Last Day in Nha Trang

Dear Family & Friends,

It’s our last day here in Nha Trang and we are wrapping things up. After a really nice closing ceremony this morning we weighed anchor and now it is on to Singapore for a little break. We saw a lot of people here in Vietnam. More importantly, we were able to make a great many friends with the local medical professionals and the government officials we worked with. I believe we have taken another step (a big step) in normalizing the relations between our two countries. Of course, this is what Mercy does so well – we open doors, we make friends, and we build partnerships.

A few of the numbers:

Total Patients Seen: 11,576
Surgeries Performed Aboard: 234
Engineering projects were held at 5 different locations (3 local clinics; 1 rehab/education center; and 1 orphanage).
Our Bio-Med technicians were able to repair and bring back into operation over $300,000 worth of medical equipment at various clinics.

None of this could happen without the hard work of those who sail aboard Mercy. This crew – from so many different specialties; different originations; as well as different countries – are really something special. All of our differences aside, what everyone has in common is how they view the people we come to treat. If you are a patient coming to Mercy (or one of Mercy’s medical outreach sights) you will immediately realize how the people of Mercy will see your life as something that has value. And isn’t this all anyone really wants from a friend or a partner?

I think I can speak for everyone aboard that we are all very much looking forward to Singapore. It’ll be nice to have a break and recharge batteries. A lot more left to do!

More to come…

Bob

Who We Are – CIVMARs

Dear Family & Friends,

Yes… That really is me standing next to 5 of the contestants from the Miss Universe pageant. This year’s event is being held in Nha Trang and these young ladies were kind enough to visit Mercy. They were aboard for several hours to eat lunch, chat with the crew, and visit with several of the patients. Yea, I know folks… It’s a tough job but somebody’s got to do it!

For the last 28 years, I have been proud to belong to a cadre of some of the finest seafarers in the world – the Civil Service Mariners (CIVMARs) of the Navy’s Military Sealift Command (MSC). CIVMARs are government employed Merchant Marine officers and seamen who operate 45 of the navy’s specialized auxiliary vessels. The ships we sail are designated with the prefix USNS (for United States Naval Ship) as opposed to the USS prefix of the regular commissioned ships of the US Navy.

Most of the ships we operate are supply vessels (fuel, stores, and ammunition) in which the delivery method is what is know as Underway Replenishment (UNREP). In this process, we will rendezvous with the warships out at sea and conduct refuelings and reprovisionings while steaming about 180 feet apart. It’s an exciting job and the CIVMARs are some of the best in the world at it!

Our ship’s officers come from a variety of places. Many are graduates (like myself) from one of the 6 Maritime Academies around the country. Some are ex-Navy and some have worked their way “up the hawsepipe” (e.g. come up through the ranks to earn their officer’s license). Our unlicensed crews are just a varied. Again, many are prior navy while others are home grown having started in entry level positions and worked their way up.

With almost a thousand people currently aboard Mercy, it is humbling to think that only 67 CIVMARs are here to operate “the ship” segment of this hospital ship. It’s the CIVMARs who navigate and maneuver the ship to each of our mission locations. We keep the engines going; operate the boats to and from the beach; keep the lights and air conditioning running; as well as noble task of transforming a bunch of lubberly doctors and nurses into real salty seadogs. <>

While the mission’s focus is medical, I can take pride in knowing this mission would never happen if it were not for the CIVMARs bringing this ship to the places we visit.

More to come…

Bob

Nha Trang

Dear Family & Friends,

We were warmly welcomed when we arrived in Nha Trang, Vietnam. We dropped anchor Thursday morning just between Hon Tre Island and the city’s beautiful shoreline. Commodore Kearns, Captain Rice, and I attended the opening ceremony later that morning. At the ceremony were dozens of local and regional government and health officials. With the exception of the sweltering heat, it could not have been any nicer.

