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Medics at Panama MEDRETE provide superior service despite austere challenges

Staff Sgt. Craikista D. Foster a technician from the 42nd Medical Group at Maxwell Air Force Base, Ala., deployed to Medical Readiness Training Exercise (MEDRETE) Panama administers an eye-chart test to a local resident at the Escuela de Cabuya school in Cabuya, Panama 15 July. The MEDRETE is a two-week long U.S. Southern Command sponsored exercise designed to hone the skills of medical personnel while providing free health care in remote locations through partnership with host nation doctors. Approximately 990 patients were seen by the medical staff at the Cabuya location 14-15 July. (Photo by Capt. Ben Sakrisson, Air University Public Affairs)

Staff Sgt. Craikista D. Foster a technician from the 42nd Medical Group at Maxwell Air Force Base, Ala., deployed to Medical Readiness Training Exercise (MEDRETE) Panama administers an eye-chart test to a local resident at the Escuela de Cabuya school in Cabuya, Panama 15 July. The MEDRETE is a two-week long U.S. Southern Command sponsored exercise designed to hone the skills of medical personnel while providing free health care in remote locations through partnership with host nation doctors. Approximately 990 patients were seen by the medical staff at the Cabuya location 14-15 July. (Photo by Capt. Ben Sakrisson, Air University Public Affairs)

Lt. Col. Steven E. Ritter a dermatologist from the 81st Medical Operations Squadron at Keesler Air Force Base, Miss., deployed to Medical Readiness Training Exercise (MEDRETE) Panama removes a skin tag from a patient with a razor blade at the Escuela de Cabuya school in Cabuya, Panama 15 July. The MEDRETE is a two-week long U.S. Southern Command sponsored exercise designed to hone the skills of medical personnel while providing free health care in remote locations through partnership with host nation doctors. Approximately 990 patients were seen by the medical staff at the Cabuya location 14-15 July. (Photo by Capt. Ben Sakrisson, Air University Public Affairs)

Lt. Col. Steven E. Ritter a dermatologist from the 81st Medical Operations Squadron at Keesler Air Force Base, Miss., deployed to Medical Readiness Training Exercise (MEDRETE) Panama removes a skin tag from a patient with a razor blade at the Escuela de Cabuya school in Cabuya, Panama 15 July. The MEDRETE is a two-week long U.S. Southern Command sponsored exercise designed to hone the skills of medical personnel while providing free health care in remote locations through partnership with host nation doctors. Approximately 990 patients were seen by the medical staff at the Cabuya location 14-15 July. (Photo by Capt. Ben Sakrisson, Air University Public Affairs)

Cabuya, Panama -- United States Air Force and Panamanian doctors began seeing patients here at the Escuela de Cabuya School as part of the Medical Readiness Training Exercise (MEDRETE) Panama on 14 July.

On the first day patients rolled in like waves, hundreds upon hundreds waited in orderly fashion; looks of curiousness and anticipation on their faces. Some looked through open doors and others looked through thick metal chicken-wire screens that serve as windows on the school buildings. The heat combined with drenching humidity created a tiring effect that lengthened the day and made the never-ending stream of patients feel even longer.

Complaints from the patients in the long lines were nonexistent; they patiently waited their turn conversing with people nearby and intently watching those at the front of the line. The small children were very interested in everything around them, but older children, aware of what was going on, frequently cried when it was their turn.

"We don't have any reason to complain. We have so much. They don't have things like toothbrushes and toothpaste," said Tech. Sgt. Crystal V. Hagler, a technician from the 42nd Medical Group at Maxwell Air Force Base, Ala. Capt Matthew J. Edwards, a dentist from 42 MG intercedes "they don't have it and they are still happy."

Several patients came in with worries of past medical issues; some were elated when told that their prior condition no longer affected them. Others would have skin afflictions removed, teeth pulled and eyeglasses prescribed. Through the ingenuity of Maj. Christie L. Barton deployed from the Surgeon General's office at the Pentagon, one effectively-blind patient even left with a pair of makeshift bifocals created from two pairs of overlapping glasses held together by duct tape.

Rooms at the schoolhouse are arranged much as wards in a hospital. U.S. family practice doctors share a room with Panamanian doctors as patient-after-patient sits in a small desk describing their symptoms; some through interpreters, others directly to Spanish speaking medics. Cutout pieces of colored paper with pictures of the alphabet line the walls. It seems an appropriate setting to teach patients about hygiene and giving children daily vitamins.

"One of the reasons I go on MEDRETES is for a reminder of reality, to realize how blessed I am," said Maj. Mikelle A. Maddox, a family practice doctor from the 42 MG. "Helping people in locations like this that have difficulty getting care otherwise is a definite benefit of being a doctor in the Air Force."

The dermatologist and the pediatrician or 'pēds' for short are busy in the next room. Outside of pēds is a swarm of people, an overwhelming number of parents looking for care for their children.

Within a smallish and intentionally dimly lit building resides the optometry staff amid four test stations with diverse needs for light; some necessitate a dark environment and others, such as reading the eye-charts on the wall, requiring more light.

Tables piled with forceps; wrapped in small blue-paper labeled in Spanish for the Panamanian docs, and plastic wrapping for the U.S. Air Force docs litter the dental office. Cords snake across the floor from a circuit breaker, installed for the occasion, to dental equipment in open aluminum suitcases near reclined dental chairs on the pitted cement floor. A chalkboard decorated with smiling stars gave hint to the schoolhouse normally operating here.

Before arriving here thoughts of malaria and dengue fever whist about but, due to a seemingly effective vector control program by the Panama government, mosquitoes are few and far between. The only exception was in the outhouse-style bathroom where mosquitoes lined the walls like trophies in a hunting lodge. However, they are eradicated by government 'Control de Vectores' personnel on the second afternoon.

At the end of each day the pharmacy next door is surrounded by a crowd awaiting their prescriptions from the day. The two day total: 990 patients seen, with more to come.

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