Blog Update!

July 15^th

            Yesterday was my first day on MEDCAP.  I was able to go out with my preceptor and one of the Navy pharmacy personnel.  I was so excited to finally see how the clinics were run here and what site we would be at.  We mustered at 0530 and took a boat and a bus ride to our site.  This was the 4^th day of MEDCAP 1 so the other pharmacy personnel had already unpacked the medications the pharmacy and we just needed to become acquainted with where all the drugs were and set ourselves up for the day. I was really hot outside but our room was not too bad because we had several fans and windows allowing for airflow. We began seeing patients come in about 45 minutes after we arrived.  We had 3 or 4 translators at all times and we arranged it so that some of the Vietnamese volunteers gave each patient a number when they came so that we could more easily determine which patient belonged to each prescription.  In Vietnam, many of the people have the same or very similar names, so the numbers helped us reduce the chance of giving the prescription to the wrong patient.  The only down side to having so many volunteers help us is that I didn’t get to have a lot of patient interaction.  Some people would shake our hands, smile, and say thank you after being counseled which was actually my favorite part of the day.  Some people actually went out for lunch but I decided to stay in and try my MRE (meal ready to eat) for the first time.  It actually wasn’t that bad.  It’s kind of like a goody bag.  You know what the main course is, but all the sides and desserts are a surprise so it’s kind of fun! 

We went out again today but it was the last day of MEDCAP 1 so they cut us off around 1300 with only a few patients trickling through until about 1500.  We then had to pack up and clean our area out.  There were so many people coming in to see if we needed help, it made it go by much quicker.  We only saw around 200 patients on the first day and about 170 on the second, which is apparently much fewer than in other countries.  I’ve heard they saw about 800 patients per day in Indonesia and the Philippines.  Even though we didn’t see as many patients, we still seemed to keep busy the entire day.

Overall, it was a great experience.  We were told that the people were very thankful to have us there and you could tell that they really appreciated all of the services that were provided.

MEDCAP 1 Site - Elementary School

MEDCAP 1 Pharmacy Team

July 16^th

Today I was able to go out and volunteer to help out with ENGCAP, which stands for Engineering Civil Assistance Program. I thought that we were going to be painting a school or something along those lines, but they split the volunteers up into two groups and my group went to a clinic that was being renovated.  Instead of painting, they handed us a hard hat, gloves, and a bunch of rakes, shovels, and other tools… I had no idea what I had gotten myself into.  The back of the clinic was full of dirt, bricks, and waste products.  The clinic had actually been throwing needles out the windows into the back yard along with other biohazardous waste.  There was a big pile in the corner where they had burned the waste, however a lot of the needles didn’t burn so we had to be really careful where we stepped.  We proceeded to rake out the area and break down the brick so that they could pour concrete over the entire area and make it all level.  Basically, I pushed dirt around all day in the blazing sun.  Well, not all day, it was more like I worked for five minutes and then rested for 20! Haha!  It was quite the experience spending the day with a bunch of construction workers.  I have so much more respect for all of them.  They have a really tough job and somehow they still managed to laugh and joke around in all that heat.  I could barely speak, I was so tired!  There were three kids, that lived next to the clinic, that came out and were trying to talk to us.  They knew very basic English like “hello”, “what’s your name”, etc.  They were really cute and friendly.  One of the volunteers did some “magic tricks” for them.  The older ones figured it out but the little one was fascinated by him and was giggling the entire time!  It was priceless. Across the street, there was a small stand selling drinks and snacks.  It was attached to a house where a bunch of people were playing games and hanging out.  They had a chicken and duck pen, which would eventually result in food on the table.  The pen was really large and it occurred to me that they probably were more humane to their food animals than in the US because it is not all so mass-produced.  The family didn’t mind us looking around and one man even came out with a smile on his face and tried to communicate with us.  I couldn’t believe how nice and welcoming they were, I half expected them to tell us to get off their property. 

When we got back to the pier, one of the guys on the ENGCAP and some other people from radiology wanted to go eat dinner on the beach so I decided to go with them.  It has been great to be able to get off the ship and eat the local food.  I feel really lucky because a lot of people have not been out in Vietnam yet and I have already been out on six days.  Being in the pharmacy really gives you so much opportunity.  I feel like I am having too much fun!  The next two days, I am scheduled for the PM shift in the pharmacy, which is from 1500 to 2330.  Tomorrow will be my first real day in the pharmacy so I am really excited.  It feels like I am going in for my first day of work!

 Breaking bricks!

Hanging out with the neighbors!

July 17^th & 18^th

            My first two shifts in the pharmacy were great.  I was lucky to be scheduled with military technicians that really knew what they were doing and were proactive in teaching me the system and letting me try it for myself.  I was able to enter orders, fill prescriptions, and even get a little extra experience in the sterile compounding hood.  I did a few add-a-vials and got to do an antibiotic reconstitution with sterile transfer.  It was exciting because it was my first time doing that since our lab class and it was actually going to a patient!  I even got to attend a couple of lectures during the daytime so I felt like I was learning a lot.  I have been really impressed with the “technicians” who work in the pharmacy.  I put technicians in quotations because these guys joined the Navy and then actually went to school to become Corpmen.  A Corpman is actually a combat medic who is trained in all aspects of healthcare.  These guys are really smart and have a lot more education than I would expect from a “pharmacy technician”.  They can put IVs in patients and they know a lot about the medications they work with.  They actually do most of the counseling to the patients.   They even do presentations for us that are at the level of a graduate student.  It has been really impressive, I have a lot of respect for them.  

