The VOICE of the 1MC

So today was D-day... Departure day for me from the Mercy. It was also the 100th day since I boarded in San Diego! On the 5 hour bus ride to the Capitol city of Phnom Penh we were teasing about missing the overhead announcements from the loud speaker also known as the 1MC. So listed below are some of the announcements you could expect to hear in a daily basis. I am sure I missed a few lines since this was just from memory. But you get the point. I will not miss waking up out of a dead sleep to a 4 am flight quarters announcement! 

The following is a test of the 1MC at the sound of this bell it will be 12 noon **ring** test complete, please regard all further alarms.

Ahhhh mercy... For the knowledge all hands there will be a general Christian service held in the chapel at 0930

Ding ding-- ding ding-- destroyer squadron 7 commander arriving

Ding ding-- ding ding--medical treatment facility Mercy commander arriving

Flight quarters flight quarters the weather decks from frame 40-74 are secured. Refrain from throwing articles overboard, the smoke lamp is out, no flash photography.... The following is a test of the Helo crash alarm. (Siren) test complete, regard all further alarms.

Man down, I repeat man down. Medical response team to tack . __-___-___ (location)

For the knowledge of all hands there will be an ice cream social held on the mess decks at 2030. :)

Please stand by for evening prayer...

MedCAP in Cambodia

I am on a cambodian boat that ferried us from the Mercy to the Cambodian shore for my last MedCAP as a Pacific Partnership Volunteer.  During the MedCAP, we host medical screenings, dental extractions and fillings, and eye exams with custom glasses. I am listening to my music and trying to wake up and as the sun starts shinning through the clouds these lyrics from Casting Crowns song So Much More stand out to me. 

"I will praise You all my days not just for the change You made in me...

I will serve You Lord always for You are my strength when I am weak. I will never be afraid for You are my rock and You protect me." 

I will make that my prayer for today.

In the bus now on the way to our site which is about an hour away. I love seeing Gods creation and how creative He is, making each country so unique. Although very poor, Cambodia is rich in lush green landscape, the rice patties stretch beyond the eye can see and people work hard. They labor for hours in the hot sun to provide for their families and I see a boy no older than 12 year of age directs his oxen strong and bound by a yoke up the road bearing a load of bricks. The land is saturated in water, currently it is rainy season in Cambodia and everything has come to life! This morning, I have seen tons of animals on the side of the road from the bus window including: cattle, chicken, ducks, water buffalo, oxen, dogs, horses, swine, and more chicken!

Many houses are raised off of the ground and you can see how important it is to keep your house from flooding. This is something I always saw in pictures, but seeing the whole community elevated is pretty cool! I noticed the schools alongside of the road all locked up and closed with the children at home or sitting along the rice patties. I asked the Cambodian medical students why the schools were closed and they informed me that all of the Cambodian primary schools are closed due to an epidemic in children called the Hand, Foot and Mouth Disease. It presents clinically as rashes on the palms, soles and mouth with high fever and many children are dying quickly. Well we have just arrived – I will pick this blog up soon!

 

 (9 hours later after our MedCAP) Due to the Hand, Foot and Mouth Disease, we are required to report how many children were seen under 12 years old with symptoms of the disease and of the nearly 200 children, I am happy to say that we had zero cases! Today at our site that was a school with open air classrooms, I worked as the discharge nurse so when patients were done seeing the doctor, dentist or optometrist, they went to pharmacy to pick up any medications and then came to my station. 

The nurses at discharge kept a tally of each service and broke the data down between age and gender. We also reviewed their medications one more time, answered any questions the patients had about the diagnosed the doctor discussed, reviewed lab work again, and referred some patients to come back on Friday for the surgical screening and echocardiograms with the  cardiologist. It was really nice to have the option of telling the patients to come back to be screened by the surgeons rather than just sending them home.

I truly enjoyed teaching the patients about their medications and discussing symptom management in regards to heart conditions and other ailments. The joy of teaching keeps planting a seed in the back of my head that I may want to be an educator one day. 

