News & Information - The Mercury - December 2009 Mercury

by CPT Corey Schultz

	MAJ Phillip Cummings of the 7225th Medical Support Unit listens to the breathing of an Ugandan man who complained of chest pain during Exercise Natural Fire 10. (Photo by CPT Corey Schultz)

About 60 Army Reserve medical personnel assigned to the 629th Forward Surgical Team of Columbus, Ohio, and the 7225th Medical Support Unit from Greenville, S.C., provided medical care to rural Ugandans, seeing about 700 people a day.

"We're sort of an emergency room for anyone who shows up," said 1LT Matthew Boyer of the 629th FST. "As a nurse, it's great when we can see that many people."

When the two buses of medical personnel arrived at Pajimo Clinic around 8 a.m., there was already a long line at the gate. Some people had traveled from miles away, including an 11-year-old girl who walked seven miles by herself to be treated for a skinned knee.

Many of the people had dressed themselves and their children in their finest clothing: colorful dresses, robes, and formal jackets.

The local residents filed in through the gate to a triage station, where U.S., Ugandan and Tanzanian medical professionals inquired about their illness or injury. Some were given medicine and released, while others were referred to one or more of the other four stations: medical, dental, optometry and pharmacy.

"There is a difference in disease patterns and how they present in Africa as compared to the U.S.," said LTC Ronald Januchoski, a physician and commander of the 7225th MSU. "With the tropical disease spectrum here, you see things you'd never see in the U.S. It's really helped me grow as a physician," he said.

Januchoski and MAJ Phillip Cummings, a physician also assigned to the 7225th MSU, treated patients at the medical station for such complaints as malaria, skin infection, pleurisy, broken bones and minor wounds, such as an infected cut on a little girl who caught her foot in her bicycle spokes.

"We're primarily providing Level I care, which is general medical care," said COL William Myers, an orthopedic surgeon assigned to the 7225th MSU. "I did have the opportunity to examine some X- rays and provide some consultations to the local doctors on orthopedic problems."

U.S. Navy and Ugandan personnel provided dental services, which included multiple extractions due to lack of dental hygiene. Patients were provided with toothbrushes, toothpaste, and instructions on how to care for their teeth.

In optometry, Dr. Francisco Cordera, an optometrist from Puerto Rico deployed with the 7225th, examined patients while other Soldiers conducted vision tests. The vision tests were pieces of paper on which was drawn the capital letter "E," facing different ways and sized differently as the rows descended across the paper. Many patients could not read the English alphabet, but this test allowed them to indicate which direction the "E" was facing. Patients were issued prescription eyeglasses, some for the first time in their lives.

U.S. Navy pharmacist Lieutenant Commander Brett English and 1LT Jon Schuller were assisted in the pharmacy by Morris, a Ugandan pharmacist whose guidance was instrumental in prescribing the medicines.

"Getting local national input on designing formulary is crucial," said English. "They know the people. Also, we see predominantly pediatric patients, but a lot of our medicines are adult-strength."

English explained that the dosing can be difficult not just in scaling down adult doses for children, but because some patients are malnourished, and their digestive systems cannot handle a large dose.

Morris' expertise was critically important in assigning the correct doses. He also knew how to provide quinine for malaria, a treatment that -- though effective -- is no longer used in the United States.

Patients were not limited to how many stations they could visit, and the team worked diligently throughout the day to treat as many as possible.

The medical personnel also provided for some unexpected contingencies. For instance, though they had not brought maternity capabilities or equipment, when a 19-year-old woman named Linda went into labor at the gate, 1LT Victoria Lynn Watson, a labor and delivery nurse at Abilene (Texas) Regional Medical Center in her civilian occupation, rushed in to help. Watson, the Pajimo Clinic's certified midwife Stella Betty Lamono, and PFC Kendra Hinds, a medic from Lubbock, Texas, worked together to deliver a healthy, 5.5-lb. baby boy.

"It's neat to see their skills and what they do to deliver a baby as compared to what we do in the states," Watson said.

After treating 714 patients, the team returned to the camp.

The medical outreach continued every day for a week, part of a U.S. Army Africa exercise, Natural Fire 10, in which the United States and five East African nations (Uganda, Kenya, Tanzania, Rwanda and Burundi) practice disaster relief and medical outreach. The intent was to learn each other's skills and procedures so that they will be able to operate more effectively in the event of an actual disaster.

"What we've started doing in Africa with the different countries we're working with is going to go a long way to stabilizing the region, even when we're not here," Boyer said. (Reserve Command)

From the December 2009 Mercury, an Army Medical Department publication.