In a few hours the anchor will be hoisted and we'll leave Cambodia. It should take no more than several days to reach Singapore, in the beginning of July, where I'll meet up with my wonderful husband and we'll tour Singapore and Malaysia before heading home. Because I obtained special access to post (civilian communication is down for the remainder of this leg of the trip related to a desire to notify next-of-kin of a tragedy before it leaks via the internet), this will be my last entry.
There will be a "man overboard" and "abandon ship" drill tomorrow. Unlike a civilian cruise ship, the only thing standing between my work or my becoming a "man overboard" is a small chain between sections of thin rail. The chief engineer explained that ships frequently leave pipes and wires exposed to discourage personnel from becoming complacent. Although we are civilians on a peaceful mission, the rationale explained to us is that the USNS Mercy is used for training active duty military personnel and their survival may depend upon maintaining a hypervigilant state of readiness.
The remainder of the time will be used by civilian medical volunteers to sleep, catch up with each other, use the gym and library, and take photographs of the helicopters and side-by-side vessel refueling. There will also be group photographs and a meal with ice cream for dessert is planned.
Representing Project HOPE, I attended the closing ceremony for the Pacific Partnership aboard the Japanese battleship. USNS Mercy, learning lessons from the Titanic, does not have any horizontal space that spans the entire ship. The ship is divided into vertical zones so that, if leaking, it can stay afloat. The Kunasaki (Japanese ship), on the other hand, has a huge horizontal room the size of a football field. That's where the ceremony was held.
We were brought from our ship to theirs by boat on a very choppy sea. We pulled alongside their ship and a large ramp was extended with a waiting line of officers who greeted us with bows and plastic keepsake fans printed with "Pacific Partnership" in Japanese and English. Enlisted crew, in matching ties and aprons, carried trays of the local Cambodia Angkor Wat beer, juices, and cola, which they offered us with welcoming smiles.
The flags of the partnership countries graced the wall and there were large tables with mounds of beautifully displayed foods: sushi, sashimi, cake, fruit beautifully sculpted, fresh seafood of all types imaginable, tiny wrapped packages containing steamed rice with pork, and beautiful vegetables and piles and piles of artfully arranged flowers. There were 2 stations set up like American carving/omelet stations, one with tempura and the other with skewers of meat. Each of us had what looked like a miniature tv tray with a cup holder, chopsticks, small plastic fork, and napkin.
There were a lot of speeches - all extremely moving - about our work for the people of Cambodia and the mission of world peace. Our American ambassador to the Kingdom of Cambodia was there (she is very impressive), as were the German ambassador, French ambassador, the leader of Cambodia, the Secretary of State of Cambodia, the leaders of the the Cambodian military, and many, many, many generals and admirals from Cambodia, Japan, and the USA. Our Commodore, Lisa Franchetti, was her usual warm and personable self. Regardless of rank and importance, everyone visited with each other; it was a gregarious, joyful, saki-filled celebration.
I was allowed to sit in a Japanese mini-sub because it was the only air-conditioned place on the ship and I was feeling a little overcome after working a full week of long shifts (and drinking my first beer). They were very kind to me and after a few moments I rejoined the party.
During the event, and off to the side, a power point presentation with music was showed photographs of everything that occurred during the mission. Also mentioned was the return by the USA to Cambodia of precious relics sharp U.S. Customs Agents confiscated from dealers engaged in smuggling. When the speeches were over our Commodore and the Japanese Commodore and 2 other VIPs were invited to don kimonos and lift mallets to beat on a ceremonial drum. They were asked to gently break the top of the drum, which revealed a HUGE container filled with sake - a Japanese keg party!
Then there was a samurai display of martial arts and everyone was invited to ask questions, take photographs, etc. My daughter Lisa's attendance at Kansai Gansai University made me a huge hit with the nurses, one of whom lives near the school. The evening ended when I boarded the first ship back to ours as I was scheduled to work my usual night shift.
Well, this is it for me. One of my proudest moments was when a higher-up asked me to remain aboard after Singapore. This was a big challenge for me, physically and emotionally, and I am so thankful I had the honor to serve others and to serve my country.
Thank you so much for keeping this mission in your prayers.
See you stateside!
Sunday, June 27, 2010
Friday, June 25, 2010
Nearing the End
I'm writing from Sihanoukville, Cambodia, the location of the final battle of the Vietnam War (the Mayguez Incident) in 1975. I've had a busy last week, volunteering for day missions that supplement my night shift work (this translates into 24+ hour shifts with a few hours in between to sleep), so please factor in my fatigue when reading this post. (And thank you, Cpt. Faye Pyles, for obtaining computer access for me after several unsuccessful hours of attempts to get on-line this morning).
The week began with the cultural issue of trying to figure out how to persuade pre-surgery patients from eating the large pots of rice we keep on the wards. A sympathy reaction of such extremes was evoked in the other patients that they began sneaking food to those awaiting surgery; explaining aspiration risks means nothing to hungry people who are uncertain whether and when a next meal will arrive.
Another cultural issue is the concept of time for people who do not wear watches. When the lights go out (i.e., the sun goes down), the patients immediately fall asleep and become a little frightened if we have to rouse them for medications during the night. I will say I never saw a group more prompt in rising once the lights come on in the morning. Issues of time also arose when patients had to wait for scheduled medications or for the doctors to make their rounds.
I continued to pass out gifts and at one point had every patient on the ward wearing a Vroman's bookstore sticker that said, "proud member of the human race." I donated the bookmarks to the library, however, because the interpreter explained my patients don't own books. The most unique gift, by far, was courtesy of the US military. A menstuating woman asked for a bit of cloth and when I gave her a sanitary napkin she was the talk of the ward. Every female patient that night, from the teenager to the woman in her late 80s, began to menstruate and I was happy to pass out souvenirs to all.
Every patient is deloused and undergoes a TB test prior to boarding but our patients on land suffer from both of these maladies. Healthcare access is rare (the Khmer Rouge executed most of the nurses, dentists, and doctors in this country). A patient my daughter's age boarded the ship with her young husband for treatment regarding pain she had experienced a considerable amount of time. The team discovered the young woman was filled with Cancer and the doctor's last written sentence was "beyond the capacity of this ship." The young woman explained there had been no available local doctors from whom she could seek diagnostic tests.
My days ashore were equally interesting. I commuted via transport owned by the USA, Cambodia, and Japan (the latter present in the area for a joint exercise). I noticed more cars in Cambodia and, to my surprise, traffic lights (evidently merely ornamentation as not a single vehicle slowed - let alone stopped - for a red light). Like Thailand, small golden altars (they look like elaborate bird houses on poles) appear outside every building. Cows, monkeys, and dogs (many sick - there is no such thing as a rabies shot here) roam the streets and, in one section of town, workers fix crab nets that line the sides of the streets. Many people are barefoot, the more affluent shod in what look like flip-flops.
I saw 3 types of homes: tin shanties in town, wooden houses on stilts in the more rural areas, and the colonial French architecture common to Vietnam. I talked myself into the last of the three and entered a foyer used as a living room, then 3 bedrooms in a row with futons (no closets or armoires), and a small kitchen in the back (no electricity or running water) with what looked like a gas-fueled 2-burner camping stove. The bathroom had a bucket and rainwater for showering. Three generations of 6 people lived there.
During the week I joined different teams to teach, visit schools, orphanages, and churches (Cambodia has not outlawed missionaries as has Vietnam). Students wear the national school uniform of white shirt and navy blue skirt or pants with flip-flops. We gave every student at every school and orphanage a beautiful pack filled with school supplies donated by the LDS (Mormon) church. At the first school about 100 children stood in long lines of girls or boys and greeted us in Khmer and then in English. They sang for us and then we played games with the children, finger-painting, blowing bubbles, soccer, and comforting some of the younger ones.
One orphanage I visited this week is run by a missionary from St. Louis. His wife said their children arrive either because poverty has forced their parents to abandon them, their parents died of TB (very common here), or their parents died of AIDs (also common here). The youngest child, nearly 2-years old, was found last year in the local market with a "for sale" sign around her neck.
We toured the grounds of the school and watched their "cafeteria ladies" cook lunch (mounds of whole fresh fish) outside, over large open fires. The orphanage kept pigs and alligators for food and each child had a small garden plot to grow vegetables.
When it was time to go the childrern were clinging to us and many asked to be hugged.
I had the privilege of teaching (I use this word loosely since my materials were in Khmer, a language unknown to me, and my students didn't know English) where our medical teams were working. We traveled first by boat and then by van into a rural area devoid of running water and electricity. Hundreds of people were waiting for us in weather well over 100 degrees, without water, without restrooms, and in the monsoon season when there are - and were - sudden heavy downpours. Frantic to be seen by a health care professional, I saw many of them lose their shoes after being directed to enter the area. They were so desperate for medical care they literally ran out of their shoes and didn't dare take the time to stop to retrieve them for fear of losing an opportunity to receive care. When it came time for me to leave I counted the shoes left behind.
My small group of 4 tried to enter by foot but so many hundreds of people starting crushing in on us that the Cambodian military escorted us in by a different route. Approximately 550 people were seen the morning I was there and an equal amount were seen that afternoon. People waited in long lines and were triaged (prioritized) in one room, each person receiving a colored paper bracelet denoting their next destination (for example, a blue paper bracelet might indicate the patient was to be seen by the dental team).
Nurses, dentists, and doctors all put in many long hours treating people who had rarely, sometimes never, seen a health care professional. Pharmacists dispensed medications (all free) and the Japanese managed to unload a huge hospital vehicle from their warship that was a cross between a tank and an recreational vehicle (RV), with large sliders on the sides to extend its width, and a portable generator.
There was no air conditioning and no shade and everyone worked many hours in extreme heat interspersed with heavy downpours. There were many children, a few pregnant women, Buddhist monks and nuns, and a woman with unequal pupils who was carried in by 2 men. She died en route to the hospital and I heard from the physician (one of my room-mates) who accompanied the patient that the hospital looked like an open-air school with a lot of rooms but no medical equipment.
I enjoyed a few hours of liberty in Cambodia and experienced a foot massage provided by fish eating the dead skin. It was excruciatingly ticklish but my feet emerged smooth and shiny. The cost for this was $3 USA and it included a regular foot massage before the fish foot massage and my choice of beer or soda. The tuk-tuk (cyclo, or rickshaw) I rode cost $5 USA for 5-10 hours of riding around town. Before the fish foot massage I visited a Buddhist monastery and pagoda that had on its grounds a fountain circled by statues of little boys peeing into it.