My Dad's Birthday Card, in 2 languages

This is rainy season, so the mud was horrendous!!! I wish I had navy issued boots, you could just rinse them off, instead my shoes are covered in mud, but overall I managed to keep my feet pretty dry. The power was a little sketchy... the MedCAP location had multiple extension cords and different plugs along the ground through the mud puddles and out in the rain. The temperature was really nice all day. We did have a few brief down pours, but I managed to stay fairly dry! 

The Night-Shift

Serving Dinner - the volunteers rotate while between location

There have been many firsts on this mission, but in the last two days I have switched to the dark side. I was never one of those who could pull an all-nighter studying for exams and in my career thus far I have never been a night-shift nurse. However, I have found that it is probably easier on the USNS Mercy ship to work through the night than it would be in what we would call 'normal' life. There are few windows and you have to make an effort to go outside, so I have gone 3-4 days before I realize I have missed the sun and to be honest, it's just too hot to go outside. Things I have come to appreciate and have a new perspective... The ship still functions at night:

Standing Watch - day and night

- I am thankful to the kitchen crew who put out midrats (midnight rations) for our 'lunch time' meal. 

-I appreciate my corpsman who sweep and swab the deck (floor) at 2am. (Sidenote... I have been swabbing the last two days and every night I try and make the mopping an excuse for going to the gym. My corpsman always shake their heads and say, oh no Miss Kelly swabbing is no substitute for the gym.) So 3:00am comes around and the wards are quiet and sleeping and now is perfect time for the staff to go to the gym in rotations. This keeps everyone from falling asleep!

-Again, such a blessing to get to work out while 'working'.

-The ships security still man their posts and roam the ships P-ways (halls).

-Translators are volunteering on this mission and switching their internal clocks with us in order to make communication possible.

-The Internet is faster! Still dial up speed, but better than trying to load a webpage while on the day shift.

-Chaplain May still has evening Sunday service and my staff covers for me so I can go worship.

-I went to do laundry at 1am and every washer was open!!! I did not have to wait and I could do more than one load!

- When it's 4am here it's 4pm in Oklahoma and 2 pm in California. And I was able to catch up with a friend for an hour because there was no one waiting for the phone after my 20 min limit!!

- The sun rise is very peaceful!

MCS Lowering the Bandaid Boat

Another portion of the ship that I should be more thankful for is the MSC staff. The Military Sealift Command is comprised of Civmars or Civilian Mariners (professional sailors). They run our ship and its pretty important even if much of their work is behind the scenes. Civmars navigate the ship, run the engine room, and perform the maintenance on pretty much everything! 

Something that stood out last night was as I was concluding my shift, I went to watch the sun rise at 0530 and there was a team of six men preparing the ‘band-aid boat’ (our ship to shore transportation) for  the day.

One man fueled the ship as it hung by on crane while two others boarded the band-aid boat and prepared to load it into the water. It truly was a team effort to tether the boat down into the water and ensure it did not hit against the USNS Mercy. Once the band-aid boat hit the water, all the ropes were quickly released put in forward drive to steady out the rocking. 

A the Bandaid boat is ready to welcome patients

Next the Civmars began to raise the sun cover, one man lifted the canvas as the other placed the posts to create a protective cover. Amazing to think that this was all done before the sunrise and this bout would continue shuttling patients and staff to and from the shore in the hot sun clear till midnight. I have a new appreciation for the Civmars!

Responding to my Nursing Friends!

One of our patients wives, during his 4 day stay, she stripped
beds after patients left before our staff could get to them.
Then fold linens and scrape meal plates. Contagious smile

Pediatric patient on the ship receiving treatment

Clinically, what stood out to me in Vietnam? That seems to be what all  my nursing friends are inquiring about, well the necessity for dermatology was astounding. Many of the stories shared by the patients seeking care aboard the USNS Mercy were horrific testimonies of hate crimes,  jealousy feuds, and abuse. The ship's dermatologist was in high demand providing laser scar revision and contracture release treatment to burn victims. In the post-operative role, I took care of a very brave 3-year-old  girl who had been burned in a house fire in an intentional fit of rage. 85% of her body surface suffered 3rd degree burns and although she miraculously survived this horrific event only 4 months prior to boarding the Mercy, her road to recovery and self worth will be a long one. The dermatologist was able to release some of the contractures behind her knees, around her ankles, hands, and buttocks which enables her to stand with straighter posture and grip a fork that will provide her the freedom to feed herself.  The  procedure essentially put microscopic holes in the skin through the scars of the dermis and epidermis giving the skin a second chance to  heal and stretch. It looks like you are aerating your lawn obviously  with a more delicate tactic!

