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Sunday, June 29, 2008

Goodbye Vietnam

Well, we pulled anchor a little after eleven this morning after a small closing ceremony on the pier. Went through the receiving line shaking hands with all the dignitaries. We had to stand for a group photo with all of the dignitaries from both sides, me being in that group reminds me of Forrest Gump where you see him in all of these historical photos. That's about how I felt, like who me??? Just to be there and witness the event was incredible enough. The coastline as we were leaving the bay was absolutely beautiful with these undeveloped beaches, rocky islands jutting up off the shore and the colorful fishing boats going by. I can see coming back here. I know we got to see the nice side and there's still a lack of freedom so all is not roses but I really feel we made some progress with this trip. The best part is the relationships built with the doctors and nurses and the people one on one. I was wishing I could have seen the two nurses I talked about earlier (pictured)when I was coming back from my last day ashore, I had such a good time with them, when as I was going down to my berthing I saw a whole tour of Vietnamese coming up the stairs and one stopped and looked at me. It was Phuong, one of the nurses and right behind her was Phuc (pr.fook). We all squealed and hugged each other and promised to e-mail each other, that was pretty cool.
Friday (your Thursday) night I went to the farewell reception and that was pretty amazing. I met Admiral Crowder who is head of the Navy for the whole Pacific, and his wife, also Dr. Julie Gerberding Director of the Center for Disease Control, the Counsel General of the Embassy in Hanoi, the Chair of the People's Committee, and several high ranking medical and military Vietnamese. What a huge honor. The band played extremely well as usual and a few people got up to dance. Of course I was one of them, I think I take after mom with that.
Not everyone enjoyed being here so much. I talked to one of the civilian mariners who had been here during the war and didn't think it would affect him but it did.
At one of the medical sites there was a Vietnamese elderly man who was in a sort of tricycle device, he had been injured by a blast in the war, he was fighting for the north. He couldn't make it inside the clinic and one of our nurses saw him sitting under a tree so she had one of the docs come over and see him. He left but then came back later in the day to give us a piece of his mind. He shouted amongst the crowd that "The Vietnamese and Americans are brothers, and diplomacy was helping the lowest man who had the least and not the guys higher up shaking hands (I'm paraphrasing) and he presented a letter to the doc for the Medical Corps along with the third highest medal awarded from the North Vietnamese that he had received himself. Incredible. I wonder what will really happen from all this. We also saw a draft dodger who had cut off his index finger so he wouldn't have to serve in the war. Some things are just the same wherever you go. We are human beings first. I want a shirt that says that.
Found a local surf shop but the only thing they had with their logo on it were the T-shirts they wore as a uniform and they were not for sale. Lots of stories, not enough time.
In a couple of days we'll be in Singapore, then after that we go to Timor Leste, they really need the help.

Happy Birthday Freddy! Love, Mom
Happy Birthday Freddy! I have to get a link to his website.

