Reservists provide humanitarian assistance in Chad

CHAD -- Armed with an ample supply of medications and medical equipment and a surplus of enthusiasm and compassion, a team of Air Force Reserve medical professionals provided aid to the central African nation of Chad as part of a humanitarian effort July 1-15.

The 13-person medical team, comprised of volunteers from nine units, accompanied a contingent of U.S. Marines to Camp Loumia, located in southeastern Chad.

While the Reservists were busy providing much-needed medical care to the civilian population, the Marines were training members of Chad’s military as part of the Trans-Sahel Counterterrorism Initiative.

Under the direction of the U.S. Department of State, the initiative is a security assistance program focusing on four countries in the Sahara region of Africa: Mali, Mauritania, Niger and Chad. This particular region, which includes vast expanses of unpopulated areas, is attractive to terrorists because it offers potential new training grounds. The initiative is designed to stop terrorists from gaining a foothold in the region by providing basic training and equipment to enhance peace and security.

“It’s truly as seamless as it can get,” said Maj. Paul Baker, Marine Forces Europe, who serves as officer in charge of the training initiative. “We’re all members of the U.S. military with a common goal of improving the nation of Chad, whether it’s through a humanitarian medical mission via the Air Force or a military training mission via the Marines.”

Maj. Tim Mitchell, defense and Army attaché representing the U.S. Embassy in Chad, said that combining the counter-terrorism and medical humanitarian missions shows people “we aren’t just here for military training, but that we care about them.”
To make sure it had everything it needed, the group secured $50,000 from U.S. European Command’s Humanitarian Assistance Program to purchase medicine and supplies. Team members brought some items with them. Other supplies they either bought from local vendors or arranged to have shipped from Europe.

Because Chad is one of the poorest nations in the world, its health-care system struggles to meet the population’s needs. The average life expectancy is approximately 47 years, and the infant mortality rate is a staggering 20 percent. Illnesses that are easily preventable or treatable in the United States are common, and often deadly, in Chad.

That became painfully clear only minutes after the Reservists opened a multi-specialty clinic.

“The first child we saw looked lifeless,” said Capt. (Dr.) Andy Lobl of the 911th Aeromedical Staging Squadron at Pittsburgh International Airport Air Reserve Station, Pa. “She was 2 1/2 years old but did not look more than a year. The child had diarrhea and became so fatigued she stopped eating. The mother had no place to go for help, so she just watched her baby wither away. As a parent myself, I cannot even imagine the agony that must have caused this woman.

“It breaks your heart to see a baby dying from diarrhea, knowing that proper feeding and hygiene would have given the infant an excellent chance to fight the disease.”
The medical team quickly went into action to give the child a chance for survival. While Dr. Lobl attempted to get a more thorough history of the patient’s illness, Tech. Sgt. Rey Garcia went to work inserting an intravenous line to provide fluids as well as medications to treat malaria and a possible bacterial infection. Sergeant Garcia is NCO in charge of the International Health Specialist program at Headquarters Air Force Reserve Command, Robins Air Force Base, Ga.

Inserting an IV in a normal baby is challenging enough, given the small size of the veins. Doing so in a patient suffering from severe dehydration is even more difficult. Fortunately, Sergeant Garcia had experience in similar situations, and he was able to place the line without any problem.

“I don’t put these in every day anymore,” he said. “But I realized the only way to give this girl a chance was to give her fluid in her veins. We needed the line. I had to do it.”
Next, the medical team arranged for a local doctor to provide follow-on care. The Marines then transported the child to the doctor’s facility.

“It was definitely a highlight of this deployment,” Major Baker said. “Utilizing our assets to help save the life of a child is not a normal mission that Marines see on a day-to-day basis.”

Although the child faces a long and arduous recovery, and her survival is not guaranteed, initial reports from the village were she was showing significant signs of improvement.

During their stay in Chad, the Reservists were able to not only provide medicine and treatment for the residents of the many villages around Loumia, but were also able to educate the people on how to maintain their health by doing some simple things such as using clean water, staying hydrated and using the proper technique for lifting heavy loads.

One day Dr. Lobl and the local doctor in Loumia presented a lecture to the village chiefs.

It was about 95 degrees, and we were enclosed in a circle of about 60 men discussing how to improve the health of the village,” he said. “Although it was not a comfortable environment, the crowd was very focused and asked great questions. I was feeling sorry for myself until I noticed the sweat pouring down the face of the fully armed U.S. Marine who was providing force protection. I’ve had a special affection for our Marine brethren since that time.”

One of the most needed services the clinic provided was the distribution of 2,500 pairs of glasses, which were donated by a Wisconsin Lion’s Club.

“It’s great to see the immediate benefits of my work,” said Capt. (Dr.) Carl Boeck,” an optometrist with the 452nd Medical Group, March Air Reserve Base, Calif. “I get the immediate reward of knowing I’m helping right away. For the other docs, they know they’re helping but can’t see it right away.”

One case that was particularly satisfying involved a 70-year-old man who came in to have his eyes checked. About 10 years ago, he had undergone cataract surgery without implants and had basically been blind ever since.

“We just happened to have a pair of post-cataract glasses,” Dr. Boeck said. “Once he put them on, he just stood at the door for about three minutes looking around because he hadn’t been able to see for 10 years. It was just amazing.”

