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Air Reserves provide medical care to Dominican Republic

A small child cautiously peers into the pediatrician’s room while awaiting her turn in line at a primary school turned temporary clinic in Hostos, Dom. Rep., April 22, during the largest Maxwell Air Force Base-planned U.S. Air Force Medical Readiness Training Exercise (MEDRETE) to date. A group of 45 medics, translators, security and support personnel derived from the U.S. Air Force, Army and Marines provided dental, dermatologic, general medicine, optometric, pediatric, pharmacy and public health services. The medics treated 2,800 patients during the first three days of the U.S. SOUTHCOM sponsored Beyond the Horizon 2009 – Caribbean. A MEDRETE is a U. S. Southern command-sponsored exercise designed to provide humanitarian assistance and free medical care to the people of the host nation, while providing an unparalleled training opportunity for U.S. and host nation forces. SOUTHCOM sponsors approximately 70 MEDRETEs per year. (U.S. Air Force Photo by Capt. Ben Sakrisson)

A small child cautiously peers into the pediatrician’s room while awaiting her turn in line at a primary school turned temporary clinic in Hostos, Dom. Rep., April 22, during the largest Maxwell Air Force Base-planned U.S. Air Force Medical Readiness Training Exercise (MEDRETE) to date. A group of 45 medics, translators, security and support personnel derived from the U.S. Air Force, Army and Marines provided dental, dermatologic, general medicine, optometric, pediatric, pharmacy and public health services. The medics treated 2,800 patients during the first three days of the U.S. SOUTHCOM sponsored Beyond the Horizon 2009 – Caribbean. A MEDRETE is a U. S. Southern command-sponsored exercise designed to provide humanitarian assistance and free medical care to the people of the host nation, while providing an unparalleled training opportunity for U.S. and host nation forces. SOUTHCOM sponsors approximately 70 MEDRETEs per year. (U.S. Air Force Photo by Capt. Ben Sakrisson)

Capt. Keiron T. Kennedy, a Flight Surgeon from the 42nd Medical Group at Maxwell Air Force Base, Ala., sutures the gums of a patient who had six rotten tooth-stubs removed at a primary school turned temporary clinic in Hostos, Dom. Rep., April 22, during the largest Maxwell Air Force Base-planned U.S. Air Force Medical Readiness Training Exercise (MEDRETE) to date. A group of 45 medics, translators, security and support personnel derived from the U.S. Air Force, Army and Marines provided dental, dermatologic, general medicine, optometric, pediatric, pharmacy and public health services. The medics treated 2,800 patients during the first three days of the U.S. SOUTHCOM sponsored Beyond the Horizon 2009 – Caribbean. A MEDRETE is a U. S. Southern command-sponsored exercise designed to provide humanitarian assistance and free medical care to the people of the host nation, while providing an unparalleled training opportunity for U.S. and host nation forces. SOUTHCOM sponsors approximately 70 MEDRETEs per year. (U.S. Air Force Photo by Capt. Ben Sakrisson)

Capt. Keiron T. Kennedy, a Flight Surgeon from the 42nd Medical Group at Maxwell Air Force Base, Ala., sutures the gums of a patient who had six rotten tooth-stubs removed at a primary school turned temporary clinic in Hostos, Dom. Rep., April 22, during the largest Maxwell Air Force Base-planned U.S. Air Force Medical Readiness Training Exercise (MEDRETE) to date. A group of 45 medics, translators, security and support personnel derived from the U.S. Air Force, Army and Marines provided dental, dermatologic, general medicine, optometric, pediatric, pharmacy and public health services. The medics treated 2,800 patients during the first three days of the U.S. SOUTHCOM sponsored Beyond the Horizon 2009 – Caribbean. A MEDRETE is a U. S. Southern command-sponsored exercise designed to provide humanitarian assistance and free medical care to the people of the host nation, while providing an unparalleled training opportunity for U.S. and host nation forces. SOUTHCOM sponsors approximately 70 MEDRETEs per year. (U.S. Air Force Photo by Capt. Ben Sakrisson)

1st Lt. John A. Vann, a physician assistant from the 42nd Medical Group at Maxwell AFB, Ala., performs an examination on a patient at a primary school turned temporary clinic in Hostos, Dom. Rep., April 22, during the largest Maxwell Air Force Base-planned U.S. Air Force Medical Readiness Training Exercise (MEDRETE) to date. A group of 45 medics, translators, security and support personnel derived from the U.S. Air Force, Army and Marines provided dental, dermatologic, general medicine, optometric, pediatric, pharmacy and public health services. The medics treated 2,800 patients during the first three days of the U.S. SOUTHCOM sponsored Beyond the Horizon 2009 – Caribbean. A MEDRETE is a U. S. Southern command-sponsored exercise designed to provide humanitarian assistance and free medical care to the people of the host nation, while providing an unparalleled training opportunity for U.S. and host nation forces. SOUTHCOM sponsors approximately 70 MEDRETEs per year. (U.S. Air Force Photo by Capt. Ben Sakrisson)

