Pacific Partnership 2010 Summary

We’ve been home a week today. All week I’ve told myself I need to write a summary of our trip. Blogs by other LDSC (Latter-day Saint Charities) people on the ship express things so well. Many of our experiences were similar and some were quite different, depending on our assignments. I’m going to use a lot of other’s writings in my summary. Warning: This is lengthy. Borrowing from Commadore Franchetti’s blog at http://pacificpartnership.wordpress.com here are some statistics. A quick summary of the measureable parts of Pacific Partnership’s 2010 accomplishments in Indonesia:

MEDICAL SERVICES

Surgeries aboard Mercy: 214

Dental procedures on ship: 190

Endoscopy: 18

Total patients seen ashore in MED/DENCAPS - Dental and Medical clinics: 33,158

Total animals seen/treated by our veterinarians: 1034

Glasses provided by Optometry services: 16,533

SMEE (Subject Matter Expert Exchanges) Activities – i.e. Educational Instruction
Medical SMEE – 4260.5 hours; VET SMEE – 383 hours,; PreventativeMED Instruction– 4836 hours

ENGINEERING SERVICES

Inpatient Ward at Daruba Hospital renovated - Negiri 1 and 2 schools refurbished
Puskesmas Kalumang Clinic renovated
Puskesmas Sulamadaha Clinic renovated
Puskesmas Tulehu Clinic renovated

Estimated Repair Value to 64 pieces of Biomedical Equipment: $681,900 repair value

COMSERV – Community Services

23 COMSERV Projects (Orphanage social visits, sporting events) 5 CPF Band Concerts

My Words: The five weeks on Mercy, living as a sailor was an opportunity of a lifetime. Am I glad we did it? YES! Would I recommend it? YES! Would we do it again? Probably not – someone else can do it next time. It was tough saying goodnight with a high five, or giving knuckles and going our separate ways to sleep. (Alright, I confess, once in awhile we snuck in a quick hug and kiss.) We were expected to live Navy rules – which includes NO public display of affection – not even holding hands. We got to see each other daily and were able to eat most our meals together. All my nursing work was done aboard ship – except one day when I helped at a MEDCAP (small community clinic.) I was privileged to ride to the site in a helicopter, which I enjoyed immensely and got some great photos. Mike worked off ship in several MEDCAPs. He saw about 60 patients/day. He also took sick call onboard for the ship’s 1000+ residents. All in all, our medical skills weren’t used nearly to the degree we anticipated, but we didn’t have a vision of all the additional purposes of the mission – to build goodwill, to improve diplomatic relationships in that region, to work as an international team, to serve as a ‘practice session’ for worldwide disaster response, and probably many other objectives we still haven’t recognized. There were many ‘moving parts’ to the mission. It must have been a mammoth of a task to coordinate it all. We were just two willing souls in a group of 35 LDS Charities volunteers. We received lots more than we contributed. Our LDS Charities people were awesome and we made some good friends with them as well as many other good people we rubbed shoulders with. Project HOPE (Health Opportunities for People Everywhere) and Hope International are 2 other NGO’s (Non governmental organizations) we worked with. They are great organizations!

Following are excerpts from other’s blogs interspersed with some of my comments. I’ve tried to give credit where credit is due. You’re more than welcome to read them, but this will be long. I’m simply recording them for memory’s sake.

Kathryn Allen, writing for Project HOPE, has some great posts at http://projecthopeinthefield.blogspot.com and I’ll borrow some of her writing. In describing the ship she says: “ Life on the ship has been a huge part of our experience here in Indonesia. As a group of us walked to the far aft end of the ship to start the tour, we admitted all we know about ship engine rooms comes from disaster movies. Titantic came up first, of course, with its scenes of sweaty seaman desperately trying to crank down the hatches.