Thursday, June 26, 2008

Shipboard living

Some days you're just plain tired. I was supposed to go out on a DENTCAP (Dental Civic Assistance Program)so I got up at 0400 after a rough night of bad sleep, but had to be in on a conference call at 0600 so I missed out on going out to the site today which was disappointing as it is headed by Capt. Craft from USPHS, working with the East Meets West Foundation. Incredibly nice person.
From reading the blog it all sounds so adventurous and exciting but the majority of the time is spent dealing with living on a ship. The constant noise from engines, exhaust, loudspeakers, and people is a chronic stress on your system, you sort of adapt, sort of. Just imagine cramming 1,000 people on an approximately 950ft converted oil tanker with patients, doctors,nurses, military, civilians, all having to eat, sleep and work in a shared space. In our berthing, as I mentioned, there are seven women, all with different schedules. For example, the other night someone went to bed at 9:00, someone came in at 02:00, then someone got up at 04:00 to work out. Not much in the way of sleep. Everyone tries to be respectful and quiet but that's extremely difficult with metal lockers and drawers. Sometimes the steam pipes clang all night from condensation. The first time it happened I got up to make sure all the lockers were secured and looked inside to make sure there wasn't any loose metal making that clanging sound, I just couldn't figure out where it came from. Then I went down to the bathroom to make sure the metal stall doors were secured open because when you are out to sea they can bang open and closed if they are secured. I didn't find out for a couple of days that is was the pipes. All that running around in the middle of the night ticked off for nothing.
Tonight the air conditioning gets cut down so they can clean the condensers, this makes it extremely hot in some parts of the ship. They try to keep the patient areas and berthing cool but in a country where the heat index hits 113 degrees outside it can get quite hot and stuffy in the ship. Then the smell of PineSol and stinky feet and other lovely odors are just the rule of the day. Not so exotic.
The folks in the engine rooms and the galley just drip sweat all day, they have really hard physical labor to perform, I don't know how they keep it up. They were camelbacks to drink water all day, but I know how it affects me just being in the heat!
Breakfast is usually from 04:30 to 06:45 then there's muster, then usually what dad used to call "field day" where everything is swept and mopped, cleaned etc. Patient areas are also done with the addition of all the complications of having patients and family members that don't speak English. Around 16:00 the same routine. In between lunch is served from 11:00 to 12:45, dinner from 16:30 to about 18:00. If you miss the meal, tough. It's very easy to get into stress eating.
You can only do laundry on certain days, and when you do you are lucky if you can get an empty washer or dryer. In all of this shipboard living you have to remember which stairwell leads to which area of the ship. It's easy to get turned around and end up opposite of where you want to go. Imagine carrying your laundry and soap, getting lost and it's hot and you are tired and maybe not in a good mood.
It's 65 steps from my berthing up to the mess decks where we eat or have the operations briefs every night. Lots and lots of going up and down stairs. The last time I was on this ship in 2006 my berthing was on the 5th deck below, I got really sick and literally had to crawl seven decks up to sick call.
The absence of privacy and all the above factors coupled with a lack of phones and a slow, limited internet service can lead to a lot of stress. Activities are planned such as kareoke night, movie night on the flight deck, or bingo, but sometimes you are just too tired or it's too hot or you just aren't in the mood. It seems like most people have a meltdown or get down at some point. The chaplains are kept very busy around here. The military are taught to not show emotion so when you mix civilians in the mission who are not trained to hide their emotion it can lead to some misunderstands and conflict. Then there's the generational difference, situations where an older experienced person has to answer to someone who is younger but of a higher rank.
Thank goodness most people look out for each other, but not always. I think everyone experiences a sense of isolation at some time and it's not fun, but where are you going to go on a ship. Some folks play guitar, I take my harmonica out on deck, one guy in the office has a ukele.
One of the cool things I've experienced here are the workouts (if I'd only go more!)such as the kickboxing, one led by this young female sailor who is soooo fit! The fun part is seeing this mix of people of all different ages,sizes and abilities, some who probably never work out much at home, working out together to the music in the patient receiving area or the hallway of the ship. Sometimes a game of ping pong is set up in the hallway or a spontaneous game of hallway soccer. Oh, by the way, India won the first International Australia/India Cricket match yesterday. I guess a bunch of Yanks formed a team and had a spontaneous game and did pretty well.
Well just thought I'd tell a little about shipboard living. There goes my workout, see what I sacrifice to keep you posted! It's dinner time and I gotta run. :)
Take care,

Tuesday, June 24, 2008

A Day in Nha Trang

Yesterday I got a "liberty" day and spent the day in Nha Trang. We took the boat over to the dock and loaded on a bus for a half day tour of the local temples and a Catholic church. I know I use the word incredible a lot in this blog but that's what it was. Our tour guide was a young man whose name translated into Pine Tree. He was great, he taught us how to say "Oh my god, that's too expensive!", really funny and helpful. First we went to an ancient Hindu temple dedicated to Shiva. It's on a hill that over looks the river that empties into the South China Sea, it overlooks a fishing village. I love the way they paint their boats, much more creative and ornate than what we would have. Then we went to a Buddhist temple with beautiful dragon sculptures and a very beautiful inside temple area where people were chanting, all the monks were in a procession going past this ornate gold and red alter chanting while a huge gong was occasionally sounded. Up on the top of the hill is a huge white Buddha, but what is even more amazing is the Sleeping Buddha on the way up to the hill. Just amazing. After we went to the Catholic Church built by the French, it had beautiful stained glass, and when I was outside I could hear the women reciting the Rosary in Vietnamese. For lunch we went to the Sailing Club, a resort on the beach and had a Vietnamese coffee which was killer, and an asian dish, sort of an egg foo young stuffed with sprouts and seafood, very fresh and delicious. Ran into a young couple from San Francisco and New York. Then the girls went to the market and did some shopping for silk and trinkets, got a red Vietnam ball cap with a gold star on it, I wonder what would happen if I wore it to a Padre's game. The food markets are amazing, dried fish, shrimp and other seafood, rices, fruits, vegetables, flowers. I could have spent a lot more time there. The Vietnamese currency is the dong, and the rate is about 16,000 dong to the dollar so I did a bit of "Christmas" shopping.
Tomorrow is the first International Cricket Match between Australia and India,two of our partner nations on board, on the beach in Nha Trang. They are quite excited about it. At the Operations brief the Aussies announced it and gave a little lesson on cricket for the cricket challenged U.S. folks. The funny story about this is a few weeks ago, a couple of the gentlemen from India and Australia were talking about having their first match on the flight deck and I suggested they announce it, and have the fun boss post it so the rest of us could watch and have a little cultural exchange. Well, they got rained out that day and now it's gone really international by having the first game on Vietnamese soil. Wish I could watch but don't think I'll be able to.
Take care all,

