A Global Force for Good

A few years ago, the United States Navy launched a new recruiting and marketing campaign using the slogan: “America’s Navy – a global force for good.” The line was apparently a flop, and the Navy threw it overboard for “protecting America the world over,” but I liked it. I thought it captured a deep truth about the Navy, which is that it is undoubtedly a “global force” and that the force exists for a good purpose, but I guess most people thought that it made the Navy sound too much like a bunch of social workers.

I was reminded of the phrase, and of an experience I had while serving in the Navy Medical Corps, when I read a recent article in the Annals of Internal Medicine.  A Navy physician retold the story of a mission he was on to a remote village in Honduras. He and his team were flown into small villages, where they would “see dozens of patients each day and dispense an assortment of symptomatic medications” and where “the most practical health benefit that we provided villagers consisted of hundreds of tooth extractions.” He further noted that “although advertised as humanitarian missions, these exercises provided US military personnel with experience working with military and civil authorities from host nations.”

It was in that context that he was confronted with a desperately ill little girl, who had been brought to the makeshift medical facility with peritonitis from a ruptured appendix. His initial request to have the girl medevac’d to a regional facility was denied, and only later authorized when he framed the request as necessary to prevent her from dying in front of the American military personnel who were there.

My own experience was less dramatic, but in some ways similar. I was serving on a training/humanitarian mission in 2010 in Indonesia aboard one of the Navy’s two dedicated hospital ships, the USNS Mercy. We also provided care in remote villages to underserved populations who had no regular access to care. We too saw dozens of patients and were only able to provide simple treatments for most – antibiotics, analgesics and the like. Some were brought on board the ship for surgical interventions, but the complexity of procedures was limited by our sailing schedule (we couldn’t offer an operation that required a week’s recovery if we were leaving in 3 days). The most frequently performed operations were cataract extractions and repair of cleft lips and palates, both of which delivered a huge positive impact.

One day, one of our “on shore” teams radioed the ship to seek permission to bring a child aboard for a diagnostic evaluation. This was not standard procedure, but the boy was sickly and cyanotic, and it was clear to all that he would die in his village if we did nothing. Here we are on board:

Nashblog_GlobalForceforGood

With the help of our entire team, we found that he had transposition of the great vessels, and were able to make arrangements with a local charitable foundation to get him to a major center for definitive evaluation and possible surgical correction.

While there was much we could not do for many people we saw, we decided that day that we could not do nothing for one child. I still like “a global force for good.”

What do you think?

2 thoughts on “A Global Force for Good

  1. I’ll just say–Go Navy– It’s a fine tradition. American media used to do a story every so often about this aspect of the military medical corps.

    I went into an AF clinic, and my PCP was re-invigorated after an absence. TDY in Honduras. Unfortunately, one of the health problems was caused by landmines. It might sound minor, but he got comfort in training locals how to give immunizations. It made a difference for some of the people that an American colonel was willing to sit and eat with them, touch and care for them. He also got donations of soccer balls.

    Doc, you did good.

    1. Three thoughts on “A Global Force for Good”

      I thank Dr Jack Riggs for his comments. It makes me reflect on the privilege and responsibility assigned to us as physicians from the developed world. I have had the opportunity to work in the developing world and I would like to share this brief story. While in Sierra Leone many years ago (I work with the West Africa Fistula Foundation) a young boy was brought to our attention. While I am an ob/gyn, in the developing world we are viewed as someone who can do anything, that is, we can help. I can still see that boys mother sitting on the concrete floor next to a listless child lying on a mat. While I could not speak her language her eyes spoke clearly of the love she had for her child and the desperation she felt. Standing next to them was the father, who looked away, with eyes that spoke of the shame he felt being unable to care for his family in this situation. This was not the first time I had seen these “eyes” and was not the last time. Reading Dr Riggs story I felt tears develop in my eyes when I thought about the child he referred to, but mostly the love and responsibility the parents felt for her. In a bit to long winded of a story I would like to say, what a priveldge and responsibility it is to be a physician. A true blessing.

      My second thought, I thank Dr Ira Nash for sharing his story. It caused me to reflect on words I have heard from those that make a career out of helping the under served. The words go something like this; curing the world is easy, you just have to take care of “one patient at a time”.

      The last thought is mine alone. When I get to heaven, a goal I hope to attain but no time soon, my anticipation is that a young boy I do not remember will walk up to me and say thanks. I will ask him why he is thanking me and he will say that one day in Africa you heard the call from my parents eyes and helped me, and for that I am thankful. You see, that little boy I saw in Africa had a bowel perforation from Thyphoid and died while I tried to repair it. I cried that day, I am crying now. But I believe and hope to meet that boy someday. We will have a good hug. What a privilege. What a responsibility.

      Thanks Ira.

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