Our tour started off calmly enough with affable Chief Engineer Joe Watts giving an overview of the ship while pointing to various places on a large framed schematic. He told us the Mercy runs 894 feet from stem to stern, 105 feet across at its widest point, and 116 feet high. We’re just a speck traveling through the vast expanses of the Banda Sea, but if the ship were dry docked, it would take three high school football fields to contain it.

Once we nodded our agreement that this is a really big boat, Joe gave us a mini- history lesson. In 1958, Project HOPE founder Dr. William Walsh persuaded President Eisenhower to donate a U.S. Navy hospital ship, and the concept of ship-based volunteer-staffed medical missions was born. We are not in that same ship, today, of course. The SS HOPE was retired in 1974. In the early 1980’s bids to build two floating hospitals from scratch went out. The National Steel Company in San Diego came back with a crazy idea to retrofit existing oil tankers into hospitals. It would save millions, they argued, and they were awarded the contract. The hospital berthing units and wards were built “prefab,” then lowered by sections into the vertical “slices” of the ship’s hulls.

A few highlights: the ship’s propeller is 26 feet wide, and has five blades instead of four, for smoother sailing should surgery be required while underway. Also, the OR is placed dead center of the ship, where the least motion can be felt. Nonetheless, I’m happy all the surgical patients have been discharged. Today, (August 4^th) as we are underway to Australia, the waves are 7-9 feet high, and we are all weaving like drunken sailors.

Finally we pushed orange foam plugs into our ears and encountered the deafening noise in the actual engine rooms. We trudged through rooms as toasty as 118˚, and then computer and repair rooms as sweetly cold as meat lockers. The main room is vast and tall enough to make one dizzy looking up, but other spaces are so tight we had to make ourselves skinny to avoid touching grimy, hot machines. Joe shouted out information along the way, and we all nodded along as if we heard and understood. Enormous boilers produce our water for drinking and washing by heating salt water to 170 degrees. Then they apply some engineering mojo involving vacuum pressure. The sucked out salt sludge is returned to the sea, and more seawater is taken in. No water shortage here, salty or not.

Our tour wound down when Joe opened a hatch and ushered us onto a small balcony featuring fresh air and blinding sunshine. He showed us the gun that shoots a line over to an oil tanker, which ultimately results in a cable that connects the two ships. A big hose is connected and 10,000 barrels of oil from the supply ship are transferred to the Mercy, as the two ships remain sailing at the exact same speed for three hours.

The next morning we actually witnessed this process, one of hundreds of wonders, big and small, we’ve experienced these last five weeks. Borrowing heavily from an LDS Charities member’s blog at http://pacificpartnership2010.blogspot.com Billie Martensen described the refueling process thusly: The Mercy was joined by Naval ship Richard E. Byrd. The two ships pulled up along side each other where 4 lines were shot across to help monitor the distance between the ships and to facilitate the hose connection to the Mercy to transfer fuel. At the same time, the helo was put into action. Trash was transferred off the Mercy, as well as outgoing mail. Then pallets of supplies were carried over to the Mercy. The whole process was fascinating and amazing! Imagine the skill it takes to land a helicopter on a moving ship! The entire process took about 3 hours.

