Teaching Chronic Disease in Central America

Patiently, Project HOPE volunteer nurse, Anne Borden, listens as an elderly lady with diabetes talks about her life. She then talks with her, giving her advice on how to better control her disease within her environment in rural Central America.

Anne will repeat this scene, over and over again, listening to and teaching each individual patient to ensure all their questions are answered and that they understand their chronic diseases. “It is very gratifying. There is a lot of individual counseling and teaching and people are very appreciative of anything you do. We get the opportunity to teach people the basic fundamentals of how to manage their chronic diseases that they are going to have all their lives,” Anne says.

So she continues, meeting with each patient, one-on-one, helping them understand hypertension, diabetes, the risk factor for stroke and the importance of following through on medications and more.

Anne first worked with Project HOPE when her employer, Massachusetts General Hospital, sent a team of volunteers to work with HOPE in Haiti following the devastating earthquake. She says that volunteering after the earthquake really made her understand how connected every one really is. Her second volunteer mission with HOPE in Nicaragua and Panama is cementing that belief.

"It is interesting that the people in these Central American countries have the same health concerns as we do in the United States," she says. "They have the same basic health problems, the same concerns, such as how they get their meds or how are you going to help them get their quality of life back."

One patient in particular that sticks out in her mind is an older Nicaraguan woman, probably about 92. She was very healthy, and had her blood pressure checked. She said that she represented all the Nicaraguans who couldn’t get out of their houses. "She was very graceful, very well spoken and sweet," Anne says.

In addition to working with patients, Anne is also serving as HOPE's Operations Officer and Chief Nursing Officer during this portion of the Continuing Promise 2010 eight-country mission. Her leadership role makes her appreciate even more the complexity and scale of this annual humanitarian assistance and health education mission. "The Navy really has the infrastructure to pull off such a large mission that helps so many people," she says. "It is [also] nice to work with the Navy people, and get the opportunity to work with all the diverse people on the boat. At lunch we had every branch of the military at the table, but the Coast Guard, plus a dentist from Canada. How often can you say that you participated in something on such a large scale and worked with people from Germany, Canada, Paraguay, and the Netherlands?”

But of course, the best part continues to be the grateful smiles and big, sometimes sweaty hugs from the people she cares for. "I would do another mission in a heartbeat. It is a way to help our neighbors," she says.

Photos and story by Bonnie Hudlet, HOPE's Volunteer Public Affairs Officer

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More than 7,000 Patients Treated in Nicaragua

“All hands on deck!” It is time to clear the helos of their cargo. Continuing Promise 2010 is preparing to leave the land of Nicaragua. And while we may be leaving, we are satisfied with the work we accomplished in the country. All in all, Project HOPE volunteers and their military and partner counterparts:

Treated 7,006 patients
Provided medical 22,613 services
Performed 149 surgeries
Participated in 31,343 educational contacts

While preparing for our departure, our work continued. While only a few had the privilege of going ashore on the last day, but all who wanted could help with clearing the choppers of their cargo.

Everyone who came off the helicopters had something in their hand, if they did not have their own things, they had a bag of mail, a shovel, or whatever else they could carry. They also formed a chain from one helo to the hangar bay to deliver the mail and whatever else they could send to the right spot with a human chain. I counted at least 100 people in the chain for the mail.

The plan for now is to pull anchor and head south to Panama. Hard to believe it is time to leave Nicaragua already.

Photos and story by Bonnie Hudlet, HOPE's Volunteer Public Affairs Officer

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Providing Care and Mentoring on Corn Island

Once again flexibility had to be put into practice.

Project HOPE volunteer, Dr. Robert Alan Jamison, a retired pediatrician from Morristown, Tennessee was chosen to go out to a remote area in Nicaragua, Corn Island, for five days and three nights. He was totally expecting to sleep on an army cot with a bivouac mosquito tent.

When the team arrived on Corn island, (about a 20 minute helicopter ride), they found out there might be some old barracks in which they could set up.

Then came the time to be real flexible, they ended up staying at a nice…well, …ahem…a resort run by a Canadian! What a shame! An anonymous donor heard the doctors and nurses were arriving to help out at the medical clinic and paid for the expense of the hotel. Dr. Alan did have to pay for his own M.R.E.s (That is what I call My Real Eatery) and did not have to eat the military M.R.E.s (Meals Ready to Eat). He admitted it was a nice surprise and did not mind paying for the food. What a reward for being willing to suffer in the heat and uncomfortable sleeping conditions!