For this posting I would like give you an idea of how we operate our missions. There are 6 programs we offer to each of the host countries we visit. These are: 1) On-board surgical, medical, and diagnostic care; 2) Medical and Dental Civil Assistance Projects; 3) Engineering Civil Assistance Projects; 4) Veterinary Civil Assistance Projects; 5) Subject Matter Expert Exchange; and 6) Public Relations. Here in Vietnam we are doing all but the Veterinary program.

On-Board Surgical, Medical, and Diagnostic Care. The real value of a ship like Mercy is that she is a large fully equipped hospital wrapped-up in a ship. With her 12 operating rooms, blood bank, CT scanner, recovery and ICU wards, Mercy brings the capabilities of a major hospital to anyplace we can drop an anchor. We expect to do about 300 surgeries here in Vietnam – about a third of them will be cleft lip repairs by Operation Smile. We will also do a number of cataract surgeries, hysterectomies, tumor removals, and juvenile hernias…and, of course, the ever popular laparoscopic cholecystectomy. This last little jewel is the surgery formally known as “having your gallbladder out.”

Medical and Dental Civil Assistance Project s are often referred to as MEDCAPs and DENCAPs. These programs are how we reach the largest numbers of people. We usually run about two MEDCAP/DENCAPs each day. Each of these consists of between 35 to 50 personnel. Every morning these teams depart the vessel and head out to predetermined sights – usually a school or a local clinic. Free medical care is offered in the form of internal and family medicine, pediatric care, optometry, pharmacy, and simple dental procedures (usually extractions). These sights will usually be able to treat about 500 people per day. We will also send ashore a number of preventive medicine experts to advise local officials on such issues as water quality and insect abatement.

Engineering Civil Assistance Projects (ENCAPs) are performed by our Seabees. They work refurbishing schools and neighborhood medical clinics. We have 6 different projects going on here in Vietnam. This year, we are lucky to have aboard a group of Australian Engineers (what they call their Seabees) working side-by-side with our folks.

Veterinary Civil Assistance Projects (VETCAPs). Mercy has aboard a number of veterinarians and veterinary techs to assist local farmers with livestock. Vietnam did not request veterinary assistance during Mercy’s visit. Nonetheless, we did do a great deal of vet work while in the Philippines.

Subject Matter Expert Exchange (SMEE). One of the goals of Pacific Partnership is, of course, to build partnerships. Sharing education and experiences is one of the most beneficial tools to accomplish this. We do this in several ways – the most common is to send medical professionals out to local clinics and hospitals to conduct training and education for local health providers. Mercy also has embarked a number of biomedical equipment techs who help repair various medical gadgets and train local operators.

Community Relations. One of the most enjoyable aspects of this mission is not only bringing medial care but also bringing a little bit of America to the people we encounter. This is done with various community relations (COMREL) projects. These range from sporting events with locals (soccer is the most popular) to volunteers going out a painting a school or orphanage. The biggest hit, by far, is the Pacific Fleet Band (Yes – we have a band). This group always draws a crowd when they play at various local venues.

I was out the day before yesterday and got to tour a number of our outreach sights. Tomorrow I’ll be going out again with Captain Jim Rice. It is absolutely amazing to watch these wonderful shipmates in action, as well as watching the tremendous impact they have with the people we meet.

More to come…

Bob

Manila

Dear Family & Friends,

Getting a Merchant Marine officer to put on the “Choker” style Dress White uniform is kind of like giving your cat a bath. Especially to a stinky old tanker captain like myself. Nevertheless, I will gladly make the exception when given an opportunity to represent USNS Mercy and participate in a wreath laying ceremony at the Manila American Cemetery and Memorial. What an incredible day we had yesterday! Commodore Kearns, Captain Rice, and I (along with a number of Mercy’s crew) had the honor of visiting this beautiful resting place of over 17,000 American servicemen who gave their lives liberating the Philippines during WWII. At the monument is a circle of stone walls engraved with over 37,000 names of those who are missing from the Pacific campaign. Included are the names of the 5 Sullivan brothers who were lost aboard USS Juneau during the battle of Guadalcanal. When you say “seventeen thousand” the number numbs your mind - until you actually see all those individual markers perfectly aligned throughout the cemetery. It is particularly sobering to think that most of these were boys between the ages of 18 to 21. If you ever get the chance to visit Manila, I highly recommend you take the opportunity the visit this place of honor. It’s well worth it!