Melinda Jennings blog at http://summerservice2010.blogspot.com describes the LDSC group tour. Our group leaders arranged for us to have a tour of the Engine Room. We spent the next hour exploring the bowels of the ship. The Mercy and her sister ship, Comfort, were commissioned by Congress in 1976 when the hospital ship used in the Vietnam war was old and needed to be replaced. The Mercy was created from an old oil tanker. This was more cost effective than building a ship from the ground up. The work was done in San Diego and was finished in 1986. The oil tanker, SS Worth, was gutted except for the engine parts and then the hospital modules and all the berthing areas were built on shore and then placed in the existing compartments. The tour was super cool, but very hot and loud. We all had ear plugs. Some of the rooms were over 118 degrees. We even got to see the rod that the propeller is attached to. He gave us some stats that were interesting. The fuel for this trip cost $8,000,000 and the whole humanitarian project is costing $25,000,000. The Mercy's fuel tanks hold over 1 million gallons of diesel fuel and 789 barrels of jet fuel, I assume for the helicopters. The ship distills its own potable water through distilling sea water. They heat the sea water until steam is formed and then put it into a vacuum and the fresh water is taken from the steam and then the extra salty left over water not distilled is put back into the ocean. With cooking, showering, washing, etc on the ship, we consume 60,000 gallons of water each day. The ship holds 356,000 gallons of fresh water. The ship has two separate plumbing systems for waste. Toilets use sea water and those pipes are 3 times as thick as regular pipes and designed for sea water. This water undergoes special treatment to meet international standard before being discharged into the ocean. The other pipes have the “gray” water from showers, washing machines, dishwashers, sinks, etc. Gray water can be put back into the sea as long as we are a certain distance from shore. Mercy’s fastest speed is 18 knots and it would take it 3 miles to stop if going at full speed. The Engineer said that we usually travel about 14 knots.

Continuing to use lots of Billie’s blog posts: Let's talk about how it is to live on a Navy ship. There are plenty of things to learn and many adjustments to be made. First, you have to wrap your head around the fact that most of the time, you have to go up before you can go down, or visa versa. Because the ship consists of compartments that can be closed off if we begin to take on water, you can't simply walk from one end of the ship to the other. The main level does go from one end to the other, so for instance, to get from my sleep area to the computer room I climb 4 flights of stairs to get to main. Then, I walk to the other end of the ship and go down 2 flights. The levels on the ship are not numbered in order. Main is main, or 0. The floor below main is level 1, below that level 2, etc. The floor above main is 01, above that is 02, etc. So, we eat on 02, but it is really 6 flights of stairs since I sleep on level 4. The stairwells are color coded, so once you learn that the laundry is blue staircase, level 01 you can find it... if you know where the blue stairwell is. Then, there are sections numbered from front to back (bow to stern or fore to aft). These are important to know as some are restricted during flight quarters when you are only allowed on the weather deck aft section 74. Some of the announcements we hear: "Reveille, Reveille! All hands heave out. Breakfast for the crew." That's our wake up call each morning at 6 AM.

At 8 AM and 4 PM there is this announcement: “Sweepers, sweepers – man your brooms. Give the ship a clean sweep fore and aft. Clean all ladder backs and stairwells, dispose of all garbage and trash in designated areas. Now, sweepers.”

And at night at 9:55 PM it’s "Tattoo, tattoo: Lights out in 5 minutes. Stand by for evening prayer.” I never did find out what ‘Tattoo’ means. Then at 10 PM the announcement says “Taps, taps - lights out – Maintain silence about the berthing areas. Taps.”

When the helo is in operation we hear: “Flight Quarters, Flight Quarters. No one allowed on the weather decks between sections ? and 74. (can’t remember the number). “No flash photography, no hats, no smoking. (The long announcement also says, "No blowing of stacks or tubes." Whatever that means.... we have all vowed not to blow our stacks!

Our days begin at 0600 with Reveille, whether we have patients or not. Breakfast is served from 0600 to 0730. At 0730, we muster in our department for roll call. Muster reports are turned in to account for everyone on the ship. At muster we are given our schedule for the day. Lunch is served from 11:30 to 1300 and dinner from 1630 to 1800. Meals are too good and my self control not so good. At 1900 is a Confirmation Brief on the mess deck. The Commodore and others give a report on the day's activities and the upcoming schedule of events. It’s good to go because it gives one an idea of what else is going on in our mission other than in my small part of this Mercy world. At 2000 (8 pm) our LDSC group meets for 30 minutes or less in the ship’s chapel for devotional. It's uplifting to our day and it gives us a chance to gather and be informed of anything we need to know as a group. Sometimes folks stay later to play games, watch movies, sing, or whatever.