Goodbye Vietnam and Hello Cambodia

Tour of Vinh City

On the 21^st of July I went on a tour of the area surrounding Vinh Vietnam.  Unfortunately our tour guides did not speak very much English and there were times I wasn’t sure what I was looking at.  However, I still had a good time and learned more about Vietnam.  Much of the tour focused on Ho Chi Min and communism.  Stops along the tour were Ho Chi Min’s birthplace, the Ho Chi Min Museum, and the Soviet Museum.  The Ho Chi Min Museum was gorgeous with pagoda inspired buildings and tranquil gardens.  The museum included a jeep Ho Chi Min rode in, clothes Ho Chi Min wore, and a memorial to Ho Chi Min.  At the memorial there was a special spot to leave flowers.  I noticed many people looking as though they were praying to the statue of Ho Chi Min.  I found this interesting as most people in Vietnam are atheist, but many practice ancestor worship.  Ho Chi Min was everywhere, as a statue in the park to paintings for sale to plates to eat off of.  It became quite apparent that the people of Vietnam have a great respect for Ho Chi Min and view him as a hero.

Ho Chi Min Museum

Ho Chi Min Museum

At the Soviet Museum we had a tour guide.  She wore a beautiful Ao Dia, a traditional Vietnamese dress.  As we discussed her dress, she told me that I could pull off an Ao Dia myself and that several places sold them in the city.  I was very tempted.  Practicality won out in the end and I did not purchase one…

Ho Chi Min Statue in the Soviet Museum

The last stop of the day was a Temple.  It was elaborately decorated on the inside with gold while the smell of incense hung in the air.  The temple set on top a mountain and offered beautiful views of the Lam River below.  It was a very peaceful, yet hot, environment.

View of the Lam River

 

Surgery

On the 21^st I had the opportunity to observe a surgery on an inguinal hernia of a three-year-old girl.  I did not have the opportunity to see much of what was going on, as there were seven other people also trying to observe, plus the three physicians doing the procedure.  The observers were Japanese and Vietnamese physicians and one medical student.   Since they are much more likely to perform a surgery than I am, I tried to stay out of their way as much as possible.  I was able to observe the teamwork between the three physicians as they worked to improve a little girl’s life.  During the surgery a drape was placed, so only the area of the body being operated on was seen.  That being said, I couldn’t forget the precious face of the little girl as the surgeons were performing their operation.  I hope she had a successful recovery from the surgery!

I had the opportunity to see some of the patients as they left the ship on the 24^th before we began sailing to Cambodia.  The patients looked so happy and waved as they passed.  It was nice to see the faces of the inpatients that received some of the medications provided by the pharmacy.  Also leaving us on the 24^th was the Japanese Ship, Oosumi.  The ship had stayed by our side from Indonesia until the end the Vietnam.  We went outside on the deck to wave goodbye to our Japanese counterparts.  I wish they could have stayed with us throughout Cambodia too.

Fun and Games

On July 24^th we held the Pharmacy Olympics.  Games included pin the tail of the water buffalo, pharmacy trivia, building the tallest tower out of boxes of prednisolone acetate ophthalmic solution in 1 minute, and a scavenger hunt.  We played in teams of two.  Josie, an Austrialian pharmacist, and I partnered up to form the Pharminators.  I’m not sure how Josie felt about being my team mate afterwards, but let’s just say that pin the tail on the water buffalo just isn’t my game.  However, we did redeem ourselves by winning the tower building contest with a whopping 24 inch tall tower.

Pharmacy Olympics

The ship provides activities to keep everyone entertained.   One night we had an ice cream social.  The navy band made it a party with their excellent playing.  Another evening we watched Mission Impossible: Ghost Protocol on the flight deck.  It was very windy and everyone’s chairs and popcorn kept wanting to blow away.  However, the weather did make the big sandstorm in the movie much more realistic!  In addition, we had a licensed acupuncturist aboard.  People could sign up for free, so I decided to try it.  I could not feel the needles as all, although there was some tingling and warmth.  I had needles in my ears, neck, lower back, knees, and ankles.  The overall experience was very relaxing I would highly recommend it.

We  left Vietnam and have been in Cambodia for the past couple of days days.  Cambodia offers exciting sites through tours I have booked and MEDCAPs, as well as lots of rain (it is the rainy season right now).

Vietnam: MEDCAP 5

I ventured into Vietnam on July 18^th, 19^th, and 20^th to assist with MEDCAP 5 (Medical Civic Action Program) at the Hung Loi Primary School.  All MEDCAP sites in Vietnam were located in the Hung Nguyen district of Nghe An.  The school I was at consisted of two, two story buildings surrounded by a concrete barrier.  The surrounding area included rice paddies and wilderness.  Two families had stands set up outside the school selling drinks, fruit, and jewelry.  The children of the families were adorable and would run into the school to play with some of the members working there.  The pharmacy was set up in one of the classrooms.  We had a lot of room to work, with the medications set up on wooden school tables lining 3 walls.  The room had ceiling fans.  However, with temperatures around 100 degrees and high humidity we still did a lot of sweating.

Family Outside of MEDCAP site

 

Three pharmacy team members form the USNS Mercy staffed the pharmacy, along with two Japanese pharmacists and one helper and three Vietnamese translators. 