This is the cosumi the Japanese ship that partnered with
PP12 this is the fair well sail as they passed us on our port side

Burns were second to motor vehicle accidents for mortality in children in Vietnam. Many children have  accidental burns from the cultural way of cooking on low stone stoves with open flame, scalding water boiling on the stove, or the cooking
grease. As mentioned before some were intentional acid burns, kerosene burns, and diesel house fires. When I was at the children’s hospital it was very eye-opening to see how well the children were healing on the burn ward, even when resources were scarce and caregivers and  nurses were spread thin. I applaud the Pediatric Hospital in Vin for their level of care and competency. We worked alongside very skilled nurses and surgeons.

A great keepsake!

I played my best game of charades today. I managed to request a skirt be fashioned  to fit me! It is a simple skirt elastic waste band and stretchy material, but  it brought so much joy and laughter to the market place. I could probably bet you that the seamstress has never made a skirt my size. We just had to laugh along side them. I wore it out of the market and did a few spins for everyone and they cheered. My friend Aubrey decided to have one made too after she saw mine. We let the ladies pick the print on our skirts. The bus was pulling away from the curb as we ran to catch it in our new skirts. Probably another sight to be seen! I also bought a hammock!

Vietnam

  “Back in ‘Nam” has been the slogan around here and most everyone on the ship has taken a chance to talk to their grandparents about being in the war and what their experience was like. Lately, the ICU has been slow with only a few patients each day. Today we are at zero patients, and although it is not a bad thing to be patient-less, however we still need to staff the unit in case of an emergency. Therefore our unit decided to play a game of physical fitness challenges including 100 pushups, 100 sit ups, and 30 pull ups a day, which usually we complete one set of 10 reps every hour or so until finished. I still have two more sets to go today but I am NOT doing the pull-ups as that is just way too comical  to observe!

Yesterday was a day of Liberty on shore in Vinh, Nghe An, Vietnam, the first country in which we have been provided liberty while in a working port.  I had a great, super sweaty, but oh-so-much-fun day! The groups of people with liberty were quite random because the staff are assigned liberty days by department, thus I ended up in a group of 5 guys. We took the bus from the ship for an hour until its last drop off location which happened to be a mall, but we had an inside source and knew there was an open-air market nearby. It was nice being with a bunch of guys, because they were all gung-ho about exploring the town, yet we certainly stood out in the crowd. Imagine in a sea of golden brown skin and beautiful black hair are five tall white men and a blonde white girl with a butt! 

Yes, even my butt stood out, the women would just walk up and pat my butt as I walked the market. My crew of guys started getting protective but overall we just had to laugh it off.  In the city no one spoke English and limited communication with the locals other than exchanging greetings!  Often you heard “Hello giggle giggle giggle”. At the market locals were found sewing on soles of shoes, adding branding logos to shoes and shirts, as well as full on tailoring of dresses and suits!

The highlight and joke of the day stemmed from walking past the neighborhood pharmacy. Its counters were filled with drugs of every kind on display, in fact Viagra was right on top of the counter next to the pain medication. Our crew had a field day discussing the access and sheer availability of Viagra! Later we walked out of the market and all of a sudden saw a grown man just bathing in the water fountain, as if it was very normal and he bathed there daily! From the market we walked about 3-4 miles to Ho Chi Min Park where a large statue and flags were on display along with some pretty green grass, where we took a break from the sun since it was incredibly hot. According to our map, we thought the Park was much closer – luckily there were some great shops along the way and we purchased every cold water bottle (because its about 107 degrees out)  we could get our hands on. I bought a pin wheel in remembrance of my Guam roommates and our adventures, throughout the day I took pictures like the pig in the Geico commercial all over Vinh City.