1st Lt. John A. Vann, a physician assistant from the 42nd Medical Group at Maxwell AFB, Ala., performs an examination on a patient at a primary school turned temporary clinic in Hostos, Dom. Rep., April 22, during the largest Maxwell Air Force Base-planned U.S. Air Force Medical Readiness Training Exercise (MEDRETE) to date. A group of 45 medics, translators, security and support personnel derived from the U.S. Air Force, Army and Marines provided dental, dermatologic, general medicine, optometric, pediatric, pharmacy and public health services. The medics treated 2,800 patients during the first three days of the U.S. SOUTHCOM sponsored Beyond the Horizon 2009 – Caribbean. A MEDRETE is a U. S. Southern command-sponsored exercise designed to provide humanitarian assistance and free medical care to the people of the host nation, while providing an unparalleled training opportunity for U.S. and host nation forces. SOUTHCOM sponsors approximately 70 MEDRETEs per year. (U.S. Air Force Photo by Capt. Ben Sakrisson)

YOUNGSTOWN, Ohio -- For most Americans familiar with the Dominican Republic, the mention of the country's name conjures up images of sandy white beaches, crystal blue waters, lush rolling mountains and destinations such as the capital city of Santo Domingo or the tourist destination of Punta Cana. 

However, there is another side to the island nation that many people are not familiar with and that is the countless villages and towns filled with corrugated tin shacks, small concrete open air hovels with a population of impoverished but seemingly content people living their lives day by day. 

This lesser known part of the Dominican Republic was the destination of a group of more than 30 Citizen Airmen that arrived to the island from Youngstown Air Reserve Station April 26 on a mission scheduled to last until May 8. 

Dominican Republic Medical Training Exercise (MEDRETE) 2009 brought the expertise of specialists assigned or attached to the 910th Medical Squadron to give much needed medical care to residents in and around two neighborhoods in the town of Azua and one neighborhood in the town of Padre Las Casas. 

By definition, the MEDRETE concept develops and cultivates global relationships by providing culturally aware, linguistically competent regional healthcare experts in support of U.S. national strategy. On the ground, MEDRETE gives medical care to a population that quite possibly has not received any type of basic healthcare in their entire lives as well as provides invaluable training to the U.S. Air Force Reserve's Citizen Airmen in a real world setting. Maj. Michael Keller, assigned to the 910th Medical Squadron and a Emergency Room doctor at St. Elizabeth Medical Center in Youngstown, Ohio, said the training Reservists receive on a MEDRETE will carry over into their civilian jobs as well. 

"What I learn on this mission, I then bring back to the community and I think that enhances my capabilities (to treat my patients)," said Maj. Keller. 

Maj. Keller was a Family Care specialist during the mission among a team that also included an In-processing Triage team, Dental Care and Eye Care specialists and a full Pharmacy staff. The MEDRETE team set up operations on fenced-in school campuses in the towns where they were working. These pre-selected sites allowed the Dominican Army to provide crowd control for the caregivers and also let the team use the classrooms to set up individual areas for their sections of care. 

The Airmen assigned to the 910th Medical Squadron were augmented by personnel from Pittsburgh's 911th Airlift Wing as well as a specialist from Travis Air Force Base, Calif. and a specialist from Hill Air Force Base, Utah. 

Pre-mission briefings estimated the team would see more than 1,000 patients per day over the span of the 10-day mission. Estimates allowed for the first day and second day of the mission to have lesser numbers due to section set up and so on. The pre-mission brief stated the team could expect to treat 500 patients on day one and 800 patients on day two of their mission in the small Dominican town of Azua. Actually, the 910th MEDRETE team saw more than 600 patients on their first day and more than 900 patients on their second day in Azua. By day three of their time in the small Dominican town, the group saw more than 1200 patients in the course of an approximately nine hour long work day. 

"It's impressive. They all really came together as a team. It was hard to tell who had been working with each other in Youngstown for years and who hadn't," said Col. Ronnie Roberts, 910th Medical Squadron commander and MEDRETE mission commander. 

A humanitarian training mission dispensing much needed and incredibly rare healthcare conducted on a Caribbean island presented more challenges than figuring out how a team of about 30 specialists would go about caring for an estimated 10,000 people in the span of about a week and a half. The security and health of the providers was paramount. The mission would suffer drastically if team members fell ill or were harmed in any way. 