Pharmacy Team Day 1

Pharmacy Team Day 3

With a total of nine of us working, we were able to dispense the medications without much of a wait.  I loved watching the teamwork between not only the different countries working together in the pharmacy, but also how the different health professions came together to provide the best patient care possible.  I was told Vietnam was not as busy as Indonesia and the Philippines.  Our patient totals were around 80, 200, and 300 on days one, two, and three respectively.  Many of the patients were older females with wrinkles, white hair, and black teeth.  I thought they were adorable (yes, even with the poor oral hygiene).  Later I learned that the discoloration of the teeth was due to chewing betel nut, a small fruit of the areca palm (I highly suggest googling for a picture of the betel smile).  Each family received only one ticket to get aid at the MEDCAP.  Often an elder member of the family was chosen to receive medical care, reflecting the respect placed upon the elderly in Vietnam.  I did not have much interaction with the patients due to the language barrier and our highly efficient interpreters.  I will say though that a smile is universal!

Working in the Pharmacy

The Japanese pharmacy members helped keep things fun in the pharmacy by bringing origami, stickers, bubbles, and fans to pass out to the patients.  Thankfully I also received some bubble solution with the coolest bubble wand ever.  I spent about an hour during our mandatory two hour lunch break to blowing bubbles with the translators.  

The Navy Band performed at our MEDCAP for two days.  Since we had a slower moment in the pharmacy, one of our translators, Harry, and I went down to listen to the band play “Moves Like Jagger” the first day there were at our MEDCAP.  I leaned in to have her take a picture of me with the band in the background and ended up getting pulled into some dancing.  Unfortunately the only other people that joined in were Harry and a darling little Vietnamese girl.  We still had a good time though.  The next day we were too busy to go watch the band, but we could hear the music in the pharmacy, resulting in a couple of mini dance parties in the pharmacy!

The Navy Band

Did He Really Just Say That?

As a side note, we had to take a 45 minute boat ride and then an hour bus ride to get to and from our MEDCAP site.  By the time I arrived back at the pier the first day I was really hot and not looking my best.  Even so, I received my first ever Vietnamese marriage proposal.  I was with a pharmacist who speaks Vietnamese and she was able to translate.  The conversation went like this:

Vietnamese guy:  “Ask her if she has a boyfriend.”

Me:  laughing

Vietnamese guy:  “Ask her if she’s willing to marry a Vietnamese man.”

Me:  laughing harder

Vietnamese guy:  “Tell her I’ll learn English for her.”

Me: laughing even harder

I was so stunned and found the situation so amusing I just couldn’t stop laughing.  I probably should have handled that situation a little better…

July 13th

I knew I wouldn’t be able to blog for a few days due to my schedule being so busy for the past 6 days. On Tuesday, the 10th, we mustered at 0700 to go to the pier to sort the medications from the Vietnamese government. We took a 45minute boat ride from the ship to the pier and when we got there it was hot! When we got off the boat, someone said “Pharmacy! That’s your box.” I laughed a little because it was a tiny, closed up trailer and we had about 22 people with us! I couldn’t believe they were serious. It was a long, hot day but we made a lot of progress. The medications were all in boxes and we had to count them out and divide them up into six different MEDCAPS. It took a long time for some of the drugs, like acetaminophen, because there was so much of it. We also sorted the medications into bags and labeled them so that they were ready for dispensing. We were told the MEDCAPS in Indonesia saw about 800 people per day so we were expecting a lot of patients. It was frustrating though because a lot of the drugs ordered by the pharmacy either didn’t come or were replaced by something not relevant for use. For example, they ordered erythromycin eye ointment and received erythromycin topical ointment. We worked all day on Tuesday and took the boat back around 1830 (6:30pm), which was perfect because we were able to sit and watch the sun set over the mountains. It was gorgeous. I was exhausted from the heat and fell asleep really easily right after my shower. We repeated this on Wednesday except we had a few less people so it wasn’t as hot and we got to go out for lunch! We took a bus to the beach and ate at a Vietnamese restaurant along the water. It was quite different than eating in the states. We had crab, shrimp, fish, squid, and some of us had a coconut to drink! It was all fresh food and quite the experience. We went back to the pier after that to continue with our packing and sorting. We then returned to the ship around 1900 (7:00pm), which was awesome because it was the end of the sunset and then the darkness fell. I have never rode on a boat in the middle of the ocean at night and it was an experience I’ll never forget. I sat outside, on the upper deck and watched the stars. It was really surreal.

I was scheduled to be at the pier yesterday, the 12th and today to finish packing but luckily we finished all of the pre-packing for all 6 MEDCAPS by about 11am yesterday. We decided to go out for lunch to treat ourselves. We hopped on a liberty bus and went to a large shopping center. It was basically a big mall but it had a grocery store in it. When we walked in we wanted to get a group picture and one of the Vietnamese clerks from one of the stands came running into our picture in the front. Then she grabbed my arm and asked her friend to take a picture with me. She was so happy. It was really nice to see that the people were so friendly to us. I noticed as I was walking around that the people looked very serious and just kind of stared at us, but as soon as I smiled at them, their faces would light up and they would smile right back at me. I just kept thinking “everyone smiles in the same language”… kind of cheesy, I know, but it is really true, especially on this mission. It was really cool to be able to see the villages and the homes people live in.

