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

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

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

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

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

•1,3oo community health volunteers have been trained

•229 village midwives have been trained

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

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

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

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

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

The Engine Room

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

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

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

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

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

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

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

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

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

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


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

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

Club MEDCAP

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

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

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

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

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

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

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

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

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

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

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.

Update: HOPE Volunteers Across the Globe

So far 2008 has been a very busy year for Project HOPE volunteers. Volunteers are an invaluable resource at Project HOPE. These folks donate their time and leave the comforts of their homes to work in places most people can't point to on a map working long hours under some of the most extreme heat conditions. They are flexible and handle any challenges that may come their way while on these missions with a smile on their faces. Below is a run down of the 2008 missions.

March-April - Project HOPE volunteers visited the West African countries of Ghana and Liberia as part of Africa Partnership Station. There they worked side-by-side West African health care providers seeing patients and also providing them with midwifery, emergency and basic health care education.

May-June- Project HOPE volunteers set off aboard the USS Boxer to deliver health care and health professional education to the communities along the western coasts of Latin America. Mission Continuing Promise '08 visited Guatemala, El Salvador, and Peru over 60 days.

June-September- Volunteers joined the crew of the U.S. Navy Hospital Ship Mercy in Southeast Asia in June. The Pacific Partnership '08 mission is currently underway and has already stopped in Vietnam and Timor Leste providing health care and health professional education to communities in need. Pacific Partnership is now in Papua New Guinea and will then head to Micronesia before Project HOPE volunteers return home in September.

August-November- HOPE volunteers are now aboard the USS Kearsarge for a four month mission along the east coast Latin America (second half of Continuing Promise '08). These wonderful health care providers will be visiting the countries of Nicaragua, Panama, and Guyana.

A sincere thank you to all those Project HOPE volunteers past and present.

-Marisol Euceda