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Special DoD Media Briefing with Commodore Kapcio and Captain Boytnon from the Pentagon Briefing Room, Arlington, Va.

Presenters: Commodore Bob Kapcio, Mission Commander; Captian Bruce Boynton, Commanding Officer, Medical Treatment Facility
August 07, 2007

(Note: The Commodore and the Captain appear from the coast of Peru via video teleconference.)

MR. WHITMAN: Good afternoon and welcome. I think most of you know that USNS Comfort is on a 120-day humanitarian assistance mission deployment to South America and the Caribbean and is providing medical assistance to patients in more than a dozen countries. It has been seeing patients in Belize, Guatemala, Panama, Nicaragua and El Salvador, and now has arrived off the coast of Peru. While in Peru, U.S. Navy, Air Force, Army, Coast Guard and U.S. Public Health Service, as well as Canadian forces and nongovernmental organizations, such as Operation Smile and Project HOPE, will continue to be providing to the people of South America health care services, including adult and pediatric primary care, dental care, optometry and other services.

Today, to talk to us about what USNS Comfort has been doing and the types of humanitarian assistance they've been providing along the way, I have the three individuals that are on the screen. I'd like to welcome them. First is Commodore Bob Kapcio, who is the mission commander. He has overall authority for the humanitarian mission and the embarked staff. He plans the logistics and operations to move people and equipment ashore each day and back.

 

Also joining him is Captain Bruce Boynton. He is the commanding office, USNS Comfort, the medical treatment facility. In other words, he is the top doctor aboard the Comfort, and he oversees the entire medical staff and is responsible for all medical procedures conducted on ship and ashore by military medical personnel.

And finally, Mr. Robert Leitch is the director of Operation Project HOPE aboard the Comfort. He is responsible for Project HOPE staff and volunteers, for the medical treatment that they provide, to include training and community outreach.

With that, I'd like to turn it over to them for some brief opening comments before we get to your questions. And with that, Commodore, over to you.

 

COMMODORE KAPCIO: Thank you. Greetings from Peru, where it's cold and chilly, but we're doing a lot of warm, compassionate things while we're down here.

Just to make a minor correction, the -- Robert Leitch from Project HOPE is stuck on the beach at his training site. He's trying to get out here before the end of the conference. But to my left and to your right is the master of the Comfort, Captain Ed Nanartowich.

Just to go over a few things, it was 120-day deployment down to this AOR -- 85 of which are workdays. President Bush sent the Comfort down to Latin America and the Caribbean to strengthen ties between the countries down here and also to provide assistance to the friends in the region. It's also part of U.S. Southern Command's Partnership for the Americas.

Peru is the 6th of 12 countries we're visiting, and we expect to be as busy here as we've been everyplace else. As we've gone, we've gotten more organized ourselves. We're much adapted to the different challenges we face in the different ports and we're doing very well as far as seeing numbers of patients.

I do want to expound a little bit on the effort that's going on on the ship. I've said before, this is a truly joint civil-military effort here. Just within the military, we have over 200 different commands on the ship. We average about 780 people onboard the ship as people come and go but nominally about 780, and that includes about 100 civilians. So when you subtract it, we've got over 200 different military commands here. That's quite a representation across the board.

We have people from the Navy, the Army, the Air Force, Coast Guard. Public Health Service is here. They have four different teams. They rotate about every 30 days. Canadian forces: We have a small contingent of Canadians also. They just rotated. And we have civilians representing the Military Sealift Command, who run the ship, the day-to-day activities on the ship -- navigation, engineering, et cetera.

 

And then we have our two non-governmental organizations. Project HOPE, who has a core group that stays with us most of the time onboard, and they also rotate out every so often. And then Operation Smile, who has embarked the ship in Nicaragua, they have embarked the ship again in Peru and they will embark one more time. So 3 of the 12 ports will work with Operation Smile.

You've heard a little bit about the services. Every port gives us some unique challenges. But for the most part, we provide pretty much the same type of service, such as eyeglasses, cataract surgeries, club foot repairs. I won't get into any specifics. I'll turn that over to my counterpart Bruce, commanding officer of the MTF, to explain a little bit more of what we do in that arena.