You can tell that this country is more controlled by the government than others. The buildings constantly alternate from rich to poor. Apparently, we are actually in a touristy area so there are a lot of hotels and beach restaurants, so it is difficult to really determine how the people live in the more rural areas. Today, the department head of the pharmacy decided we didn’t need to go out to the pier, so we mustered at the pharmacy at 7am. I really wanted to learn how the pharmacy worked and learn the system so I was sticking around in the pharmacy with my preceptor in hopes that I would be able to become acquainted. Suddenly, the department head came in and told me that I had been signed up to watch a surgery that day! I quickly went downstairs to the OR and signed in. They gave me the option of seeing a cataract surgery, an undecended testicle, or a hysterectomy. I chose the hysterectomy. The surgery had already begun when I came in so it took me a little bit to understand what was going on. They had just opened the women up and were working on getting the uterus out. I watched the entire surgery and after they removed the organs, I was able to look at them and see the ovaries and the uterus and the fallopian tubes. The uterus was apparently much larger than normal because it had fibroids in it which was causing the women a lot of pain and a lot of bleeding. It was kind of gross but I couldn’t stop staring at it. The thing I found the most interesting about the surgery was the way the doctors interacted. There were two main surgeons, an American and a Vietnamese doctor. They also had a Japanese doctor and another Vietnamese doctor assisting. They had a translator there but for the majority of the surgery, they were able to communicate without using the translator. The only time they used her was when they were discussing differences in their techniques or how they usually perform the surgery. They were asking why the other one typically did it one way versus another and then they would compromise and choose a way they both agreed on. They really seemed to respect each other. It also seemed as if the American doctor was teaching the Vietnamese doctors, which was really cool. I was able to watch a second surgery directly after the first one, which was a cervical polyp removal. This patient was much younger and I was able to see her before the surgery. She seemed so frightened to come into the operating room. I could only imagine what it must be like going on to a foreign ship and then come into an operating room full of foreign doctors who are speaking a language that you don’t understand and then having to undergo such an invasive procedure. (if you’re a women, then you understand) She was awake the entire time with only an anti-anxiolytic to help calm her. The surgery only lasted about 20 minutes and then she was able to go back to the holding room to be with her escort. Later that day, I went to a lecture on neuro rehabilitation which was really interesting. On most days, twice per day, the department of medical services offers lectures on different topics. I wasn’t aware of this previously but I am going to try to go from now on.

Night Shift and Liberty

The Night Shift

I was assigned to work three night shifts in a row.  It was my first time working a night shift.  I was a bit worried about being so tired I couldn’t keep my eyes open for the entire eight hours (11pm until 7am).  Anyone that knows me knows how strongly I feel about getting sufficient sleep (like 8 or 9 hours a night).  However, it wasn’t as much of a problem as I foresaw.  The florescent lights on the ship make it easy to not know the time of day (especially if you don’t look out a porthole).  Also, lights are out in berthing from 1000 until 1600 for day sleepers.  It was a good experience making IVs in the biological safety cabinet.

Volunteering in the Galley

Project Hope volunteered to serve food this past Sunday evening.  We were each given a fancy paper hat to wear, which quickly became drenched in sweat.  It was so hot in the galley even my ankles were sweating.  I have so much more respect for those that have to work there every day!  On a side note, I was really surprised at the number of people who wanted brussels sprouts.  Who knew they were so popular.

Getting ready to serve food.

Exploring Vinh, Vietnam

Yesterday I had a liberty day and went in to Vinh with five other members of the pharmacy crew.  We did some shopping along the streets of Vinh and in the local market.  The local market was a crazy maze of just about everything from knockoff designer handbags and shoes to disco balls and flashing lights to fabric and clothes.  I purchased a rice paddy hat, which local people actually do wear in Vietnam! 

We also spent quite a bit of time in the shopping mall, “Big C.”  The mall has stores in the lower two levels, a supermarket in the third, and a foot court on the fourth level.  I had my first shrimp burger there at the McDonald’s of Vietnam, Lotteria.  The shrimp was actually compressed into a pattie.  I found it to be delicious. 

In the evening we went to the beach and walked down to let the warm ocean water hit our toes.  The city really came alive at night as the lights flashed, music played, and people came out to enjoy the beach and restaurants.  My favorite thing I saw while waiting for the bus was what I like to call the “party golf carts.”  They looked like extended golf carts (two rows of seats behind the driver), with flashing rope light around the frame, and loud music playing.  They were a fun alterative to a taxi.

The Next Three Days

In the upcoming days I will be going out to the fifth MEDCAP.  I'm looking forward to having some patient interactions and listening to patient stories.  An RN told me of two patients recently brought onto the ship for surgery due to scars on their face upper arms and torso.  Both patients said the burn was originally due to fireworks.  A translator was able to learn that the scars were, in reality, from some much more horrific.  In retaliation for their husband cheating on her, a women may have acid poured on her.  One of the patients has lived with the scars for around 18 years.   I cannot imagine the pain or humiliation felt by these women for something that was not their fault.  I truly hope their surgeries are successful and wish them best of luck.  I'm saddened to know these kinds of incidents and retaliations are still occurring against women.

Arriving and Ship Life

I feel bad it’s taken me so long to upload a post to the blog.  It took us a while to gain access to the Internet and it takes patience and quite some time to upload (I spent over an hour one day just trying to upload this blog…and it still didn’t work).  Therefore, I have written a very long entry.  I would recommend reading it in sections!

Traveling to the USNS Mercy

Dayna and I left Dulles on July 3^rd and arrived in Manila, Philippines on July 4^th after 2 flights that totaled over 18 hours.  Our Project Hope adventure truly began on July 5^th when we caught the bus to take us to Subic Bay to catch the ship.  We survived the terrifying experience of driving through Manila with 6 lanes full of crazy drivers.  The rules of the road, such as stop lights and turn signals, only seemed to be a suggestion.  Sadly, our bus did not fair as well.  Not too far into the journey, we began to smell burning rubber and the air conditioning stopped working.  Then about 2 hours into the 3 hour bus ride, our bus began smoking in the back.  It was so thick I could barley see the people sitting in the back of the bus; the smell so intense that I could taste the burning rubber on my tongue.  The bus driver told us to just open our windows.  We knew something was wrong and opening the windows would not be much help.  Not too much later the bus died.  It was actually quite a comical experience.  To top it off, there was a spider the size of my fist on the bus.  Thankful someone shooed it down the aisle and off the bus, but not before I stood up on my seat in fear of it going on the offensive!  We had to wait about an hour for another bus, but we had a gorgeous view of some mountains and a breeze to cool us off!  When the other bus arrived the group showed awesome team work moving the bags to the new bus assembly line style.  The experience bonded those of us riding the bus!  I knew this trip would be full of unexpected adventure after this kind of start.