Sunday, June 22, 2008

Incredible experiences the past two days

The past few days have been busy, starting with the Opening Ceremony on Friday at the pier in Nha Trang. It was extremely gracious and beautiful. To see our Commodore and Captains sitting at the same table with the Chairwoman of the People's Party and the Ministry of Defense officials was absolutely incredible. It was a small group that got to witness this special event. I took some video, hope it turned out. The best part was walking through the receiving line and shaking hands with the representatives from Vietnam. When I told this Vietnamese military official that I was a nurse from San Diego State University he broke out in a big smile and said he was the Director of the Military Medical Division and shook my hand vigorously. To see him smile was a big win for me.

Yesterday I got to work at one of the medical sites set up at a school in Nha Trang. It again was incredible! Working side by side with the Vietnamese nurses and doctors was such a great experience. These clinics are hot, crowded, there's a language barrier and all kinds of unfamiliar things but it is worth every bit of it. We saw over 400 patients yesterday. The two nurses I worked with were excellent. Education seems to be a high priority here. I learned a few phrases in Vietnamese, and had the best time with them. So many stories to tell. The guy with the "I'm proud to be an American" T-shirt on, the elderly man whose hands were messed up from the war, the elderly women who would just light up if you gave them a smile. I was helping this one elderly woman through the crowd to the next station and the other elderly women sitting on their heels waiting all smiled and exclaimed, reached out to me or bowed, just because I was showing a little respect to one of their own.
I then went down and helped the East Meets West Foundation doing a dental workshop. They had a huge crowd. Capt. Craft who is the only American dentist working with them introduced me to the staff and then let me teach some of the children about dental care using a big set of teeth and a big toothbrush while they watched a cartoon video about dental caries. He said I can come back and work with them again. They do incredible work.
Operation Smile are doing tons of cleft lip surgeries, we have 62 pediatric patients on board tonight, the ward is totally full. Plus they have their mothers and some family with them, so we have a full house tonight. I went down to the receiving area and there were babies crawling all over the place.
Tomorrow I'm going to visit some of the Buddhist temples and hope to get to the market to see what they have. I hope to post more pictures but again the bandwith is so slow it's takes a long time to download just one.

Thursday, June 19, 2008

Good Morning Vietnam!

I woke up this morning a little late and threw on my clothes to run up to the mess deck so I wouldn't miss breakfast, it was about 7:00. You have to eat when the meal times are set or else you are out of luck. Before going in to grab my food, I took a peak outside and saw land, so I went outside for a quick look at what my first view of Vietnam would be like. I can't explain the feeling. It was so much more beautiful than I imagined. There are a few islands where we were anchored and from the deck you can see this incredible series of low mountain ranges and the low lying beach areas. I was fortunate enough to be able to attend the opening ceremony as a representative of SDSU. The reception was very gracious and beautiful, of course there is a lot of caution but that is to be expected. There are plans for the engineering crews to work with the local Vietnamese in refurbishing clinics and schools, which I think has a lasting impact. Our doctors and nurses will be working side by side with the Vietnamese medical providers which is historic. Operation Smile will be doing about a hundred surgeries, it's just a golden opportunity to share knowledge and understanding.
There is an emotional part to those of us over 40, of course I think about my dad a lot and wonder what he would think of all of this. I bet he's up there grinning. I just got through calling my mom in Florida just to have her hear my voice from Vietnam. My son Fred surprised the heck out of her the other day. He lives in San Diego but drove out with a friend who is getting transferred overseas and he was able to drop in and give her a quick visit. That was pretty cool. Going to sign off. Take care.

