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U.S. Medical Team Helps Islanders See Clearly Now

By Douglas J. Gillert
American Forces Press Service

BASSETERRE, St. Kitts and Nevis, May 17, 1999 – The bright smile on the child's face said it all: "I can see!"

Eyeglasses delivered and fitted by ophthalmologists from Wilford Hall Medical Center, Lackland Air Force Base, Texas; Walter Reed Army Medical Center, Washington; and Sheppard Air Force Base, Texas, did the trick for hundreds of children and adults here. The glasses were supplied by Lions Club International.

At the only hospital in this, the capital city of St. Kitts, a Caribbean island of some 30,000 people, and at an outlying health center, the docs and technicians took refractive readings and, when needed, fitted their patients with glasses that closely matched their vision needs.

"We can match their prescriptions to about 95 percent," said Air Force Dr. (Col.) Steve Waller, chief of ophthalmology at Wilford Hall and leader of a medical readiness training exercise here for two weeks in May.

The team also included an orthopedist and dentist and supplemented the efforts of two independent duty medical technicians deployed here with military engineers since February. Their combined missions fall under the aegis of New Horizons, an annual training exercise conducted by the U.S. Southern Command and involving mostly reserve component forces. This year, the command dedicated New Horizons to helping Caribbean countries recover from damage caused by Hurricanes Georges and Mitch in late 1998.

Most of the island's population is descended from West Africans and is susceptible to diseases common to African Americans, Waller said. These include diabetic hypertension, which can lead to eye problems, glaucoma and cataracts. The island has some medical specialists, but they aren't equipped to provide the same level of service as the DoD team and, for instance, nurse precious anesthesia by skipping it for many outpatient surgical procedures.

Air Force Dr. (Maj.) Jack Atwater, chief of anesthesiology at Wilford Hall, said the pain some patients suffered was appalling and he was dumbfounded by the antiquated equipment available to the island medics. He and Dr. (Capt.) Kathy Weesner, a Wilford Hall resident anesthesiologist, made sure patients these two weeks received the proper painkillers before any operations began.

The team brought all its own medical equipment and supplies, including anesthesia machines and a portable eye refractor that reads and prints out the patient's prescription in seconds. At the J.N. Franz Hospital and a nearby dental clinic, they used existing operating rooms and the local nursing staff assisted them with patients.

"We conduct seven to eight trips a year to Central and South America, but this is our first visit to St. Kitts," Waller said. "The people here are so poor, they can't afford to pay for expensive procedures, so that may be one of the reasons the hospital doesn't as readily use anesthesia as we do in the states. The hurricane ruined most of the sugar cane crop, which is their main livelihood, so they're just all that much poorer. There's simply no way they can afford to go out and buy expensive new eyeglasses, so us giving them these glasses can be a life-changing experience for them."

Waller said the team isn't here to provide continuity of care -- they won't be able to follow up on their patients beyond the two weeks they're here. But they can and have shared their medical expertise with the local medical staff as much as possible, he said.

"We also can learn things from them," he said. "Sometimes physicians in these remote locations have learned how to do without all the equipment we depend on. It's a good lesson for any doctor in a primitive situation and helps us prepare for potential field medical practice during military contingencies."

Inside one of two operating rooms, Army Dr. (Col.) William Wilson, chief of glaucoma surgery at Walter Reed Army Medical Center in Washington, calms an elderly woman before administering anesthesia beneath her eyeball. "This will sting and burn a little but not long," he assured her. Soon, he has clamped her lids back to expose the damaged eye and within the hour, he has removed a cataract and installed a new plastic lens that will renew her vision.

Depending on patient needs, the artificial lenses are designed for near or far vision. A pair of glasses will provide complementary corrective vision. As Wilson finishes his patient, Air Force Dr. (Capt.) Jeffrey Yee, a general ophthalmologist at Sheppard Air Force Base, Texas, begins a similar procedure on another elderly woman.

And so it goes, hour after hour, as St. Kittians line up for health care they probably wouldn't otherwise get. Sometimes during the day, the American medics look around the shabby and somewhat dirty hospital and frown.

"You can tell this was a pretty nice hospital, probably before the hurricane," Atwater said. "The operating suites are pretty much the same as we have back home. It's a shame they can't keep it up better."

But their two weeks are almost up and the military medical team is beginning to sort through supplies and getting ready for the plane ride home. Air Force Tech. Sgt. Melodia Woolford, an independent duty medical technician from Offutt Air Force Base, Neb., will take some of the bandages, syringes, eye drops and other medicines and supplies. She'll use them at a temporary U.S. military camp here to treat the military engineers she deployed with in February until they, too, go home in June. She'll also continue care to islanders as much as possible.

Back in the states, Wilford Hall and others will begin putting together another readiness training team for other trips planned for Honduras, Costa Rica, Peru and Grenada. The trips will better train the medics for future field operations, build bridges of friendship and cooperation across the Americas, and for awhile, at least, help hundreds of people live better lives.

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Click photo for screen-resolution imageAir Force Dr. (Col.) Steve Waller examines the eyes of a patient at the J. N. Franz Hospital, Bassetere, St. Kitts May 10. Chief of ophthalmology at Wilford Hall Medical Center, Lackland Air Force Base, Texas, Waller led an Air Force and Army medical team providing free health care on the Caribbean island for two weeks. Their visit was part of the U.S. Southern Command's strategy of building relationships in its area of responsibility, Central and South America. The medics also benefit by experiencing practice in primitive conditions they could also encounter supporting military operations. Douglas J. Gillert  
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Click photo for screen-resolution imageArmy Dr. (Col.) William Wilson performs cataract surgery on an elderly patient May 10 at a Basseterre, St. Kitts, hospital. Wilson, chief of glaucoma surgery at Walter Reed Army Medical Center in Washington, and two Air Force ophthalmologists saw hundreds of patients during their participation in a two- week medical readiness training exercise sponsored by the U.S. Southern Command. Douglas J. Gillert   
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Click photo for screen-resolution imageAir Force Dr. (Capt.) Kathy Weesner checks on a patient awaiting eye surgery in Basseterre, St. Kitts. A resident anesthesiologist at Wilford Hall Medical Center, Texas, Weesner said the opportunity to participate in the two-week medical readiness training exercise was an experience most residents don't get. Douglas J. Gillert   
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Click photo for screen-resolution imageA smile cracks the face of Air Force Dr. (Col.) Steve Waller's first patient of the morning after he selects a pair of sunglasses from hundreds of free pairs of donated eyeglasses Waller brought to St. Kitts in May. Waller, chief of ophthalmology at Wilford Hall Medical Center, Texas, headed a medical readiness training exercise, one of several the U.S. Southern Command sponsors each year to Central and South American countries. Douglas J. Gillert   
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