View from the Broken Down Bus

Getting Settled into Ship Life

Once on the ship we signed in and received some initial information, including our bunk and two lockers.  I ended up with a top bunk, so two bunks are below me.  It was a bit challenging at first without a ladder, but now I can get up and down without too much fear of falling (which is quite a feat for someone as clumsy as I).  Getting up there makes me feel like an acrobat flying upward before falling onto a soft cushion of mattress.  I will admit however, having the top bunk is not conducive to making the bed.  It is really challenging, so I generally just sleep on top the covers in fear of having to go though that whole experience again!  The food in the mess hall is pretty much just like any other cafeteria food.  Some days are better than others…  Breakfast is generally pretty good and I would be perfectly happy to get breakfast sandwiches and chi tea for all three meals!  They really have packed so much into every nook and cranny of the ship.  There are 3 gyms (they even offer workout classes), a library, barbershop, chapel and more aboard.

There are around 1,200 people currently living on the ship.  There are only 35 members from Project Hope and we span over the entire US from Washington state to Washington DC.  California State University and the Church of Latter-day Saints have quite a few people on board.  In addition, there are military personal not only from every branch of the US military, but from around the world, including Canada, Australia, New Zealand, Philippines, and Chile.  I am really looking forward to getting to know more people and learn about their countries as the mission commences.

Liberty Days

Our first few days on the ship were liberty days (aka free days).  There were free buses to various places around Subic Bay.  A few Project Hope people and I went to the mall and various street venders.  Subic Bay is beautiful and all of the people I met were so friendly!  Also, they are very good at selling their wares, especially to me!  We couldn’t walk more than a few feet without someone attempting to sell us something from sunglasses to unofficial UNSN Mercy t-shirts.  Savvy shoppers barter with shopkeepers to get the best price.  I paid the stated price for most of my items because it was still a rather cheap price and I know the people don’t make a lot of money.  However, I did get a rather good deal at the last place we stopped.  I was interested in buying a dress, but didn’t have enough money.  It only took me saying sorry and turning around to leave for the price to suddenly drop down 50%.  It was kind of thrilling to know I’d gotten such a good deal!

Sailing to Vietnam

The ship left Subic Bay on the 7^th.  We went onto the flight deck to take some photos and see the action.  It was really cool to see the 2 ships pushing and 1 ship pulling the Mercy to help get it out of port (they were so small compared to the Mercy).  Of course we also took this opportunity to take photos.

Departure Photo (Back: Andrea and Brittany, Front: Dayna and Ravi)

We arrived in Vinh, Vietnam on the 10^th.  The pharmacy team, including me, got started the same day inventorying and packing the medications needed for each MEDCAP.  This process occurred on the pier in a large, gray storage container that provided some “air conditioning.”  We have to take a 45 minute boat ride to the pier.  After the use of my seabands and some meclizine, I find the ride quite enjoyable.  The wind plays with your hair and occasionally the ocean sprays upward to give you a kiss on the cheek!  It’s quite refreshing after a day of work in over 105 degree weather with heavy humidity.  After three full days of packing, the medications for all 5 MEDCAP sites are completed!  I may have sweated more than I even had in my life, but it was worth it to help those in need.

Pharmacy Team Packing Medications for the MEDCAPs

In the Upcoming Weeks

I received my schedule for the next couple of weeks.  I will be working the first of my three night shifts tonight from 11pm until 7am.  The night shift offers more opportunities to make IVs and I’m looking forward to gaining more inpatient experience.  I am then scheduled to go out with MEDCAP 5 from the 18^th until the 20^th.  In addition, on one of my liberty days I’ve signed up to go on a tour of Ho Chi Min’s childhood home and some temples.  I’ll have lots to experiences share in the upcoming weeks and I’ll do my best to get updates posted!

My Final Post!

My last week on the mission was as usual filled with a lot of rewarding, memorable and fun moments. I, together with the other pharmacy personnel on the ship spent most of the week organizing the medications and supplies for the various MEDCAPS for the impending mission in Cambodia. The ship also held a lot of events over the week to mark the end of the mission in Philippines. Among the events was a musical concert hosted at the Mess hall of the ship on Saturday the 30th of June 2012. An ensemble of Filipino children treated us to an array of danceable and head-nodding tunes from traditional Filipino flutes called Ukeleles. These children exhibited remarkable dexterity and fluidity on the instruments and set the crowd agog when they ended the show with a rendition of Bruno Mars’ "Just the way you are". It was followed by the week's Missions update hosted by the Australian contingent. These weekly updates keeps us abreast with the progress of the entire mission and provide us with pertinent information concerning the mission. Our hosts provided with a lot of comic relief and interesting information about Australia and the mission as a whole. This weekend’s update was concluded with presentations of certificates for those of us leaving the mission in the coming week. Alexis, Zara and I were honored to be among those presented with certificates by the mission commander and the commanding officer of the ship. We were scheduled to dock at our liberty port in Subic Bay, Philippines on the late afternoon of 2^nd July 2012. Our preceptor, Zara along with other personnel at the pharmacy department kept us entertained on the morning of this day by organizing a pharmacy Olympics at the pharmacy. Among the sidesplitting events of the Olympics were: “Bowling with coconuts” and “Drawing on a rubber glove”. We were then invited to partake in a colorful Navy tradition called “Manning the Rails” an hour before we docked at Subic Bay. In this event, Navy personnel clad in their ceremonial white attire line up along the rails of their Naval Ship whenever they dock at a Naval port or pass another Navy Ship. It was indeed a breathtaking scene and an honor to be allowed to be part of this esteemed tradition, standing along the rails with these distinguished men and women of the Navy for about an hour till we docked at Subic Bay. The whole Pharmacy gathered at a plush restaurant in Subic Bay called Gerry’s Grill when liberty was granted in the evening to enjoy some sumptuous Filipino cuisine and say our goodbyes. We really had a good team going on at the pharmacy department and morphed into a tight-knit and very efficient group.