Adjacent to the pagoda and monastery was a cemetery reminiscent of the spirit houses of Eklutna (near where we lived in Anchorage, Alaska) and the cemetery near our home in New Orleans, Louisiana, with above-ground spirit houses. Atop each grave was an elaborate mini-pagoda with the elegant and ubiquitous tile I saw all over Vietnam's sidewalks and in the buildings of Cambodia.
Everywhere I went my Project HOPE shirt was spotted and I was thanked either in Khmer ("aw-koon") or in English "thank you for what you do for my country" and every time they would make the "Y" (hands clasped before their faces) and smile. This has been a profoundly humbling experience.
I spent a busy week working, teaching, and visiting schools and orphanages. I was invited to be part of the team to represent Project HOPE at the closing ceremony this evening on the Japanese military carrier. After the ceremony I'll return to our ship and assume charge nurse (supervisor) night duties in my ward until 7 a.m. tomorrow morning. There is not much time left before I meet David in Singapore and I can't wait to be with him again. All of us work long hours, realizing this is the time to serve - sleep can wait.
The week began with the cultural issue of trying to figure out how to persuade pre-surgery patients from eating the large pots of rice we keep on the wards. A sympathy reaction of such extremes was evoked in the other patients that they began sneaking food to those awaiting surgery; explaining aspiration risks means nothing to hungry people who are uncertain whether and when a next meal will arrive.
Another cultural issue is the concept of time for people who do not wear watches. When the lights go out (i.e., the sun goes down), the patients immediately fall asleep and become a little frightened if we have to rouse them for medications during the night. I will say I never saw a group more prompt in rising once the lights come on in the morning. Issues of time also arose when patients had to wait for scheduled medications or for the doctors to make their rounds.
I continued to pass out gifts and at one point had every patient on the ward wearing a Vroman's bookstore sticker that said, "proud member of the human race." I donated the bookmarks to the library, however, because the interpreter explained my patients don't own books. The most unique gift, by far, was courtesy of the US military. A menstuating woman asked for a bit of cloth and when I gave her a sanitary napkin she was the talk of the ward. Every female patient that night, from the teenager to the woman in her late 80s, began to menstruate and I was happy to pass out souvenirs to all.
Every patient is deloused and undergoes a TB test prior to boarding but our patients on land suffer from both of these maladies. Healthcare access is rare (the Khmer Rouge executed most of the nurses, dentists, and doctors in this country). A patient my daughter's age boarded the ship with her young husband for treatment regarding pain she had experienced a considerable amount of time. The team discovered the young woman was filled with Cancer and the doctor's last written sentence was "beyond the capacity of this ship." The young woman explained there had been no available local doctors from whom she could seek diagnostic tests.
My days ashore were equally interesting. I commuted via transport owned by the USA, Cambodia, and Japan (the latter present in the area for a joint exercise). I noticed more cars in Cambodia and, to my surprise, traffic lights (evidently merely ornamentation as not a single vehicle slowed - let alone stopped - for a red light). Like Thailand, small golden altars (they look like elaborate bird houses on poles) appear outside every building. Cows, monkeys, and dogs (many sick - there is no such thing as a rabies shot here) roam the streets and, in one section of town, workers fix crab nets that line the sides of the streets. Many people are barefoot, the more affluent shod in what look like flip-flops.
I saw 3 types of homes: tin shanties in town, wooden houses on stilts in the more rural areas, and the colonial French architecture common to Vietnam. I talked myself into the last of the three and entered a foyer used as a living room, then 3 bedrooms in a row with futons (no closets or armoires), and a small kitchen in the back (no electricity or running water) with what looked like a gas-fueled 2-burner camping stove. The bathroom had a bucket and rainwater for showering. Three generations of 6 people lived there.
During the week I joined different teams to teach, visit schools, orphanages, and churches (Cambodia has not outlawed missionaries as has Vietnam). Students wear the national school uniform of white shirt and navy blue skirt or pants with flip-flops. We gave every student at every school and orphanage a beautiful pack filled with school supplies donated by the LDS (Mormon) church. At the first school about 100 children stood in long lines of girls or boys and greeted us in Khmer and then in English. They sang for us and then we played games with the children, finger-painting, blowing bubbles, soccer, and comforting some of the younger ones.
One orphanage I visited this week is run by a missionary from St. Louis. His wife said their children arrive either because poverty has forced their parents to abandon them, their parents died of TB (very common here), or their parents died of AIDs (also common here). The youngest child, nearly 2-years old, was found last year in the local market with a "for sale" sign around her neck.
We toured the grounds of the school and watched their "cafeteria ladies" cook lunch (mounds of whole fresh fish) outside, over large open fires. The orphanage kept pigs and alligators for food and each child had a small garden plot to grow vegetables.
When it was time to go the childrern were clinging to us and many asked to be hugged.
I had the privilege of teaching (I use this word loosely since my materials were in Khmer, a language unknown to me, and my students didn't know English) where our medical teams were working. We traveled first by boat and then by van into a rural area devoid of running water and electricity. Hundreds of people were waiting for us in weather well over 100 degrees, without water, without restrooms, and in the monsoon season when there are - and were - sudden heavy downpours. Frantic to be seen by a health care professional, I saw many of them lose their shoes after being directed to enter the area. They were so desperate for medical care they literally ran out of their shoes and didn't dare take the time to stop to retrieve them for fear of losing an opportunity to receive care. When it came time for me to leave I counted the shoes left behind.
My small group of 4 tried to enter by foot but so many hundreds of people starting crushing in on us that the Cambodian military escorted us in by a different route. Approximately 550 people were seen the morning I was there and an equal amount were seen that afternoon. People waited in long lines and were triaged (prioritized) in one room, each person receiving a colored paper bracelet denoting their next destination (for example, a blue paper bracelet might indicate the patient was to be seen by the dental team).
Nurses, dentists, and doctors all put in many long hours treating people who had rarely, sometimes never, seen a health care professional. Pharmacists dispensed medications (all free) and the Japanese managed to unload a huge hospital vehicle from their warship that was a cross between a tank and an recreational vehicle (RV), with large sliders on the sides to extend its width, and a portable generator.
There was no air conditioning and no shade and everyone worked many hours in extreme heat interspersed with heavy downpours. There were many children, a few pregnant women, Buddhist monks and nuns, and a woman with unequal pupils who was carried in by 2 men. She died en route to the hospital and I heard from the physician (one of my room-mates) who accompanied the patient that the hospital looked like an open-air school with a lot of rooms but no medical equipment.
I enjoyed a few hours of liberty in Cambodia and experienced a foot massage provided by fish eating the dead skin. It was excruciatingly ticklish but my feet emerged smooth and shiny. The cost for this was $3 USA and it included a regular foot massage before the fish foot massage and my choice of beer or soda. The tuk-tuk (cyclo, or rickshaw) I rode cost $5 USA for 5-10 hours of riding around town. Before the fish foot massage I visited a Buddhist monastery and pagoda that had on its grounds a fountain circled by statues of little boys peeing into it.
Adjacent to the pagoda and monastery was a cemetery reminiscent of the spirit houses of Eklutna (near where we lived in Anchorage, Alaska) and the cemetery near our home in New Orleans, Louisiana, with above-ground spirit houses. Atop each grave was an elaborate mini-pagoda with the elegant and ubiquitous tile I saw all over Vietnam's sidewalks and in the buildings of Cambodia.
Everywhere I went my Project HOPE shirt was spotted and I was thanked either in Khmer ("aw-koon") or in English "thank you for what you do for my country" and every time they would make the "Y" (hands clasped before their faces) and smile. This has been a profoundly humbling experience.
I spent a busy week working, teaching, and visiting schools and orphanages. I was invited to be part of the team to represent Project HOPE at the closing ceremony this evening on the Japanese military carrier. After the ceremony I'll return to our ship and assume charge nurse (supervisor) night duties in my ward until 7 a.m. tomorrow morning. There is not much time left before I meet David in Singapore and I can't wait to be with him again. All of us work long hours, realizing this is the time to serve - sleep can wait.
Thursday, June 17, 2010
Cambodia
Sitting outside in the cool breeze, watching the armada of squid boats lining up in preparation for an evening of fishing, is nothing if not sublime when sipping a soda and enjoying the shore of Cambodia from aboard a converted oil tanker now hospital ship. The helicopters and boats ferry goods and people to and from the ship. The mountains of Vietnam gave way to Cambodia's rows of softly rolling hills. The water seems rougher but the weather, while still over 100 degrees, seems milder. The mood, after our rest asea, is elevated.
We spend 12 days in each country then sail for 2 days to the next. After I disembark in Singapore the ship will continue to Timor-Leste then Micronesia. Security forces are engaged to ensure the safety of the mission and these conscientious young people stand watch on the ship, circle us on smaller boats in the water, and protect us during land sojourns.
My assignment here is to work 13 hours each night for 8 nights before I switch to days and an opportunity to go ashore to teach. I remain in a medical-surgical (non-emergency) adult unit. The Cambodian patients seem a little taller than the Vietnamese and while both sleep in the clothing they wear during the day, the Vietnamese women dressed in pants with tunics and the Cambodians wear silk pajamas. The latter seem to grow their hair longer and wear it bound up in pony-tails (as opposed to chignons). Unlike the Vietnamese, it seems there are more issues explaining the use of running water. The patients seem particularly apprehensive to use showers. Malnutrition seems equally prevalent in both patient populations but TB and AIDS appear in higher rates in Cambodia.
The first night I had Cambodian patients in my ward they seemed wary of being on a ship so I returned to my room and hauled out the sack of party favors I brought with me. I passed out the gifts and my ward filled with patients proudly sat cross-legged on their cots, earnestly blowing large, yellow, Sponge Bob Square Pants kazus.
I continue to instruct patients in the use of showers, water fountains, and toilets. When a patient asked me (via an interpreter) for a drink and I invited her to the water fountain, she cupped her hands under the water and drank as if from a well or a river. A male patient of mine was unable to comply with my instructions to use the shower, so great was his trepidation at maneuvering the simple shower apparatus. He was polite but apologetic and the interpreter had infinite patience in his attempts to help.
