Anchor's away

started on aug 20, 2011

anchor's away

we got news that there is a possibility that a hurricane/tropical storm will hit Haiti sometime tomorrow night.  This led to the decision to take down the MEDCAP site, and pull anchor to sail south until Tuesday.  No one really knows what's going on or what will happen.  Everything is TBD.  Basically, we are planning to come back to Haiti after the storm clears (if there is a storm).  We will continue the mission as planned, however, if the storm turns out to be a hurricane then the mission may potentially turn into a disaster relief mission.  The Comfort is equipped with a 1,000 patient bed capacity, 80 ICU beds, 12 operating rooms, Interventional Radiology, Endoscopy, Dental, and Opthamology suites, CT scan, and more.  The team from Project Hope includes three Orthopedic Trauma surgeons, a general surgeon, a Certified Registered Nurses Anesthetist, Internal Medicine physician, a pediatrician, and and critical care nurses.  No one wants to see Haiti go through the same casualties it did from the earthquake in 2009 so we are all hoping for a calm effect.

Malaria prophylaxis - feels a bit like "one flew over the cuckoos nest".  someone has to witness you taking your malaria med everyday.  I had to change my sched from night to days with my med because they check it during morning muster.  Apparently, the last time the Comfort was in Haiti, a few people were infected with malaria and that's why they have been very strict.  

So far we have provided 10 surgeries in one day.  Three of the ten were pediatric patients.  One girl had a piece of wood stuck under her eyelid that caused abrasions in her eye that Optho removed  She did well (see pic below).  When our peds nurse received the call from the PACU, we were told that the child was a "brat".  Let's think about this -- a 5 year old girl who has never had proper healthcare, probably barely saw a physician in her life, was taken on a humongous ship filled with Americans who do not speak Creole, takes her to a room full of lights and had a stranger open her eyes and poke around it.  This was a frightened child, not a "brat".  Kids on these kind of missions go through the same trauma of being passed around, poked, cut, bandaged up and mostly without explaination.  There is no Child Life Specialist on the ship who could explain the procedures to them in a way they can understand.  Their parents may not even understand the process of the surgery.  Everything is new and scary. 

Another patient was a 9 year old with Familiar Juvenile Polyposis - a syndrome that presents as multiple polpys in the gastroinestinal tract.  She had polyps removed in 2009 (probably when the Comfort was last year for CP 09).  The surgeons successfully removed 3 colorectal polyps but since they are re-occuring, she will need a follow up and polyp removal in the future.   

Aug 23 - we are on the way back to Haiti after word that Hurricane Irene made a right turn, and skipping Port-Au-Prince.  We are finishing the mission as planned and so far there is no word that we are extending our time in Haiti.  

Aug 24 - back in Haiti and it seems like there's no damage done or need for a disaster response.  We boarded some of the patiens who are scheduled for surgery for the next few days. The plan is to perform surgeries that were scheduled for the days we were in sea and compensate for time loss by extending the OR day.  I will be at a MEDCAP (Medical Civic Assistance Program) tomorrow. 

picture from the flightdeck - home of the helos.  the boys behind me are playing football.

dinner - cabbage, potato, watery tomato soup... beggars can't be choosers.

Continuing Promise 2011

Dejavu!

That feeling like I was just here, as if I never left, is overwhelming and difficult to decipher. Am i excited? Anxious perhaps? Happy to be back? Sad to re-live some memories? I'd say all of the above. Being on the USNS Comfort, which is a carbon copy of the Mercy, brings back a lot of feelings -- good and some unwanted. However, I feel a sense of comfort (no pun intended) that I am currently sitting under the lifeboats, facing the ocean, listening to the roaring sounds of the ship, and surrounded by military personnel. It takes me back to last year when I enjoyed a summer in the middle of Indonesia around people whom I have never met, but had the most memorable time of my life.

Let's start at the beginning. Driving from the airport to the port where we got on the band-aids to get on the Comfort was the least enjoyable part of my day. With that said, driving down the streets of Haiti and passing the street before making a right turn onto Bernard Mevs Hospital was a warm welcome that I am in fact in Haiti. As much as I talk about how the mission at Medishare kicked my ass, that we worked 7 nights straights, and throwing our scope of practice to the back burner, in retrospect (just like everything else), it was a best trauma experience I have ever done.

We have 20 people from Project Hope on this rotation. We are the largest PH group for Continuing Promise. It's always nice to see familiar faces so I couldn't help but hug Faye Pyles (medical coordinator who was our Operations Director on the Mercy) and Mary Jane Reed (MJ) when I saw them. There are two orthopedic surgeons, an internist, a pediatrician, few nurses (PACU, OR,med/surg adult and peds, ICU), Public Affairs Officer, etc. I haven't met everyone yet, only the people that came in today. Some of the PH volunteers have been onboard since Norfolk, some came on earlier flights, and the rest will be coming in tomorrow.


Now back on the Comfort. We dragged our bags up what seemed like endless ramps... bla bla bla... I get in CASREC (casualty receiving that has been used as triage/discharge room) and a stampede of conflicting emotions rushed through me. The most distinct was the smell. I can't quite describe it, like a mix of chlorox and the hallways at my high school -- weird. We went straight to the MESDEC to grab dinner as it was nearing1900 (end of dinner). I go down the food line. I remembered why half my luggage was compiled of food. See, the ship has hundreds of stairs that we have no choice but to use and one would think that we'd lose weight without trying, but the food is by far the healthiest so I think it evens out. I didn't lose weight on the Mercy but I left with legs and thighs of steel! Also, one major difference that already sets apart my experience on the Comfort is that I get officer berthing!!! No more dipping down to the floor or falling off the top bed. No more sharing 4 shower stalls with over a 100 girls. No more room restrictions and having to use a flashlight between 1000 to 1600 (lights are off in the entire berthing to accomodate the night shift's sleeping schedule). Now, I get to share a suite with 7 other officers in a two bunk bed with loads of space. I have a locker room that fits my luggage along with 4 drawers for my goodies! It's a total upgrade!

So after getting some housekeeping done (checking in hospital administration, filling out malaria paperwork, and muster [roll call] time for the following days), I take a quick shower and run to the weather deck with my lap top, water, and iphone... with a sad realization that I forgot my iphone in the room as I was charging it... doh! But who cares! I walked around and reminisced on each part of the weather deck. There is nothing more peaceful to me than being outside, feeling the breeze from the ocean, with the smell of smoke because I am sitting by the smoking deck. WHO CARES!?

So tomorrow I muster in the post-op. There is no pediatric ward on the Comfort so I'm assuming I will be taking care of adults and peds. There was some confusion as one of the docs in sickbay asked if I could work there instead or have me do off site stuff? I'm not really sure but I know he was trying to get me not to work in the wards. I guess I will find out tomorrow when all that is sorted out. I'm okay with staying on the ship. I have been ashore in Haiti and I think others who have been on the ship for 6 months would much rather take that spot, understandably so. From what I gather, the people on the ship did not have liberty days in every country unlike the Mercy. They did, however, had a few days of liberty in Peru and Costa Rica.

WIth all that said, I am planning to make the most out of my 10 days on board. 10 days seems so short compared to 5 weeks! I remember when we had 10 days left on the Mercy I thought and felt like it went by so fast! If all goes well, I certainly plan on going back on the Mercy for a FEW MONTHS next year... God willing! Let me bite my tongue and see how this experience goes first.