The doctor said he was really surprised at the number of people who suffered from cataracts. Many of them were caused by fungus and parasites in the water.
“I tried to educate them about filtering their water through a fine linen or T-shirt,” he said. “This will help control the problem.”

Many of the reservists who volunteered to go to Chad had previous experience with medical missions abroad. For example, in his civilian capacity, Dr. Lobl has visited Nepal, Swaziland, New Guinea, the Philippines, South Africa and Morocco.

“I’ve always done humanitarian medical work as a civilian, but I had never done it with the military,” Dr. Lobl said. “I saw it as a good opportunity to combine my interest in international health with my service in the Air Force Reserve.

“There was an entirely different feeling performing this mission as compared to participating in international missions as a civilian. Every minute of my time here I had the feeling of helping people as a representative of the U.S. and the Air Force. When the patient numbers or heat began to affect our team, that fact always kept us highly motivated.”

One of the biggest challenges the Reservists had to overcome was the language barrier. A couple of cadets from the U.S. Military Academy served as translators for both the medical team and the Marines.

“Also, the Chadian Army supplied us with four interpreters, and we were able to recruit additional help from the family members who came to visit. They were more than willing to help us,” Sergeant Garcia said.

What makes translating so difficult in the region around Loumia is the fact that people speak different languages: Arabic, French or a local tribal language. At times it took more than one translator to communicate.

When performing missions in foreign countries, it is imperative to have people who are knowledgeable of both the language and customs of the host nation. Capt. Alvin Scott of Hurlburt Field, Fla., a Medical Service Corps officer and participant in the International Health Specialist program, filled that role. He was one of two active-duty members who went on the trip.

“As an IHS’er, I am required to be a specialist in a region of the world. My region is Africa, and I’m trained in French and educated on African culture,” Captain Scott said.
Over the years, the captain has traveled to Senegal, Egypt, Morocco, Kenya and Ethiopia.

“I’ve found that the training I’ve received in both language and culture has been a huge help in assisting in this operation,” he said. “I look forward to other opportunities to work in the region. First-hand knowledge of the people of Chad and their customs and culture are extremely important to mission success.”

Because of Captain Scott’s background, he had the arduous task of handling patient flow. The first day was a big learning experience.

“The first day we tried first-come, first-served, and it was chaos,” he said. “We soon learned the best way to manage the situation was to work within the context of African culture. We began using the village chiefs to sort out who was to receive treatment from their village.

“It worked extremely well. This system reinforced the village ties and reduced the amount of stress on everyone.”

While Captain Scott was ensuring appropriate patient flow, the other team members were busy seeing and treating patients with a variety of ailments.

“We saw a lot of malaria, which can be a lifetime disease,” said Maj. Mike Cooper, a physician’s assistant with the 445th Aerospace Medicine Squadron, Wright-Patterson AFB, Ohio. “We saw a lot of pregnant women and small children. On a few occasions we were able to intervene in some life-threatening situations involving small children by administering IVs.”

During the course of treatment, Major Cooper and the doctors would talk to the patients about the simple things they could do to stay healthy like eating the right foods, using clean water for cooking and cleaning, and exercising proper care when handling and preparing food.

“They seemed extremely grateful for our services and eager to hear our advice,” Major Cooper said. “I was humbled by the way our words had so much power and influence over their behavior and concerns about illness. They had a great amount of faith and trust in our knowledge and skills.”

One such patient was Dagay Martine, a resident of the village of Trantrangalla, who visited the clinic with her daughter.

“I appreciated the way they treated me,” Mrs. Martine said through a translator. “It’s the first time I’ve been treated so nicely in a long time. I could never pay for this nice medical care on my own.”

Major Cooper had a chance to spend a significant amount of time with the village doctor while he was seeing patients.

“One of the big things they wanted us to do was share our knowledge with the local doctor and other medical personnel,” he said. “I think he (the village doctor) will take away a lot of knowledge that will help him treat patients in the future. We also provided him with a supply of medicine he can use to treat patients of his own.”
While the medical team members worked daily to treat a myriad of preventable diseases, they were pleasantly surprised by the Chadians’ dental hygiene.

“Overall, I was very impressed with the condition of their teeth,” said Col. (Dr.) Paul Skaggs, a dental surgeon at Headquarters Fourth Air Force, March ARB. “I saw very little decay in children, and most adults had essentially clean teeth. When we pulled a tooth, it was usually a single tooth such as a lower molar. We think the small amount of decay is due to the lack of refined sugars in their diet.”

Because of the absence of electrical equipment, the dentist had to manually perform the tooth extractions. This process took five times longer than it would have if the dentists were practicing at home and was physically exhausting in the oppressive heat.
“This humanitarian mission has been very rewarding,” said Dr. Skaggs. “It’s actually been one of the highlights of my military career. I’ve never done anything more physically challenging yet so immensely rewarding.”

(Sergeant Babin is assigned to the 926th Fighter Wing public affairs office at Naval Air Station Joint Reserve Base New Orleans, La. In August, another team of Reserve volunteers traveled to Niger with a group of Marines to provide medical assistance to the civilian population.)

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