By Master Sgt. Ruby Zarzyczny, 939th Air Refueling Wing Public Affairs
/ Published October 25, 2005
COBAN, Guatemala -- Outside a primitive five-room elementary school hundreds of villagers lined up to receive medical, dental and optometry care.
Thirty-three Airmen left Offutt Air Force Base, Neb., April 23 to provide that care for 10 days at three different schools in villages surrounding the city of Coban in the mountainous region of central Guatemala. Air Force Reserve Command’s 710th Medical Squadron at Offutt AFB was the lead unit for this medical readiness training exercise that supports the Humanitarian Civic Assistance program through the International Health Specialist program.
The goal of the MEDRETE mission was to give free medical care and education to Guatemalans who cannot afford medical and dental treatment, eyeglasses or medication, said Maj. Jerry Hall, 710th MDS medical planner.
The American doctors, dentist and medical technicians got “unbelievable” medical training, according to Major Hall. During their stay in Guatemala, they saw 8,505 patients.
“Seeing the tropical diseases, they are seeing things they wouldn’t get a chance to see in the U.S.,” he said.
The team consisted of 12 medical technicians, six physicians, four physician assistants, two dentists, two dental assistants, two nurses and an optometrist. They worked with the Guatemalan military, local community members, leaders and medical professionals to care for patients.
“It is much better training anytime you can actually practice your profession on real patients,” said Col. (Dr.) Steven Gonzalez, 710th MDS chief of professional services and troop commander. “You learn more, train better and improve your abilities. There is only so much you can learn with simulations.”
The mission served many training requirements, according to the colonel. It helped prepare for pre-deployments planning activities, and it provided training for the employment aspect of deployments by arranging for airlift, travel, billeting, meals and more the same way as deploying for real-world operations.
Teambuilding was another aspect of the training.
“While working together in an adverse environment, we try to be flexible and get through challenges the same as we would during a wartime deployment,” Colonel Gonzalez. “A sense of bonding between comrades -- that bond is what makes the mission work. Learning and cooperating is the essence of all military operations.”
Col. (Dr.) Donald Grande of the 66th Medical Group, Hanscom AFB, Mass., was another physician on the team and a dermatologist. He said he saw cases in Guatemala that he had only read about.
“Doctor Grande has been invaluable to the other physicians,” said Maj. Collen Kelley, a flight surgeon from the 439th Aerospace Medical Squadron at Westover, Air Reserve Base, Mass. “He has been able to diagnose many patients, and I have been able to learn so much about tropical skin diseases from him in the last week.”
Colonel Grande saw more than 450 patients in his first six days in country. His cases included Leishmanisis disease, which is transmitted by the black fly; many fungal infections such as Actinomycosis of the jaw; pigmentation disorders; and skin cancers.
“One woman I saw had a large bleeding basal cell carcinoma, a common skin cancer on her nose,” Colonel Grande said. “I was able to treat the cancer by debulking and cartelizing it.”
The treatment improved the woman’s health as well as her quality of live. Without the treatment, the skin cancer would have continued bleeding and could have spread to the bone.
“It gives me a great feeling to provide care to the patients we’ve seen during this training exercise,” he said. “It makes me feel like I’m making a difference by helping these people.”
About two thirds of the patients in the MEDRETE clinics were children. And, although all the physicians in the clinics treated the children who come to the clinic, Maj. Yvette Guzman, an individual mobilization augmentee from Robins AFB, Ga., was the only pediatrician on the deployment. Her primary concerns about the children were the lack of awareness in nutrition, prenatal care and hygiene.
“If the children here were provided a daily balanced meal they would be growing according to the Academy of Pediatrics standards,” she said. “Right now most of the children are at the 30th percentile due to the lack of nutrition.”
Other major concerns for the children were the large number of skin infection and parasite cases.
“I have seen an overwhelming amount of scabies in this population,” said Maj. Guzman. “Because the children play in the dirt, the family sleeps in the same bed, the bedding isn’t washed often, the whole family is affected.”
This problem could be solved with soap and clean water.
“Educating the population about hygiene and nutrition is the key to improving the Guatemalan’s lifestyle,” said Major Guzman. “Teaching the children in school about health, hygiene and nutrition through visual aids like coloring books helps educate them as well as their parents about a balance diet, the food pyramid and basic hygiene like brushing your teeth and washing your hands and face.
“I saw 10 children who had chicken pox when the vaccination for chicken pox is available and free in Guatemala,” said Major Guzman. “Educating the population about the importance of vaccinations and annual physicals for children could also improve the health of Guatemalans.”
Guzman said she was overwhelmed by the poverty and lack of resources.
“It makes my heart sad, but I’m happy that I’m here to help the pediatric population,” she said. “The Guatemalan people are very humble and very grateful for what we are doing for them. They asked me when we can come back.”
In addition to treating patients, the MEDRETE team offered preventive health information and education to the community.
“The purpose of providing preventative health education is to reduce widespread diseases like intestinal parasites and scabies,” said Maj. Ronnie Roen, a flight surgeon from the Air National Guard’s 117th Air Refueling Wing. Birmingham Airport, Ala.
Before the patients were treated individually by the general medicine physicians, they gathered together in one area while Major Roen and other members of the MEDRETE gave preventive health classes to the Guatemalans explaining how to prevent these diseases. During these classes, proper water sources, hygiene to prevent parasites and parasite treatment were explained as well as self treatment of common ailments and dehydration prevention.
“We taught the people how to prevent intestinal parasites by boiling their water,” said Major Roen. “We also explained the importance of good hygiene and the need to quickly treat skin parasites because they spread rapidly.”
In addition, the public health team treated parasites on a widespread basis during these classes.
“We de-wormed everyone because the parasites spread from person to person, so if we take care of everyone at once it’s no longer there to spread,” said Major Roen.
“We have seen a great deal of poverty and suffering among the Guatemalan people,” added Colonel Gonzalez. “The people know to boil their water, but they can’t afford to chlorinate it, and the infrastructure cannot afford to provide clean water to the population.
Colonel Gonzalez said preventative health care will help the people but they need improvements to their country’s infrastructure to obtain the best preventative medicine -- clean water.
“If they pay us in coffee – that would be great,” he said.