By U.S. Air Force Capt. Candace N. Park, 12th Air Force (Air Forces Southern) Public Affairs
/ Published July 16, 2012
HUANCAVELICA, Peru -- An 11-year high school physics and chemistry teacher was struck by a second calling about nine years ago: to serve his country as a U.S. Air Force physician.
He set out to become an obstetrician/gynecologist through the Health Professions Scholarship Program, always with the goal in mind of one day serving those in need, at home and abroad. He envisioned using his knowledge and compassion to make a difference in the lives of others on a global scale.
The past two weeks of his Air Force career have been the experience he had been dreaming of when he first decided to change paths nearly a decade ago.
Today, Capt. James Small wakes up in the remote, mountainous region of Huancavelica, Peru, energized to start a full day of patient care in his new office: an Emergency Medical Support (EMEDS) Health Response Team (HRT) mobile hospital set up in a soccer field nearly 13,500 feet above sea level.
It's winter and the air is frigid. Yet, when Small arrives at work, lines of people have been waiting since the early morning hours to receive specialized medical care from him and about 40 of his colleagues deployed here from the 633rd Medical Group, Joint Base Langley-Eustis, Va.
In cooperation with the Peruvian government, three weeks ago truckloads of pallets traveled more than 11 hours up winding mountain roads to a dirt soccer field in Huancavelica, where the U.S. Air Force team and Peruvian soldiers unloaded the trucks. The U.S. and Peruvian service members worked for nearly 24 hours to unpack the boxes and assemble their contents into a 22-room, 6,300 square-foot, network of medical tents that comprise the EMEDS HRT hospital.
"I was absolutely blown away--it was so impressive--from the moment we reached the compound and we saw the network of tents that were set up," says Maj. Gen. Mark Sears, U.S. Southern Command's deputy commander for mobilization and reserve affairs, who visited the EMEDS HRT site. "And to think of the incredible logistics of how it had to be moved in and set up; then we got inside and saw all of the activities that were going on and the people that they were treating. It was absolutely phenomenal."
The EMEDS HRT is deployed here as part of New Horizons, a U.S. Southern Command-sponsored annual joint and combined training and humanitarian assistance exercise that takes place in Latin American and Caribbean countries.
In preparation to deploy as part of New Horizons Peru 2012, the EMEDS HRT trained and worked together for about six months. They rehearsed how the EMEDS would be assembled, who would work where and how patients would flow in and out of the facility.
This deployment experience has brought them together as a team, Small says.
"We've pulled together, we've bonded, and we've gotten to know one another," he says. "This experience will make us a better hospital back at home station and prepare us to deploy in future contingencies."
The EMEDS HRT is comprised of a variety of light and lean modular, rapid response medical packages that can be used in a myriad of operations such as humanitarian relief, wartime contingencies and disaster response.
The life-saving benefits of the EMEDS have been tested before in Latin America and the Caribbean. A similar EMEDS HRT was field-tested in Trinidad and Tobago during another U.S. Southern Command-sponsored exercise, Fuerzas Alliadas Humanitarias (FAHUM) in April 2011, and in March 2010, an EMEDS deployed to Chile following as part of a disaster relief mission.
The local hospital in Angol, a city southeast of Conception, Chile, was deemed structurally unsound as a result of an 8.8-magnitude earthquake Feb. 27, 2010. With the nearest operation ward more than 40 miles away, and many other local hospitals overwhelmed with casualties following the earthquake, local Chilean officials requested assistance from U.S. forces to help with primary care capabilities.
About 60 Air Force medical personnel responded to the call for help and set up an EMEDS facility in Angol, Chile. The Air Force medics worked alongside Chilean medical personnel from the local hospital to meet the daily medical needs of the local community out of the mobile facility. That EMEDS team was equipped and staffed to provide surgical, primary care, pediatric, radiological, gynecological, laboratory and pharmaceutical services.
In two weeks of patient care, U.S. Air Force and Chilean medical personnel worked side-by-side to attend to more than 300 patients and performed about 40 surgeries, and gave back Chilean physicians 60 percent of the bed space lost as a result of the earthquake.
Some Airmen who deploy on these types of EMEDS missions consistently report that the ability to go quickly to help those in need is something they'll remember for the long-term.
"It has been a very rewarding experience," said Senior Airman Amber Olszen, an aerospace medical technician who deployed to Chile from the 81st Surgical Inpatient Squadron at Keesler Air Force Base, Miss. "We built a hospital from scratch. It was hard work, but I would do it again in a heartbeat and the Chileans were very grateful for it."
The Airmen deployed to Peru as part of the New Horizons EMEDS HRT mission express a similar sentiment.
"I think it makes me a better person to see the world from a different perspective--it makes me a better doctor, gives me a compassion and understanding for the human side of medicine," Small says. "It gives me a renewed spirit for my role as a physician."
