Tuesday, July 14, 2009

Final Day of the Mission

Today was Sunday. The day of rest. But not for the Navy Medical Strike Team. Today was our ultima dia (final day) of providing medical, optometry, and dentistry to the kind people of this rural town in Northwest Nicaragua. Sure, hundreds of the population had come through the line more than once and gotten a second and third and even fourth medical opinion at the same medical clinic, but we were helping and that is all that mattered. I loved the people at this site. They lived off the land and although poor, they had solid values. Once again, still in a slumber, I paid an early morning visit to the Food Stand of Erika and Cristina and baby Angel for several cups of instant coffee and even had to go for a Coke Light this morning and one of those Gelatin things out of the Yellow Bear container. They badgered me again for not getting them a whole assortment of medications for the baby, and I once again told them I was doing my best. I know Latinos are melodramatic with their body language, but the Nicaraguans take the cake. They are feisty! If I don’t hear the word “dolor” (pain) again for quite some time I will not be disappointed.

After the patients are let into the gate, they assemble into different lines marked off by ropes based on what specialist they need to see. This morning I peered out the window and saw a big someone seeking services that had come to the incorrect clinic- a cow. Yes, that is right, a cow had gotten into one of the lines and was waiting patiently to be seen. Unfortunately we had to turn the cow away, but called one of our vets who administered some vaccinations, and the cow ultimately got what he came for. I snapped a photo through the blinds as they took the cow away and chuckled.

My translator today was a middle-aged woman from Managua named Denise. She spoke English so well, I didn’t realize she was a native Nicaraguan. We moved fast today wanting to help as many people as possible on our final day, and having an outstanding communicator helped out tremendously. I was especially grateful when Maria came along- a 17 year old girl that was late on her menstrual period. I asked how late, and she said just over a month, looking terrified. We did the test, and sure enough she was pregnant. When I delivered the news, she was devastated and scared. Tears streamed down her face. She was trembling. In Spanish I tried my best to console her and ask if her parents knew and if they would be supportive. Maria shook her head no. Between sobs, she told us how her parents had told her that if she got pregnant as both her older sisters did that they would disown her. At this point I took her hand, and looked desperately on Denise, and together we were able to get Maria to have some hope. She wanted to go to Veterinary School in Managua, was unmarried, and we tried to encourage her. It was going to be tough, but she could do it. Unplanned pregnancy- an issue that affects the entire world, but especially challenging in this region.

At lunch I spoke more extensively with Denise about life in Nicaragua. She told me that her parents took her throughout Nicaragua countryside when she was growing up, so she was able to see the differences between urban and rural living of the people. Over the past few decades there have been so many upheavals from socialist influences, corruption, civil war, coups, farm redistribution, and now a cycling back to the Sandinista leader everyone knows as just “Daniel” (Daniel Ortega), who was elected by the highest candidate percentage of the vote (although just 38%) in the past election. Denise shook her head side to side when talking about this….politics. There is so much more to be done and for a just democracy, there needs to be fair elections. I listened some more and then changed the subject...I emphasized our desire to partner and learn and assist Nicaragua in education and public health issues, and she said “Thank you. For this we are most grateful.” And we got back to doing just that….

There is an ER doc in our group, CAPT Andy Johnson, that is super talented and the head of Emergency Medicine at a great Navy training program in Portsmouth Navy Hospital. We call him “The Machine”, because he consistently outdoes the rest of us in the number of patients he sees each day. He has a focus like none other, and works straight through lunch. Throughout the mission the 200 mark had so often evaded Dr. Johnson’s grasp. Today was the final day, and as the afternoon was winding down, we got hourly updates from Dr. Cole on Dr. Johnson’s status. Sure enough, around 3:30 pm Dr. Johnson triumphantly marched into our room- “Two Hundred and Seven!” That got a standing ovation and many looks of astonishment. I dropped my stethescope.

We saw so many patients this final day that we overloaded the pharmacy. We took turns helping out in the back handing out packets of vitamins, and medicine for pain and gastritis until all were taken care of. Chief Weber walked in with a several day old baby that was crying. It was a great sight. Big Chief Weber and the tiny infant. And then the baby spit up and it was an even better sight.