Our medical sites triage (prioritize) almost 1,000 people at each stop; many of whom walked miles, and all of whom wait in over 100-degree heat, to be seen. Last night a young enlisted person told me she had to walk away to compose herself after so many hundreds of people begged her to see their children; her appreciation for things such as free vaccinations for children grew enormously.
This evening our ward interpreter told us he wanted to become a patient. The charge nurse referred him to the sick bay and our interpreter is now our patient (diagnosis "wrist pain"). He was not begrudged a clean bed and a hot meal. We find that almost all of our patient escorts become patients themselves before the actual patient they escorted is ready to leave.
Last night I cared for patients with breast cancer, nasal polyps, post reconstruction surgery, exploratory procedures, and gallstones. There are male and female patients in the open ward, which looks like a giant dorm room. I broke out the stickers and everyone got either a little boy or a little girl sticker, with an extra one to take home, after which patients put their hands together before their faces (an action called a "Y") and said, "aw koon" (thank you).
It's now nearly 8 a.m. and I've been up working all night but I need to do laundry before going to sleep. Project SMILE (repairing cleft palates in children) is now aboard and the USNS Mercy's populations has increased to about 1,200 people (rendering internet access tenuous). If I am unable to access the internet again during this trip I will add something after docking in Singapore in just over 2 weeks.
Thank you again for joining me during my time aboard the USNS Mercy as a part of Project HOPE.
We spend 12 days in each country then sail for 2 days to the next. After I disembark in Singapore the ship will continue to Timor-Leste then Micronesia. Security forces are engaged to ensure the safety of the mission and these conscientious young people stand watch on the ship, circle us on smaller boats in the water, and protect us during land sojourns.
My assignment here is to work 13 hours each night for 8 nights before I switch to days and an opportunity to go ashore to teach. I remain in a medical-surgical (non-emergency) adult unit. The Cambodian patients seem a little taller than the Vietnamese and while both sleep in the clothing they wear during the day, the Vietnamese women dressed in pants with tunics and the Cambodians wear silk pajamas. The latter seem to grow their hair longer and wear it bound up in pony-tails (as opposed to chignons). Unlike the Vietnamese, it seems there are more issues explaining the use of running water. The patients seem particularly apprehensive to use showers. Malnutrition seems equally prevalent in both patient populations but TB and AIDS appear in higher rates in Cambodia.
The first night I had Cambodian patients in my ward they seemed wary of being on a ship so I returned to my room and hauled out the sack of party favors I brought with me. I passed out the gifts and my ward filled with patients proudly sat cross-legged on their cots, earnestly blowing large, yellow, Sponge Bob Square Pants kazus.
I continue to instruct patients in the use of showers, water fountains, and toilets. When a patient asked me (via an interpreter) for a drink and I invited her to the water fountain, she cupped her hands under the water and drank as if from a well or a river. A male patient of mine was unable to comply with my instructions to use the shower, so great was his trepidation at maneuvering the simple shower apparatus. He was polite but apologetic and the interpreter had infinite patience in his attempts to help.
Our medical sites triage (prioritize) almost 1,000 people at each stop; many of whom walked miles, and all of whom wait in over 100-degree heat, to be seen. Last night a young enlisted person told me she had to walk away to compose herself after so many hundreds of people begged her to see their children; her appreciation for things such as free vaccinations for children grew enormously.
This evening our ward interpreter told us he wanted to become a patient. The charge nurse referred him to the sick bay and our interpreter is now our patient (diagnosis "wrist pain"). He was not begrudged a clean bed and a hot meal. We find that almost all of our patient escorts become patients themselves before the actual patient they escorted is ready to leave.
Last night I cared for patients with breast cancer, nasal polyps, post reconstruction surgery, exploratory procedures, and gallstones. There are male and female patients in the open ward, which looks like a giant dorm room. I broke out the stickers and everyone got either a little boy or a little girl sticker, with an extra one to take home, after which patients put their hands together before their faces (an action called a "Y") and said, "aw koon" (thank you).
It's now nearly 8 a.m. and I've been up working all night but I need to do laundry before going to sleep. Project SMILE (repairing cleft palates in children) is now aboard and the USNS Mercy's populations has increased to about 1,200 people (rendering internet access tenuous). If I am unable to access the internet again during this trip I will add something after docking in Singapore in just over 2 weeks.
Thank you again for joining me during my time aboard the USNS Mercy as a part of Project HOPE.
Sunday, June 13, 2010
En Route to Cambodia
The 2 nights at sea provided welcome relief and an opportunity to catch up on sleep. For me the highlight was my last night on the ward when my patients, sitting in a circle, spoke through 2 active duty personnel (born in Vietnam and like my "adopted" son, Tuan, arrived in the USA as teens).
My patients repeatedly described their experience aboard as "paradise, paradise" and told me about the hours they waited in the hot sun to get evaluated by a doctor in order to be seen on the ship. They said that without access to medical care death comes so frequently and unexpectedly that they just try to work hard every day and hope to make it to the next day. Not a single one of my patients had ever had a vacation day or left their village.
When I told the patients I would be meeting with the Commodore and have an opportunity to relay messages they became very quiet then started to whisper. The sailors explained the patients were stunned at being invited to address a person of such high import and were unable to respond other than with gratitude. We talked for about an hour; an older man described his experiences during the Vietnam war with the South Vietnamese military.
A few of my impressions include my older patients' agility (remarkable), including a 93-year old woman who walked without assistance. The "younger" 80-year old patients woke daily to exercise next to their bunks. Several women had terrible acid burns on their faces from husbands. Several men described more than one wife.
The Commodore told us we treated over 19,000 patients in less than 2 weeks. Four major construction projects were completed, including a medical clinic and school. Hundreds of surgeries, evaluations, and community service projects were completed. Again, I am humbled by the honor to serve and astonished by the lack of access to medical care. The historic nature of the mission was explained to us as this is an attempt to reestablish a relationship with Vietnam (particularly salient as it is being courted assiduously by China).
A quick word about computer use. I do not have access to a computer at work on the wards. Those computers are exclusively for military personnel and solely for the hospital-military intra-net. Because email is not deemed priority, I succeed in gaining online access either around 11:30 at night or 4:30 in the morning. These are my work hours so I am able to get online only during time off. Because accessing my individual email requires a minimum of an hour or two, time constraints dictate I only open the "summary" email David prepares. Posting this blog does not entail email machinations but can be equally frustrating - thus the sporadic posts.
Now underway, the undulations of the ship at sea are calming. The best description is that they are like gentle aftershocks after a small earthquake. I can feel the floor rolling but it is constant and, as I wrote, somewhat calming. Helicopters land periodically and the 800 foot ship travels at 18 knots (about 20 mph). Small flying fish that look like hummingbirds hover next to the ship. The water is a deep cerulean blue and the air is spectacularly clean and salty.
All of us are on malaria prophylaxis (some of our group a little ill from its side effects) and the State Department briefing I attended warned about parasites, dengue fever, hepatitis, and the largest HIV/AIDs rates in Asia. We were told that Cambodia will not restrict movement the way Vietnam did and we will be treating people in 3 provinces, rural places where homes are built on stilts, and in places whose populace has never seen Americans.
Yesterday was our day off and mine looked like this: I ate breakfast from 7 until 7:15 a.m. and then went to my work station (Med-Surg Wards 1 & 2) to muster. Attendance, taken at muster, is to ensure no one is overboard and disseminate information. Afterward I went to the "Cas-Rec" (Casualty Reception) to attend a wound care lecture given by a medical officer from Australia (we are 8 partnering nations trying to standardize emergency preparations for natural disasters such as the 2005 tsunami, Katrina in New Orleans, and most recently, the earthquake in Haiti). Then I went up to the mess deck to attend several briefings by ship personnel and an American dentist living in Cambodia.
The Commodore also briefed us. She is a charismatic married mom who usually leads 6 ships in the Destroyer Squadron based in San Diego, California. In the Navy over 25 years, she provided an informational briefing and a security briefing. I found it interesting to learn our arrival and departure dates are intentionally vague related to security concerns. Thus we do not know our future arrival dates, neither to Cambodia, nor Singapore.
After the briefing I attended a frocking (promotions) ceremony from 11-noon on the flight deck. About 20 active duty Navy personnel were congratulated by superiors and cheered by hundreds of their peers. We were all invited to the mess deck for celebratory cake and a "steel beach" party which occurs on a steel deck in lieu of a sandy beach. Heat concerns drove the party inside but it remained festive and everyone appreciated the hot dogs, hamburgers, and ribs. The steel beach, combining lunch and dinner, was followed by an ice cream social.
After lunch I went on a tour of the engines graciously given by the Chief Engineer of the ship, who leads a crew of 28 civil servants. We were provided with ear plugs and warned that the temperatures would exceed 100. The equipment was awesome and stretched the equivalent of several stories high. Small, air-conditioned rooms were used for fascinating explanations.
Still going strong, I stopped in the library to exchange my book (I can't fall asleep without reading) and after opting out of yet another meeting I spent several hours top side (out on the deck) watching the magnificent scenery and reflecting on things heard and seen. After I showered I retired to my rack (bunk) to read and had my real first night of sleep (I work nights). It was heavenly!
This morning after mustering I got a haircut. At first they were reticent to cut my hair (usually there are only 2 choices: hair trim or head shave) but I persuaded them that regardless of the outcome I would be fine. The young woman who cut my hair did a fine job and I was pleased to learn I was allowed to give her a tip. The barber shop looks similar to a civilian shop but neither a shampoo nor a blow dry are provided and everyone must sign in and out.
Unfortunately, I missed the malaria briefing because I attended the State Department briefing. We were warned about medical risks to us (I have already cared for TB-positive patients) and that lack of maps prevent adequate land mine clearance. The USA saved its maps but neither China nor Russia did and casual walks result in a limb loss that makes amputatees a common sight in Cambodia. Additionally, crime and robbery are common in this area (we are on a strict "buddy" system) and the Department of State instructed not to resist attackers, that crimes are not investigated by local police, and to avoid cyclos (rickshaws).