We arrived in Manila (Pearl of the Orient) Sunday afternoon. I got to get out in town for a little bit. We were mostly busy. In addition to the ceremony, Mercy hosted a reception Monday night for a whole bunch of dignitaries. Our old friend Ambassador Kenny came aboard to wish us well and say goodbye. Good party and good times were had by all!

Our stay in Manila was much to short. We departed this afternoon and are now on our way to Nha Trang, Vietnam. We will rendezvous with USNS Tippecanoe tomorrow for a little gas – about 600,000 gallons (you wouldn’t like the mileage on this ride). We’ll be there Thursday morning! We’re ready to begin phase II of this little sojourn.

More to come…

Bob

Farewell Cotabato

Dear Family & Friends,

We said goodbye to Cotabato on Thursday – next stop is Manila for a logistics stop and short break. The passage through the inland waters of the Philippines is just amazingly beautiful. While most of the medical staff is getting some rest, I’m spending a lot of time on the bridge. The navigation is pretty straight forward. There are several narrows that require a little extra attention; however, the weather has been fantastic so the transit has been mostly routine. What does make this interesting is the large number of small fishing (banka) boats scattered throughout these island’s waters. I mean, we have seen literally thousands of them. I have no idea what divine providence makes the fish want to hide out directly along the ship’s track…and, of course, the fishing boats will always be where the fish are. Makes things interesting…

The first leg of our transit was through the Basilan Strait – between the Zamboanga Peninsula and Basilan Island – which took us into the Sulu Sea. From there we went north and entered the Tanon Strait which lies between the islands of Negros and Cebu. Our destination was Calibayog City on the western side of the island of Samar.

We’re doing something a little different this year in order to reach a larger number of people in this region. While Mercy was in Cotabato, a “Fly-Away” team of medical and dental personnel – along with a number of Seabees - were transported by a C-130 aircraft to Samar. This was a great success! This air mission enabled us expand our presence beyond Mindanao. We dropped anchor Saturday morning just off the coast of Calibayog City to pick up our folks who have been working there for the last two weeks. After about 5-hours sitting on the hook – and all our folks aboard – we got underway for the run up to Manila.

We entered the San Bernardino Straits in the early evening (I know these waters quite well) and will be in Manila tomorrow morning. This short break is going to help everyone recharge so we can go at it again.

Here are just a few numbers from our stay in the Southern Philippines:
1) Total Patients Seen/Treated – 26,383 (!!)
2) Patients Seen Aboard Ship – 961
3) Surgeries Performed – 312
And this was only our first mission site. We have 4 more to go!

More to come…

Bob

Helicopter Incident

Dear Family and Friends,

I’m sure many of you have seen the news about the shooting at one of our helicopters. Day before yesterday, one of our helos made a startling discovery after it returned to Mercy bringing back a group of folks from a medical outreach sight. After landing on deck, the maintenance team noticed hydraulic fluid leaking from the tail rotor section. Upon further inspection, a bullet hole was discovered in the cowling below the rotor. It was most likely fired from a rifle while the helicopter was traveling over land. No one was injured and the pilot didn’t know he had been shot at, much less hit, all during the flight.

As the press reports stated, we did temporally “suspend operations.” I happy to report that today we are back to completing all mission objectives.

We’re not sure who is responsible for this incident. We are working closely Philippine authorities to find out who perpetuated this act. The mood of the crew is: We will not be intimidated! Everyone aboard believes in this mission and understands the needs of the people we are working to help. An overwhelming majority of the population here supports our efforts. Now is not the time to turn-tail just because someone decided to take a few pot shots at us.

