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Got home last night. Incredible that you can waste two entire days for a two hour flight! The last week of Project Hope I though I would never get home, but once home it was like I had never left.

What a great experience! I knew before I left that I would be touched by the patients who live in daily povery, that there would be days I would cry for the patients who did not have access to services that we not only expect, but demand immediately. For example, I met a gentleman who had been hit by a car while riding his motorcycle. He fractured his left hip, femur, and tibia. His hip and femur were repaired surgically, but his tibia was left displaced and dangling. Five years later he could not walk, you did not need an xray to see the fracture, and he would move the bones back and forth for you when you could not believe what you saw. Without work he does not have insurance or cash to pay for the surgery, without a working leg he cannot work. Stories such as this are plentiful in Central America.

What I did not expect was to meet so many wonderful people on board the ship. People from all over the world with a lifetime of stories to tell. People with accomplishments and resumes full of exciting adventures and accomplishments. It was so fun just to sit down and chat and exchange stories and information. The physicians and NPs on board the ship not only challenged each other to obtain a higher degree of competence; but they challenged me, an NP student they will never see again, to reach up and out across the world to gain the most out of work and out of life. As role models the raised my expectations of myself as a student, a professional, a friend, and a mother.

Costa Rica

We have been out to sites in Costa Rica for four days now. Surprisingly, many of the people are poor, but they seem to have access to healthcare. The government mandates that businesses provide all employees with health insurance. The employees pay a set percentage of the premium so those who make more pay more. Those who are not employed do not have insurance and have to pay cash for healthcare unless there is a life threatening emergency. Still, it seems that most of the people coming to us have had appropriate care. The problem arises when they have to wait several years for non-emergent surgery. Non-emergent and unnecessary are not synonymous. I have seen several women with cervical dysplasia who had to wait two years for treatment. A 19 month old with congenital hip dysplasia was on a four year wait list for surgery; the mother had been told by then it would be too late. There is a private system where they can pay to have surgeries performed for cash but most cannot afford it. In some ways, this is more frustrating than those who have no healthcare at all because their expectations for what we can do for them are higher. Scores of surgeries are performed on the Comfort but they are limited to those with a quick recovery which does not require extensive follow up.

The people of Costa Rica are warm and happy. They love to joke and laugh. Our translators are medical students from San Jose who give us great insight into the culture, the health system, and the daily issues that the people of Punta Arenas face. They have also helped me compile a list of great places to visit in Costa Rica. Unlike El Salvador, we are allowed to leave the ship at night and eat at the nearby restaurants. This makes living on the ship a lot easier since the food is the greatest hardship of all!

Last night one of the physicians traveling with Project Hope gave a commemorative presentation on 9/11. He was on the disaster relief team that was present at the World Trade Centers for two weeks immediately following the disaster. His pictures and heartfelt descriptions put a personal twist on the event that one just cannot get by watching the news. This is one example of what has made this excursion so out of the ordinary. I have met people from all parts of the world and they all have fascinating stories to tell.

It is hard to believe that we will be leaving for home next week and graduating on Saturday! I am quite homesick, but not yet ready to leave.

from Lori

August 1, 2011
Project Hope 2011: El Salvador
Hello everyone!
We landed in San Salvador on July 14 and were met at the airport by Earl Peterson, a soft spoken southern gentleman, and experienced Project Hope volunteer who greeted us with open arms and escorted us to the Hilton for our overnight stay and boarding of the ship the following day. Not knowing what to expect and knowing nothing regarding military life - I followed the lead of those who had committed to previous missions. I could not have completed the first week without the direction of Randy and Faye to show us the way.
A typical day starts with getting up at 5A, having meals with the enlisted personnel, muster (roll call), going out on MEDCAPS (giving care at the sites), and with our off days consisting of laundry, working out, reading, and catching up on sleep. Over 900 patients are seen daily from general and family medicine, ophthalmology, ENT, women’s health, accompanied with pharmacy, physical therapy services. Sites close down after all the patients are seen and we come back to the ship around 16:30 -17:00. Dinner is served between 17:30-19:00, and an overview of the day’s activities by the various commanding officers at 19:30. Afterwards you’re exhausted, shower, and retire to your berthing quarters to get a few hours of sleep and do it all over again.
The days are long, hot and exhausting at times but rewarding; it’s when you get that firm hand shake, smile or hug from that individual who walked and stood in line for several hours to get to the site to be seen by a health care provider. For many patients, this is the only healthcare they have had in several years, prescriptions are unable to be refilled due to the financial expense and this may be the only care they receive until the mission returns to this area.
The unexpected kindness and respect from all aboard is truly refreshing. I had forgotten what it felt like to say hello to everyone you meet, strike up a conversation or sit and enjoy a meal with someone you don’t know but feel like you have known them all your life. People aboard the ship go out of their way to help you. Not just tell you how to get there but actually take you there. This has been particularly helpful, since I have been lost on every part of the ship for the past week. The military personnel know that look ……….????????. No one gets irritated, brushes you off, raises their voice or lets you struggle. I am surprised no one has thrown me overboard from all the questions: where is……..? It’s taken a week but I think I am figuring it out. When I have found the red floor I know I am going in the right direction.
The Comfort is just as the website portrays it – a white navy vessel with red crosses on it. But what it doesn’t demonstrate are all the combined efforts of the different branches of the military – US navy, army, and air force working with nations from Canada, Columbia, and the Netherlands to join in the efforts in providing humanitarian care and working as one. But what surprises me the most is all the NGO’s, the non-governmental organizations- doctors, dentists, nurses, and other health care providers worldwide who have volunteered their time to this mission. Without all the sum of these parts this mission could not function as a whole.
Got to Costa Rica and had liberty at Punta Leona for four days before starting on the second half of the mission. Lots of sun, walks along the beach, and zip lining and touring Jaco Beach. We are about to check out after lunch to return to the ship. MEDCAP starts tomorrow. Lori