"Bowling with Coconuts"

                                                   Manning the Rails

I got up on the morning of 3^rd July 2012 at 0400 hours and got ready for our morning muster at 0500 hours. We checked out from the various departments on the ship after the muster and got on the early morning shuttle to the Capital, Manila, from where were scheduled to depart to the U.S the next day. Manila is a busy and bustling city where the traditional Filipino transportation systems of Jeepneys and tricycles are ubiquitous. Our bus was stuck in traffic for about an hour and a half on the popular Manila Street, Edsa, enroute to our hotel. I took this opportunity to take in the sights and sounds of this busy city from our bus. We visited the popular Mall of Asia, among other sites after a few hours of rest at the hotel. It was refreshing to see a display at the forecourt of this huge Mall in honor of the our July 4^th Independence Day. I willingly acquiesced to the requests of some of the Filipinos at the Mall who wanted a picture of me alongside the statues of iconic Americans like Michael Jordan, Marilyn Monroe and Elvis Presley in this display. I arrived in the U.S on July 4^th 2012 after an 18-hour flight from Manila to Washington Dulles Airport enroute Tokyo, Japan.

                                                            At the Mall of Asia

It has been a privilege, an honor and a priceless opportunity to be part of this mission. I have through this mission witnessed the goodness of mankind when resources and expertise are pulled together to come to the aid of underserved populations around the world. I have derived a lot of satisfaction from putting my shoulders to the wheel of this noble humanitarian mission to bring relief and smiles to the faces of thousands of people. I have on this mission also interacted with beautiful people and cultures that I ordinarily will not have been in touch with. I feel blessed to have been on the mission!

I will like to extend my utmost gratitude to Dean Alan Mckay, Dr. Dawn Havrda, Nicole Clindinst and the entire staff and faculty of the Bernard J. Dunn School of Pharmacy for the diverse roles they played in making this mission possible and most rewarding for us. I will also like to thank everyone who followed me on this blog. I hope I was able to bring you along on this most fulfilling ride through my blog posts. I am changed, charged, challenged and hungrier than ever to succeed because of my experiences on this mission!            

Monday, July 9th

Disclaimer:  It has been very difficult to update the blog because at first we didn’t have access to the Internet and now that we do, it has been running really slow. 

Monday, July 9th

Yesterday, we spent the morning in the pharmacy spending more time getting acquainted.  We were supposed to receive our schedules but we had to wait because liberty days (also known as a day off) were being assigned for Vietnam and they needed to work the pharmacy schedule around those days.  The pharmacy personnel are so nice and they all really want to teach us what they can.  There are a lot of students and volunteers in the pharmacy.  There are 3 pharmacist volunteers so far but 2 more are joining us in Vietnam.  We then have 2 technician volunteers and about 6 other students affiliated with University of California San Diego.  They are all either pre-pharmacy or incoming P2’s at the University of Buffalo.  It is a little crowded in the pharmacy now but when people begin staggering shifts and going out on MEDCAPs (medical civil action programs), it will probably be easier to maneuver around and learn more about how the pharmacy runs.  The pharmacy let us go around 2:45pm so I quickly went to do some laundry and then we ate dinner and played some games at night.  I went to bed around 10:30 and I slept like a baby.  I have been sleeping really well ever since the boat departed the Philippines.  The motion kind of rocks me to sleep. =)

           

We had quite a bit of excitement today because we had to do an abandon ship drill.  We had to dress in long sleeves, tuck our pants into our socks and wear a hat.  We looked ridiculous.  We then had to grab a life jacket (which was like a race) and then go up on the flight deck and check in at our lifeboat station to make sure we knew where to go.  We were up there for about 25 minutes in the scorching sun and humidity.  Yes, even in the middle of the ocean, it is ridiculously humid.  It occurred to me to just go running and jump into ocean.  I had a life jacket on and I was sure they would be able to get me back up with a ladder or something.  I then realized that the water was probably just as hot as the air and most likely wouldn’t cool me off, so I refrained.  After that, we went back down to the pharmacy to get our schedules and go over some problems that the pharmacists and technicians gave us earlier that morning.  They were pretty much just examples of prescriptions that have been processed in the pharmacy before and we had to do the calculations and find what was wrong with the scripts.  It was very actually very helpful since I had not seen some of the calculations in a while.   