I don’t wish to sound cavalier about what has happened. Trust me when I tell you, everyone is deeply concerned about what has happened and is doing everything possible to ensure the safety of our people working ashore and aboard. Nonetheless, you can never totally eliminate risk when doing a mission like this – you can only manage it the best you can.

Since the beginning of history, there have been those who have used violence, or the threat of violence, as a means to further some political agenda. However, only a thug would attack a hospital ship or, in this case, a transport to and from a hospital ship. We will continue to take measures to protect our people; and we will not be driven away by some coward who believes he can change our minds by threatening us. We will complete this mission!

More to come…

Bob

Why We Do This

Dear Family & Friends,

I am often asked the question: Why is Mercy on this humanitarian deployment? There are many reasons to do a mission like this. For me, the best reason is because - we can. We are, after all, the United States. As such, we have the means to do a mission like this and therefore we should. What’s the point of having such a magnificent platform as USNS Mercy if you’re not going to use her? Nonetheless, I’m sure there are many who see the world pragmatically and ask: What is the “return-on-investment” to the American taxpayers who funded this mission? My own pragmatic answer to this question is that “By doing humanitarian missions, we are better prepared for disaster relief missions.” Allow me to explain…

USNS Mercy, and her sistership USNS Comfort, were built for the purpose of Combat Trauma & Life Support. They were conceived and designed at the height of the Cold War as a means to care for large numbers of causalities in some epic battle. Although called to several conflicts, our hospital ships (thankfully) have never been required to do the actual mission they were designed for. In the past, Mercy and Comfort were never really given serious consideration as disaster relief responders. Although superb trauma platforms, these hospital ships could never hope to arrive to some disaster in time for what’s know in medical parlance as “the golden hour.” Therefore, these ships sat idle (Mercy in San Diego/Comfort in Baltimore) for many years waiting for a specific mission we hoped would never happen. This all changed on December 26th 2004.

The massive earthquake which struck off the coast of Sumatra generated a tsunami that ripped a path of destruction across the Indian Ocean. An estimated quarter of a million people were killed while several million were left homeless. The US Navy immediately responded by sending the Aircraft Carrier USS Abraham Lincoln and the Amphibious Assault Ship USS Essex. Then, on January 1st 2005, the USNS Mercy departed San Diego and headed for the stricken region. It was an interesting decision to send Mercy. After all, Mercy is a trauma platform and by the time she arrived there wouldn’t be many trauma cases. The work would be primarily clinical – and Mercy was never envisioned as a clinic - to supplement the local medical infrastructure destroyed by the tsunami. Nonetheless, some really bright people began to figure out how to use this vessel in ways never before imagined by the folks who designed and built her.

One of the most innovative ideas came when then CNO Admiral Vern Clark, called the CEO of Project HOPE Dr. John Howe, and asked if HOPE would like to join Mercy on this relief mission. Dr. Howe could not have been more enthusiastic. This formed an important partnership and broke down a lot of existing paradigms. Our hospital ships could directly team up with Non-Governmental Organizations (NGOs) in disaster relief efforts. Many of these organizations have extensive experience working in various regions around the world. They also can provide health and medical professionals – many of whom would already be working in the stricken areas when the hospital ship arrived.

Building on the foundation of the 2005 Tsunami mission, Mercy departed on a humanitarian mission in April of 2006. Many lessons from the 2005 mission were applied and a significant number of minor alterations were made to Mercy’s configuration and supply allowance. We began to realize that… If the lessons from a disaster relief mission could improve a humanitarian assistance mission; then, the lessons learned from a humanitarian mission would most certainly improve future disaster relief missions.

As we continue to do these humanitarian missions, Mercy is no longer just a trauma platform. She is now a fully functional, fully equipped, multi-capable, and state-of-the-art hospital that can go almost anywhere in the world – anytime she is needed! As many of you know, I was born and raised in Napa, California…about 50-miles north of San Francisco. When you’re from the Bay Area, “disaster preparedness” is practically embedded in your DNA. Being the pragmatic guy that I am, it only makes since to keep a ship like USNS Mercy ready for whatever the next disaster might be.