We have Seabees doing construction projects at various sites. We have a band that goes out and plays in various ceremonies so -- we have a veterinary service. We have another group of people called biomedical repairmen who go out and repair medical equipment, which is a -- we're finding more and more that that's a unique skill and much- needed service in the places we've been.

So on behalf of everyone on the Comfort and the leadership, I just wanted to be able to tell everyone that it's really heartwarming every day. We watch the people come and go. They're working long hours. They get up at about four in the morning. They're heading out on boats and helicopters first thing in the morning, where you have to be back on the ship at night.

So by the time they get back, it's 7:30, 8:00 at night. So this is the first port we've actually had some cool weather -- up in Guatemala and Belize and that area. The heat indexes were 110, 115 degrees, so these people were putting in some long days in hot environment. And every day they got back, I'd be down there to great them, and they'd have a smile on their face and couldn't wait to go out the next day.

So they know they're making a difference. They love making a difference. A lot of people volunteered to come on this mission and give up their summer vacations and everything else to come on this deployment, and it's really what's made this mission special.

With that, I'll turn it over to Captain Boynton to explain some of those specific things in the medical and dental world that are going on.

CAPT. BOYNTON: You know, each country is different and presents unique challenges. We provide the same level of services and the same kinds of services to each country, and this is very much like an amphibious operation. By helo and boat we go out and send teams out every morning. They set up in primary care sites, where we give adult and pediatric care. The dentists go out and fill teeth and pull teeth and put on flourides and sealants. We provide immunizations. We set up a rudimentary pharmacy. We do lab work, and we usually do that in two or three sites. And then in addition sites, we will screen individuals that the host nation has identified as needing surgery, and those patients will then come back to the Comfort and have their surgery and recover back on the ship. In addition to that, we'll have sites where we do teaching for both patients and for host nation health care professionals.

As the patients come back to the ship -- and sometimes we have had as many as 100 patients on the ship -- then we will retrograde our troops, our docs and nurses back to the ship to take care of them. So each day we try to assess what are the needs in each of the sites, what are the needs on the Comfort, and figure out how to allocate our resources. But in every site that we go, we get -- we're greeted with open arms, with smiles, with -- as my folks say, with powerful thank yous, and it's -- we've touched their hearts and they've touched ours.

COMMODORE KAPCIO: Just to take a little bit more of what Bruce said, the -- I mean most of the places we've been it's been truly open arms. Our doctors got off the buses in Guatemala, and the people just started cheering. They -- there's chants of, "We love the Americans" everywhere we've been, and it's been extremely heartwarming for all of us that have been involved with this.

I just want to kind of leave the opening remarks with a couple quotes. The first one was from President Saca of El Salvador. He said in an open print statement, he said, "This type of diplomacy really touched the heart and soul of the country and the region and is the most effective way to counter the false perception of what Cuban medical teams are doing in the region."

The second quote I'd like to leave you with was Vice President Morales in Nicaragua, who told Ambassador Trivelli that what impressed him most during the ship tour was "The deep love, respect and professionalism demonstrated by the medical staffs toward their Nicaraguan patients." And I think those two quotes really kind of sum up what we've done so far in this deployment.

With that, we'll open it up for any questions you have.

MR. WHITMAN: Well, thank you for that overview, and we do have a few questions here. We'll go ahead and start with Al.

Q This is Al Pessin from Voice of America. Can you tell us what the cost of this mission is? And also, can you tell us, among the military folks who go out ashore on these missions you were describing, are they in uniform, and why or why not?

COMMODORE KAPCIO: The cost of the mission -- I guess by the end -- I mean, the costs are coming and going and we try to work that as we go, but the projected cost I think in the end will be somewhere between 20 (million dollars) and $25 million.

To answer your second question, yes, all the military people go ashore, are wearing uniforms and -- as they are on the ship. The only people that's not wearing uniforms are those in the non-governmental organizations. But other than that, everybody's wearing uniforms.