Our local cook of the rice crepe

One of the guys, Chris and I decided to be adventurous and tried some local grub, in reality we had no clue what this lady was cooking, but it looked like she poured a white rice paste over a cheese cloth and steamed it. Once she removed the cheese cloth from the steam bath, the rice paste came out looking like a thin crape or even transparent paper.  Seating was a bit odd, Chris and I sat in these child sized chairs and ate the local food with chopsticks. The cooks brought out a fish sauce or dip and then some chopped chili and lime, I started to squeeze the lime over the ‘rice crape’ and the locals started to laugh and pointed at the fish sauce. Thus, in goes the chili and lime into the fish sauce and Chris and I ventured at our first ever ‘BANH MUOT NONG.’ I asked a translator on the ship today and she said it translates into hot rice cake. My sister did a quick Google translation and she got ‘hot smooth ball’… hmmmmm…  Well it did not taste like much, but the experience was fun.

After our food incident, the rest of our group was waiting and looking for the liberty bus, yet it never passed by, so we waved down a cab to get back to the beach which became an interesting endeavor, as we did not know the name of the beach. Similar to our experience in the city, our taxi driver did not speak an ounce of English, I showed him a picture that I had taken along the way and he was like ‘oh oh oh oh’ and nodded his head as if he knew which beach we were aiming for and ushered us into his cab. Impressively, our gang made it back to the right beach which happened to be 30 minutes away! By the time we arrived, it was dark outside and there was a techno show of lights all around. Such a spectacular site, everything around us was lit up: the statues had lights, locals were selling glow sticks and fun glowing toys, and each of the golf carts/mopeds were all decked out in lights that flashed to the techno music! 

Dinner was our next adventure and it became a game of charades. The guys and I would point at a picture on the menu and pray that something edible would arrive! I ended up with the best plate of food out of the group, it was ramen like noodles with beef on top. Ultimately, the server arrived and everyone at the table just pointed to my plate and pushed their plates away.  Overall, my Liberty day was so refreshing and the laughter was never ending!

Also - here's a link to to the Pacific Partnership's latest blog

Philippines and Subic Bay

 Hello friends and family! Yes I know, I am long overdue for a blog post... and I think more frequent and shorter posts might be your preference, but I have procrastinated and thus the need for a longer post about the past three weeks while in the Philippines.

To be honest, these last twenty-two days have been hard; physically, mentally, and spiritually. I knew when I signed up that this mission would be difficult, but I was really envisioning rainbows, flowers, and great moments of healing. 

While on Vacation at Subic Bay

Since joining the USNS Mercy on May 1^st, there have truly been some phenomenal surgeries accomplished on the ship and tremendous testimonies of healing. While serving as a nurse, I have seen vision restored, massive tumors removed, limbs straightened and people being give a second chance to walk again. In the Philippines the most challenging aspect for me was the sheer amount of hours we put in on the floor. Every person on our team worked 14 days straight in nothing less than 12 hour shifts. After these gruelingly long days serving the people of the Philippines Islands, I had little motivation work out at the gym and relax. Something wonderful I have had to look forward to was the special times set aside for our woman's bible study and prayer group started back in Indonesia. It is such a blessing to have these women come together and lift each other up in prayer.

The patients during this rotation in the Philippines were much more critical than those we helped in Indonesia. There was also more time to conduct surgeries and post-operations care in the hospital since the ship stayed anchored in place. Something really exciting was I took care of my first ventilated (life support) patient. I originally requested to support one of the nurses in taking care of this patient, but he then offered to let me receive the patient directly out of surgery and recover them. It was a great teaching moment and I really appreciated that the nurse gave me the opportunity and supported me through the experience.

  

Sleeping Quarters on the ship
for patients and their escort

We also had large amount of children surgical cases, in fact on one of the fourteen days, our floor had to set up more beds in the ICU and every patient we saw that day was under 20 years old, our floor essentially became a pediatric ICU!  One young boy had a pretty extensive abdominal surgery and it was quite rough for this little guy. He ended up having a 10-day stay in the Intensive Care Unit with close monitoring.  In the end he recovered very well and I was responsible for taking care of him for 8 of of those 10 days. He was a challenge primarily because he cried a lot... he was a young boy and his pain was sever, but when I touched his pinky toe, he cried. It was then that I knew it was not physical pain, rather out of fear and emotional pain. Nevertheless, we became buddies and although we couldn’t understand each other, we made the most of it and the language barrier almost didn’t matter. The words "nooo Nurse Kelly, nooo" almost became endearing :) While taking care of him, I had him walk every other hour and that’s when the tears and whining came... He would be walking completely unassisted and once he realized it, he would start crying for me. 

