DoD Medical Outreach Efforts in Central America Build Partnerships, Stability
By Dialogo July 23, 2013
From providing surgical assistance to overburdened hospitals, supporting disaster relief and building local health capacity, a mobile U.S. military medical unit based in Honduras is helping fill health gaps across Central America with the hope of contributing to enhancing stability in a region where poverty and violence have been commonplace.
Based at Soto Cano Air Base in Honduras, Joint Task Force-Bravo (JTF-B) serves under U.S. Southern Command and carries out joint medical readiness training exercises (MEDRETEs) with partner nation militaries and health ministries in the region that include public health education, disease screenings, deworming and vitamin programs, disaster preparedness training, dental and medical care for underserved populations in Central American countries. JTF-B also sponsors local specialty MEDRETEs in plastic surgery, pediatric orthopedics, urology, and eye, ear, nose and throat care.
“The U.S. presence working in conjunction with Ministry of Health, host nation armed forces and other host nation government institutions helps not only improve the image of these institutions but also provides recognition in the presence of the population,” said Guillermo Saenz, MD, a Honduran doctor who serves as JTF-B’s Host Nation Liaison Medical Officer.
JTF-B has been engaged in humanitarian medical activities in Honduras since the early 1980s and regionally the last five years. “What has evolved through the years is that it has become more organized with more clear objectives,” said Dr. Saenz. “It also has diversified into not only general and specialty MEDRETEs, but into other fields like research projects and training.”
Among JTF-B’s key initiatives is a monthly partnership between its Mobile Surgical Team (MST) and Hospital Escuela, a Honduran training hospital in the capital Tegucigalpa (approx. 850,000 pop.) where the team helps fill gaps in surgical services. The team also supports a hospital in the small colonial city of Comayagua 50 miles outside the capital twice a week and another on a weekly basis in La Paz, a rural mountainous and jungle region.
“We work in conjunction with the Honduran surgeons doing all that’s in the scope of general surgery,” Dr. Saenz said. “It helps a lot due to the scarcity of supplies and personnel. The Ministry of Health doesn’t have enough operating room (OR) personnel to do all the surgeries that they have booked.”
Each MST, comprised of a surgeon, nurse anesthetist, two OR nurses and technicians, and sometimes other specialists, works at the Honduran hospitals for 1-2 days per visit. “The MST handles acute trauma (gunshot, knife wounds, accidents), as well as emergent surgical cases (appendicitis) and elective cases,” said Maj. Charles Boggs, USA, MD, MST Surgeon and Commander. “The MST off-loads cases from the Honduran teams and expedites patient care, often saving lives. “(Honduran doctors) are very skilled but often need more manpower for the large patient load and emergency cases. The hospitals gain additional surgical resources to provide quality care to patients, which is very appreciated by the Honduran surgical teams and public.”
The partnership and trust with Honduras has grown through the MST’s consistent presence. The U.S. and Honduran doctors also learn from each other. The MST trains Honduran providers on new anesthesia drugs and OR techniques, and laparoscopic surgeries. “(Likewise) when resources are limited, the Hondurans have tremendous insight on use of alternative techniques and treatment regimens appropriate for Honduras (which the U.S. physicians can apply in other low-resource settings),” Dr. Boggs advised.
JTF-B’s approaches reflect efforts by the U.S. Defense Office of Force Health Protection & Readiness (FHP&R) to develop international health policies promoting host country capacity building that is compatible and sustainable with local resources. “This is a great example of DoD helping a region in need fill a health care gap and assist the host nation military and civilian health agencies in a positive, meaningful and lasting way,” said Dr. Warner Anderson, Director of FHP&R’s International Health Division.