Apart from the nice surprise of not having to sleep in a tube made of netting, Dr. Alan was very pleased with the health he saw in the children on Corn Island. They were very clean, and out of all the children he saw, there were only two with impetigo (skin infections) and a few had colds, etc. Over all the whole medical team saw 300 people per day.

“On Corn Island they have limited resources and it can be difficult getting the flow of medical equipment and medication to the clinic.” Dr. Alan says. One of the items needed was medication for nebulizers. The team was able to communicate the need and have more delivered to the clinic from the ship.

“The staff makes a good effort and they really care for the people on the island,” Dr. Alan says.

In addition to caring for patients, the retired pediatrician, said he enjoyed the consultation opportunities he had with local health care providers. The local providers would bring patients for him and another doctor to see for a consultation, and vise-a-versa. It was a real interchange of ideas and working together. There was a mutual respect for the knowledge that each had.

“These people are healthy and don’t always need meds, but they need someone to talk to, someone to recommend and encourage basic health care and physical fitness,” he adds. “They come to seek attention to their problems and complaints. It helps create a relationship between the inhabitants and the clinic. Part of it is to help them realize that there is a clinic right there for them. We can also encourage them in routine health care and to take advantage of what is available to them.”

Dr. Alan said that Tylenol, Ibuprofen and vitamins are not readily available and they want them and need them at the clinic. He said that after the medical site is closed, the medications that were not used are left for the clinic.

When asked what he came back with from his five-day adventure, Dr. Alan says “Friends.” He will try to stay in contact with the administrator of the clinic, Fay, and see how he can get some items that were specifically requested to them.

Story by Bonnie Hudlet, HOPE's Volunteer Public Affairs Officer

Photos for this story provided by Dr. Alan Jamison

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"We Are All Just Doctors and Nurses"

"I get to wear civilian clothes,” answers Carma Erickson-Hurt, RN, when she was asked, "What is the biggest difference between serving as nurse in the Navy and volunteering as a civilian with Project HOPE?"

“It really is a big deal after having to wear uniforms for four months straight in the past,” she adds.

Carma retired from the U.S. Navy in 2007, and she is volunteering in leadership position, serving as HOPE’s Medical Director aboard the USS Iwo Jima and ashore in Nicaragua and Panama. Her military experience is proving beneficial. Carma not only knows what to expect and it is comfortable with her surroundings, she is also enjoying crossing paths with people she has worked with in the past. One of the nurses on board was under her command when she was in the Navy, now the nurse has advanced and is doing very well.

Carma first became familiar with Project HOPE when the organization, along with other NGOs and other branches of the military joined forces together to work in Tsunami relief in 2005. “It worked very well, and proved it can be done. We are all just doctors and nurses,” Carma says. When she was able to volunteer for relief work herself, she looked up the one volunteer organization she knew and applied.

Carma has found that no matter where she goes, the attitudes of the patients are all about the same. “They are very appreciative. They wait their turns patiently and really don’t question the “why” of where they have to go. They are all very grateful,” she says.

This is Carma’s second volunteer mission with HOPE. Earlier this year, she volunteered for Project HOPE onboard the USNS Comfort hospital ship in response to the earthquake in Haiti. She adds that working the Project HOPE helps give people an idea if they are really cut out for this type of work or not.

Carma has gotten to know some of the first-time HOPE volunteers including Jill Blashka, a pediatric nurse from Alexandria, Virginia. While Jill has worked the night shift onboard the USS Iwo Jima and Carma worked in the ward on the ship later in the afternoon both share their same philosophy about their patients. “This is quite an exciting time for the patients,” they both agree. “Due to the distance from shore, patients get to be flown in by helicopter. They bring one family member or a friend with them to be their helper or friend or just a comfort with them. No one complains.”

They are all so grateful to have their life made a bit better by caring hands.

Photos and story by Bonnie Hudlet, HOPE's Volunteer Public Affairs Officer

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Doctor Brings Experience and Compassion to Volunteer Work

Iraq, Kosovo, Somalia, Haiti, Sri Lanka…the list goes on and on. Now, as a Project HOPE volunteer, Dr. Tom Hoggard can add Nicaragua and soon Panama to put him on over 20 missions. His work in refugee camps around the world has given him lots of experience. He has become an expert in tropical diseases and has already taught a class while the ship was in transit to Nicaragua. He not only teaches others, but he is learning daily about things he has never seen before now.