Finally we had a little chat (via the interpreter) about realistic expectations because this little man may have looked like he was about 6 years old, yet he really was 11. Eventually he asked me, "Why don't you pity me? I am not a strong man!" That broke my heart, it was then that I realized it may not be about the pain of walking post- surgery, but the tears came from him being teased so much as a kid that he was more so emotionally broken. This kid definitely had a cheering team in the ICU and around the ship as we walked everywhere!

Patients and Escorts arriving from the Islands

While treating him, we walked to all of his radiology tests, to the pharmacy when I needed to pick-up meds, and then finally on one of the last days we walked outside and saw the helicopters and jelly fish! His mom was so sweet too - she spoke broken English, but over the 10 days she too gained confidence and sometimes filled in as an interpreter when ours were off the unit. The whole ship took an interest in this little man! The optometry unit came and fitted him for glasses and you could tell he loved them because he stopped squinting. Later in the week I called the dental unit to see if they had any open appointments for escorts to be treated and unfortunately they said they were full. I went to my women’s prayer that night and mentioned it to them and one of the women, Georgie, a dentist from the Australian Air Force and my roommate was like.."I'm off tomorrow and I'm a dentist I'll just tell a hygienist to set up a room for me! Bring the little boy’s mom in at 8:00am" this happened one hour before they were leaving the ship! It was really nice to see all the departments come together and support this family especially after a very long post operative stay.

Taking care of our little patient!

The boy’s mom also asked me if I had a recorder on my phone, she had written a song this week and wanted to sing it for me. It was beautiful! We borrowed a guitar from the ship’s chapel and she played the song again and looked so in her element. The public affairs staff was walking through the ICU and heard the music and asked if they could set up a recording space and record her song. Public Affairs is going to use it as the music behind THIS slideshow! She also got a copy of her songs. It was so beautiful to see how God worked through our various teams to bless this family and in turn how much they taught us and showed us perseverance in the face of trials.

Yes that's a glass of wine while
on Liberty in Subic Bay

The hardest part of the time in the Philippines for me was that I did not have one day off the ship. I returned from my Indonesian MedCAP on June 8th and did not set foot on soil until we pulled into Subic Bay for liberty on July 2^nd and believe me, I was getting a little stir crazy. :) Thus when we received four days off the ship at Subic Bay, I was super excited! Liberty was fun and it was super nice to get off the ship, and it has prepared me for the next destination, I am ready to sail to Vietnam!!! We will be there in 2 days and I have promised my sister, Kim that I will try to get better at posting small tid bits and blogs! Well hopefully you made it through my long blog and I hope that my stories can inspire and bless others so please feel free to share my blog with others in your lives!

Coming back from MedCAP

Checking up on a recovering patient

What's been going on in this part of the world?!? Well I recently was mentioned on Project HOPE's Blog!   And if you haven't taken a moment to check out the following links, I strongly encourage you to do so:

Project Hope Website

Pacific Partnership Blog

US Navy

We returned to the USNS Mercy ship on Saturday June 9th and man this ship feels super full!!! The Intensive Care Unit has been incredibly busy recovering Indonesian patients who are arriving directly out of the Operating Room. Since arriving back from the Islands, I have been recovering the pediatrics’ clef lip and palates. From this experience, I can possibly see a potential future career with Pediatrics! Here's a YouTube video of an example of the amazing work taking place on the ship. The staff have been recovering patients who have lost a significant amount of blood in surgery and we have become the ward for post-op staff members and for other ship related injuries. If you are a navy sailor this would be the ship you would want to get hurt or sick on.

Port of Sangihe on June 3, 2012

I may share this a few times during this experience but I can honestly say that I will never complain about working 4 days in a row again! Here on the USNS Mercy while stationed in a mission port each person works a 12-hour shift each day. On a lighter note, the limited bed and living space on the ship now feels luxurious after sleeping on a cot with a mosquito net and food cooked in mass for 1000+ people tastes amazing again after eating Meals Ready to Eat (MRE's) for 6 days!

