MEDCAP 2: Day 3

Today was an excruciatingly humid day. It wasn't even that hot out but the humidity was intense! The pharmacy was busy today and constant vs. yesterday's splotchy chaos. That's more of what we expected though so it wasn't terrible. We dispensed over 400 prescriptions and had fun with our interpreters in the process. We saw many people with hypertension, VERY bad hypertension. The dentists and opthamologists refused to see patients with BP >150/100 since most of their problems were caused by there high blood pressure. Some patients were treated immediately and asked to wait for 30 min to be reevaluted. Most patients could then be seen after their BP came down. My MRE lunch today was pretty terrible. I'm actually looking forward to ship food...
Tonight as we were finishing up, we were called to an emergency muster. We were told that some buses had been arranged for us to go to the beach in 15 min! I was SO excited even though I didn't bring any swimming attire. But I quickly changed into PT gear, ran to sign the liberty sheet, and was on the first bus to the beach. We even got a police escort for the 6km trek to the shore. It was so beautiful, remote, and serene.

 I didn't want to get in at first but everyone but a few were in the water within minutes. I got in for about 5 minutes total and I'm so glad I did because it was quite refreshing. One girl actually got stung by a jelly fish so I'm thankful I didn't stay in too long! Our interpreters came too so we took lots of pictures and had some laughs. All the locals came down to the beach to watch us as if we were celebrities. The interpreters said everyone is just so fascinated by us and appreciative that they ust want to be around us. It's very flattering that they all love us being here. As we returned to the school grounds, the children were so excited we were back to play basketball with them.
Slowly people began to gather around the pharmacy steps with a guitar and started singing songs. We stayed there for almost 2 hours! It reminded me of some summer nights in NH when we sang around the campfire. We also got the Indonesians (including the kids) to sing their national anthem. It was really cool to hear the whole thing. I was sitting here just trying to take it all in knowing these are some amazing memories I'm making. we mustered briefly before heading to bed. One more full day of treating patients before a half day on Friday before our departure on Saturday. (Little did I know that Friday would actually be our longest day here...)

MEDCAP 2: Day 2

This morning was HOT! I immediately started sweating when I got up and moved around. It's really not even that hot just extremely humid. We ate breakfast, met as a group to discuss points from yesterday & the POD (plan of the day), and got the pharmacy prepared for the day. When our interpreters arrived, Ray gave me a 'cheat sheet' of common phrases we probably had him say a million times yesterday. So hopefully by the time we leave, I will have al the basics of Indonesian pharmacy terms down!
It was a long, hot day in the pharmacy. I didn't stop sweating until the sun went down. I did learn some main counseling points for certain antibiotics which was a good review, and got to see more patients. We definitely had way more chronic disease and acute illness patients today than yesterday so I feel much better about being able to help people. As we wound down for the evening, we were told that we could leave for liberty for a few hours! So we got the opportunity to walk down to the markets nearby. It was quite the experience. As we were walking, people drove by on mopeds waving or came out of their homes to say hello. Once we got down town, people immediately came up to us to shake our hands and take pictures. It's a weird feeling knowing we are a spectacle to them. We brought a few of our interpreters to help guide us and talk to the shop owners and what not. The place was busy and bustling with town folk who run the market as well as people who had followed us down as we walked past their homes. We browsed some shops for awhile before deciding to walk back to the school compound. On the way back, the children walked with us singing songs, holding our hands, and telling us Indonesian words. The people here are so welcoming and appreciative of our presence. When we got back to the school, the security guards were singing karaoke! Some of the Navy guys were playing 5v5 basketball with the kids. It was really cool to witness everyone hanging out together, playing, and having a good time. We went to bed shortly after evening muster since we were all tired from the poor night's sleep the night before. I still didn't sleep well since I was so hot. However, what sleep I did get was rudely interrupted by a morning thunderstorm. As I lay in bed listening to the rain on the tin roof and enjoying the cool breeze, I suddenly realized this would be a perfect time to get a shower and soap up. So I got out of bed and thoroughly enjoyed a cool morning shower at 0530 to start my day. (Little did I know, this would be the only shower I got on this excursion...)