One experience Billie had was visiting children in an orphanage. They have so little. No parents. No room of their own. Precious few belongings. They smile and laugh and freely give love and affection. These particular children have a great desire for fresh water. Their water comes from a nearby stream and it is contaminated. So, every Saturday for two years, they have fasted and prayed for fresh water. They donate whatever little money they may have so that once each year, they can give to children less fortunate.

One Saturday, we arrived at their orphanage as they were singing hymns and worshiping to break their weekly fast. Initially, I did not know it was a worship service, nor did I know about their fasting and prayer, but I felt the Spirit more strongly than I have felt it in a long time and I knew I was in the midst of something special. I listened to the prayer given in closing. The only words I understood were "Terima kasi." (Thank you.) Those words were spoken so many times in prayer that it caused me to wonder how they could possibly have so much to be thankful for. You see, we didn’t know they had been fasting and praying, and they didn’t know that in the supplies we had just delivered there were water filters, donated by LDS Charities. I’m blessed to be part of Heavenly Father’s ‘hands’ in answering the earnest prayers of these children. I feel even more blessed to have been taught this lesson in faith from them.

Billie says, “Indonesian people are gentle, kind and thankful. They live very hard lives, yet they do not seem to know it. They are quick to smile and easy to hug. They are teaching me how easy it is to reach out and physically touch another with a handshake, a hug or a kiss on the cheek. They are teaching me to be thankful and appreciative of the smallest of things. I'm am never more humbled than when we tell a patient they are ill, but we cannot help them and they thank us. They are grateful we took the time to see them and for them, that is enough.”

When patients come on board, they get checked with a thermal scan for fever, get a chest x-ray to look for signs of tuberculosis. If the x-ray is suspicious but not conclusive, they are sent for a CT scan. Unfortunately, if they do have TB, they leave the ship immediately. Each patient comes with a friend or family member as an escort. If either has TB, they both must leave the ship. If the patient is clear of TB they can come back the next day with another escort and try again. We've had a very high rate of TB and it is disheartening to turn them away. We do give them the medical report and a letter to take to a place where they can receive treatment for TB. Once cleared for TB, patients are checked into CASREC (casualty receiving). I, Susan, work in CASREC where patients have their weight and vital signs recorded, get treated for lice if necessary, have lab work done, a brief physical exam and history to include religious food preferences - Muslims don’t eat pork. Part of my responsibility is giving the nurse on the wards a report and then getting the patient to the proper ward. The escort they bring stays with them the whole time, until they leave the ship. Discharge planning, another responsibility of CASREC, coordinates the boat they ride back to the pier, makes sure they understand their medications, how to care for their wounds, and when to seek medical treatment. We also make sure they have a way to get home from the pier and arrange any help they need. Then we instruct them, all this through an translator, on what to do if they get seasick and escort them to the pier and beyond. As some patients rode the "Bandaid" boat to shore with their discharged group, one mother told, through an interpreter, about her care on the Mercy. She told about how good the care was and how friendly and kind everyone was to her and her daughter. She loved the food and said the sleep was good. Then she said, "All of the doctors and nurses were so kind and cared for us so well, I feel full without food." ........ me too.

Each evening, there must be an accounting of how many are on the ship. We keep track of the patients and their escorts. Some patients end up having two escorts. It is usually a child that can't be left home, so we have one parent as a patient, the other is the adult escort and the child comes along for the ride. It gets quite confusing as to who is who sometimes. Then, to make it more complicated, many escorts become patients after they arrive. Usually it's because they need dental work. So, at the end of the day, we report how many patients, how many escorts, how many females/ males went off the ship and how many patients are left. If we are off in our numbers, we work until we find it and the count is correct.