Whenever Tom can, he gets off the ship and goes on shore to work with the people. I had a chance yesterday to ask him about some of his impressions. Actually, one doesn’t have to ask him. He is smiling the whole time out here! He loves this work!

Tom loves seeing this cooperation between civilians and the military. That as HOPE volunteers we are being ambassadors too. We are able to bridge the gap between those that can go and those that cannot.

“This is payback time for me,” says Tom. “I have had a wonderful life as a doctor, now I can give back in return. A lot of what we do here is assurance, because we are here for such a short time, we can’t do major medical work, but we can talk to the people, get them to understand their concerns, and refer them to the right medical resources.”

He emphasized that the great local translators help a lot in understanding the situations that the people face.

“One situation that sticks out for me was the lady that rode on horseback for five hours, and then in a boat for four hours the day before to spend a few minutes with a doctor the next day,” he said.

Tom added that for him it is all worth it, with all the warmth he receives when greeted. “They are so thankful that we are here for them.”

He said that he is looking forward to taking home all the good thoughts about working with other HOPE volunteers and the military. “It has been a wonderful experience. HOPE volunteers have their hearts in the right spot and so does the military. We are little cogs in a big wheel that is quite helpful with relations between the USA and other countries we visit.”

One more thing… Tom Hoggard, MD is finding a lot more material for teaching. Watch out students at Oregon Health & Science University in Portland! You might be given a whole lot more information to study.

Photos and story by Bonnie Hudlet, HOPE's Volunteer Public Affairs Officer

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Working Medical Clinics in Nicaragua

“I hurt here.” “I have pain all the time there.” “She doesn’t eat.” “He falls all the time when he runs.” “My child’s legs hurt at night.” “My doctor said …, what do you think?” Sometimes the doctors and nurses are there to confirm, and to affirm to the people that they are fine and to help them with pain management.

There are other times they have to clean a wound and bandage it. Sometimes they find something that could be serious and refer to them the right local doctors and authorities for long-term care. Sometimes a sore throat means they can be helped with this one visit with the provided medicine.

Whatever the doctors can do, they do it and with joy. There are times there is not much they can do, but provide a smile and direction, but that is what we are here to do, help and build relationships.

Myself, Anne, and Drs. Vicky, Earl, and Alan were elected to go ashore today. It took a bit to get into the routine for the first timers, but it wasn’t long before they were seeing patients, consulting with each other and the other medical personnel. Lots of water was drank by all, well they had better drank lots of water! I might need to check on the doctors to make sure they are taking care of themselves!

The site at Blue Fields is in a school that they closed for a week so that the military and NGOs would have a good place to set up the clinic. The engineers will be doing some minor repairs at the school while we are there. So the school also gets some benefit for closing for the week

Photos and story by Bonnie Hudlet, HOPE's Volunteer Public Affairs Officer

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Volunteers Endure Heat and Humidity to Provide Care

While several Project HOPE volunteers went ashore today, the rest of us wait, clean, type, read, do laundry, exercise, visit, learn from others on board, etc. It will be great to hear their stories when they return.

Due to the heat and humidity, they have warned us that most of us won’t want to go ashore more than a few days in a row. There is a need to look out for each other and work as a team to keep us all well.

One of the really cool things here, uh besides the air conditioning on board, is the opportunity we have to meet people from all branches of service, and not just from the USA, but there are people from Canada, Paraguay, Holland, and a few other places. It’s a wonderful opportunity to share in cross-culture ideas and where people have been in the services.

Did you know that there is a military branch called the United States Public Health Service? I did not until I came on board. They say that they are one of the best-kept secrets of any military branch. Yup, lots to learn daily with such a mix of people!

Photos and story by Bonnie Hudlet, HOPE's Volunteer Public Affairs Officer

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Volunteers Arrive in Nicaragua

After two days at sea, we set anchor near Blue Fields, Nicaragua. During those two days we spent the time getting settled, figuring out the routine, and the Project HOPE volunteer nurses, doctors, and practitioners have been in meetings. They also helped the nurses restock and get ready for the work to be done in Nicaragua. The Navy personnel were so grateful to have the extra hands and to have others work beside them voluntarily.