It was really exciting to get our schedules!  Starting tomorrow, we will be going over to the pier in Vietnam on a boat to begin sorting out the medications.  The Vietnamese government required that we get the medications from them and they won’t let us bring them on the ship.  Therefore, almost all of the pharmacy personnel have to go out all day to sort the medications out for the upcoming MEDCAPS.  MEDCAP 1 begins on Wednesday, July 11^th.  No one will be staying overnight in Vietnam so we will all be coming back every night to the ship.  The first four days, I will be out on the pier sorting medications.  After that I will be working on the last two days of MEDCAP 1.  The next day, I have a liberty day and I will be able to get off the ship.  I think I am going to do a tour that the ship has organized.  I am not sure which sites it goes to yet, but I heard one is a temple so it sounds really great!  After that, I have a couple shifts in the pharmacy, another liberty day, and then I will be going out on MEDCAP 5 for two of the days followed by a couple more shifts in the pharmacy.  I have a lot of days working with my preceptor, which I am really excited about because he is really enthusiastic and is always taking the opportunity to teach us new things.  We don’t have our schedules yet for the Cambodia part of the trip but I am really excited to see how the next 15 days plays out!  I will update as often as I can and take lots of pictures.  I did not attempt to upload pictures this time but Brittany and I have been taking a lot.  I will try to upload some when the Internet becomes more reliable.  So long for now!

            

Saturday, July 7th

Saturday, July 7^th 

Hello!  I have finally had a few minutes to sit down and write.  Our journey here has been quite eventful so far.  We arrived in Manilla, Phillipines after spending 18 hours on two different airplanes.  We spent the night in a nice hotel and then caught a ride to the Marriott hotel where the bus picked us up.  The Marriot was a gorgeous hotel with a HUGE mall in it and a casino!  It was guarded really well.  We met a bunch of people from Project Hope while waiting for the bus.  Most of them are physicians or nurses that volunteer their own time to go on these missions.  Many of them have participated in missions on the MERCY before this trip.  The bus ride was great because we got to ride all through the city of Manilla.  It is a really big city that was very populated.  We then got to see how the people lived outside of the city.  We saw farmers working in the blazing sun and humidity.  It really looked awful to be out there.  There were a bunch of little shacks in the trees near the land they worked on, but I wasn’t sure if they lived there or just retreated there when they needed rest.  The views of the countryside were really beautiful.  After a little while, the mountains in the distance began to get bigger and more beautiful.  Unfortunately, our bus started billowing clouds of smoke about 30 minutes before reaching our destination, Subic Bay.  We had to pull over and wait for another bus to come get us.  Luckily the bus driver stopped at a great spot where we had awesome views of the mountains.  We arrived at the ship a little while later, checked in, and got settled into our bunk, or as the navy call it, our rack.  It took awhile to get our lockers set up so we spent the night getting settled in. 

The ship was on liberty our first few days so we were able to get off the ship yesterday and today to explore Subic Bay with a few of the volunteers that are also with Project Hope.  We went to a local mall and walked around to little stands where the locals were selling their hand made items.  I liked a lot of their stuff but a lot of it was too big to bring back with us so I purchased a few small items.  We walked along the shoreline and got some great pictures of the ship and some palm trees.  We then went to a mall area and ate our last meal off the ship and then we headed back on to get ready to pull away from the dock and get going on our mission to Vietnam.  It was amazing to watch the ship pull away.  As the mountains became more distant and the fog set over and the sun began to set, it was really an incredible sight to see. 

            We had our first pharmacy meeting today, July 7^th when we got back to the ship.  We were given a few tours of the ship and the pharmacy so that we would be able to find places and things when needed.  I am still a little confused as to how the pharmacy operates on the ship and the difference between inpatient and outpatient.  We were given an orientation of the pharmacy personnel and what would hopefully be going on in the next few days.  Everything is uncertain right now because Vietnam is being strict as to what we are allowed to do.  Apparently they have taken away a lot of the community events that were scheduled and they won’t let us prepare the drugs prior to our arrival.  They won’t even let us bring them on the ship.  So on Tuesday, July 10^th when we arrive, we will have to take a boat to the pier in order to sort the medications on land.  We are not sure who will be going yet, but we will be getting our schedules tomorrow so we will know then. 

            There are phones on the ship so that we can call home but the Internet has only been available for us in the coffee shops that are off the ship in Subic Bay.  We are trying to get our accounts set up so that we will have access on the ship now that we have left.  I didn’t sleep great the first night but that was mainly due to someone’s alarm going off at 3:45am and never turning off.  It’s a little bit like summer camp in the berthing areas, we are in really close quarters.  So far most of the people that have been on the ship have been staying in hotels in Subic Bay.  Tonight will be the first night where everyone is back on the ship so it should be interesting to see how crowded it is.  I should probably go to bed now, it has been a long day. Goodnight! (well, good morning for those back in the states) =)

First Post!

July 3^rd, 2012

It is the night before Brittany and I depart for our journey and of course I cannot sleep!  I am feeling a spectrum of emotions from sad to scared to extremely excited!  I am so ready to see what the next five weeks has in store for us.  It has been quite exciting the last few weeks as I read Alexis and Kofi’s blogs.  They have had so many incredible experiences.  The anticipation of what our mission is going to be like is overwhelming with so many possible scenarios running through my mind.  I can’t believe that we have been offered this opportunity and the fact that it has finally arrived is so surreal. 

            We depart tomorrow July 3^rd from Washington, Dulles airport around 1:35 and after a 14 hours flight (yes, 14 hours!) we will arrive in Korea for a short layover and then continue onward to Manila in the Philippines.  We are going to spend the night in a hotel and then board the ship the next day, which will be July 5^th.  Shortly after that (I am not quite sure what day exactly), we will head to Vietnam!  I am so excited to see how the people live and what the country looks like.  I will be sure to take many pictures!