This mission has taught me a great amount of humility. While on the MedCAP, I treated many patients with TB, leprosy, tumors, goiters, deformities, and ulcers. The Indonesian patients are thankful for any service and help provided by the USNS Mercy because access to medical care and healthcare providers is limited. The nearest hospital or clinic could be 200 miles away and transportation is often by boat yet even in those facilities, they have limited capabilities. On the island if you need blood it's a donor to recipient donation only, because there is not a supply held up in blood bank. Essentially one has to trust that their family member is healthy and compatible. WOW!!!

 We have had some unexpected weather the last two days and today I am a little sea sick!

Talaud Islands, Indonesia

In the helicopter on our way to the Island

We are on day three here at Talaud Islands with the MedCAP and the crowd has been lining up since 4 am. Yesterday if i am remembering correctly, we saw 273 people! Here on site we have dental, optometry, medical, physical therapy, laboratory, and pharmacy. 

Check out a video of the “Blackjacks” of Helicopter Sea Combat Squadron (HSC) 21 used one of their MH-60S Knight Hawk helicopter to provide supplies in Indonesia!

The kids are so fun and full of life. They laugh at me as I attempt to speak words in Indonesian but then help me out too!

Last night the translators took us into 'town' to the market. I bought some mentos from a shop!! My tagalong children pulled me in every direction to their friend’s shops. Then the kids walked us home to the school singing jingle bells in English.

Our sleeping quarters - cots and mosquito nets

Then we took our cots with our mosquito nets outside to sleep. I actually slept because it was cooler. Still hot but not as bad. Well we had an early morning wake-up call. Monsoon style rain! It turned into the first shower we all took! Shampoo and all in our bathing suits! And we washed some of our shirts claiming the change in downpour was The cycle changing.. Wash, rinse, spin!

Today June 5th we saw 350+ patients! I was in the triage area doing vitals and basic assessments. We noticed a large percentage of our population had blood pressures > 230/120 and they were wanting to go to optometry for blurry vision. So… I taught the waiting crowd about high blood pressure, prevention, signs and symptoms, and treatment. They were very receptive and asked good questions. Later I worked with a local nurse to improve the education for tomorrow to alter it towards Indonesians. 

The Chief cutting up coconuts for our team

Tonight the translators and the head of the district here arranged a bus and some cars to transport our team to the beach!!! We had so much fun it was like a spa for us! As I was getting out of the water I was stung by a jelly fish. That was not so fun... It was like a sudden burn by an iron. The welts formed on the inner side of my right upper arm and across my chest. One of my corpsman offered to pee on it, but I opted out. :) The swelling is down and the stinging is gone now and it's time to attempt sleeping outside again! Hopefully no rain!!!!

 Here's a fun article on the Pacific Partnership site!

Getting ready to land in the Talaud Islands

We've arrived in Indonesia!

The Feast at the Mayor's

We have arrived! Waking up to lush hills was a wonderful welcome to Indonesia. On June 1st we on loaded our first patients and translators. I was so anxious and and extremely excited to recover my first patient out of surgery. I was assigned a 41 yo male who was scheduled to come out of surgery around 1130.... 6 hours later as my shift was coming to and end he arrived. I ended up assuming care and responsibility for him for 2 hours. My corpsman did a great job assisting me and we  both learned a lot about recovering a pt straight out of the OR and running a nerve block. 

 

I also had the opportunity to assist in recovering a 4 month old post lateral clef lip repair and little ear tubes! She was beautiful and being a part of a life changing surgery for her was very special. We had her in the ICU just to make sure her airway was stable. She recovered like a champion and began feeding after two hours!!!

Yesterday I got to get off the ship and foot a breakfast at the mayors house.  We ha a full spread of authentic food and great hosts. It seriously prepared me for the humidity and heat of the next  6 days. That was the first day I have ever set foot in another country!!!

Practice makes perfect!

This morning I am going to my first MEDCAP Medical Civic Action Program today for 5 nights!!! We are being flown in the helicopter to our site!!! This is all a very exciting adventure. It's going to be hot. We are expecting to see 300+ people a day. This island has no doctors and one nurse for 83,000 people. Pray for safety and some cool breezes!!!!