First responders build relationships, expertise Published June 2, 2009 By Kevin Walston Operation Southern Partner Public Affairs GEORGETOWN, Guyana -- More than 20 of this capital city's best medical first responders crammed into a small classroom at an austere regional airport Monday to gain insight into how their U.S. counterparts treat blast injuries as part of Operation Southern Partner-Caribbean. Operation Southern Partner is a two-week 12th Air Force-led event providing intensive, subject matter exchanges with partner nation Air Forces in the U.S. Southern Command area of operations. The exchanges cover dozens of specialties interfacing with not only host-nation experts in Guyana, but also Barbados, St. Lucia, Grenada, Trinidad and Tobago, Jamaica and Belize. The medical personnel, comprised of doctors, nurses and medical technicians, were part of a Defense Institute for Medical Operations team, focused on international medical education and training. These exchanges of knowledge and experiences are exactly what Marcian Gravesande, a Guyanese registered nurse with more than 27 years of experience, said she's looked forward to for a long time. "I knew this would be a chance to not only improve our knowledge and skills, but to also learn what techniques we can use in places where we don't have the latest high-tech equipment," Gravesande, who works in Georgetown's Mercy Hospital, said. "Our U.S. allies have access to equipment and advanced techniques, whereas we are forced to use only our gut feelings when it comes to some types of treatment." First responders are the initial people to see and evaluate a person after an injury. Whether it's a person on the street, a paramedic, or a nurse at the door of the hospital, time is of the essence and could be a key factor regarding how successful follow-on treatment will be, said Dr. (Capt.) Andrew Muck, Wilford Hall Medical Center emergency medicine physician. Muck, who led the blast injury seminar, said it was important that the Guyanese first responders are able to realize the spectrum of injuries people can have after a blast. "The lessons the U.S. military has learned in Iraq and Afghanistan have helped us develop new techniques that could be easily applied here," Muck said. "They don't have all the equipment that we have, but we're trying to help them understand what can be done when you don't have it at your disposal." Not having the top equipment readily available is something Gravesande said she's become accustomed to in this city of 150,000 people, many of whom arrive at the hospital not in an ambulance, but in private cars or on motorcycles. "I'd like to see us develop to the point where we don't have to leave the country for some types of surgeries as we do now," she said. "People often die because we don't have the necessary equipment to treat them...we could save more lives and it's my hope that we'll be able to in the future." Dr. (Capt.) Adam Balls, who works with Doctor Muck in Wilford Hall's emergency room, said he hopes that the Guyanese first responders will leave with a greater vision and understanding of their role in providing good medical care. "We call it the golden hour in trauma because that first hour is the most critical time in patient care," Doctor Balls said. "It involves recognition, stabilization and treatment of life threatening conditions. We want to provide them with the knowledge and skills necessary, and give them the confidence that they can do it." Gravesande believes that continued exchanges between the U.S. and Guyanese medical professionals will aid immensely in improving the overall health care of Guyana. "We've improved so much, but still have a long way to go," Gravesande said. "The knowledge that they've provided us today can serve as a good foundation for the future." "Sometimes, they have limited resources and we wanna give them hope and guidance in understanding that they can provide good care, even with limited resources," Balls said. "We'll employ our lessons learned...they'll see what can be accomplished, even when you don't have the latest and greatest equipment."