            That is all for now, I should get to sleep.  The next time I update will be from the USNS Mercy in Southeast Asia!  Thank you Shenandoah University for such an amazing opportunity!!

LAST BLOG!!

 So it’s July 1^st and the last full day in the pharmacy together as a team! The time has flown by and been filled with endless life-time memories. The last few days here have been very busy! I was on MEDCAP 6 in the Philippines for days 3 and 4 and it was HOT!

To get to the MEDCAP on the first day, we mustered at 0530 and I got to ride the Japanese LCAC, which is like a giant hover craft. It was very loud and hot since there is no airflow inside. It reaches speeds of 60 knots when at full speed. The journey in the LCAC takes about 10 minutes but the whole process of transporting 100 people took almost an hour. Once we got to the pier, we had to pick up all our pharmacy supplies from the storage boxes and load them on the trucks. We then rode in vans to the MEDCAP site, which was at a school and only 10 minutes away. Our site was right along the coast and we could see the Mercy sitting out on the water. The morning went by quickly as we started seeing patients by 0800 and were extremely busy! We had lots of help though with 3 Japanese pharmacists and 5 or 6 local volunteers as translators. Someone came by at one point with bags of fried bananas, which of course were delicious! It was the perfect mid-morning snack. When we broke away for lunch, Chief surprised us by saying she had the hook up for us. We walked across the compound and were treated to fresh grilled tuna and rice. Sprinkled with onion and lime, it was AMAZING! Pharmacist Paul and I sat by the ocean and chatted while eating our delicious meal. We then went back to seeing patients for the afternoon and stopped around 0430. We then packed up and transported back to the pier where we had to wait an hour for our ride back to the ship in the hot LCAC. That night, I was exhausted! We had a muster time for 0630 the next day, which was is like sleeping in around here.

The next day I was up bright and early to get a hearty breakfast before the day. Since we were the only MEDCAP going out that morning, we were pleasantly surprised and happy to ride the band-aid boat instead of the LCAC. It was a sunny morning and the breeze from the boat ride was quite an enjoyable start to the day. When we arrived, we got the meds from the boxes again and immediately went to the site to start seeing patients. We were told that for lunch today we would get to go to a local restaurant and we were preordering to speed the process up. I knew then that it would be a good day! The Japanese pharmacists were back and ready for another day. They were imperative to our operation running smoothly and were so friendly and funny. They always asked questions when they weren’t sure about something and would tell us about meds and strengths they had that were similar to what we were dispensing. The morning flew by and before we knew it, we were closing up shop to head out for lunch. When we got to the restaurant, I was shocked. It was beautiful! It looked like a garden with ponds of water with fish and sea shells strung together hanging everywhere. We were seated in a pavilion area that had the sea shells hanging all around the roof. The server immediately started bringing out our food and we were amazed. It was so much food and looked like delicacies. We had crab, shrimp soup, bitter melon, pancit, fried calamari, and I had fresh pineapple juice. It was superb to say the least! After we stuffed ourselves, we slowly headed back to the compound. It wasn’t that we didn’t want to go back, just that we were so full we couldn’t move very fast. However, once we got back and got things rolling, the afternoon flew by as well. We started cleaning up a little earlier than yesterday because the locals were throwing us a reception. So once we got all our extra meds packed away, we loaded them in the trucks and drove them to the pier where they were unloaded and stacked away to be palatized for helo transport. We then all climbed back into the vans to head to the Sports Complex for the reception. The drivers got lost briefly but we still managed to get there. When we walked in the doors and saw the reception area, my mouth dropped. The locals put on this formal dinner reception with homemade food and everything. I was stunned. It seriously felt like a surreal dream. They immediately invited us to try some sticky rice and ice cream as well as explaining the culture of reception and that the set-up is how they do their annual town party. They had one lady singing and her voice was beautiful! There was also a roast pig set out and people greeting us everywhere. As few minutes later, the lights dimmed more and music started playing. They began a cultural dance and it was amazing. I can’t even describe all the details but the whole experience was surreal to me. After the dance, they started passing out appetizers and invited us to take a seat at the dinner table. The woman began singing again as they passed out cold bottles of water. After the song, one of the local officials spoke and thanked us for all our help and invited us to get some food from the buffet. We happily obliged since we knew our time here was limited. The food was AMAZING! I didn’t expect anything less though and was so happy to be eating real food. It seemed that as soon as I finished my plate, we were told we had to leave. It was so short and such a whirlwind of an experience I had a hard time comprehending everything that had just happened. Hopefully my pictures and video captured the experience. We went back to the pier and got on the LCAC to get back to the ship (no band-aid boat L).  When we got back, I was immediately informed of 2 events for that evening that I wanted to attend so I got a quick shower and headed back up to the mess decks.

Our entertainment for the evening was a group of kids performing a concert for us with their ukuleles. The set lasted about 30 minutes and was great! They even played Bruno Mars – Just the Way You Are. They were fantastic! We then went into our weekly command mission update meeting sponsored by the Aussies so it was quite entertaining. That was then followed by a certificate presentation for all the people leaving in Subic Bay. There were quite a few people leaving in Subic so there will be a very new crew coming on before the Vietnam mission. The next few days are going to be fun-filled with lots of activities and busy with packing! We arrive in Subic Bay on July 2^nd and we leave for Manila on the 3^rd and fly out the morning of the 4^th. So as this mission and my first pharmacy rotation come to a close, I am so excited to be returning home and share my experiences with my friends, family, and colleagues. Thanks for following me throughout this journey and I’ll see you all states-side!