Today, the military is going ashore for setup. At this site, we have to anchor so far out that every has to be flown to shore, therefore the space is limited as to who and what goes ashore. Also, Nicaragua has limited the flights to morning and late afternoon or evening only.

The planning and coordination of all this really boggles the mind. I applaud all who coordinate this and get the mission accomplished.

Photos and story by Bonnie Hudlet, HOPE's Volunteer Public Affairs Officer

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Volunteers Adjust and Prepare for Important Work

No matter how much you hear about the bedding and locker area called the “racks,” it is another opportunity to demonstrate more flexibility. It is a bit of a struggle for some of us Project HOPE volunteers who are a bit organizationally dysfunctional! Ah, this is where flexibility and patience is extra handy for those around people like me!

Our locker is under the bed, the bed is the top of the locker, so we have to lift the bed to get things into or out of the lockers. No such things as drawers or upright lockers. In the mornings it is quite the choreograph as women get ready for the day. We take turns getting our things, then getting out of the way of the other person. It is a choice of letting the other person be more important than yourself, and it works very well.

Sleeping in the racks is a whole other act of flexibility! There is so little headroom that one cannot even hold a book all the way upright to read it. When one turns over you are bound to hit the wall.

During one of the meals, one of the crew mentioned how tired they were. I reminded them that they were going through culture shock. We often don’t think of culture shock during an event like this because we are on USA property, but it is a whole new way of life that we must adjust to very quickly. Not only do we have to be flexible with each other and the new life we live for these weeks, but with ourselves. We often forget that we need to give ourselves room to make mistakes and to learn. It is OK to be tired and to be flexible with personal expectations.

Learning how to get around on the ship is a bit mind boggling! It is like a three dimensional maze. The halls, oh, excuse me, P-ways, look the same. No real identity except for a numbering system. Although there are multiple ways to get around, usually once someone finds out how to arrive at a location, he stick with it and won’t change the route much. Although it seems impossible, one does eventually figure things out. Fortunately, military personnel are more than happy to help us find our way around. They know the feeling! They don’t seem to forget how easily they got lost too.

Photos and story by Bonnie Hudlet, HOPE's Volunteer Public Affairs Officer

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

Meet the Volunteers in Nicaragua and Panama

A new team of Project HOPE volunteers joined Continuing Promise 2010 aboard the USS Iwo Jima and ashore to offer their medical expertise in Nicaragua and Panama during their one-month service.

Jillian Blashka, a pediatric nurse from Alexandria, Virginia, is serving on her first volunteer mission for Project HOPE.




Anne Borden, a nurse from Kittery Point, Maine, brings 26 years of experience in surgical trauma and cardiology to her second volunteer mission with Project HOPE. Earlier this year, she volunteered in Haiti. She is serving as HOPE’s Operations Officer and Chief Nursing Officer onboard the USS Iwo Jima and ashore in Nicaragua and Panama.

Dr. Mary Burry, a physician from Portland, Oregon, is on her first volunteer mission with Project HOPE, but she brings extensive international health experience to her volunteer position. Dr. Burry has worked with disaster relief teams in Somalia, Albania, Turkey, Mozambique, Ethiopia, Afghanistan, Sri Lanka, Papua New Guinea, Honduras, Pakistan, Zimbabwe and Iraq.

Carma Erickson-Hurt, a nurse from Island Park, Idaho, retired from the United States Navy in 2007. She specializes in palliative care. Carma first worked with Project HOPE when stationed on board the USNS Comfort in response to the tsunami in 2005. Most recently Carma volunteered with Project HOPE as the Chief Nursing Officer for disaster relief medical care aboard the USNS Comfort hospital ship in response to the earthquake in Haiti. She is serving as the HOPE Medical Director onboard the USS Iwo Jima and ashore in Nicaragua and Panama.

Dr. John Hoggard, a family medicine physician from Portland, Oregon, is on his first volunteer assignment with Project HOPE. His international health experience includes many missions caring for refugees of drought, war, floods, tsunami and earthquakes.

Bonnie Hudlet, a photographer from Hayden, Idaho, is a first-time volunteer for Project HOPE. She brings a wealth of photojournalism experience from South America and Argentina to her position as HOPE's Public Affairs Officer onboard the USS Iwo Jima and ashore in Nicaragua and Panama.