I also learned about the pervasive sex slavery of children in Cambodia, that men become monks to learn to read, Cambodians use chopsticks in conjunction with spoons and fingers, and that wells and rivers are primary sources of domestic water. Many of us old enough to remember Pol Pot know that up to 50% of the populace was executed by its leaders and all educated city dwellers, if not executed, were dispersed rurally. The result of the indigenous genocide is a serious brain drain and lack of educated citizenry (doctors and dentists, inter alia).
And so we prepare to arrive at this largely Buddhist country the size of Oklahoma, where according to the State Department, military weaponry is readily available and constitutional protections are extended only to the local Khmer people.
Should be interesting!
My patients repeatedly described their experience aboard as "paradise, paradise" and told me about the hours they waited in the hot sun to get evaluated by a doctor in order to be seen on the ship. They said that without access to medical care death comes so frequently and unexpectedly that they just try to work hard every day and hope to make it to the next day. Not a single one of my patients had ever had a vacation day or left their village.
When I told the patients I would be meeting with the Commodore and have an opportunity to relay messages they became very quiet then started to whisper. The sailors explained the patients were stunned at being invited to address a person of such high import and were unable to respond other than with gratitude. We talked for about an hour; an older man described his experiences during the Vietnam war with the South Vietnamese military.
A few of my impressions include my older patients' agility (remarkable), including a 93-year old woman who walked without assistance. The "younger" 80-year old patients woke daily to exercise next to their bunks. Several women had terrible acid burns on their faces from husbands. Several men described more than one wife.
The Commodore told us we treated over 19,000 patients in less than 2 weeks. Four major construction projects were completed, including a medical clinic and school. Hundreds of surgeries, evaluations, and community service projects were completed. Again, I am humbled by the honor to serve and astonished by the lack of access to medical care. The historic nature of the mission was explained to us as this is an attempt to reestablish a relationship with Vietnam (particularly salient as it is being courted assiduously by China).
A quick word about computer use. I do not have access to a computer at work on the wards. Those computers are exclusively for military personnel and solely for the hospital-military intra-net. Because email is not deemed priority, I succeed in gaining online access either around 11:30 at night or 4:30 in the morning. These are my work hours so I am able to get online only during time off. Because accessing my individual email requires a minimum of an hour or two, time constraints dictate I only open the "summary" email David prepares. Posting this blog does not entail email machinations but can be equally frustrating - thus the sporadic posts.
Now underway, the undulations of the ship at sea are calming. The best description is that they are like gentle aftershocks after a small earthquake. I can feel the floor rolling but it is constant and, as I wrote, somewhat calming. Helicopters land periodically and the 800 foot ship travels at 18 knots (about 20 mph). Small flying fish that look like hummingbirds hover next to the ship. The water is a deep cerulean blue and the air is spectacularly clean and salty.
All of us are on malaria prophylaxis (some of our group a little ill from its side effects) and the State Department briefing I attended warned about parasites, dengue fever, hepatitis, and the largest HIV/AIDs rates in Asia. We were told that Cambodia will not restrict movement the way Vietnam did and we will be treating people in 3 provinces, rural places where homes are built on stilts, and in places whose populace has never seen Americans.
Yesterday was our day off and mine looked like this: I ate breakfast from 7 until 7:15 a.m. and then went to my work station (Med-Surg Wards 1 & 2) to muster. Attendance, taken at muster, is to ensure no one is overboard and disseminate information. Afterward I went to the "Cas-Rec" (Casualty Reception) to attend a wound care lecture given by a medical officer from Australia (we are 8 partnering nations trying to standardize emergency preparations for natural disasters such as the 2005 tsunami, Katrina in New Orleans, and most recently, the earthquake in Haiti). Then I went up to the mess deck to attend several briefings by ship personnel and an American dentist living in Cambodia.
The Commodore also briefed us. She is a charismatic married mom who usually leads 6 ships in the Destroyer Squadron based in San Diego, California. In the Navy over 25 years, she provided an informational briefing and a security briefing. I found it interesting to learn our arrival and departure dates are intentionally vague related to security concerns. Thus we do not know our future arrival dates, neither to Cambodia, nor Singapore.
After the briefing I attended a frocking (promotions) ceremony from 11-noon on the flight deck. About 20 active duty Navy personnel were congratulated by superiors and cheered by hundreds of their peers. We were all invited to the mess deck for celebratory cake and a "steel beach" party which occurs on a steel deck in lieu of a sandy beach. Heat concerns drove the party inside but it remained festive and everyone appreciated the hot dogs, hamburgers, and ribs. The steel beach, combining lunch and dinner, was followed by an ice cream social.
After lunch I went on a tour of the engines graciously given by the Chief Engineer of the ship, who leads a crew of 28 civil servants. We were provided with ear plugs and warned that the temperatures would exceed 100. The equipment was awesome and stretched the equivalent of several stories high. Small, air-conditioned rooms were used for fascinating explanations.
Still going strong, I stopped in the library to exchange my book (I can't fall asleep without reading) and after opting out of yet another meeting I spent several hours top side (out on the deck) watching the magnificent scenery and reflecting on things heard and seen. After I showered I retired to my rack (bunk) to read and had my real first night of sleep (I work nights). It was heavenly!
This morning after mustering I got a haircut. At first they were reticent to cut my hair (usually there are only 2 choices: hair trim or head shave) but I persuaded them that regardless of the outcome I would be fine. The young woman who cut my hair did a fine job and I was pleased to learn I was allowed to give her a tip. The barber shop looks similar to a civilian shop but neither a shampoo nor a blow dry are provided and everyone must sign in and out.
Unfortunately, I missed the malaria briefing because I attended the State Department briefing. We were warned about medical risks to us (I have already cared for TB-positive patients) and that lack of maps prevent adequate land mine clearance. The USA saved its maps but neither China nor Russia did and casual walks result in a limb loss that makes amputatees a common sight in Cambodia. Additionally, crime and robbery are common in this area (we are on a strict "buddy" system) and the Department of State instructed not to resist attackers, that crimes are not investigated by local police, and to avoid cyclos (rickshaws).
I also learned about the pervasive sex slavery of children in Cambodia, that men become monks to learn to read, Cambodians use chopsticks in conjunction with spoons and fingers, and that wells and rivers are primary sources of domestic water. Many of us old enough to remember Pol Pot know that up to 50% of the populace was executed by its leaders and all educated city dwellers, if not executed, were dispersed rurally. The result of the indigenous genocide is a serious brain drain and lack of educated citizenry (doctors and dentists, inter alia).
And so we prepare to arrive at this largely Buddhist country the size of Oklahoma, where according to the State Department, military weaponry is readily available and constitutional protections are extended only to the local Khmer people.
Should be interesting!
Thursday, June 10, 2010
Tam Biet Vietnam
Tam biet ("good-bye"), Vietnam.
Tonight on the flight deck Vietnamese VIPs arrived to thank us and bid adieu. The low-rising mountains before which sit the villages faded into darkness. The endless stalls of colorful fruits and vegetables (that taste wonderful but whose identities I cannot pinpoint) tended to by women in conical hats, and the delicious neon green and blue drinks sold in plastic baggies, will soon be a memory. I listened to the military band and saw a falling star streak across the sky.
The night before last I had an opportunity to visit the pediatric section and hug a very sick child. Last night I helped an old man urinate via catheter and he was so relieved (sorry, couldn't resist) he hugged me. Today, while querying one of my patients, a grey-haired matron sitting in the opposite bed smiled at me and said, "thank you, doctor," and I was hopeful she knew English (the interpreters supplied by Vietnam are young military men and do not know rudimentary English). I corrected the matron ("I am a nurse") and asked whether I may impose on her to translate for me. The old lady smiled, nodded, then turned to my patient and said, "thank you, doctor." Undaunted - quick wit that I am - I again explained to the matron, this time more slowly, what I needed. After asking whether she understood she again smiled, nodded, then turned to my patient and said, "thank you, doctor."
A subsistence fisherman, working nearby, accidentally sliced through the tendons and nerves on his arm. Under any other circumstances I would not consider this man lucky, but in this case his injury near the USNS Mercy was a lottery win because the surgeons operated with alacrity and his arm was saved. The fisherman and his wife spent the night on the ship and he received free medicines to take home with him to ensure a complete recovery.
I have had my hands kissed, I have been hugged, I have cared pre- and post- surgery for patients with gall bladder problems, cataracts, dental issues, Cancer, ovarian cysts, neck tumors, burns, a thyroid mass, and hernias. I assisted a man with a cleft palate whose surgery enabled him to close his mouth properly for the first time. I comforted a young woman facing surgery that may render her unable to bear children.
The last time I was ashore a group of us scrubbed and cleaned to create examination areas for medical treatments. Villagers who saw us began to gather, rubbing their eyes, their heads, or their stomachs, which indicated to us that word of our mission had spread. A large group of school children joyously waved and shouted, "hello! hello!"
While in the field I ate my first MRE (Meal, Ready to Eat) and its ingeniousness intrigued me. An MRE is a field ration, a thick packet the size of a small novel, encased in plastic and containing about 3,000 calories of food and drink. By adding a few tablespoons of water, a chemical reaction creates the equivalent of a miniature microwave and, sans electricity, I heated up a chicken breast meal with macaroni and cheese. Packets added to water create everything from carbonated beverages to milkshakes (albeit warm ones). Postcards are sometimes printed on the cardboard in the MRE and I was lucky enough to get the gold standard for field negotiations: M&M candies.
I am the sole Project HOPE nurse on my ward and work alongside nurses from Singapore, Australia, and Canada. Most of the nurses on my unit are in the reserves (this mission is being used as their training exercise) and I have the privilege of working with active duty nurses. Many of the personnel were kind enough to share their stories from Iraq and Afghanistan.
Each of us had a unique Vietnam experience influenced by duty station, medical site, and area of expertise. In addition to our work we take turns attending events such as visiting nearby foreign ships and attending ceremonies. Unfortunately, accidents also happen. Yesterday one of the military personnel was injured when the rolling stairs leading up to the ship trapped her leg and rolled over her foot (she is recuperating in one of the wards). We climb a lot of stairs (I see them in my sleep) and the work we do requires very long hours and a lot of hard work and yet, universally, there is a spirit of gratitude to be part of this mission; it is an honor to be here.
In the next few days we'll sail through the South China Sea and into the Gulf of Thailand to begin working in Cambodia. While underway ("steaming"), we'll practice drills, hear lectures, take malaria prophylaxis, and prepare the wards for the next batch of patients.