Wednesday, June 18, 2008

Getting ready for Vietnam

Well, now it's getting exciting again. Some days on board the ship are a challenge, especially when it's hot, the air conditioning isn't working and you've got seven women sharing a room with only two chairs! We've picked up a lot more people. Project Hope arrived yesterday along with some of our Partner Nation folks from India and Korea. We have about 25 Pre-Dental students from UCSD, and others I am sure I am forgetting but don't mean to. We had a presentation for the NGOs about the East Meets West Foundation which was founded by LeLy Hayslip, author of "When Heaven and Earth Changed Places". I happened to read that when I was on the Mercy in 2006. Hugely inspirational to me, it sharpened my motivation to go into global nursing. Capt. Craft, Dental Officer gave the presentation and when he started telling the story about how they got started, I thought "how lucky am I to meet someone who works with such an incredible woman." You should read the book, the movie Heaven and Earth was sort of based on the book but some artistic license was taken. We are not sure what we are going to be facing as to what types of care we will be allowed to give, but we are just happy to have the chance to be here anyway. The Navy Band will be playing at one of the sites which will make it the first time in 32 years that the Navy Band has played in Vietnam. Public Affairs has made U.S./Vietnam pins for everyone on board which when the Commodore gave me one, I almost cried as it made me think of my dad. He was here in 1969 in Quang Tri (sp?)right on the DMZ. I brought a picture of him with me and show it to people now and then, most of the comments are something like "wow! That's the real thing!" It was very special to receive that pin from Commodore Kearns, nothing official, we were just at a briefing and asked if I had one yet. I don't know when I'll be able to get onshore as there are a lot of people and only so many spots. I'm just waiting for someone to get on the intercom tomorrow and yell "Good Morning Vietnam!" Let's see what happens. I just can't believe we really get to do this! Those of us who grew up in that era I think have a special sense of gratitude about this process. Baby steps in getting along. Take care.

Saturday, June 14, 2008

Philippines June 14, 2008



Trying to catch you up on a month of what we've been doing is an onerous task, but in a nutshell:
We just finished a couple of weeks doing clinics in the Mindanao area of the Philippines. We've seen over 10,000 patients at the sites and have done somewhere between 250-300 surgeries including the story from Chief Cohen that I'll post below. In addition, they've held educational seminars at the local hospitals,civic projects such as building or re-furbishing clinics (Thank you SEABEES) and building projects such as wastewater treatment plants. Can't forget the veterinarians - this time they've sent out vets to treat different animals,everything from dogs and cats to caribao which are a type of water buffalo. All of this is being done by the local departments of health,including the Autonomous Region of Muslim Mindanao, the Armed Forces of the Philippines, the U.S. Navy, Army, Coast Guard, Marines, Australian, Philippines , Japan, Canada armed forces personnel, the U.S.Public Health Service, Operation Smile, and the 3P Foundation a local NGO based out of the U.S. which was founded and is directed by Mr. Andrew DeRossi. He's been in the Philippines for thirty years so is an excellent resource for collaboration in this area. He donated all of the medical equipment at a clinic we refurbished in Samar.
I just wished the planners of this mission would have included some of the Disaster Medical Assistant Teams (DMAT)from the U.S. as they are very well trained and experienced.
Many people will never know the sacrifices these people are making in order to participate in this mission. Missing birthdays, graduations, anniversaries are all very hard not to mention just the stress of living on a ship with a thousand other people from a bunch of different places. Some days can be pretty tough but CPO Cohen puts it very well in the following letter.

Friends and Family;



Let me take a moment of your time to tell you about my day. A few minutes ago a Marine who works for me asked me if we would get any medals or awards for this deployment, such as the Humanitarian Service Medal. I told him that we would not be eligible for the HSM, but some of us might receive something like a Navy and Marine Corps Achievement Medal or perhaps a Flag Letter of Commendation. Then I told the Sergeant that I had already received something much better than any medal they could give me. I explained how a short time ago I had stopped into the Physical Therapy room for an adjustment since I hurt my neck in a fall yesterday (not serious, getting better thanks for asking.) While I was there I saw a 15-year-old Filipino boy named Romeo. I thought he was younger than that because he is fairly small for his age. I first saw Romeo there yesterday when they wheeled him in on a wheelchair. Romeo was very excited to be in a wheelchair because for the first time in years he was able to move around on his own without having to depend on other people. When Romeo was nine-years-old he was injured in a bomb blast when his village in the Republic of the Philippines was caught up in fighting between rival factions. His legs were so badly burned in the blast that scar tissue prevented him from even straightening his leg. His legs have atrophied so much that they are smaller around than my arms. For the last six years he has been unable to walk, and his father has carried him around. When not carried, he crawls around on his hands. He is totally dependent on family members to take care of him.

