Mission: delivering preventive medicine

Four veterinarians with the U.S. Public Health Service Commissioned Corps recently offered preventive services while on a humanitarian mission aboard the USNS Comfort, a U.S. Navy hospital ship.

The veterinarians served in one-month rotations while the ship traveled to Latin America and the Caribbean. The ship ended its four-month deployment in mid-October when it returned to Norfolk, Va.

The occasion marked one of the first times that USPHS veterinarians were invited by the U.S. Department of Defense's Southern Command to participate aboard a Navy vessel on such a mission, side by side with other health professionals.

Along with one rotating veterinarian and one U.S. Army veterinary technician—Sgt. Leona Thomas—the crew included human medical professionals who conducted surgeries and vaccinations, dispensed pharmaceuticals, and issued eye glasses. Dentists and staff performed tasks such as tooth extractions, fillings, and fluoride applications. Overall, more than 740 personnel were aboard the ship.

"This was the ideal showcase for the one-world, one-health initiative, with all clinical health care and applied public health partners coming together," said Capt. Hugh Mainzer, chief veterinary officer of the USPHS Commissioned Corps.

"It shows the importance of veterinary medicine as part of the one-health approach to protecting and improving the lives of populations not only around the world, but in our country as well."

Captain Mainzer noted that, with just two veterinary professionals on board at a time, as many as 17,772 animals were treated over the course of the four months. The medical staff treated 98,658 patients.

Lieutenant Commander Gregg Langham, a laboratory animal veterinarian with the Centers for Disease Control and Prevention, served as the veterinarian aboard the Comfort on the second rotation, July 13-Aug. 14. He traveled to Nicaragua, El Salvador, and Peru, spending four to five days in each country.

A culmination of events led Lt. Cmdr. Langham to participate in the mission, including having served as the acting public health veterinarian in New Orleans three days after Hurricane Katrina and working with a wide variety of species in his role at the CDC. Besides his DVM degree, he has a master's in public health.

As part of the Comfort mission, Lt. Cmdr. Langham's primary responsibility was vaccinating and deworming livestock and companion animals. Many times, owners would bring animals to where he was stationed near the ship, but in Nicaragua, he was able to travel into the country to provide services.

"The more animals that we can deworm and vaccinate, the better off the regions we went to will be later on," he said. Rabies is endemic in the countries he traveled so, rabies vaccinations were a key priority.

Another responsibility was overseeing the local veterinary team in each country that offered Lt. Cmdr. Langham assistance. Typically the teams included veterinary students. In Peru, he was invited to give a lecture on veterinary public health at the veterinary medical college within the Department of La Libertad.

While he enjoyed his time on the Comfort mission, Lt. Cmdr. Langham said providing veterinary care in the different countries was not without hurdles. Some of the obstacles were logistics, such as obtaining medical supplies, and bridging the language barrier, though translators were helpful. Just working in the region's hot weather was a challenge.

There were also a few unusual patients, including two primates in Peru and a horse with a vampire bat bite in Nicaragua.

"The largest concerns we had were basic medicine. There was nothing complicated," he said. "When you get a few cases you're not sure how to deal with and you're working in that four- to five-day window, you ask yourself, 'What can I do to help?'"

Overall, he estimates that about 2,500 animals were treated on his leg of the trip.

While Lt. Cmdr. Catherine Rockwell, regional public health training coordinator with the Department of Agriculture's Food Safety and Inspection Service, treated a few animals when she served the first rotation as veterinarian on the Comfort, June 13-July 14, she mostly offered her skills in other ways.

"The challenge that I faced as the veterinarian on the USPHS team one was in the logistics of site visits," she said. "The U.S. Navy did not take into account that, for the veterinarians to be most effective and have the most impact, we would need to be mobile and go to our patients to deliver services." She traveled to Belize, Guatemala, and Panama on her rotation.

"While I had the opportunity to conduct vaccination clinics for dogs, cats, and some horses at the medical and dental mission sites, I did not have the ability to move out into the surrounding communities to conduct site visits to local farms to treat herds of livestock" she said. "By working closely with the medical operations and logistics officers aboard ship, the groundwork was laid that ultimately provided the mobility the veterinarians on teams two, three, and four needed to visit local farms."

While on the Comfort mission, Lt. Cmdr. Rockwell and her veterinary colleagues served as members of the ship's preventive medicine team, which included physicians, environmental health officers, environmental engineers, nurses, and an entomologist. Part of the team's mission was to deliver information to local communities.

"We conducted educational classes for adults and school-age children where we delivered information on good hygiene practices and disease prevention measures, such as water treatment, safe food handling, and prevention of bite wounds to prevent exposure to rabies," she said.

"We encountered nothing but positive feedback," she added. "Everybody was just so grateful for everything that we could provide to them."

Following Lt. Cmdrs. Rockwell and Langham on the Comfort was Cmdr. Elvira Hall-Robinson, a veterinary epidemiologist with the Food and Drug Administration's Center for Veterinary Medicine. She traveled to Ecuador, Colombia, and Haiti.

"The overall experience was great. We were helping people and their animals one country and one animal at a time," she said.

Serving the last rotation was Cmdr. Princess Campbell, an environmental health specialist with the Environmental Protection Agency. From Sept. 12-Oct. 15, she traveled to Curacao, Trinidad and Tobago, Guyana, and Suriname.

Commander Campbell was responsible for zoonotic disease control mainly in large animals. She also treated cows for mastitis, performed lameness examinations on several horses, held small animal vaccination clinics, and performed a few small animal surgeries.

"This was a very rewarding experience," Cmdr. Campbell said. "I was touched by the response and expressions of gratitude from the farmers and pet owners who received services, and even the country representatives with whom I bonded during this humanitarian mission."

While offering preventive medicine and other services on the Comfort mission was not without challenges, many of the veterinarians who participated agreed they are eager to serve in a similar role soon.

"I refer to this as a once-in-a-lifetime experience with tongue in cheek, since I hope I get the opportunity to serve in this capacity again," Cmdr. Campbell said.