The language barrier between mostly English speaking care givers and mostly Spanish speaking patients was also an enormous challenge. With this in mind, planning for the mission began many months ahead of time and involved Department of Defense personnel assigned to the U.S. Embassy in Santo Domingo and personnel from the U.S. Southern Command. 

Everything from the purchase of cases of bottled water to an armed escort of more than 15 Dominican Army soldiers to securing as many translators as possible was considered and put into place. Maj. Patrick Lanaghan, 910th Medical Squadron Medical Science Officer was in charge of much of the mission pre-planning and the effort to try to consider every contingency seemed to be paying off. Although the climate in Azua is a far cry from that of Northeast Ohio, Maj. Lanaghan noted that after some adjustment, the team was good to go. 

"Coming down from Youngstown, we weren't prepared for the heat and humidity but we are doing well. We are drinking lots of water and taking care of each other. We are making sure everyone is staying hydrated," said Maj. Lanaghan. 

Maj. Larry Woods, a MEDRETE Family Care specialist assigned to the 910th Medical Squadron, agreed with the science officer's assessment of the team and their preparation. 

"We have been preparing for this for months and we're real happy to do something like this," said Maj. Woods. 

Although the team put in long, hard, exhausting days, working in temperatures around the 90 degree mark with 90 percent humidity, the satisfaction of treating patients ranging from a 26-day old infant to a woman reported by townspeople to be 120 years old seemed to be a common thread among the MEDRETE team members. 

"It just boils down to what this person needs and how can I help this person. It's a joy. It's really great," said Lt. Col. Christopher Rugaber, an Eye Care specialist and a veteran of several MEDRETE's assigned to the 910th Medical Squadron. 

Maj. Larry Woods, a Citizen Airman who, as a civilian, works as a cardiovascular specialist and Intensive Care doctor at Trumbull Memorial Hospital, was equally impressed by the team and the Dominican residents seeking the rarely available medical care. 

"They (the MEDRETE team) are working their hearts away to try and provide the (most) amount of care they can give in such a short amount of time and the Dominican people are just all grateful. You have to see it to believe it," said Maj. Woods. 

The 910th Medical Squadron MEDRETE team worked together to treat all types of ailments that included vitamin deficiencies, dermatitis, skin infections, heart and lung problems, parasite infestations, a variety of eye problems and tooth decay as well as oral infections due to the lack of preventative dental care. 

Lt. Col. Rodney Waite, a Dental Care specialist, said his section was seeing 100 to 150 patients per day requiring care. 

"We're seeing a lot of patients and each will require a (tooth) extraction or two, so, we have been pretty busy," said Lt. Col Waite. 

Although very few of the MEDRETE specialists spoke Spanish, they were able to communicate with their patients through volunteer translators provided by the Dominican Army and the Azua Rotary. The MEDRETE team members that were bilingual such as Tech. Sgt. Maritza Ramirez, an aeromedical technician assigned to the 910th Medical Squadron, were an incredible asset contributing to the mission's success. 

Sergeant Ramirez assisted patients working through the In-processing section of the MEDRETE by speaking with them in their native language to aid in filling out triage slips in English that would help the team members to give them the care they needed. She also acted as the official interpreter during the Opening Ceremonies of the mission held by local dignitaries welcoming the MEDRETE mission to the town of Azua. The language skills of Sergeant Ramirez and the other Spanish-speaking team members were appreciated by the rest of the group. Tech. Sgt. Dennis J. Kilker Jr., a 910th Airlift Wing Public Affairs photojournalist providing support for the mission had the ability to see every section of the MEDRETE's work in detail. 

"The bilingual personnel such as Sergeant Ramirez were indispensable and worth their weight in gold towards the overall success of the mission," said Sergeant Kilker. 

By the end of this mission, there were countless moments of incredibly touching bedside manner to the smallest child or most elderly woman or examples of the expertise to pull a tooth with the bare minimum of tools needed to do the job and still keep the patient comfortable. 

The team members also demonstrated over and over the ability to test someone's vision and fit them with a pair of prescription glasses that would improve their quality of life by measures that cannot be calculated or the means to distribute toothbrushes, toothpaste, vitamins and other prescription medications to help island residents fight off ailments for even a brief period of time. 

In short, the Citizen Airman assigned or attached to the 910th Medical Squadron came together to form a Medical Readiness Exercise team on a mission that not only brought the finest medical care and unbridled compassion to thousands of residents of the Dominican Republic but honed the skills of the team's medical specialists for future missions anywhere that the Air Force Reserve might need them.

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