Billie said she was thinking of many nurses back in the states one day as she discharged a woman who had surgery. Her husband and infant had stayed with her the entire time. We give them all beds and food while they are here. So many nurses back home get all uptight if family members come to visit during off hours, or heaven forbid, use the patient's bathroom! Then, all patients in the U.S. must go out of the hospital in a wheelchair and are assisted into the car. Infants must be properly buckled into car seats. Culture shock!!! Here, sometimes just a day post-op, the patients walk down 6 levels of ramp to a dock hanging off the side of the ship. They have to step onto a boat that is rocking and rolling in huge waves. Then they get a sometimes rough ride to the pier ( we see our fair share of vomiting.) At the pier, they climb out of the rocking boat and traverse across a rather challenging ramp. Those in wheelchairs are scared to death as military men lift them over all the obstacles, sometimes all in the pouring rain. I haven't seen a car seat yet, but I did see a guy on a motorbike with one kid in front and one kid on the back. It’s not uncommon to see an entire family of 5 on a motorbike.

Melinda says of her SURGCAP where she scheduled for the OR – “We got to see all the people who were due to have surgery and I enjoyed meeting everyone, especially the children. I loved the children. Even with those deformed faces they smiled and their eyes lit up. I can't wait to see them after surgery. What a blessing to have such a life changing surgery and to be able to look like other children. I think we booked about 10 cleft lip repairs and 2 of those were grown men. I can't imagine living my whole life with such a terrible deformity

“We spent 5 ½ days doing surgery in Ternate. I have been able to see many surgeries that I would never see in the states. We did about 20 cleft lip and palate surgeries on children and even some adults in their 30's. It was amazing to watch the transformation from cleft to whole. We treated many children with clefts, hernias, and even one little 8 year old had 2 cataract surgeries and could not see before she came on board the Mercy and left with her sight. That is a life changing miracle for her. Sometimes it is hard to think of all those people who came to get help, but we had to turn them away because of time constraints. I feel bad that we cannot help everyone, but in the end I do believe it is about reaching out to the “one”. One person can make a difference and as we touch each one individually they in turn can go out and touch others lives. We just need to do the best we can serve others in life, keep a positive attitude in life and be grateful for all that the Lord has blessed us with.”

Melinda reports the OR saw all sorts of lumps and bumps taken off. One older woman had a huge type of “skin tag” that was like a pendulum hanging down about 12 inches from under her armpit. The bump on the end was as big as her fist. She would just tuck this pendulous bump into her bra to stash it out of the way and she had lived with it her whole life. Two other women had lipomas on their backs that were as big as a breast that were removed. It would be a bit awkward trying to fit a normal shirt. It has been so nice to help these people. They are happy and a humble people who have shown great gratitude and love towards us. It has been a joy to work among them.
When we leave a port we have to get all the surgery equipment, beds, IV poles, machines, tables and such and tie them to the wall so we are ready to go out to sea. I guess this is what is meant by “Batten down the Hatch”. Then on Monday we'll start over and untie everything once more so it will once again be ready. It's like totally closing up shop for the winter and stowing all the gear and then 2 days later getting it all out again.

Harold Davis, our LDSC Veterinarian, is a very kind, gentle man with a special spirit.. He told a story of his Army Captain who is in charge of all the Vets. He described her as a regular rough and tough Army person. He said one day his group was talking about the dangers of being in this part of the world and possible terrorist dangers to the Mercy. He then shared this profound statement from this Army Captain, she said, “I don't have to worry as I have Mormon Angels all around me. Mormons are too good and too kind for anything bad to happen to the Mercy.” This was a touching story and I feel blessed to be a part of a group that is perceived this way. There are some amazing people here and I feel privileged to be a part of this whole experience.

