthy ways to deal with stress, I sensed that simply listening and validating their concerns was worth so much more. The session may have continued for hours had the charge nurse not reminded the staff that they must return to work.

Prior to departing back to the comfort of my temporary home on the USNS Mercy, a staff nurse by the name of Rose offered me a cup of tea. For a few moments we engaged in livelier talk of the effects of chewing beetle nut, a Papua New Guinea equivalent of a double shot espresso from Starbucks. Then she briefly disappeared, returning with something tucked under her arm. She proudly handed me a small shoulder strap bag made from a fibrous straw material with a distinct design. She went on to explain that this bag was not made in a factory, rather by hand, and the design was unique to her village only. How humbling that someone with so little was so willing to give what I suspect was her personal possession to a stranger. I did not find a beetle nut inside as I had hoped, but this simple gesture, along with warm smiles and hugs from my nursing colleagues in Papua New Guinea will be an experience I will forever cherish.

Jan