MEDCAP 2: Day 1

Today started very early and was quite eventful! I mustered at 0530 and then proceeded to the flight deck for our helo safety brief. I got  my flight assignment and grabbed some breakfast before returning to the flight deck to prepare for lift-off. It was very cool to see the ship from the air and some of the islands of Talaud, Indonesia. The water was a turquoise blue and the mountains were full of jungle thrush and very steep! When we landed, we were immediately greeted by an Indonesian military member. As I started to look around, I noticed that the entire landing field was surrounded by town-folk watching us. As we walked down the road to the school where we would be staying, people were lined up all the way down the road saying 'hi' and trying to shake our hands. It was like we were celebrities or something! Once we got to the school compound, it started to rain. We sat and waited for the helos to return with our 12 pallets of supplies. We then unloaded all our gear and set up the pharmacy. Before we started seeing patients, we ate lunch and I had my first MRE (meal, ready-to-eat). I must say it wasn't too bad but I can see how they would get old very quick! We started seeing patients at 1300. We were sent 3 translators to help us communicate the medication directions and counseling points to the patients. We got to know them pretty well already and they are fun, kind, and personable people!
The local people here are so appreciative of our assistance. It has already been a humbling experience since most of the patients are very sick and what we would think to be a standard treatment in America is actually an impossibility here. Most people were under the impression that this mission was a 'SURGCAP,' meaning we would be screening patients and doing surgeries. It was quite depressing at times when patients would bring us their paperwork and prescriptions and the cheif complaint note was 'lump in L breast x5 years & lump in L lymph x2 years' with just a prescription for Tylenol or Motrin. We definitely don't have the capabilites to treat cancer on this mission since it requires such extensive follow up. Some of the cancer cases were very gruesome and it was difficult to see these terminal patients in such pain and discomfort. It was hard to explain to these patients that even in the US, we wouldn't be able to treat them since their condition was so far along already.
I know being here does help most of the people we see but it's heart-breaking to be unable to help some of the severe patients. After we shut down for the evening, some of the Navy guys had the opportunity to play basketball with some of the kids. It was nice to hear some sincere laughter after such a long day. As we got ready for bed, the decision was made to have us (Flying Officer Warren, HM2 Rodriguez, and myself) to sleep in the pharmacy. Since it was unable to be locked and some windows were missing completely, we decided that staying here would possibly deter unwanted visitors.

Before bed, I had the lovely experience of having to pee in a bag for the first time. This is the toilet system we will be using for the next few days. The Navy provided us these disposable bags with some kind of absorbable material to reduce the smell. It was also realized tonight that the shower bags were forgotten so we most likely won't be showering for 5 days since the ship is already 250+ miles away. Thankfully we have tons of cleansing wipes which will have to do!
That first night of sleep was actually not too bad although my anxiety kept me from falling asleep right away and the uncomfortable cot caused me to wake up every time I rolled over. They were also small so I couldn't stretch out all the was especially since the mosquito nets were the most restricting part. OVerall, the slight breeze through the windows with the sound of the geckos, bats, and cicadas made it reminiscent of my childhood camping memories.
I was woken up by the light around 0530 but dozed until 0615. I then got up and proceeded to prepare for the second day!

June 3, 2012

Sorry this is another old one, but I wanted to go in order! I'll post my MEDCAP experiences soon :)

June 3, 2012

Tonight is my last night on the ship before departing for my MEDCAP on the southern most island of Talaud, Indonesia. I asked around and finally figured out what MEDCAP stands for: Medical Civil Assistance Program.  The location will be at a school on the island and the patients will be treated from 0800 to 1600/1700 daily. I am required to meet up on the flight deck at 0520 for a ‘helo safety brief’ at 0530.  That means I’m definitely getting a helicopter ride to the MEDCAP location!  We were shown the cots we will be sleeping on and the ‘bathrooms’ we will be using.  Word is that when the locals found out about our visit, they immediately offered to house the volunteers during the mission so I know they are excited about us being there and are very kind people. I’m really looking forward to all the new experiences coming in the next few days!

Since I last posted, we have received and very quickly organized the medications for the Indonesian MEDCAPS. It was a crazy couple of days trying to get everything together. The main problem was that some of the medications in Indonesia are different from US drugs in strength, ingredients, and packaging. It was frustrating at times but our team is a very hard-working crew and we all work together quite well.  There are definitely some fun characters in our department so it’s been a good time throughout the process.

There have been a few days when I miss home and know for sure that military life is not for me.  The adventure of my upcoming MEDCAP has kept me busy and my mind off home! There is plenty of support available within my department, berthing area, and onboard that no matter what situation may arise, there’s always someone to talk to.  I do wish that the internet was more reliable so that I could talk to my friends and family more often but the break from technology has also been nice since I know I rely on it too much sometimes.

The other evening, one of the pharmacy techs took the initiative to teach me about the IV hoods they have on board. It was definitely a new experience since they do not have a sterile room but just the hoods with the big gloves to put your arms in.  I haven’t used that kind before so it was pretty neat to make an IV in the middle of the ocean! He also showed me how to check prescriptions just like a pharmacist would and how to double check calculations done by the tech before an Rx is sent out.  The hardest part was adjusting to the format of the orders and how the computer prints out the prescription label. I’m sure with more practice, I would get used to it very quick. I also had the opportunity to look up some information for a doctor on Thyroid Storm.  Thankfully the patient didn’t actually have this condition since the meds (PTU and methimazole) are not available on board to treat for it. The physician was just checking incase there was a complication during surgery causing the severe disorder.  I’m not sure if the doc went through with the procedure knowing that the medications needed to treat it were not available.