Melinda told about seeing many pallets of boxes donated by Latter-day Saint Charities. They were labeled hygiene kits, school kits, surgical supplies, medical supplies. They sported the same logo we have on our shirts. It was especially cool to see the boxes labeled hygiene kits and school kits as I have personally been involved in creating these kits. I felt a touch of home as we saw these. To be a part of an experience that we are able to share these items, that are lovingly put together by LDS members is pretty cool. Know that these kits are being put to use and are appreciated by the Indonesian people. While working in the scullery, one of the supply officers said the Pacific Partnership had a finite budget and was running out of certain medical supplies when the LDS church came forward and basically said, “What do you need?” They then filled the gaps by sending more supplies to the Mercy. He said it was amazing the amount of supplies donated by LDS Charities. He was very impressed and complimentary of the LDS church. Melinda also comments on the Optometry lab and her tour of when they were making glasses. They cut all their own lenses and have glasses of various strengths all complete for when they go ashore on MEDCAPS. The department has given out thousands of pairs of glasses, from distance lenses to reading glasses. That 's a lot of lenses to cut! The sailor working there picked up a really thick lens and let us hold it up to look through and you could see a whole person's face in this small lens. It reminded me that life is all about perspective. It's our choice how we view life. I have found it interesting that some people may grumble or complain about life, but in the end if we keep a proper perspective and keep in mind the big picture then our lives can be a lot better. I try to remember this each night as I crawl into my miniscule bunk to go to sleep. It's all about the experience and complaining about my bed won't make it any bigger or fluffier, so I just do my best to roll over without hitting the wall or falling off and go to sleep! Melinda also got a tour of the Bridge, or control center of the ship. She says,“ I really wanted to see the Bridge, but it is behind the “red” lines that we cannot cross. The Bridge is located at the highest point forward on the ship. The view is amazing! The Navigator showed us all the GPS's, maps, steering consoles, and cool computer planning screens. He showed us the course the Mercy had taken around the islands of Indonesia and our projected path to Australia. He showed us charts with sea depths that helped him keep the Mercy a safe distance from shallow water. Navigating takes a lot of math and time and is a very complicated job. The navigators work 4 hour shifts then are off for 8 hours then on for 4. On the starboard side on the deck is this huge, 12 inch diameter or so, beautiful lit up compass that is checked every 30-60 minutes against fixed points on the shore to make sure the ship is still where it needs to be in the harbor. He has to calculate where the anchor is and then the length of the anchor and the length of the ship to make sure that when the tide and current moves the ship, it won’t get into shallow water. It was all very interesting to learn and it was an education what the navigator job entails. Modern GPS's, paper topical maps, and old time compasses are used to make sure everything is correct. There is no room for error. Adjacent to the compass is a gigantic pair of binoculars and when I looked through them I could see details of houses on the shore. The binoculars are used to find fixed points on the shore to make the calculations to anchor the ship and to make sure it stays where it should. Very interesting!

August 4^th We are sailing to Australia and are in the more open seas. It’s stormy and the waves are high. It has been interesting to watch people walk down the ship corridors swaying side to side with the movement of the ship. The Navy is steeped in tradition and one tradition which is almost spiritual to watch is when the flag is raised each day at 8am and then when it is lowered each evening at sunset. The sailor who is in charge of this duty dresses in his/her best whites in respect for our flag and our amazing country, The United States of America. Melinda said, “I sat in silent wonder as the flag was raised one morning and to add to the moment the sailor who raised the flag, HM2 Smith was a friend of mine who works with me in the operating room. I am grateful to be an American and am grateful for the men and women who serve in the Armed Forces who leave their families and sacrifice so much for our freedom. We should never lose sight of this precious freedom we have and always remember that our country was established by God fearing men who loved the Lord and wanted America to be free. We are truly blessed.”

August 5^th we docked at a pier in Darwin, Australia. Mike and I got off the ship and checked into a hotel for the night. We did some sightseeing around Darwin and went to an open air flea market on the beach. We had dinner at a nearby casino’s buffet. It was fun to walk around the city and see so many people from the ship.

Aug 6^th morning was spent on a tour of a Wildlife Park. Australia has some fascinating animals. There were 5 other LDSC members on our tour. We had to check out of our room, and had no good place to spend the next 8 hours before boarding our flight home.

Aug 7^th It was a long flight home. We spent Saturday night with John’s family and attended the LeSueur Sunday gathering before driving home. It’s good to be back!