More to come…

Bob

…and then a miracle happens!

Dear Family & Friends,

The following was posted in the comments by ISC Shawn Cohen - one of our many outstanding Chief Petty Officers embarked aboard Mercy. It is such a great story I thought I should move it to the main postings. So please welcome guest blogger Chief Cohen:

More to come…

Bob

*********************************

Friends and Family,

Let me take a moment of your time to tell you about my day. A few minutes ago a Marine who works for me asked me if we would get any medals or awards for this deployment, such as the Humanitarian Service Medal. I told him that we would not be eligible for the HSM, but some of us might receive something like a Navy and Marine Corps Achievement Medal or perhaps a Flag Letter of Commendation. Then I told the Sergeant that I had already received something much better than any medal they could give me. I explained how a short time ago I had stopped into the Physical Therapy room for an adjustment since I hurt my neck in a fall yesterday (not serious, getting better thanks for asking.) While I was there I saw a 15-year-old Filipino boy named Romeo. I thought he was younger than that because he is fairly small for his age. I first saw Romeo there yesterday when they wheeled him in on a wheelchair. Romeo was very excited to be in a wheelchair because for the first time in years he was able to move around on his own without having to depend on other people. When Romeo was nine-years-old he was injured in a bomb blast when his village in the Republic of the Philippines was caught up in fighting between rival factions. His legs were so badly burned in the blast that scar tissue prevented him from even straightening his leg. His legs have atrophied so much that they are smaller around than my arms. For the last six years he has been unable to walk, and his father has carried him around. When not carried, he crawls around on his hands. He is totally dependent on family members to take care of him.

As Romeo gets older, he is getting too big for his father to carry around. His father is smaller than I am, and I couldn’t imagine carrying him around all day. When his family heard that our hospital ship, USNS MERCY, was coming to Mindanao they asked if we could help. His case was accepted, and our team of doctors decided to cut away the scar tissue that bound Romeo’s leg like webbing and replace it with a large skin graft taken from his back. His father asked one of our surgeons, Commander Todd, if the boy would ever be able to ride his bicycle again. Dr. Todd said there was a remote chance he may one day be able to ride a bike - and perhaps even stand on his own – although the boy would probably never walk more than a few steps.

Today, a few days after his surgery, I saw Romeo walk on crutches for the first time since the explosion. He was surrounded by family members and his doctors - Commander Todd, Commander Tan, Commander Douglas (his plastic Surgeon), Captain Goldberg (his physical therapist) and a Navy journalist who captured the moment on video. We all watched as he climbed up on the exercise bike and rode like he was competing in the Tour de France! His father and sister watched in amazement with tears streaming down their cheeks. This is a boy who now has a chance to do things on his own. To go to school, work, play with friends, grow up and raise a family. His father shook our hands and hugged us all, then looked into my eyes and said “Salamat Po” (a sincere thank you.) I would have traded all my medals for those two words.

So that was my day. How are you all doing?

Sincerely,

Shawn Cohen

CPO, USN

BTW: I was lucky this morning to have young Romeo walk into my office for a visit. See photo (Romeo is the good look’n one on the left! :-)

Who We Are

Dear Family & Friends,

I am not a professional writer; however, I spent most of last night having what professional writers call “Terror of the Blank Page.” I knew I needed to write something…anything… But what? It was as though the “writing lobe” of my brain went ashore for a couple of beers and left me here on the ship to fend for myself. Come on, Mr. Lobe, it’s time to go to work! Today at lunch I realized the answer was sitting all around me. Aboard this vessel we have so many different people from so many different organizations. There are Civilian Mariners (like myself), Helicopter Pilots, Doctors, Nurses, Seabees, and Veterinarians. We have professionals aboard from partner nations - Australia, Canada, Japan, and the Philippines. So far, this Blog has mostly focused on what we have been doing. Perhaps, dear readers, you would like to know a little about who we are.