Well that’s it for now, I’m off to finish packing and go to bed since I have an early morning and a big day tomorrow! Hopefully I’ll be able to blog every day about my experiences on the Island!

Salamat Pagi! That is Indonesian for Good morning. I have made it a point to at least learn how to greet in the languages of the countries we visit. They love the effort to speak their language! The past 2 days has been two of my best days in life! I have witnessed the warmth, hospitality and the gratitude of the people of Indonesia. I have also been convinced of one fact; we are all the same people with the same needs, whoever were are and wherever we are on the face of this planet! We all have a need for acceptance, a need for respect and are capable of bringing pure joy and happiness in the lives and faces of anyone regardless of language or geographical barriers.

My awesome adventure began on the morning of 4^th June 2012 when I got a ride on a rib boat to one of the Islands in Talaud as part of a delegation from the ship to embark on some community relations on the Island. It was really a thrill of a ride! My sunglasses literally flew off my face into the sea. That was how fast the boat was! We were greeted ashore by the locals with pump and pageantry. We felt very welcomed! We began interacting with the people as best as we can, after the exchange of pleasantries and that was when my hitherto unrecognized celebrity status was discovered. Every one of the locals wanted a photo-op with me! I had mothers handing me their babies in order to have a picture of their babies and me! Apparently they have this fascination with my height! They thought I was Shaq or something. My incessant salutation of Salamat Pagi to everyone I met in no small measure also contributed to the reception I got from them.

We proceeded to a high school soccer field and got ourselves into a soccer match with the high school soccer team. The sweltering heat coupled with the awesome stamina of these kids contributed to me being out of breath and worn out after only five minutes in the game. Though my stamina was suspect, my skills were never in doubt! Suffice it to say that we lost the game to these youthful, exuberant kids after about an hour of a fun-filled game of soccer. Other members of the team also played volleyball with some of the school kids. After the soccer game we indulged the children with a game of duck, duck, goose. They took to the game so much that they were still playing it when we got on our bus. I also took the opportunity to engage in some interesting conversations about a host of issues with the few locals who could speaks a little bit of English. I thoroughly enjoyed spending time with the people on the Island and can still envisage the beautiful faces beaming with smiles and affections as we said goodbye.

I again had the opportunity yesterday to be part of a 30-member delegation that graced the opening ceremony of our humanitarian mission on another Island. We were transported on the rib boat again and this time around I made sure everything on my person was bolted down. I however couldn’t prevent myself from being splattered with seawater, as was the case in my previous ride. As usual, it was an exciting ride! We were again met ashore with a very colorful cultural display. While waiting for the dignitaries who had gone to the hospital ship for a tour, the locals again used the opportunity to have pictures taken with us. I was again treated like a celebrity on this Island with most of the locals looking for the opportunity to have their pictures taken with me. I did enjoy the attention but most importantly I did enjoy the pure and palpable joy that our presence here has brought these awesome and resourceful people. After about a forty-five minute wait, the dignitaries came back from the ship and the ceremony began. It was a short ceremony that commenced with a word of prayer and ended with some brief remarks from Captain Morgan (yeah I know, that name sounds familiar), the command of our ship, a Politician from the Island and another Captain from our ship. We were then treated to some sumptuous Indonesian cuisine and some local music. 

My interactions with the locals this week was a very rewarding and enlightening one. I look forward to being with them on my MEDCAP next week. The rest of the week is predicted to be relatively uneventful since we are pretty much caught up with the processing of medications for the various MEDCAPS. I also do not have any more events planned for the rest of the week. I promise to keep you all updated on this awesome adventure I am currently part of. Terima Kasih! (Thank you)

Tuesday, May 29, 2012

Sorry I haven't posted in so long! I've been writing but unlike Kofi, my internet has had some issues.. Ironically, I'm currently on my MEDCAP and have better internet than on the ship. Hopefully I'll post something every day while I'm here to catch you all up with everything!!