As Romeo gets older, he is getting too big for his father to carry around. His father is smaller than I am, and I couldn’t imagine carrying him around all day. When his family heard that our hospital ship, USNS MERCY, was coming to Mindanao they asked if we could help. His case was accepted, and our team of doctors decided to cut away the scar tissue that bound Romeo’s leg like webbing and replace it with a large skin graft taken from his back. His father asked one of our surgeons, Commander Todd, if the boy would ever be able to ride his bicycle again. Dr. Todd said there was a remote chance he may one day be able to ride a bike - and perhaps even stand on his own – although the boy would probably never walk more than a few steps.

Today, a few days after his surgery, I saw Romeo walk on crutches for the first time since the explosion. He was surrounded by family members and his doctors, Commander Todd, Commander Tan, Commander Douglas (his plastic Surgeon), Captain Goldberg (his physical therapist) and a Navy journalist who captured the moment on video. We all watched as he climbed up on the exercise bike and rode like he was competing in the Tour de France! His father and sister watched in amazement with tears streaming down their cheeks. This is a boy who now has a chance to do things on his own. To go to school, work, play with friends, grow up and raise a family. His father shook our hands and hugged us all, then looked into my eyes and said “Salamat Po” (a sincere thank you.) I would have traded all my medals for those two words.

So that was my day. How are you all doing?



Sincerely,

Shawn Cohen

CPO, USN

Kind of says it all.

Thursday, June 12, 2008

Mercy Musings

Thursday June 12, 2008 - Off the coast of the Philippines

Well, I’ve been on the U.S.N.S. Mercy a month already, and since trying to e-mail everyone to keep up with what I am doing has been difficult, I’ve been talked into blogging. I wished I had started it a month ago but I was too chicken. Hopefully, I can be your eyes and ears on this adventure of a lifetime. Not easy dragging a child of the ‘50s into the 21st century, but probably a much better way of keeping in touch with people and recording some of my experiences. Some days, such as this one, it may be very lengthy, sometimes not. This will not always be grammatically correct, there will be misspellings, and I may have to eat my words every now and then but here goes.
One day I got a call at a conference. “I hope you don’t mind but I volunteered you for something”. Knowing it was my graduate advisor Dr.Frost, who has done so much, so quietly, for so many people, I had very little hesitation in accepting and answered “Sure, what is it?” “How would you like to go on the Mercy?” I couldn’t believe my luck! I had been on the Mercy to Banda Aceh and Nias, Indonesia in 2006 and really wanted to go again but was in the middle of graduate school for Global Emergency Preparedness and Response at San Diego State University. I was thinking it would be for a couple of weeks or maybe a month at the most. The Mercy was planning on going to several countries including Vietnam, Papua New Guinea and Micronesia. I was stoked! Little did I know that I would be on this venture for nearly four months. At the planning meeting for the trip I asked, “which leg of the trip do you want me to go on?” I was trying to figure out that if I had to choose between Vietnam, Papua New Guinea, or Micronesia, which would I pick? When they told me the whole thing, I inwardly gulped, knowing what a challenge it was to live on the ship for a couple of weeks much less for an extended period of time, but excited non the less. Would I have the mental and physical stamina? (We’ll find out)
To tell you the truth, I never even thought I would be a nurse, (I wanted to be an archaeologist) much less voyaging across the Pacific in a Navy ship with nearly a thousand other people. Currently my area of interest in nursing is in International Civilian/Military Collaboration for Humanitarian Assistance and Disaster Response. This was the perfect opportunity as the Navy is working with several Host Nation and U.S non-government humanitarian agencies to deliver assistance to these countries.
Well, enough about how and why I got here. We are finishing our first leg of this trip and will leave the Philippines in a few days. I’ll try and recap what we’ve done and post pictures when I can, but I just remembered I have laundry to finish, (yes, you have to do laundry on the ship) and then head to the mess deck for an ice-cream social celebrating Independence Day here in the Philippines. Looking forward to some time on the ground in Manila.