Therefore, I think I’ll slightly alter this Blog’s course from time-to-time. I will continue to write about the places we go and the people whose lives we touch. However, every now and then, I will also post the intermittent scrivening to be called: Who We Are. In these posts I hope to highlight the many different people, from many different organizations and professions, which make a humanitarian mission aboard a hospital ship possible. Provided, of course, Mr. Lobe cooperates.

It is day 5 here in Cotabato. Our missions ashore continue with a whole lot of people being seen by our medical providers. Here aboard Mercy, the surgeons are doing some really interesting cases. The crew is getting its rhythm and the missions are running smoother every day.

My thanks to all of you who have left comments to my postings on this Blog. All of them have been very kind and I really do appreciate it!

More to come…

Bob

Operation Smile

Dear Family & Friends,

The name of Mercy’s voyage this year is Pacific Partnership 08. One of our goals is to partner relationships with other nations, as well as non-governmental organizations (NGOs), to better the lives of all of us who live in and around the Pacific region. One of the most rewarding of our many partnerships is perhaps the teaming-up of USNS Mercy and the wonderful folks of Operation Smile!

Operation Smile was founded in 1982 by Dr. William P. Magee and his wife Kathleen for the purpose of repairing children’s cleft lips and cleft palates. Volunteers from this suburb organization travel around the world helping children born with these terrible deformities. It really is a lot of fun having them aboard. And watching the outstanding work they do is amazing.

For the last several days our patient receiving area has been filled with the sounds of children. Their facial disfigurements notwithstanding, these are regular children doing regular children type things: Running, jumping, laughing, screaming, yelling, and playing! These kids absolutely touch your heart when you see them. Some of the crew gave out coloring books and crayons (And I haven’t a clew as to why these particular items just happened to be aboard my ship!). This was a big hit and we now have many of these wonderful “works-of-art” posted throughout the vessel.

Over the last four days, The Operation Smile team was able to perform surgery to 54 children. That is 54 lives that have changed for the better. These children now have the chance to have a normal childhood without the shame of this horrible disfigurement. This morning, we said our goodbyes the Op Smile team that joined us here in the Philippines. Other teams will be joining us at our future mission sights. For me, it is such a privilege to be able to play a small part in helping this organization change the lives of children around the world! What could be better then a partnership that makes beautiful children even more beautiful then they already are.

More to come…

Bob

The Human in Humanitarian

Dear Family and Friends,

At tonight’s briefing, Commodore Kearns made a very interesting comment. He said, “For the last several months I have continually used the word humanitarian – as in ‘Mercy’s upcoming humanitarian mission...’ Today I was able to see the human in humanitarian.” He later told me about what he had seen. There was a little girl, an Operation Smile patient for a cleft lip, headed into surgery. On one side of her was a nurse holding the IV bag, on the other side was her father holding her hand. The little girl was obviously scared to death but was being reassured by both the nurse and her father that everything was going to be alright. It was all very human.

What never ceases to amaze me is the courage of the people who come to Mercy. To be boated out to this massive vessel anchored in a harbor. You step aboard to a thousand strangers whose language you don’t speak. You listen to the weird and continuous sounds of a ship’s machinery and ventilation systems. Bizarre foods are being served. Many of these folks are not even used to air conditioning. And as terrifying as this might be; the people come. And in the case of this father, he will trust this ship with his most precious possession - his own child.

I know exactly what the Commodore was feeling. For the last several months I have been wrapped up in the myriad of details necessary to get this ship here. As a professional mariner, I understand all too well the technical requirements of a voyage across the Pacific. As the work piles up, it’s easy to find one skimming over the word humanitarian when using the expression “humanitarian mission.” And then the day comes along when you see a child - born with a terrible deformity – walk aboard your ship. Holding her hand is a father desperately hoping to give this child a normal life. It is all very human.

There really is a human in humanitarian. And it is in our humanity we will find the method of our compassion for others.

More to come…

Bob