The Final Voyage

OK- better late than never! After getting back to the states and getting in to the next rotation (which was not NEARLY as cool as being in the Pacific) it kind of got away from me to put up my final blog (plus I was having a tough time admitting it was really over). So here it is- the last stop of my amazing trip, FSM, and my final farewell:

We celebrated the 4^th of July by attending the opening ceremony

for the start of the FSM mission, and continued on with a softball game of the SeaBee’s (the Navy construction crew that was based on the island) versus the softball leagues in FSM. We lost terribly but got to enjoy

some sunshine, some rain, and some good company. We walked the island a little and explored, finding some restaurants and beautiful views. The next night Andy and I got to attend the opening reception which was on the LCU (the smaller boat inside the ship that takes us to and from the island). We had the band playing, good food to fill us up, and we got to rub elbows with everyone including the ambassador to the United States in FSM.

Some of the worksites in FSM were nicer than we had experienced before. At our first site we were in a classroom that had lights and a running fan that would turn on after noon which was a pleasant surprise.

The next site I was at I got to set up the camp (manual labor time!) and organize the workflow in our area. These were all outside tents, but we made the best with what we had.

A lot of the patients had skin and fungal infections due to the VERY high humidity (most days it felt like you were in a

swimming pool), so we quickly ran out of some of the creams and solutions and had to compound some of our own medications. It was a great experience to learn to work with what you have and use whatever resources possible.

Andy and I, along with the other girls from Project HOPE got to attend the closing reception at the ambassador’s house. This was a good time for us to say our tearful goodbyes to everyone as we had to leave the ship the next morning, a day earlier than originally expected (with the military

you learn to expect the unexpected). We got to enjoy a dance show put on by the locals, some great food, and listened to speeches from the Vice-President of FSM, the Governor, and various officers from our ship. At the end of the night we all reluctantly loaded back on the LCU and headed back to the ship. We spent a few hours late into the night saying more goodbyes and headed to our racks for our last night on the ship.

0630 muster came way too soon. Lugging the past 6 weeks worth of luggage down ladders to the LCU and boarding it for the last time suddenly made me realize this really was goodbye. We had some of the crew who weren’t leaving with us come down to the well deck to say goodbye, so with the last of the hugs and exchange of emails, we boarded the LCU to leave the Cleve forever.

After the well deck filled up and we pushed out the back for the last time we were greeted by our friends lining the top of the flight deck waving and yelling their goodbyes- that’s an image I’ll never

forget. They woke up early to to give us the official “goodbye” they said we deserved. With tears in my eyes I waved until they were out of site.

This is an experience I will never forget, something I am so unbelievably thankful to have experienced. I think everyone should take time from their lives to reach out and help other people, spend some time out of their comfort zone, and work through situations they never thought possible to complete. To everyone I worked with ‘thank you’ for being part of my team, to everyone that made this possible you will forever have a place in my heart for allowing me this opportunity, and to everyone that has followed or read this blog I challenge you to go out and make a difference no matter how big or small.

Thank you Shenandoah University, thank you Project HOPE, and thank you to everyone aboard the final voyage of the USS Cleveland- we did her well.

Pohnpei, FSM

Well, all good things must come to an end, but we saved the best for last. Pohnpei, of the Federated States of Micronesia (FSM) was our final stop. The island, a lush, tropical garden situated in the Pacific about 500 miles north of the equator and a few thousand miles west of Hawaii, where it rains on average 17.5” every month, was a gorgeous location for our final mission with Project HOPE. Needless to say it rained regularly, sometimes more than four times a day, but between each quickly moving rain shower, the sun would shine and keep things nice and toasty-warm.

This weather made for interesting transport to and from the ship on the LCU (Landing Craft Utility), which has no roof or covering, so we were always praying that we would miss the rain, unfortunately it didn’t always work out how we wanted. We did get to watch a bunch of gorgeous sunrises and sunsets though. So, there were more than a few days, where if you didn’t soak your clothes sweating in the heat, you were rained on and soaked anyway.

