Peggy Walsh Goebel, RN, BSN, MSN, DNSc, stood near the shore in remote Guatemala and surveyed the crowd. Hundreds of people men, women, and children had come from near and far after hearing a U.S. Navy ship carrying doctors and nurses would visit to provide free medical care. Goebel, a 57-year-old nurse from Sebastopol, Calif., worked triage that day, going from person to person to ask their names, assess them, and group them according to medical need.
Late in the afternoon, as the visiting medical team neared the end of an exhausting day, Goebel met a woman in her 60s who reported such pain in her abdomen that breathing was a chore. The woman told Goebel she had walked for 15 days to that spot by the sea, drawn by the promise of help. Goebel approached a weary doctor on the womans behalf even though the doctor and his colleagues already had treated an untold number of patients.Peggy Walsh Goebel, RN (front row, second from right) with Project HOPE healthcare staff.
This woman walked for 15 days to see us, Goebel recalls telling the doctor. We will see her, right?
He agreed to perform one more operation, and soon the woman received life-changing medical treatment.
Like nurses everywhere, we were often able to get the doctors to do what we wanted, Goebel says with a chuckle. We would say, We will take care of this person! Its called the art of creative manipulation.Goebel teaches proper handwashing technique to a young boy in Panama.
Goebels persistence paid off surgeons told her the woman had an incarcerated hernia that caused a tennis ball-size protrusion from a spot beneath her navel. Had she not undergone surgery, doctors told Goebel, she might have died.
Its one of many vivid memories Goebel accumulated while volunteering with other nurses, doctors, and healthcare professionals who worked alongside medical teams from the U.S. military on a unique mission to Latin America and the Caribbean.
Comfort departs with high hopesGoebel poses with a mother and son who were treated by USNS Comfort staff.
Nearly 1,500 volunteers and members of the armed forces served aboard the USNS Comfort, a floating Navy hospital, on a four-month deployment from June to October that took them to 12 countries, including Belize, Colombia, Ecuador, El Salvador, Guatemala, Guyana, Haiti, Nicaragua, Panama, Peru, Suriname, and Trinidad and Tobago.
President Bush ordered the mission in the spring as part of a larger initiative called Advancing the Cause of Social Justice in the Western Hemisphere. The effort includes the creation of a healthcare training center in Panama, the White House says, as well as a three-year, $75 million initiative to help students in Latin America improve their English skills and give them the chance to study in the U.S.
All together, the Comforts doctors, nurses, and other healthcare professionals expect to treat 85,000 patients and conduct up to 15,000 surgeries, Bush said March 5 during an address to the United States Hispanic Chamber of Commerce. He spoke at the Ronald Reagan Building and International Trade Center in Washington, D.C.
These are people who need help. These are people who might not otherwise get the basic health care they need to realize a better tomorrow, he said.
He told the group the military medical teams would vaccinate people, help build medical clinics, and perform other services.
With the deployment of the Comfort and the work of the military medical teams, were making it absolutely clear to people that we care, Bush said.
Politics aside, people firstGoebel with a young patient during the Comfort’s Belize stop.
In ordering the mission, analysts say, the administration sought to counter the influence of an anti-American leader in Venezuela, Hugo Chavez, whose government has provided foreign aid to countries in Latin America and the Caribbean. Chavez has forged close ties to Cuba, and he coordinated the travel of thousands of Cuban doctors to Venezuela, where they provide medical care to the poor. Yet a U.S. military spokesman downplayed the desire to check Chavez in the decision to send the Comfort on its unique mission.
Weve done this long before there were individuals in countries with leftist or socialist ideologies, said Jose Ruiz, a civilian spokesman in Miami for the U.S. Southern Command, which oversees U.S. military affairs in Latin America. We would do this regardless of the leadership in certain countries. Its good for the U.S. to build partnerships.
The Comfort mission was unusual in that civilians gave their time alongside servicemembers by volunteering through two non-profit organizations Operation Smile, which coordinates 30 medical missions on an ongoing basis in 25 countries, and Project Hope, which seeks to improve health care in about 30 nations. Nurses volunteered through both organizations aboard the Comfort, an 894-foot ship with a 1,000-bed hospital and 12 operating rooms. They were part of medical and dental teams that went ashore to provide general surgery, ophthalmologic surgery, basic medical evaluations and treatment, dental screening, optometry screenings, and other services, says Lt. Susan Henson, a Naval public affairs officer aboard the Comfort.Goebel with more members of the Project HOPE team.
Goebel says she learned of the volunteer opportunity while visiting Project Hopes website this spring. A nursing instructor at Santa Rosa Junior College in Santa Rosa, Calif., and Dominican University of California in San Rafael, Calif., Goebel has worked in hospitals and classrooms for the last 25 years. This spring, she says, she felt the need to recharge her batteries, so she took a sabbatical and started searching for ways to do that. As a former Peace Corps volunteer in Honduras, she has long felt an affinity for the people of Latin America. She volunteered on disaster-relief teams after hurricanes hit Central America. A trip to Latin America aboard the USNS Comfort seemed just the thing to rejuvenate her even though she barely had spent any time at sea.
I took a three-day cruise to Ensenada once, she says, but thats about it.
Soon enough, she found herself climbing aboard the ship, thanks in large part to the willingness of Project Hope to pay her travel costs to and from the dock. Goebel spent about three weeks on the ship, disembarking at ports in Belize, Guatemala, and Panama. She worked alongside active-duty personnel and reservists with the Navy, Army, and Air Force, as well as the U.S. Public Health Service and U.S. Coast Guard and civilians with the Military Sealift Command, which typically transports fuel, equipment, supplies, and ammunition to the U.S. military.
The Comfort typically dropped anchor off shore, and Goebel rode with others in smaller boats that took them onto the beach, where throngs of people in need would line up in hopes of receiving treatment.
According to the U.S. Southern Command, the civilian and military medical team treated more than 98,000 patients during the Comforts mission.Goebel with an elderly patient.
Goebel has vivid memories of many of them. She remembers Jorge, a 4-year-old boy whose cerebral palsy relegated him to a stroller until a surgical procedure allowed him to sit up in a wheelchair. Doctors referred him to a physical therapist to determine whether he might one day walk on his own. She also remembers 2-year-old Hector, whose parents had taken him to several doctors in an unsuccessful effort to correct his clubfoot. Doctors from the Comfort performed a surgery that will let him walk like other boys his age.
This was foreign aid on a different level, Goebel says. It made me feel humble and grateful for all that we have in the United States. It was an example of the best the U.S. has to offer. It restored my faith in humanity, and it recharged my soul.
Critics have wondered whether the mission focused more on public relations than providing quality health care. They point out the U.S. governments efforts to generate news coverage of the trip, noting the ship carried more public-affairs specialists than surgeons. They also say medical personnel on the Comfort used only some of the ships operating rooms. In addition, they say the government took a one-size-fits-all approach by offering the same healthcare services at each stop, without regard to the particular needs of each country.
In response to criticism, the U.S. military says it will learn lessons from the mission and improve the next time around. And Goebel praised the hard-working healthcare professionals for creating lasting memories and good will in much of Latin America.
Its only fair to celebrate and acknowledge a job well done, and this was definitely a job well done, she says. I personally observed a group of outstanding, dedicated, compassionate, and hard-working military doctors, nurses, corpsmen/women working long, hard 14- to 16-hour days striving to provide health care to many people who came to our various clinics.