As the EMEDS HRT mobile hospital was finally set up in the soccer field in Huancavelica, Peru, a little more than two weeks ago, a buzz ignited in the community, and people began lining up for appointments to receive care in one of the five specialties the EMEDS HRT offers: pediatrics, internal medicine, family medicine, gynecology, and dental.
Small describes the Peruvians who gather to wait in the middle of the night in the freezing temperatures as "cheerful" and "truly grateful" for the opportunity to receive medical care as they make their way into his clinic.
"The patients have only met you for a minute, yet they fully give you their trust," Small says. "I've been reminded throughout this experience that there's a true element of trust that is the doctor-patient relationship."
With the assistance of interpreters provided by the Peruvian regional government and health ministry, each specialty clinic of the HRT attends to a max of about 70 patients per day for a total daily patient count of about 350. In addition, about three patients receive general or orthopedic surgery per day in the facility. Over the EMEDS HRT's four-week deployment, medics anticipate they will attend to about 7,000 patients.
But, Small says it isn't about the number of patients per day he sees that make this experience the one he's been anticipating since he joined the Air Force. For the teacher-turned-doctor, it's the human side of medicine that has been the most rewarding.
"The 30 minutes you spend with one patient might be the most important time they've spent with a person in years," Small says. "You're connecting with them during that time you spend together in the tent--you're reassuring them that they are healthy, and they are so grateful for their care.
"I think after the fundamental necessities of life -food, water, shelter, safety--most people desire health," Small says. "They want to live a long life. Having an option to see a physician can give them reassurance about their life."
Small says the experience in the EMEDS HRT is making him a better health professional.
"I'm having an opportunity to do what I hoped I'd do eventually, " Small says. "I'm going to come away from here with a deeper level of compassion and appreciation of what I can do for my patients. The patients at home aren't any different from those I'm seeing here, but somehow being in a different place intensifies your understanding of who you are as a physician."
The EMEDS HRT is just one of several parts of the humanitarian assistance and training exercise New Horizons ongoing in Peru until the end of August.
U.S. Air Force and Army medics are working alongside Project Hope, a non-government organization, to bring medical care to 11 communities, where they set up community clinics in schools so citizens can receive free medical care. New Horizons medics anticipate they will attend to 30,000 patients between the EMEDS HRT and the various medical readiness and training exercise locations.
Additionally, U.S. and Peruvian military engineers are working side-by-side on two community infrastructure construction projects in the Ica region of Peru: a clinic in Independencia, and a multi-use community center in Tambo de Mora. Both of the towns where construction is taking place were devastated by an earthquake in 2007.
"I've had an opportunity to visit several of the sites," Sears says. "It's a critical piece in not only bringing infrastructure, and training for our folks, but just the relationship building overall for our country with this partner nation."
Sears says military-to-military training exercises like New Horizons are very valuable preparation to respond together to future regional challenges, like natural disasters.
He says the regional response to the Haiti earthquake relief efforts seen in 2010 were a great example of regional collaboration enhanced by previous combined training.
"Like with Haiti relief, when all the countries in this (region) want to help out one of their own, they're going to send whoever they can and the experts they can," Sears says. "But if they've had an opportunity to train beforehand not only with U.S. forces but with responding forces from other partner nations, it just helps that collective regional response to be even more effective."
The three-month New Horizons Peru activities will culminate in a disaster response subject matter expert exchange between U.S. and Peruvian first responders, where about 150 participants will practice responding to a simulated earthquake and an aircraft crash scenario.
New Horizons Peru 2012 isn't the first time U.S. Southern Command service members have participated in humanitarian assistance and training missions in Peru.
New Horizons 2008 took place in Ayacucho, Peru, where U.S. and Peruvian military engineers completed the construction of three schools, two clinics and a water well.
In May 2011, the USNS Comfort visited Paita, Peru as part of Continuing Promise 2011. Highlights from that mission include the treatment of 7,352 patients and completion of two community infrastructure projects. A team of military and non-government organization personnel also repaired water systems at two sites, providing Peruvians in the area long-term access to potable water.
The 2011 visit was the third time Continuing Promise visited Peru; the USS Boxer visited Huacho and Salinas, Peru in June 2008, and the Comfort visited Salaverry, Peru in August 2007.
In January 2012, High Speed Vessel (HSV2) Swift deployed to Peru as part of Southern
Partnership Station 12 an annual deployment of U.S. ships to the U.S. Southern Command area of responsibility in the Caribbean and Latin America. Service members aboard the HSV2 Swift spent three weeks working with Peruvian civilian and military peers discussing and developing best practices and procedures on a variety of topics.
During the deployment, U.S. Navy Seabees and Marines completed renovations and reconstruction of three school sites alongside Peruvian marine combat engineers. The exchange concluded with a recognition ceremony at a school in Ancon, Peru, where three Seabees from Naval Mobile Construction Battalion 23 and six Peruvian engineers built three classrooms for the benefit of 1,000 students.