Tuesday, May 29, 2012
 We’ve been at sea now for the past 4 or 5 days. The days seem to run together out here in the middle of the Pacific, but it sure has been a fun few days! We’ve been super busy in the pharmacy since we left port in Guam. The order of the countries that we’re visiting is Indonesia, Philippines, Vietnam, and Cambodia. So it seems ironic that we finished prepacking the medications for Cambodia first and Indonesia will be the last one we do. It all has to do with politics of course since Indonesia required that we purchased the drugs from them. Therefore, we won’t be able to prepackage anything until we get close enough to have the meds helicoptered onto the ship. So when that happens in the next day or two, we will be packaging all the meds for Indonesia in a 2-day period before our treatment excursions (called MEDCAPS) begin.
MEDCAPS stands for Medical Something Something Something. We’ve learned so many acronyms in the past week that I honestly cannot remember them all! Basically, it’s where a few staff from each department are assigned to a specific location to treat the people of that city or area. For Indonesia, there are 5 MEDCAPS in which all of them are 5-day overnights. So depending on where you are assigned, you will either be staying in a ‘hotel’ or a tent for that 5-day period. I say ‘hotel’ because it could pretty much be a few pieces of wood thrown together like a shelter. The MEDCAP I have been assigned to is staying in a tent and there are still debating as to whether they will be sending a porta-potty and solar shower with us. Yep, there’s a possibility that we will not be showering for 5 days and in fact, the best advice I’ve received is that it may be wise to bring baby wipes along. I certainly am not sure what I have gotten myself into with this trip but I certainly will come out on the other side just a bit more thankful for the things I have at home.
The baby wipes thing bring up a whole other issue I’ve had on this trip. The list that Project HOPE gave us was pretty accurate but there are more than a few important pieces of info missing. I have bought more items in Guam and on the store ship than I have on souvenirs so far! It’s been really frustrating because most of the items I’ve had to purchase, I could have just brought with me if I had known! So Brittany and Dayna, I hope you’re reading this because it will definitely help when you are packing J !  You will need a long-sleeve shirt. They require it for the abandon ship drills because they don’t want you to burn. Kofi and I didn’t have it (I refused to buy one just for the drill since I knew I wouldn’t be wearing long-sleeves again any time soon!), but someone definitely noticed and said something to us about it! Also, you will need to bring some of those wall hooks that you can just stick on. They use them everywhere for hanging clothes, towels, etc since there’s no closets or doors to hang it on. You need a safety pin for your laundry bag (most random thing ever) and high-efficiency laundry detergent. I may be able to list a few other pointers as the trip goes on but those are the big things for now.
So far, I’ve learned so much but can’t even begin to describe all of it. Most of it just comes daily as I learn about the military way to do things and how they continuously change their own rules. It’s definitely been fun and I’ve already met some great friends, but I do miss home when I let my mind wander and not keep busy. There are 3 gyms on board and a library (with free phone calls!!!) so I have definitely been busy when I’m not playing cards with my peers, working in the pharmacy, and roaming the ship! Although it’s been nice to be at sea for a few days to allow us to get acquainted to everything, I’m really looking forward to arriving in Indonesia to begin the real reason behind this humanitarian mission! Hopefully I’ll be posting again before I leave for my MEDCAP since I’ll be out in the jungle for 5 days…..

The past few days have been very busy at the pharmacy. We have been working around the clock to get the medications ready for the various Medical Civic Action Programs (MEDCAPS). We received the medications for Indonesia three days ago and had to get them ready by today, when the first MEDCAP departs for the field, from the ship. The mission in Indonesia has been subdivided into five MEDCAPS, visiting five different locations in Indonesia. The readiness and availability of medications and supplies is by all intents and purposes the foundation on which the whole mission stands. It is therefore imperative that we get the medications sorted, pre-packed, labeled and ready to go as scheduled. Thankfully everybody at the pharmacy has been willing to put in long hours to ensure that these tight deadlines are met. The mission recognized our effort with this short clip of us busily at work on its website.

We have through this remarkable effort made ready, medications and supplies for 4 of the 5 MEDCAPS and are ahead of schedule for the last MEDCAP, which leaves for the Islands of Talaud on the 9th of June. I happen to be a team member on this 5th MEDCAP. We leave the ship on the morning of 9th June 2012 for the Islands of Talaud for our medical mission, staying in tents overnight for 4 nights and returning to the ship on the 13th of June. My team had an orientation yester night on the mission and our living conditions while on the field and we left the meeting with the knowledge that we will basically be living in tents and living on MREs (Meals Ready to Eat) for the length of our mission. The opportunity to touch thousands of people in these remote Islands and to deliver healthcare to them however makes these little sacrifices worthwhile, fulfilling and even exciting. Alexis is on MEDCAP 2, which departs the ship tomorrow morning for the same Islands my MEDCAP will be visiting. She will be returning to the ship on the same day my MEDCAP will be departing the ship.

I had the honor to be selected yesterday to represent the various NGOs on the ship at a dinner held in honor of Kristen Bauer, U.S Consular General (ambassador) to Surabaya, Indonesia here on the ship. At the dinner, the ambassador conveyed to us the impact of the mission, the profound gratitude of the people of Indonesia for the mission and life in Indonesia. I also had the opportunity, at the dinner to interact with some Navy Captains and medical personnel onboard the ship.

I also depart the ship tomorrow morning as part of a community relation team for a sporting event in Sulawesi with the beautiful people of Indonesia. I understand it will be a soccer match. I look forward to bringing the whole stadium alive with my soccer artistry. Stay glued here for updates of the match……