Tam biet, Vietnam.
Tonight on the flight deck Vietnamese VIPs arrived to thank us and bid adieu. The low-rising mountains before which sit the villages faded into darkness. The endless stalls of colorful fruits and vegetables (that taste wonderful but whose identities I cannot pinpoint) tended to by women in conical hats, and the delicious neon green and blue drinks sold in plastic baggies, will soon be a memory. I listened to the military band and saw a falling star streak across the sky.
The night before last I had an opportunity to visit the pediatric section and hug a very sick child. Last night I helped an old man urinate via catheter and he was so relieved (sorry, couldn't resist) he hugged me. Today, while querying one of my patients, a grey-haired matron sitting in the opposite bed smiled at me and said, "thank you, doctor," and I was hopeful she knew English (the interpreters supplied by Vietnam are young military men and do not know rudimentary English). I corrected the matron ("I am a nurse") and asked whether I may impose on her to translate for me. The old lady smiled, nodded, then turned to my patient and said, "thank you, doctor." Undaunted - quick wit that I am - I again explained to the matron, this time more slowly, what I needed. After asking whether she understood she again smiled, nodded, then turned to my patient and said, "thank you, doctor."
A subsistence fisherman, working nearby, accidentally sliced through the tendons and nerves on his arm. Under any other circumstances I would not consider this man lucky, but in this case his injury near the USNS Mercy was a lottery win because the surgeons operated with alacrity and his arm was saved. The fisherman and his wife spent the night on the ship and he received free medicines to take home with him to ensure a complete recovery.
I have had my hands kissed, I have been hugged, I have cared pre- and post- surgery for patients with gall bladder problems, cataracts, dental issues, Cancer, ovarian cysts, neck tumors, burns, a thyroid mass, and hernias. I assisted a man with a cleft palate whose surgery enabled him to close his mouth properly for the first time. I comforted a young woman facing surgery that may render her unable to bear children.
The last time I was ashore a group of us scrubbed and cleaned to create examination areas for medical treatments. Villagers who saw us began to gather, rubbing their eyes, their heads, or their stomachs, which indicated to us that word of our mission had spread. A large group of school children joyously waved and shouted, "hello! hello!"
While in the field I ate my first MRE (Meal, Ready to Eat) and its ingeniousness intrigued me. An MRE is a field ration, a thick packet the size of a small novel, encased in plastic and containing about 3,000 calories of food and drink. By adding a few tablespoons of water, a chemical reaction creates the equivalent of a miniature microwave and, sans electricity, I heated up a chicken breast meal with macaroni and cheese. Packets added to water create everything from carbonated beverages to milkshakes (albeit warm ones). Postcards are sometimes printed on the cardboard in the MRE and I was lucky enough to get the gold standard for field negotiations: M&M candies.
I am the sole Project HOPE nurse on my ward and work alongside nurses from Singapore, Australia, and Canada. Most of the nurses on my unit are in the reserves (this mission is being used as their training exercise) and I have the privilege of working with active duty nurses. Many of the personnel were kind enough to share their stories from Iraq and Afghanistan.
Each of us had a unique Vietnam experience influenced by duty station, medical site, and area of expertise. In addition to our work we take turns attending events such as visiting nearby foreign ships and attending ceremonies. Unfortunately, accidents also happen. Yesterday one of the military personnel was injured when the rolling stairs leading up to the ship trapped her leg and rolled over her foot (she is recuperating in one of the wards). We climb a lot of stairs (I see them in my sleep) and the work we do requires very long hours and a lot of hard work and yet, universally, there is a spirit of gratitude to be part of this mission; it is an honor to be here.
In the next few days we'll sail through the South China Sea and into the Gulf of Thailand to begin working in Cambodia. While underway ("steaming"), we'll practice drills, hear lectures, take malaria prophylaxis, and prepare the wards for the next batch of patients.
Tam biet, Vietnam.
Saturday, June 5, 2010
The First Week Ends
Our voyage is 25% complete. The last few days on this side of the international date line have been intense! I was pulled from orientation to work as charge nurse this week and interesting cultural issues abound. The patients are educated to remove clothing before showering (not after) and to sit on the toilet (as opposed to squatting next to it). Last night a patient looked askance when I used a water fountain and was so pleased when I pantomimed an invitation to him to drink (he did -with a big grin). When I presented a gift of markers to a young woman she asked (through the interpreter) if she may eat them.
Our patients are very poor and very appreciative. Last night I had on my ward a young woman around my daughter's age who weighed 65 pounds (you read that correctly). We gave her food and she seemed so shy and so grateful. She is only 35-years old but has a 20-year old daughter herself. She is very ill and I tried to comfort her. Another patient on the ward suffered from terrible burns, another chest pains, some will see dentists for the first time, and others are there as "escorts" because each patient may bring one person with them. Frequently our escorts turn into patients themselves and who can blame them for desiring food and care?
The wards are built with efficiency in mind. The beds drop down from poles like petals on a flower. There is no privacy; patients sleep in what looks like a dorm room with each escort nearby. Every patient is offered pajamas and a robe (many refuse, opting to sleep in their clothing) and given a towel, a pillow, and a blanket. Restrooms, which include showers and stocked with soap, are segregated (of course) by sex. Overhead lights are extinguished at 10 p.m. The nurses' station is a desk with several computers (that I am unable to access) and the (locked) medicine cabinet located to its side, alongside a sink. Basic supplies are unlocked and lined up neatly with a more adequately stocked supply room located unobtrusively to the side. All garbage (everywhere on the ship - personal berthing, the dining hall, the hospital wards) is separated into paper, plastic, metal, vegetable/hazmat(biological waste).
The work is rewarding - and endless. New shifts start every few hours (remember, this ship is a city and military personnel may include barbers, plumbers, secretaries, and cooks, in addition to medical personnel and volunteers). Also, this is a humanitarian mission so people come and go from the ship constantly to build clinics, provide healthcare, and even to ensure our safety in the water and on land.
Initial screening, including TB and lice, is done onshore for those boarding the ship for in-patient care (although late last night radiology identified a potentially active TB patient in my ward and I spent several hours before I could transfer him to an isolation unit). Patients and their escorts with lice are treated, given new clothing, and show up on the ward wearing hospital gowns, robes, and slippers.
Our shifts are longer than civilian shifts (both regarding the amount of hours per shift and the amount of shifts per week) and, in accordance with the ever-present efficiency credo, time is not wasted. For example, friends waiting for a jitney during shore liberty were asked to count pills while waiting. Tomorrow, my day of liberty, I will be ashore helping set up a medical post during the morning, return to the ship to sleep in the afternoon, and report for night shift hospital work after dinner.
At midnight I receive "mid-rats," short for "midnight rations," consisting of dinner leftovers. Each of us rotates up to the mess deck to eat. Once daily everyone on board "musters" (gathers) in their functional unit (the volunteers, like active duty personnel, work in a variety of departments) to ensure safety. Attendance is taken and announcements are made. A "man overboard" drill means mustering in the unit and an "abandon ship" drill means mustering next to our assigned life boat (there are 10).
Every room has its own address, like a house, that looks like a social security number. The first number is the deck, which corellates to the story of a building. The second number is the location as it relates to the front or back of the ship. For example, "0" is in the front ("bow") and "150" is in the back ("stern") so front/back location is ascertainable via the middle number. The third number acts the same way a street address' last digit identifies which side of the street to find a house. An even address may be found on the port side, odd on starboard. ("Port" is to the left when facing the bow.) So if I am told I may do laundry at 3-100-5, I find the third deck, walk toward the end of the ship, and look on the right side of the hallway.
This week I presented a short talk, through an interpreter, to a group of Vietnamese generals. I explained how standardization of nursing in the USA is accomplished through texts and tests. Their cordial but probing questions revealed that Vietnam is working on implementing licensure standards. There had been other nurse presentations prior to mine which, unfortunately, I missed related to work hours. The generals (5-star, 4-star, and 3-star) had clearly been researching which system to implement as they compared and contrasted ours to those of other countries. They shared some of their opinions about nurses that reflected the unfortunate universal bias against predominantly female vocations and, to my surprise, they asked why Vietnamese students in the USA opted to be nurses instead of doctors or lawyers.
This evening a group of us were transferred into officers' quarters. The new berthing differs from enlisted quarters in that there are only 6-8 people in each room, with 2 sinks, and a small table with 2 chairs. The beds seem slightly larger (but I may be in error) and instead of 2 lockers, each of us received a set of lockers that resemble a small armoire replete with pull-out drawers. In lieu of floor-to-ceiling bunks ("racks"), the racks are limited to 2 tiers, akin to traditional bunkbeds with small ladders.
So that was our first week and 25% of the mission. A lot of work and very rewarding but it is now past midnight Sunday morning and in 4 hours I need to rise to catch the boat to shore and help set-up the medical post. I'm going to grab some mid-rats, take a shower, and take a nap (I'm trying to stay up most of the night to prevent falling asleep on the job when I return to night shift tomorrow).
Thanks for keeping our mission in your prayers.
Our patients are very poor and very appreciative. Last night I had on my ward a young woman around my daughter's age who weighed 65 pounds (you read that correctly). We gave her food and she seemed so shy and so grateful. She is only 35-years old but has a 20-year old daughter herself. She is very ill and I tried to comfort her. Another patient on the ward suffered from terrible burns, another chest pains, some will see dentists for the first time, and others are there as "escorts" because each patient may bring one person with them. Frequently our escorts turn into patients themselves and who can blame them for desiring food and care?
The wards are built with efficiency in mind. The beds drop down from poles like petals on a flower. There is no privacy; patients sleep in what looks like a dorm room with each escort nearby. Every patient is offered pajamas and a robe (many refuse, opting to sleep in their clothing) and given a towel, a pillow, and a blanket. Restrooms, which include showers and stocked with soap, are segregated (of course) by sex. Overhead lights are extinguished at 10 p.m. The nurses' station is a desk with several computers (that I am unable to access) and the (locked) medicine cabinet located to its side, alongside a sink. Basic supplies are unlocked and lined up neatly with a more adequately stocked supply room located unobtrusively to the side. All garbage (everywhere on the ship - personal berthing, the dining hall, the hospital wards) is separated into paper, plastic, metal, vegetable/hazmat(biological waste).