The locals were used to the rain and heat of course, and again like in Timor Leste, despite the weather thousands of people made their way from all over the island to visit our clinics. The first week, I worked at Nanpei High School, a complex where for the first time our pharmacy was set up inside a building, and occasionally we were blessed with electricity and ceiling fans. During the second week, I was at Pohnpei hospital, where we worked alongside the Micronesian pharmacists and techs. They were great, and went out of their way to serve as translators for us, which was reassuring in that they already had some experience and training in counseling patients.

The people in general were very friendly and grateful, and many of them spoke English, which made all our jobs a little easier in that we didn’t have to rely on the interpreters as much as in Timor. The main health issues I saw were musculoskeletal problems, and so the pharmacy dispensed a lot of ibuprofen and acetaminophen. Apart from treating back and knee pain, we sent out a lot of de-worming regimens, which made up a good deal of the rest of the prescriptions. I suppose that was a good sign, but with a diet mostly consisting of fresh fish, fruit and vegetables, it is not hard to see why they were a generally healthy people.

After the clinics work was complete, the ship’s schedule changed and had to head back to San Diego a day early. As this was the last part of my rotation, quite a few people left the ship for good a day early to fly out of Pohnpei and head back home. But because our planed flights and accommodations didn’t coincide with this recent change of schedule, we were provided with other lodging. The lodging came as a surprise to the ten of us departing from Pohnpei though, as we were put up by the U.S. Ambassador and his wife at their residence. They fed us dinner with vegetables from their own garden, set up the rooms for us to sleep in, made us breakfast, and even drove us around for some souvenir shopping. It was quite an experience, and was a very special cap on the end of our time with Project HOPE. After a few more days on the island and after catching a tour to visit some waterfalls, some ancient ruins and swimming with manta rays, I did a bit of unwinding from, and finally boarded the plane and enjoyed a wonderful 33 hours of travel before arriving back at home in Virginia.

It is amazing how quickly the trip has come and gone, but it is an experience I will always remember. The wonderful people I was privileged to work with, all the people helped, the different and interesting cultures I interacted with, and the time working and living with the Navy are all irreplaceable experiences that will travel with me wherever I go. It was such a great time and I recommend it to anyone. I especially want to thank Project HOPE and Shenandoah University, but to everyone who made this possible, I want to thank you so very much.

Andy

Timor Leste

Bon Dia!

That means good morning in Tetun- the language of Timor Leste! It was an amazing experience that has taught me so much.

We had really long days with transfers off the ship as early as 0530 (or O-dark-thirty as we like to call it!) but they were well worth it. Riding on the LCU (the transfer ship that is inside the USS Cleveland) was awesome but a real try for patience on those early mornings sometimes.

You wait for the Cleveland to fill with 9 feet of water (doesn’t sound right I know but it works!) and then the LCU backs out. It was an AWESOME thing to see though, just a little time consuming. It was well worth it when you got to see the patients we helped and become part of the community.

In Timor Leste I worked at various MEDCAP sites distributing medications, got to run a 7K that got routed incorrectly and turned into a 13K, and went to a COMSERV to paint a school that was built by a pervious mission, unload donations for the school and play with the school children.

I marked dosing cups, syringes, and medication vials with a Sharpie to show dosing, I would give all the children their first doses of azithromycin in order to make it easier on the parents for the remaining days (even though it sometimes induced tears) and I would simplify the directions as best I could. For other types of meds like inhalers and creams “show-and tell” worked great. I know it’s not the biggest of things, but any little bit that I could help them understand better made me feel great!Each experience has helped me grow as not only a health care professional, but as a person as well. I’ve met some amazing health care staff and military personnel and become great friends with the people on the ship I otherwise would never have had the chance to meet!

The people of Timor were very kind. Even though there was a language barrier, if you just explained something to them and organized them in the lines through the MEDCAP sites, they soon got the program and followed suit. Being a part of this mission has taught me many things. I have learned I can take the lead on situations and can become very creative to try to simplify things for patients. Many of the people of Timor can’t read English so I started creating different things to help the patience with compliance.

The kids of Timor loved it when you took their pics and getting to see them- it even helped some of them stop crying after an unwanted check-up. I will miss seeing their faces change as they see the pics and the curiosity in their eyes as they approached the pharmacy tent. At each site we say about 600-1200 patients and completed a plethora of scripts, but to me the satisfaction wasn’t in the numbers of patients we saw or scripts we filled; it was in knowing that maybe with my help I made at least one persons day a little better.