Dr. Robert Alan Jamison, a retired pediatrician from Morristown, Tennessee, just recently returned from a HOPE volunteer mission in Indonesia. He's again using his pediatric expertise onboard the USS Iwo Jima and ashore in Nicaragua and Panama.

Dr. Victoria McEvoy, a pediatrician from Cambridge, Massachusetts, is serving on her first volunteer mission with HOPE onboard the USS Iwo Jima and ashore in Nicaragua and Panama.


Dr. Earl Wellington, a retired physician from Harlingen, Texas is serving on his first mission for Project HOPE. Onboard the USS Iwo Jima and ashore in Nicaragua and Panama, Dr. Wellington is volunteering as an Internal Medicine physician.

One more rotation of HOPE volunteers will serve Continuing Promise 2010 alongside their Navy counterparts as the ship continues its eight country humanitarian assistance and health education mission through Colombia, Costa Rica, Guatemala, Guyana, Haiti, Nicaragua, Panama and Suriname.

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Pharmacy Student Blogs About Project HOPE Volunteer Experience

Elizabeth Johnson is a Doctor of Pharmacy Candidate at Shenandoah University in Winchester, Virginia. A first time volunteer for Project HOPE, Beth worked as a pharmacy technician onboard the USNS Comfort. Read about her experience in El Salvador and Nicaragua in her own words.

HOPE Comes Full Circle in Latin America

LTJG Hussein Rawji transported Project HOPE volunteers from the USNS Comfort to their medical worksites in Nicaragua. Forty years ago, his mother-in- law joined HOPE volunteers onboard the SS HOPE as part of the local medical community that helped volunteers deliver primary care and distribute the donated medical supplies in Corinto, Nicaragua.

Read his story

Medical Care and Community Service

Medicine isn’t the only thing the Project HOPE volunteers practice during the Continuing Promise mission. Along with their Navy counterparts, our volunteers have completed about three community service projects in each of the seven countries we’ve visited this year on USNS Comfort.

Today, HOPE volunteer Elizabeth Roughead and I visited the Santa Eduvigis retirement home with a dozen or so Navy, Army, Air Force, and other NGO volunteers to fix their gutters, install a drainage ditch, generally clean up the outdoors areas, and—maybe most importantly—visit with the folks living there.

This service project, and others like it, which the Navy calls “COMREL” projects—Navy shorthand for “Community Service”—is just one of the events that Elizabeth has participated in during Continuing Promise. As a volunteer administrative assistant, she has rotated through each department onboard USNS Comfort, the Navy’s hospital ship and base of operations for the deployment.

“Its really a great experience, because I get to see a little of what everyone onboard does,” says Elizabeth. “When I heard that the Navy was shifting towards these type of cooperative deployments, I knew I had to get involved in some way. I have biology degree, but no medical background, so I help out wherever I’m needed…and there’s a lot to do.”

Elizabeth, whose father is Adm. Gary Roughead, the Navy’s top admiral, has had her finger on the pulse of the Navy’s humanitarian missions since 2005, when Project HOPE, the Navy, and other NGO’s pulled together for the first time to support the relief effort for the tsunami in Southeast Asia.

“Being able to come out and give back something that I know actually helps people—health care—has really made me glad to have done this,” says Elizabeth. “When you see someone’s life change overnight, like I have when I was working with the doctors and nurses in the OR and the post-op wards, makes it all worth it.”

Thanks for reading-Jacob

Mother Drives Her Son Across Two Countries to Get Care

Another awesome story is this little boy, Oscar. He and his mother are actually Salvadoran. He’s got strabismus (wandering eye), and his mother brought him to one of the sites in El Salvador late in the stay last week. Late enough that we were able to do a work up for him, but not able to get him into one of the ORs—they had all been booked for some time.

So she asked, “Where are you going next?” We told her, and with a simple, “Ok,” she left...Only to show up at the site in Chinandega, Nicaragua, on the first day it was open, paperwork in hand. She’d driven him across two countries just to see us. The ORs were wide open. With that drive, she’d changed the course of her son’s life. He was operated on today, and as the muscles in his eyes get used to their new positions, they will line up as they should.

Thanks for reading-Jacob