The work is rewarding - and endless. New shifts start every few hours (remember, this ship is a city and military personnel may include barbers, plumbers, secretaries, and cooks, in addition to medical personnel and volunteers). Also, this is a humanitarian mission so people come and go from the ship constantly to build clinics, provide healthcare, and even to ensure our safety in the water and on land.
Initial screening, including TB and lice, is done onshore for those boarding the ship for in-patient care (although late last night radiology identified a potentially active TB patient in my ward and I spent several hours before I could transfer him to an isolation unit). Patients and their escorts with lice are treated, given new clothing, and show up on the ward wearing hospital gowns, robes, and slippers.
Our shifts are longer than civilian shifts (both regarding the amount of hours per shift and the amount of shifts per week) and, in accordance with the ever-present efficiency credo, time is not wasted. For example, friends waiting for a jitney during shore liberty were asked to count pills while waiting. Tomorrow, my day of liberty, I will be ashore helping set up a medical post during the morning, return to the ship to sleep in the afternoon, and report for night shift hospital work after dinner.
At midnight I receive "mid-rats," short for "midnight rations," consisting of dinner leftovers. Each of us rotates up to the mess deck to eat. Once daily everyone on board "musters" (gathers) in their functional unit (the volunteers, like active duty personnel, work in a variety of departments) to ensure safety. Attendance is taken and announcements are made. A "man overboard" drill means mustering in the unit and an "abandon ship" drill means mustering next to our assigned life boat (there are 10).
Every room has its own address, like a house, that looks like a social security number. The first number is the deck, which corellates to the story of a building. The second number is the location as it relates to the front or back of the ship. For example, "0" is in the front ("bow") and "150" is in the back ("stern") so front/back location is ascertainable via the middle number. The third number acts the same way a street address' last digit identifies which side of the street to find a house. An even address may be found on the port side, odd on starboard. ("Port" is to the left when facing the bow.) So if I am told I may do laundry at 3-100-5, I find the third deck, walk toward the end of the ship, and look on the right side of the hallway.
This week I presented a short talk, through an interpreter, to a group of Vietnamese generals. I explained how standardization of nursing in the USA is accomplished through texts and tests. Their cordial but probing questions revealed that Vietnam is working on implementing licensure standards. There had been other nurse presentations prior to mine which, unfortunately, I missed related to work hours. The generals (5-star, 4-star, and 3-star) had clearly been researching which system to implement as they compared and contrasted ours to those of other countries. They shared some of their opinions about nurses that reflected the unfortunate universal bias against predominantly female vocations and, to my surprise, they asked why Vietnamese students in the USA opted to be nurses instead of doctors or lawyers.
This evening a group of us were transferred into officers' quarters. The new berthing differs from enlisted quarters in that there are only 6-8 people in each room, with 2 sinks, and a small table with 2 chairs. The beds seem slightly larger (but I may be in error) and instead of 2 lockers, each of us received a set of lockers that resemble a small armoire replete with pull-out drawers. In lieu of floor-to-ceiling bunks ("racks"), the racks are limited to 2 tiers, akin to traditional bunkbeds with small ladders.
So that was our first week and 25% of the mission. A lot of work and very rewarding but it is now past midnight Sunday morning and in 4 hours I need to rise to catch the boat to shore and help set-up the medical post. I'm going to grab some mid-rats, take a shower, and take a nap (I'm trying to stay up most of the night to prevent falling asleep on the job when I return to night shift tomorrow).
Thanks for keeping our mission in your prayers.
Tuesday, June 1, 2010
USNS Mercy
A snafu translated into a night in a local hotel in Qui Nohn, a coastal city on the Gulf of Tonkin. Restless, I awoke at 4 a.m. and walked on the beach. Although quite early, the beach was crowded with hundreds of Vietnamese swimming, performing exercises in slow motion, and buying and selling live eels and small crabs. We were told we were the topic of discussion at a Peoples' Committee Meeting (it didn't help that we did not have an exact count of how many volunteers are in our group) and several hours later we boarded buses for the port where we were marched through a military checkpoint and onto a small boat (called a "bandaid"). We sailed into the Gulf of Tonkin and entered the South China Sea en route to the USNS Mercy.
We passed fishing vessels, villages with pagodas, and a large statue of a soldier on the top of a hill. As we rounded a bend we caught site of our huge floating hospital, the USNS Mercy, painted white with the international symbol of peace and medical care (a red cross) on each side. It was a very exciting and emotional moment and I felt proud to be part of this mission to bring hope and health care to people who have never seen doctors or nurses.
After boarding the Mercy we walked in front of what looked like a camera on a tripod, a heat scan, to determine whether any of us were feverish (and if so would be quarantined). We completed paperwork and were given berthing assignments. All of us nurses drew top bunks ("racks") in a compact room of about 100 women. The navy is nothing if not efficient and our room mimicked an RV: no space was wasted.
The racks are stacked floor to ceiling with roughly the dimensions of a coffin. Each has a nightlight with a tiny mirror and a curtain to draw for privacy (reminiscent of the old timey railway cars). There is not enough room to sit up in bed so during our first night there was a cacophony comprised of older nurses jumping down stacks of 3 beds and groping in the dark for restrooms and volunteers muttering "ouch!" as they hit their heads on the ceiling or the bunk above. To enter my bed I had to shimmy up the wall, grabbing the footrests upon which each sailor draped her personal towel, and fling myself over the rail without hitting my head on the ceiling. I started giggling so hard I had to put my head in my pillow to avoid disturbing others.
We were each assigned a locker, located in a row at the end of the racks. The restrooms and showers are on one side of the room and, because hospital work involves shifts, lights are out until 4 p.m. to enable night shift people to sleep. The effect on us is that we unpacked in the dark before attending several briefings.
There are about 950 people aboard and that night visiting contingencies from Japan and Singapore were honored. The "mess deck" (dining room) was multilingual, friendly, and loud. We stood in a cafeteria-style line, took silverware, and pointed at our selections. The food is hearty and there were several choices of pasta, meat balls, and chicken. Then we carried our food across the hall to a huge spotless area of tables with plastic table clothes and every condiment known to human kind. There is a choice of sodas, juices, water, milk, tea, coffee (Starbucks, no less), salads, fresh fruit, and desserts. The food is wholesome, plentiful, and good. Several big screens (news, both commercial and military) are positioned around the room and add to the noise. Each table has a "lip" around its edge to prevent spills in the event of turbulent seas.
I spent a good portion of my time trying to orient myself. The good news is that everyone is so friendly that regardless of where I went sailors offered to assist me. Active duty military personnel are impressive. I met teenagers and young adults in their twenties with enormous responsibilities which they handled with great dignity. I asked a young woman who helped me whether she left family behind and she described her 3-month old newborn in San Diego. It took everything in me not to put my arm around this young child who was clearly homesick but admirably stoic and uncomplaining.
The Mercy is a small city divided into neighborhoods which can only be reached via main "highways" (stairwells). Imagine about 7 buildings of 7 stories each pasted next to each other and the only way to get from one building to another - this is a lesson learned from the Titanic - is to climb to the top of one "building" and then walk over to the next. There are no underwater compartments that stretch from one side of the ship to the other. I need to walk up the equivalent of 5 stories of stairs to reach the main hallway to traverse the ship and then descend 5 more stories of stairs to reach my ward. There was a reason they questioned all of us about whether we were in good physical shape! There are 3 gyms, divided into categories (cardio, spinning, weight), a library with telephones and computers for the use of active-duty personnel, and a lounge for each class of worker (enlisted, officer, etc.). There are 4 computers for civilians to share and because air space is a consideration, we are (understandably) not a priority. Conditions are sparse and the ship has the appearance of a 1950s high school, clean but shopworn. There is a lot of noise, a lot of walking, and an awful lot of hard work - which is why I'm here.
I started work today with an orientation and, in an hour, return for my night shift duties. This morning I woke early and strolled the decks outside, watching the sunrise on the South China Sea. My assignment tonight is to admit Vietnamese adults to the ship (although I've been told the interpreter doesn't know English - go figure) and taking care of them post-surgery and prior to their disembarkation. I am on a "med-surg" (non-emergency) ward and receive patients after cataract surgery, hysterectomy, and gall bladder removal. In two days I am "charge" which means I will supervise the ward.
Because part of this mission is diplomatic to reestablish ties with Vietnam, I was selected, with 3 other nurses, to give a presentation to Vietnamese VIPs on the standardization of nursing in the United States. Everyone is very aware of their role on this mission and no one on leave is allowed to wear a shirt with an American flag or the words "USNS Mercy" on caps or clothing. I lobbied (unsuccessfully) to gain permission to distribute the American flags I brought to the Vietnamese generals.
Can you imagine what a photograph that would have made?
We passed fishing vessels, villages with pagodas, and a large statue of a soldier on the top of a hill. As we rounded a bend we caught site of our huge floating hospital, the USNS Mercy, painted white with the international symbol of peace and medical care (a red cross) on each side. It was a very exciting and emotional moment and I felt proud to be part of this mission to bring hope and health care to people who have never seen doctors or nurses.
After boarding the Mercy we walked in front of what looked like a camera on a tripod, a heat scan, to determine whether any of us were feverish (and if so would be quarantined). We completed paperwork and were given berthing assignments. All of us nurses drew top bunks ("racks") in a compact room of about 100 women. The navy is nothing if not efficient and our room mimicked an RV: no space was wasted.
The racks are stacked floor to ceiling with roughly the dimensions of a coffin. Each has a nightlight with a tiny mirror and a curtain to draw for privacy (reminiscent of the old timey railway cars). There is not enough room to sit up in bed so during our first night there was a cacophony comprised of older nurses jumping down stacks of 3 beds and groping in the dark for restrooms and volunteers muttering "ouch!" as they hit their heads on the ceiling or the bunk above. To enter my bed I had to shimmy up the wall, grabbing the footrests upon which each sailor draped her personal towel, and fling myself over the rail without hitting my head on the ceiling. I started giggling so hard I had to put my head in my pillow to avoid disturbing others.
We were each assigned a locker, located in a row at the end of the racks. The restrooms and showers are on one side of the room and, because hospital work involves shifts, lights are out until 4 p.m. to enable night shift people to sleep. The effect on us is that we unpacked in the dark before attending several briefings.