Timor Leste

The days are flying by! We set sail from Timor after I participated in what I felt like two very productive, three-day clinics (A.K.A. MEDCAP #1 & 2). Well, I only worked one day at MEDCAP #2, but we saw almost six hundred people in half a day, so it felt like I served the three days. We had to stop seeing patients and start tearing down all of the tents and packing up at noon that last day to allow everything time for transport back to the ship for the long sail to Micronesia.
Of the thirty thousand or so patients seen so far by Pacific Partnership 2011 (the greater mission that Project HOPE is a part of), I’ve heard the Timor sites saw somewhere between five and ten thousand patients! And working on these sites is not the air conditioned, padded floor, community pharmacy or clinic of back home in the States. I saw the sun come up every morning, and we didn’t make it back to the ship until well after dark most nights. We work under a tent or canopy, with a few tables set on a dirt floor to hold the limited medications we have give. It is hot, sweaty, dusty, and all around uncomfortable work. But it is was a great experience etched forever into my mind, one I could never forget, nor would I trade it for anything.

The people of Timor were gracious, our interpreters were amazing, caring people, and all of the U.S. and partner-nations we worked with made the whole operation very satisfying. I hope things continue as such, and that our efforts made Timorese lives better.

Now, back on ship, we will prepare as best we can for our next set of clinics in the Federated States of Micronesia, specifically on the islands of Chuuk, Yap, Kosrae and Pohnpei. It will take us about a week of sailing to reach those islands, so we will have plenty of preparation time it seems. Ship life is still slow, and relaxing, but my fellow Project HOPE’ers and I are making the most of it. We get to spend a lot of time talking with Navy and partner-nation health professionals, and we get to learn more and more about the amazing sacrifices our military and others make serving around the world. We also are getting to see some amazing feats of United States Navy logistics in their RAS OPS (Resupply At Sea Operations). We watched as a Navy helicopter picked up pallet after pallet from the resupply ship, carried them over to our ship’s flight deck, and dropped them off, while never touching down once. Then, the resupply ship pulled alongside ours, and the two leviathans were attached with lines so that a zip-line of sorts could be strung up and used to transfer goods, which would fuel the ship, feed its personnel, and support all of the missions to come. It was amazing! Now that’s logistics. I heard from a Navy officer, during the operation that the ability to perform a RAS set us apart during World War II, and helped us win the Pacific campaign. If you watched the skillfully orchestrated operation I did, you would see why, in this single and small, yet incredibly complex piece of Navy life, we have the best military in the world.

Later today, I’m off to get a tour of the helicopters, the ship’s bridge (command center), and possibly later this week we’ll make it down to engineering to see what drives this great steel beast. It’s hard to believe that we are already in the second half of the mission, yet there is still so much left to do. Until next time…

Land Ho!

Well, we did it. We traveled halfway around the world, boarded our ship, and figured out how to find our beds, the showers, and food - the necessities. Now, after only a little more than a day's sail, we are anchored off the coast of Timor Leste, where the first of our medical missions on this rotation will take place.
According to the schedule, I'll get to work at two different sites on the island in the next week or so, both of which will be around the capital of Dili. If it works out, I might also get to run in the marathon race (well, I'll run 7K, while others run the full marathon), which is a piece of the partner-building mission here in Timor. Plans change daily around here, so I can just do what they ask me, and wait for the next "brief" to find out what is new.

Ship life is great though, apart from being away from my family. Eating, sleeping, exercising and reading compose most of my day. Last night was special though, as we celebrated the 113th Hospital Corpsman's birthday, and suprisingly enough we have US Army on board, and so it was a dual celebration of the Army's 236th birthday as well. There was a really touching ceremony commemorating those who have served before, all long with all of the niceties such as cake, a juice-like drink, and some fun and dancing.

Another part of ship-life is the struggle for communication. So, whenever the internet or phones are working I try and contact my family back home, but neither are very reliable. Today, the Navy is busy with the current operations, which allows us civilians band-width enough to get some things done. After tomorrow, life should get quite a bit busier (and hotter) as we hit the shore and get to work. Until then...adieu

All Aboard the USS Cleveland!