The five days in Somotillo was wrapping up. We had done our job- 6000 patient encounters during our time here. In a demonstration of our commitment to the partnership with the Nicaraguan Ministry of Health and the Town of Somotillo we presented them with a token of our thanks, and they in return presented our team leader Dr. Cole with a very large bottle of aged Nicaraguan rum. We all clapped and thought it an awfully nice gesture. That evening we enjoyed that rum, telling story after story from the travels of our past months together. Dr. Ed Taylor entertained us with the playing of a Nicaraguan flute and many of us dressed in the host country attire as we celebrated the culmination of mission that we will remember forever.

Now starts the journey home. From Corinto to Managua, and Managua to Miami, and then eventually back to Washington D.C. where this journey started back in May. This seven weeks has been filled with so much emotion, reflection and memorable times. A mission where we made new friends, helped thousands, educated, were humbled, and made many throughout the Americas smile. I am glad that I wrote down these reflections. On this journey I have met some of the most incredible, talented, and compassionate health care providers in the world today. We crossed the Panama Canal and the Equator for the first time together. We saw upwards of 60,000 patients over the past two months, worked long days in the heat, helo rides, boat rides, good times and bad times together. I hope that it provided a view into the great work and important component that Humanitarian Assistance/Disaster Relief makes in our Global Security Strategy today. It truly influences the relationships amongst the governments and on an individual level of how the United States is viewed. This “soft power” is crucial in bringing our nations together in peace and partnership enabling a more prosperous and safer future for all. This is Continuing Promise 2009. Until next time…from the USNS COMFORT. Go NAVY MEDICINE!


  1. Thank you for sharing the joys and pains of your journey. I have learned so much through your eyes and words. You are a great inspiration.

  2. Your journey, im sure will not be forgotten, by the wonderful people in Nicaragua, I am sure that you and everyone involved, have touched their lives and they will remember what you have done. Thankyou for sharing your story, I hope people will read this, and truly try to come together to make a difference. Please let me know if there is any way I can help? Michidee

  3. Hi,
    Your last blog about the journey is "just right". To quote a line from Tracy Kidder's Mountains Beyond Mountais, "The world is full of miserable places, one way of living comfortably is not to think about them, or, when you do , to send money." You have shown by your blogs and those of others on the USNS Comfort what we can do to help others, you may never realize this but you've inspired others to volunteerism. It is also just right that a possible nominee to head the United States Agency for International Development, Dr Paul Farmer is the subject of that book.

  4. A beautiful ending to a wonderful journey. I too am thankful you wrote of your reflections and shared your pictures. It has been so much fun and very educational keeping up with the USNS COMFORT and its crew.

    Welcome Home Andy~

  5. Absolutely shocked to see Dr. Johnson's pic here! I'm an ER nurse and I have worked with him...I was wondering where he's been. He's a great doctor and what you are all doing is amazing. God bless all of you!!!

  6. And, yes...... WELCOME HOME and congrats to a job well done. From your always supportive BMLT group.

  7. You will continue to write here right? i mean, your skills are amazing and the pictures you paint with words is extremely beneficial to many of us who will never see the parts of the world that you see, have seen and will see.

    Jerri Ann

  8. Thank you for sharing your adventure Andy, through your thoughts and photographs. They say a photograph says a thousand words…YOURS HAVE SAID SO MUCH MORE! I believe that GOD HELPS THOSE THAT HELP OTHERS and rewards them. I’m sure for you Andy and the members of USNS COMFORT the smiles of the people you have helped, especial the children would be reward enough. However, I hope a lifetime of God’s rewards finds you all.

  9. I am so going to miss these blogs! Written w/just the perfect balance of the personal touch of the lives and ways of this country as well as from the perspective of those living it. Thanks so much for taking the time to not only write, but write so well, to the point that we feel as if we're right there with you!

  10. Andy: a very well written synopsis of the journey. Congratulations on all your efforts in preparing this. It was a privilege. John Fortunato

  11. Andy,
    Didn´t get a change toe say goodbye to you in Person! Thanks for the hard work and fun on the ship.

    Nicole (RNN)