There are about 950 people aboard and that night visiting contingencies from Japan and Singapore were honored. The "mess deck" (dining room) was multilingual, friendly, and loud. We stood in a cafeteria-style line, took silverware, and pointed at our selections. The food is hearty and there were several choices of pasta, meat balls, and chicken. Then we carried our food across the hall to a huge spotless area of tables with plastic table clothes and every condiment known to human kind. There is a choice of sodas, juices, water, milk, tea, coffee (Starbucks, no less), salads, fresh fruit, and desserts. The food is wholesome, plentiful, and good. Several big screens (news, both commercial and military) are positioned around the room and add to the noise. Each table has a "lip" around its edge to prevent spills in the event of turbulent seas.
I spent a good portion of my time trying to orient myself. The good news is that everyone is so friendly that regardless of where I went sailors offered to assist me. Active duty military personnel are impressive. I met teenagers and young adults in their twenties with enormous responsibilities which they handled with great dignity. I asked a young woman who helped me whether she left family behind and she described her 3-month old newborn in San Diego. It took everything in me not to put my arm around this young child who was clearly homesick but admirably stoic and uncomplaining.
The Mercy is a small city divided into neighborhoods which can only be reached via main "highways" (stairwells). Imagine about 7 buildings of 7 stories each pasted next to each other and the only way to get from one building to another - this is a lesson learned from the Titanic - is to climb to the top of one "building" and then walk over to the next. There are no underwater compartments that stretch from one side of the ship to the other. I need to walk up the equivalent of 5 stories of stairs to reach the main hallway to traverse the ship and then descend 5 more stories of stairs to reach my ward. There was a reason they questioned all of us about whether we were in good physical shape! There are 3 gyms, divided into categories (cardio, spinning, weight), a library with telephones and computers for the use of active-duty personnel, and a lounge for each class of worker (enlisted, officer, etc.). There are 4 computers for civilians to share and because air space is a consideration, we are (understandably) not a priority. Conditions are sparse and the ship has the appearance of a 1950s high school, clean but shopworn. There is a lot of noise, a lot of walking, and an awful lot of hard work - which is why I'm here.
I started work today with an orientation and, in an hour, return for my night shift duties. This morning I woke early and strolled the decks outside, watching the sunrise on the South China Sea. My assignment tonight is to admit Vietnamese adults to the ship (although I've been told the interpreter doesn't know English - go figure) and taking care of them post-surgery and prior to their disembarkation. I am on a "med-surg" (non-emergency) ward and receive patients after cataract surgery, hysterectomy, and gall bladder removal. In two days I am "charge" which means I will supervise the ward.
Because part of this mission is diplomatic to reestablish ties with Vietnam, I was selected, with 3 other nurses, to give a presentation to Vietnamese VIPs on the standardization of nursing in the United States. Everyone is very aware of their role on this mission and no one on leave is allowed to wear a shirt with an American flag or the words "USNS Mercy" on caps or clothing. I lobbied (unsuccessfully) to gain permission to distribute the American flags I brought to the Vietnamese generals.
Can you imagine what a photograph that would have made?
Sunday, May 30, 2010
Hanoi Arrival
Hello again!
The Vietnamese government is holding us (possibly overnight) so I have a few minutes on-line here in a port hotel lobby before boarding the ship either today or tomorrow.
My trip over was uneventful; I had forgotten that flying economy on THAI is like flying first class on domestic flights in the USA (e.g., an open bar on the flight and real silverware). I arrived in Bangkok, Thailand after 17 hours and made a mad dash across the airport to my connecting flight with no time to spare and another 2 hours in the air. As I looked out the window after the flight landed I was surprised to note an international airport with only 2 runways and 4 airplanes. I was keenly aware that the relationship between our country and Hanoi defined the young adulthood, and all of the college years, of my husband and many of our friends, all of whom have never been dearer to me.
With the other passengers I signed an oath I had not sneezed or coughed at any time before or during the flight. On the ground we had to pass a line of military personnel who observed us (checking for illicit sneezes?) and one passenger was "invited" to accompany a military officer. I had changed into my Project: HOPE t-shirt, per instructions, and draped my stethoscope around my neck in an effort to ease my passage through immigration. Despite my efforts I was followed by someone in uniform who appeared to be taking notes.
In the terminal I was approached by a man who said he was there to collect me for Project: HOPE. I was relieved until my antennae kicked in and I realized the Project: HOPE t-shirt made me an easy target. While he was trying to get me to enter a taxi I demanded to see his ID and I think smoke began to come out of my ears because he backed away - slowly. I started to question drivers about the fare, and between the variety of different fares quoted, and being followed by military personnel, I became exasperated and decided to walk to the hotel. I ducked behind security to enter the office of the head of the airport, who surely would have done a "spit take" if he had had liquid in his mouth. Despite his shock at seeing me in his office he graciously supplied directions to the hotel and reassured me regarding safety.
Interestingly, as I headed down the road to only one of two international airports in this country, during the 1.5 kilometer walk I counted only 1 truck, 2 cars, and about 7 mopeds (small motorcycles). The hotel, a remnant from French colonial occupation, lacked door locks and housed rodents. I promised Project: HOPE I would remain flexible so I gulped twice and headed out to go explore the city. To my great good fortune, I ran into 2 other volunteers (a pediatrician and our public affairs officer) and they relayed the welcome information that Project: HOPE decided to relocate us to a different hotel in central Hanoi. The shuttle ride was filled with rice paddies surrounding us, water buffalo in the street, and landscape dotted with gorgeous remnants of French colonial architecture interspersed with bombed out buildings.
We were greeted by the head volunteer, recently returned from his honeymoon, who told us he met his wife on the same mission a few years earlier, in which he had to medivac his now-wife out of the country because she had contracted dengue fever. Definitely could have done without that tidbit of information.
After checking into the hotel I accomplished 2 of my goals: I photographed 2 Communists who had fought against the USA waving the American flags I brought, and more importantly, I toured the Hanoi Hilton prison, which was emotional and which I would prefer not to describe.
I walked around Hoan Kiem Lake with the famed tortoise pagoda that serves as the emblem of the city (the myth is that the emperor received a divine sword to protect the city and after accomplishing his feat a tortoise rose up and nabbed the sword to return it to the heavens). I toured the Old Quarter, in which each street is named for the major commodity it sells, including the flower market street, the fruit market street, the silk street, the rice street, the paper street, and the votive object street. I explored St. Joseph's Cathedral, Thu Le Park, West Lake, the huge Ho Chi Minh statue and mausoleum, and the one-pillar pagoda.
I walked until my shoes literally began to separate at the seams and then I rented a rickshaw and rode around town for an hour (and saw Asian tourists engaged in identical rickshaw tours, all of us smiling and waving at each other). One funny thing that happened is that when the rickshaw driver took off he drove straight into the oncoming path of a truck. My life did not flash before my eyes but I said out loud, "well, at least I got to see Hanoi" (chuckle).
Make no mistake, Hanoi is a relic of French colonialism. The architecture is exquisite. The French pastries and baguettes rival those in Paris and I am inexorably addressed with a respectful "Madam." When I insisted on buying a coca cola for my rickshaw driver several people gathered and began to smile and shout out, "Nice Lady! Good Lady!" it was lovely.
I was up this morning shortly after 3 a.m. I met up with several group members, each more interesting and more wonderful than the next and from all over the USA in jobs ranging from physician to photographer to physical therapist to nurse to dentist. After a 2-hour flight we arrived in the port city of Qui Nohn on the Gulf of Tonkin.
Although the Vietnamese embassy in Washington, D.C. issued our passport visas nearly a month ago, the Peoples' Committee want to "review" everything and thus, we just learned, we will spend the night here in Qui Nohn. "Flexible" is unquestionably our leit motif.
I was told it may be a few days until we may use the on-ship email and there is a chance that blogging will not fit the security profile. If this is so, I will say an early "good-bye" and again ask that you pray for the success of this important medical and diplomatic mission (the Vietnamese want to reestablish a relationship with the USA and our government has chosen to do this via civilian medical personnel providing much-needed health care). We are here to serve. The conversation and laughter are constant, the good will is high, the sense of adventure higher, and the line to use this computer grows.
I carry you, my family and friends, in my heart.
The Vietnamese government is holding us (possibly overnight) so I have a few minutes on-line here in a port hotel lobby before boarding the ship either today or tomorrow.
My trip over was uneventful; I had forgotten that flying economy on THAI is like flying first class on domestic flights in the USA (e.g., an open bar on the flight and real silverware). I arrived in Bangkok, Thailand after 17 hours and made a mad dash across the airport to my connecting flight with no time to spare and another 2 hours in the air. As I looked out the window after the flight landed I was surprised to note an international airport with only 2 runways and 4 airplanes. I was keenly aware that the relationship between our country and Hanoi defined the young adulthood, and all of the college years, of my husband and many of our friends, all of whom have never been dearer to me.
With the other passengers I signed an oath I had not sneezed or coughed at any time before or during the flight. On the ground we had to pass a line of military personnel who observed us (checking for illicit sneezes?) and one passenger was "invited" to accompany a military officer. I had changed into my Project: HOPE t-shirt, per instructions, and draped my stethoscope around my neck in an effort to ease my passage through immigration. Despite my efforts I was followed by someone in uniform who appeared to be taking notes.
In the terminal I was approached by a man who said he was there to collect me for Project: HOPE. I was relieved until my antennae kicked in and I realized the Project: HOPE t-shirt made me an easy target. While he was trying to get me to enter a taxi I demanded to see his ID and I think smoke began to come out of my ears because he backed away - slowly. I started to question drivers about the fare, and between the variety of different fares quoted, and being followed by military personnel, I became exasperated and decided to walk to the hotel. I ducked behind security to enter the office of the head of the airport, who surely would have done a "spit take" if he had had liquid in his mouth. Despite his shock at seeing me in his office he graciously supplied directions to the hotel and reassured me regarding safety.
Interestingly, as I headed down the road to only one of two international airports in this country, during the 1.5 kilometer walk I counted only 1 truck, 2 cars, and about 7 mopeds (small motorcycles). The hotel, a remnant from French colonial occupation, lacked door locks and housed rodents. I promised Project: HOPE I would remain flexible so I gulped twice and headed out to go explore the city. To my great good fortune, I ran into 2 other volunteers (a pediatrician and our public affairs officer) and they relayed the welcome information that Project: HOPE decided to relocate us to a different hotel in central Hanoi. The shuttle ride was filled with rice paddies surrounding us, water buffalo in the street, and landscape dotted with gorgeous remnants of French colonial architecture interspersed with bombed out buildings.