It’s official! We’re aboard the USS Cleveland, all checked in to our “racks” (beds) in our berthing units (rooms) and briefed and ready to go! Our first few days were adjusting and getting used to the Navy ship life. To get around the ship you have to go through quite a few narrow halls and be able to move through the different holes and ladders. Balancing and maneuvering through everything is a task in itself- then you have to actually figure out where you’re going. It’s not too difficult to figure your way around the ship since it’s a little smaller than some of the Navy hospital ships, but the trick is to remember which level or deck you need to be on. Everyone is really nice and will not only direct you where to go, but will also escort you there on the way. Every morning we muster (meet) on the flight deck at 0700 to delve out the days plans and answer any questions anyone may have. It’s VERY windy out there in the morning, but it’s nice to see the sunrise off the ship deck. So far there hasn’t been much to do since the crew pre-packed and prepped everything prior to docking in Australia so they’ve all told us to just familiarize ourselves with the ship and become accustomed to the Navy life. I’m in one of the top racks in my berthing area so I have to learn to climb a little more gracefully than normal in and out of bed since there aren’t ladders and I don’t want to squash the people below me! Everyone has been really nice about it though and even the seniors understand the difficulty of getting in and out of the 3rd rack. Showers are very quick and sometimes a little chilly- there was no hot water the other morning, but at least that makes it easier to take a fast shower! We get three hot meals a day and get to enjoy some down time to read, exercise in the gym, or socialize with the crews on board. There are people from the Navy, Marines, Army, Project HOPE, and other volunteers to socialize with and each person has their stories from home/ life on the ship. I felt a tad lost for the first day, but realized if I just got over being afraid to ask questions and start conversations, the people on the ship are more than happy to help out. We got a nice tour of the ship and got to see the LCH that will take us to shore on our MEDCAPS. It’s in the well deck (the part that is even with the ocean) of the ship where after people are aboard the compartment will fill with 9ft of water and the back will open up to let the boat out into the ocean. I’ve heard that after the first few times on the LCH the excitement wears off, but as for now I’m really looking forward to venturing out! My first MEDCAP is tentatively scheduled for June 22nd , but I may also have a chance to go on shore to run a 5K or volunteer medical services for a marathon on the 18th of June in Timor Leste (our next stop). We’ll find out soon if we’re allowed to run or not, but either way we’ll get to go ashore and help. When we go on shore we have to muster at 0430 and be on the LCH by 0600, which is going to be an EARLY day, but I’m down and ready for it! We’re supposed to get underway today at 1530 and head out to the open sea. We get to see the ship off from the upper deck, which is really exciting for us civilians that have never experienced it before! I’m so excited to get this journey started to help the people of Timor! I hope you enjoy my journey so far and the bit of pics I can get to upload J More medically pertinent stuff to come soon! YAY! G’Day Mates!

Good Day Mate!

HELLO from Australia! Tomorrow is our final leg of our journey to head up to Darwin from Sydney to get ready to board the ship! I'm really excited to see yet another part of the world I've never been to! After 21 hours on a plane I'm really glad Andy and I decided to spend a few days in Sydney before another 6 hours of flying, although the movie selection was pretty good I'm not sure how much more sitting I could handle. We decided to stay in Bondi Beach to get in some scenery and experiences. We walked the coastal walk, met some people from all over the world, and got to see some amazing views! Since we've been staying in hostels I'm hoping this will somewhat prepare me for the ship life I'm about to lead for the next 5 weeks. Although the "racks" we're gonna stay in will be different then the bunks we're in now, at least I'm getting used to having to crawl and climb to get in and out of bed and share spaces with people I've just met. It's tough to get used to the routine of living out of a suitcase and sharing bathrooms and living spaces with strangers from all over the world, but I'm starting to like it! Everyone has their stories from where they've traveled to and where they came from. In just a couple of days of met people from Italy, Holland, Britain, France, and Brazil. I can't wait to see what the rest of the trip has in store for me. I'll send another shout out when I get to the ship and have more interesting things to blog about! I'm off to explore more of Australia!!