Q And can you speak to why you make the decision to have them in uniforms, and does that vary if you're in other countries or other parts of the world?

COMMODORE KAPCIO: There's -- I mean, I never considered not wearing uniforms -- I guess is the first question. We're proud to serve. We want them to know who we are. And it's just the -- it's what we've always done here, and I haven't seen any situation that would cause me to think otherwise to wear civilian clothes.

MR. WHITMAN: Guy

Q Commodore, it's Guy Raz with NPR.

Q He's still talking.

COMMODORE KAPCIO: We do have a robust force protection plan. We work with the local -- the U.S. embassies and the military groups that are in country. Host nations are providing security everywhere we go. We do have a security detachment on board, and to date that has not been an issue whatsoever.

Q Okay. All right. Commodore, this is Guy Raz with NPR. Can you describe how the word gets out in some of these countries? I mean, are posters put up, advertising? How do people know that you're arriving?

And the second question is, when you do arrive, how do people in sort of the more remote parts of these countries get out to the areas where they can receive treatment?

 

COMMODORE KAPCIO: Yes, there's -- back in the springtime, we sent teams of approximately 10 people to each of the countries to start determining -- working with the host nation Ministry of Health, the U.S. embassy and the U.S. military groups in country to start determining what sites would be the most applicable. And I think for a lot of countries that's where the advertising started -- some even sooner than that.

There's -- I know that the embassies and mil group public affairs departments are putting out -- there's pre-press releases before we come to the local media. There's radio. And we try to do sites -- various sites. We don't just stay -- usually don't stay at one site. We're usually at multiple sites while we're here. We found most efficiently, if we're at two or three sites, we may stay at one site two or three days and move to another site somewhere else in the country, fairly close to where we are, to provide services.

We've had people arrive on horseback, bicycles. You name the form of transportation, and they show up.

We had one woman in Guatemala that had heard over the radio -- she lived 290 miles away from where we were, and she heard the advertisement over the radio four months prior to us getting there, and she spent four months plotting about how she was going to get to Puerto Barrios. And a combination of walking, taxi and truck and staying in a hotel -- took her six days to get to the port, but she made it. And she got her hernia repaired.

So a lot of pre-press before we get there, and we do put up posters when we arrive. And -- but also just seeing this great big white ship with red crosses on it off the coast sends an awful big signal.

MR. WHITMAN: Go ahead.

Q Hi. Gordon Lubold with the Christian Science Monitor. You mentioned the warm welcome you're getting in some of your stops. I wonder if you could talk about why the countries that you're visiting were chosen, why are -- you know, why were they chosen, and would you consider going to some of other countries that were not on this tour, maybe, in future deployment?

 

COMMODORE KAPCIO: I know a little bit about how they were chosen. Some of the work was done even before I was named and before any of us were named that we were going to do this. U.S. Southern Command, I know, had a -- this was part of their Partnership for the America(s) initiative. I did participate in a couple VTCs where countries were discussed between U.S. Southern Command, Joint Staff and the State Department. All were involved in deciding which countries.

 

We knew we only had a definitive amount of time, and based on some of the lessons learned from Mercy -- from the Mercy deployment out in the Pacific and what they were trying to do down here, they narrowed the list down to 12 countries. As I said, I was not in on some of the definitive decisions on why countries were chosen, and I really don't know. U.S. Southern Command, I guess, is best posed to answer any questions about whether this was going to happen again in the future.

 

I do know that the original plan for this was a 90-day deployment, and they added on another 30 days because they wanted to go through the Panama Canal. But other than that, I was not in on any of the specific decisions -- none of us were -- about why individual countries were chosen.

 

Q (GORDON LUBOLD): A question unrelated to that. What's the most maybe exotic or different or strange procedure you've done over the course of the deployment so far?

 

COMMODORE KAPCIO: I'll turn that over to my medical counterpart. I have my own opinion, not being a medical officer. But I will tell you for me, some of the most amazing ones are the club-feet repair, knowing that you're getting these young children with a club foot, who probably would grow up to be basically a cripple, and is going to walk off the ship actually going to have a normal childhood, be able to walk normal and run normal like a child. That's pretty amazing when you see that surgery done.