We were greeted by the head volunteer, recently returned from his honeymoon, who told us he met his wife on the same mission a few years earlier, in which he had to medivac his now-wife out of the country because she had contracted dengue fever. Definitely could have done without that tidbit of information.
After checking into the hotel I accomplished 2 of my goals: I photographed 2 Communists who had fought against the USA waving the American flags I brought, and more importantly, I toured the Hanoi Hilton prison, which was emotional and which I would prefer not to describe.
I walked around Hoan Kiem Lake with the famed tortoise pagoda that serves as the emblem of the city (the myth is that the emperor received a divine sword to protect the city and after accomplishing his feat a tortoise rose up and nabbed the sword to return it to the heavens). I toured the Old Quarter, in which each street is named for the major commodity it sells, including the flower market street, the fruit market street, the silk street, the rice street, the paper street, and the votive object street. I explored St. Joseph's Cathedral, Thu Le Park, West Lake, the huge Ho Chi Minh statue and mausoleum, and the one-pillar pagoda.
I walked until my shoes literally began to separate at the seams and then I rented a rickshaw and rode around town for an hour (and saw Asian tourists engaged in identical rickshaw tours, all of us smiling and waving at each other). One funny thing that happened is that when the rickshaw driver took off he drove straight into the oncoming path of a truck. My life did not flash before my eyes but I said out loud, "well, at least I got to see Hanoi" (chuckle).
Make no mistake, Hanoi is a relic of French colonialism. The architecture is exquisite. The French pastries and baguettes rival those in Paris and I am inexorably addressed with a respectful "Madam." When I insisted on buying a coca cola for my rickshaw driver several people gathered and began to smile and shout out, "Nice Lady! Good Lady!" it was lovely.
I was up this morning shortly after 3 a.m. I met up with several group members, each more interesting and more wonderful than the next and from all over the USA in jobs ranging from physician to photographer to physical therapist to nurse to dentist. After a 2-hour flight we arrived in the port city of Qui Nohn on the Gulf of Tonkin.
Although the Vietnamese embassy in Washington, D.C. issued our passport visas nearly a month ago, the Peoples' Committee want to "review" everything and thus, we just learned, we will spend the night here in Qui Nohn. "Flexible" is unquestionably our leit motif.
I was told it may be a few days until we may use the on-ship email and there is a chance that blogging will not fit the security profile. If this is so, I will say an early "good-bye" and again ask that you pray for the success of this important medical and diplomatic mission (the Vietnamese want to reestablish a relationship with the USA and our government has chosen to do this via civilian medical personnel providing much-needed health care). We are here to serve. The conversation and laughter are constant, the good will is high, the sense of adventure higher, and the line to use this computer grows.
I carry you, my family and friends, in my heart.
Monday, April 12, 2010
In the Beginning
Welcome!
"Are you nuts?!" is the usual reaction when people find out I left a cushy and cozy retirement to return to school and become a nurse. I loved being a lawyer and I am still surprised at how challenging it was to become a nurse. The academics were not difficult but the challenges of technology, and learning new psychomotor skills, were real - and at times frustrating.
David, my always supportive husband, located an accelerated program within a day's drive of our home and children in California. A suburb of Las Vegas, Nevada was a fun place to attend university but conquering the challenge that is Technology was a climb I did not expect. I joke about being a Luddite but temerity and hubris were not enough to keep me from weeping tears of self-pity over how to use a computer, create power point presentations, and maneuver through the class "blackboard" to post assignments and take tests.
When my Bachelor of Science (BSN) loomed large it was time to decide how best to use my new skills to fulfill my goal of service to country through service to others. We headed for Tampa, Florida, because my husband David's father, who is now deceased, was ill. Second Lt. Doyle W. Tucker, a bombardier during World War II, was shot down by the Nazis and held as a prisoner of war. The choice to serve in a Veterans' Affairs (VA) hospital was easy. I applied and was accepted.
I started work in the spinal-cord injuries unit of the James A. Haley Veterans' Hospital, caring for both veterans and active-duty military personnel injured in Iraq and Afghanistan. My days were filled with joy and sorrow. Yes, patients died, but young teenagers who were paralyzed began to walk, a young soldier got married, and patients old and young discovered they could continue to live, and did, agreeing to discharge from the hospital and start their new lives.
When John, one of the doctors, jokingly asked each morning, "How's it going, Terry?" I was able to respond candidly that physically and emotionally, working as a nurse is both the most difficult and the most rewarding work I've ever done. I signed up to work for America's heroes and ended up working with them. Nurses, whose hard work and dedicated service make the rest of our lives possible, are the greatest.
During my year of service I also worked as a professor at a local college and, during the evenings, earned my Masters degree in Nursing Education (MSN). I was serious about service and knew from my research that it's not a shortage of nurses our country faces, but a shortage of professors to teach Nursing. Professors earn less than half of what nurses earn; there is no incentive to teach. I found the ideal service project for retirement. Perfect. There was only one last thing to do.
My wonderful mother, Edith, is an award-winning AIDS activist. She began to volunteer at a time when HIV/AIDS was not as well understood as it is today. One of my mother's dear friends, Edwina, went to Africa to do HIV/AIDS volunteer work and my "final frontier" was to serve abroad prior to settling down to teach. The problem, however, was that I had absolutely no idea where to begin.
To my great good fortune, one of the volunteers in the hospital heard about my dilemma and introduced me to a remarkable person, General C. William Fox, Jr., MD, the chief operating officer for Project HOPE. Dr. Fox was inspiring, encouraging, and the real deal, an American hero. I learned all about the mission of Project HOPE (Health Opportunities for People Everywhere) and its creation over 50 years ago when Dr. Walsh, a medical officer during World War II, refused to accept the substandard conditions of those in the South Pacific and persuaded President Eisenhower to donate a hospital ship from our Navy to help others.
Project HOPE hospital ships travel the world on humanitarian missions. Project HOPE staff change the lives of others and provide relief at disaster sites after earthquakes, such as in Haiti, and after tsunamis. I prayed and prayed I would be worthy of their mission and selected for service. And that's the beginning!
Now I have to sign off to buy supplies, to scan the necessary documents, and to apply for my visa. The last week of May I leave for Vietnam, then Cambodia, and end up in Singapore in July, where my loving husband will join me to tour Singapore and Malaysia before our return to California. I consider it a privilege to be a part of the mission and ask you to pray for its success. Keep me in your thoughts and prayers. I will try to post regularly from the ship.
"Are you nuts?!" is the usual reaction when people find out I left a cushy and cozy retirement to return to school and become a nurse. I loved being a lawyer and I am still surprised at how challenging it was to become a nurse. The academics were not difficult but the challenges of technology, and learning new psychomotor skills, were real - and at times frustrating.
David, my always supportive husband, located an accelerated program within a day's drive of our home and children in California. A suburb of Las Vegas, Nevada was a fun place to attend university but conquering the challenge that is Technology was a climb I did not expect. I joke about being a Luddite but temerity and hubris were not enough to keep me from weeping tears of self-pity over how to use a computer, create power point presentations, and maneuver through the class "blackboard" to post assignments and take tests.
When my Bachelor of Science (BSN) loomed large it was time to decide how best to use my new skills to fulfill my goal of service to country through service to others. We headed for Tampa, Florida, because my husband David's father, who is now deceased, was ill. Second Lt. Doyle W. Tucker, a bombardier during World War II, was shot down by the Nazis and held as a prisoner of war. The choice to serve in a Veterans' Affairs (VA) hospital was easy. I applied and was accepted.
I started work in the spinal-cord injuries unit of the James A. Haley Veterans' Hospital, caring for both veterans and active-duty military personnel injured in Iraq and Afghanistan. My days were filled with joy and sorrow. Yes, patients died, but young teenagers who were paralyzed began to walk, a young soldier got married, and patients old and young discovered they could continue to live, and did, agreeing to discharge from the hospital and start their new lives.
When John, one of the doctors, jokingly asked each morning, "How's it going, Terry?" I was able to respond candidly that physically and emotionally, working as a nurse is both the most difficult and the most rewarding work I've ever done. I signed up to work for America's heroes and ended up working with them. Nurses, whose hard work and dedicated service make the rest of our lives possible, are the greatest.
During my year of service I also worked as a professor at a local college and, during the evenings, earned my Masters degree in Nursing Education (MSN). I was serious about service and knew from my research that it's not a shortage of nurses our country faces, but a shortage of professors to teach Nursing. Professors earn less than half of what nurses earn; there is no incentive to teach. I found the ideal service project for retirement. Perfect. There was only one last thing to do.
My wonderful mother, Edith, is an award-winning AIDS activist. She began to volunteer at a time when HIV/AIDS was not as well understood as it is today. One of my mother's dear friends, Edwina, went to Africa to do HIV/AIDS volunteer work and my "final frontier" was to serve abroad prior to settling down to teach. The problem, however, was that I had absolutely no idea where to begin.
To my great good fortune, one of the volunteers in the hospital heard about my dilemma and introduced me to a remarkable person, General C. William Fox, Jr., MD, the chief operating officer for Project HOPE. Dr. Fox was inspiring, encouraging, and the real deal, an American hero. I learned all about the mission of Project HOPE (Health Opportunities for People Everywhere) and its creation over 50 years ago when Dr. Walsh, a medical officer during World War II, refused to accept the substandard conditions of those in the South Pacific and persuaded President Eisenhower to donate a hospital ship from our Navy to help others.
Project HOPE hospital ships travel the world on humanitarian missions. Project HOPE staff change the lives of others and provide relief at disaster sites after earthquakes, such as in Haiti, and after tsunamis. I prayed and prayed I would be worthy of their mission and selected for service. And that's the beginning!
Now I have to sign off to buy supplies, to scan the necessary documents, and to apply for my visa. The last week of May I leave for Vietnam, then Cambodia, and end up in Singapore in July, where my loving husband will join me to tour Singapore and Malaysia before our return to California. I consider it a privilege to be a part of the mission and ask you to pray for its success. Keep me in your thoughts and prayers. I will try to post regularly from the ship.
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