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U.S., Gabonese Military Surgical Teams Partner During Training Exercise

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Performing surgery is inarguably a complicated and intricate task. However, regardless of location, the basic steps are the same.

Army 1st Sgt. Donna Wilson, a practicing nurse specialist, removes an intravenous catheter from a patient during Medical Readiness Training Exercise 17-4 at Hospital D’Instruction Des Armees in Libreville, Gabon, June 19, 2017. Army photo by Staff Sgt. Shejal Pulivarti
Army 1st Sgt. Donna Wilson, a practicing nurse specialist, removes an intravenous catheter from a patient during Medical Readiness Training Exercise 17-4 at Hospital D’Instruction Des Armees in Libreville, Gabon, June 19, 2017. Army photo by Staff Sgt. Shejal Pulivarti
Army 1st Sgt. Donna Wilson, a practicing nurse specialist, removes an intravenous catheter from a patient during Medical Readiness Training Exercise 17-4 at Hospital D’Instruction Des Armees in Libreville, Gabon, June 19, 2017. Army photo by Staff Sgt. Shejal Pulivarti
American, Gabonese medical professionals partner during MEDRETE 17-4
Army 1st Sgt. Donna Wilson, a practicing nurse specialist, removes an intravenous catheter from a patient during Medical Readiness Training Exercise 17-4 at Hospital D’Instruction Des Armees in Libreville, Gabon, June 19, 2017. Army photo by Staff Sgt. Shejal Pulivarti
Photo By: Staff Sgt. Shejal Pulivarti
VIRIN: 170619-A-IO170-046

Three surgical professionals who partnered with a Gabonese military surgical team learned this firsthand as part of a ten-person U.S. Army medical team that participated in the U.S. Army Africa-led Medical Readiness Training Exercise 17-4 held at the Hospital D’Instruction Des Armees here.

Even the basics can pose challenges when operating with a team that speaks different languages and often uses different tools, but the U.S. Army surgical team welcomed the challenge and went into the MEDRETE hoping to learn.

“The language barrier has been interesting,” said Army Maj. (Dr.) Christina Riojas, a general surgeon from Womack Army Medical Center at Fort Bragg, North Carolina. “We’ve been able to sign with our hands, use broken English -- and even some Spanish -- in addition to the use of our interpreters to communicate while in the operating room. It adds some time during surgery, but it has been working and we are able to communicate.”

The team spent fourteen days in Gabon working alongside their individual Gabonese counterparts and functioned solely with on-site equipment and resources.

“In the United States, there is a lot of stuff in the operating room that we have that you would think makes performing surgery easier, but [the Gabonese military medical professionals] don’t have those things here, and it’s not an issue,” said Army Staff Sgt. Jennifer Singh, an operating room technician from the 14th Combat Support Hospital at Fort Benning, Georgia. “They are still able to perform the surgeries necessary successfully with the tools they have.”

The mission called for them to build sustainable relationships with the Gabonese and also to improve their individual readiness in their respective fields.

“My job is to quickly put the patient to sleep and make sure that they stay alive so that the surgeon, regardless of who that is, can do their job,” said Army Maj. Fernando Lopez, a certified registered nurse anesthetist with the 14th CSH. “I think one of the things this mission shows you is how to function with limited resources.”

Army Staff Sgt. Jennifer Singh, an operating room technician, works with a Gabonese military medical professional to perform a gall bladder surgery during Medical Readiness Training Exercise 17-4 at Hospital D’Instruction Des Armees in Libreville, Gabon, June 19, 2017. Army photo by Staff Sgt. Shejal Pulivarti
Army Staff Sgt. Jennifer Singh, an operating room technician, works with a Gabonese military medical professional to perform a gall bladder surgery during Medical Readiness Training Exercise 17-4 at Hospital D’Instruction Des Armees in Libreville, Gabon, June 19, 2017. Army photo by Staff Sgt. Shejal Pulivarti
Army Staff Sgt. Jennifer Singh, an operating room technician, works with a Gabonese military medical professional to perform a gall bladder surgery during Medical Readiness Training Exercise 17-4 at Hospital D’Instruction Des Armees in Libreville, Gabon, June 19, 2017. Army photo by Staff Sgt. Shejal Pulivarti
American, Gabonese medical professionals partner during MEDRETE 17-4
Army Staff Sgt. Jennifer Singh, an operating room technician, works with a Gabonese military medical professional to perform a gall bladder surgery during Medical Readiness Training Exercise 17-4 at Hospital D’Instruction Des Armees in Libreville, Gabon, June 19, 2017. Army photo by Staff Sgt. Shejal Pulivarti
Photo By: Staff Sgt. Shejal Pulivarti
VIRIN: 170619-A-IO170-022

The three-person American operating room team integrated completely into the Gabonese surgical staff. Working with their respective counterparts -- the certified registered nurse anesthetist, OR technician and general surgeon -- they observed and assisted in more than 35 surgical cases.

Working in the resource-limited environment exposed the team to situations that challenged them to be creative, Singh said.

“I’ve definitely learned. Watching them do it, it made me put my innovative cap on. In another surgery, I didn’t have something called a Kittner and I came up with a way to make one on the back table so the surgeon could use it even though I didn’t have it,” she said. “So, the limited resources and equipment helps you think outside the box, especially after seeing them make the necessary tools out of what they have available.”

Aligned with Army Chief of Staff Gen. Mark Milley’s vision, this mission provides a small medical team a chance to train individually and together as a team, alongside partner nation service members, to be operationally ready for what the future might hold.

Riojas said, “The opportunity to function within that environment, it’s been really valuable. This could possibly simulate a future military real world scenario and being able to be here in a controlled environment is really good training and experience.”

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