The other one for me is the cataracts. I never realized that children could have cataracts like we've seen down here. And we've had a 12, 13-year-old boy who had cataracts in both eyes, basically was blind, and walked off here being able to see. And that's pretty amazing.

But I'll let Bruce answer some from a medical perspective.

 

CAPT. BOYNTON: I think another example would be those cases that Operation Smile does, where a child with a cleft lip and palate has his or her life changed and are accepted into society in a way they never were before, when they have that repair. And when you see the look on the mother's face, it's like having her child reborn right there in front of her. It's something that touches all of our hearts.

MR. WHITMAN: Courtney.

Q Captain Boynton, this is Courtney Kube from NBC News. I'm just curious. You have such a short time in each country, and it sounds like these procedures, some of them are pretty extensive surgeries.

And are you concerned about any kind of follow-up medical help that these people will have, or the lack thereof?

CAPT. BOYNTON: We absolutely have to -- have to consider that. And that dictates the kind of surgeries we can do. For instance, we can't do heart transplants. We can't do any kind of surgery that involves prolonged follow-up. Not only that, but on the last day we're in country, we have to do surgeries that have a very, very short recovery time, and those that require even several-day recovery time, we have to do that at the beginning of our visit to the country.

Now, there are some operations, like those done by Operation Smile, where they have the follow-up already wired with practitioners in the country. So we have to gauge this very particularly for the individual patient; how much recovery time is there, who is going to follow the patient, is this a procedure that we can do at this particular time. So you're absolutely right. Critical issue.

COMMODORE KAPCIO: Which is another reason that we work closely with the local ministry of health, so if there are issues like that, we can work with the local ministry before we leave on any follow-up cases.

MR. WHITMAN: Al

Q Commodore, there's clearly a humanitarian benefit to this, and you mentioned a diplomatic benefit. How is this a military mission? Why would a military asset be used for this?

COMMODORE KAPCIO: Actually it's a perfect military mission because one of the thing we're here to do, just like most military exercises, we're here to train U.S. personnel. And there's a lot of doctors and nurses on here and other people that have never been involved in any type of operation like this. They've almost operated solely in a hospital. And what this is giving them is a different type of medicine. They're seeing lots of things they wouldn't normally see.

And this is really an investment for our personnel in a humanitarian-type or disaster relief mission, which is also what we're prepared to do down here. We're prepared to respond. We're basically a mobile, flexible platform, and we can respond pretty much to most things that would happen down here from a disaster relief type of an event.

So it really provides our personnel some great training and things they don't normally see or do.

 

Q It's Gordon Lubold from the Monitor again. Just curious -- maybe you mentioned it and I missed it, but how many people have you had to turn away, if any, and what are the issues there? I mean, I imagine once you create a demand it's a little hard to turn it off.

COMMANDER KAPCIO: We're here for most places five to six days. I think for the most part -- I wouldn't say we have a big turn-away population just because of the management of that, but there's some -- I'm going turn it over to Bruce because there are some things that we've done to mitigate that, but he can talk a little bit more about that.

CAPT. BOYNTON: For instance, we can't control how many people show up at a site on a particular day. So it may be that if a thousand or more people show up, we can't see all those people on a particular day. So what we do, we can calculate fairly accurately how many people we'll be able to see on that day and the next several hundred we will give rain checks to -- little numbers that will allow them to get head-of-the-line privileges on the next day. So that's one way.

The other reason I think we're not turning away people is we're seeing people who have stood in the line more than once. We see the same people back getting repeat services. They come one day for dental, then come the next day for eye glasses. Therefore, I think that we are seeing those people who show up for services.

 

MR. WHITMAN: Okay, gentlemen, we have reached the bottom of the hour here, and we know that you're busy. But we appreciate you taking the time today to talk to us about the mission that you've been on, and it's been very informative and insightful for us. And we wish you the best as you start on the home stretch and on your way home.

Thank you for your time.

COMMODORE KAPCIO: Thank you.

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