An update from onboard USNS Comfort

This comes to my attention via Cliff (http://randommusingsbycliff.blogspot.com/) and arrived to him via The Armorer's page (http://www.thedonovan.com/archives/2010/01/haiti_relief_ge.html). Thanks a bunch, Cliff; this kind of info is important.

This is an email from an individual aboard the hospital ship USNS Comfort, written whilst enroute to Haiti.

"Sorry it’s been so long for an update but internet access has been non-existent on the ship. In fact as I’m typing this I still don’t have access but I wanted to catch some notes on my laptop and mail them as soon as I can.

When I do send email, if you reply please delete all the text of the email I sent you to keep the message small. The bandwidth for this entire ship is less that 1 MByte per second. Way less than what you have in your home. And here it’s shared by almost 1,000 people.

I got on the ship without a hitch and they assigned me berthing. They told a petty officer to show me where I’d be. He looked at my paper and said, “Oh no, sir. You don’t belong there!” and took me to the enlisted berthing. That was fine by me but it turned out he was wrong and I’ve ended up in a stateroom with four senior Navy Captains. How’d the old Sarge ever end up here with these O-6s?! I have to remember to behave and not pick my nose…

We were supposed to get underway Friday at 1800 but were delayed. There are two diesel powered electrical generators on the ship and when they went to fire one up, neither would start. So they placed a temporary generator on the deck and wired it up. Electricians worked all night and we shoved off the pier around 1000 Saturday with only that external power. Because of that limited power and how this old ship’s wiring is configured, we didn’t have any communications. None. The Skipper and the ship’s master were communicating on satellite phone and a hand held maritime radio. The Navy sent a big ship full of people out to sea with no comm… THAT’s how serious the Navy is about getting the Comfort into Haiti ASAP.

A few hours out of the Chesapeake into the ocean they got the power up and started bringing internet service up. But there was just a small fire in the radio room. As I type this, power is all back and running and ‘soon’ we’ll have internet access. Then I’ll send this.

We understand that a lot of the media is bad mouthing the Navy. They always seem to take the half empty glass frame of mind. They ask how is it that China has people on the ground operating and the Comfort still isn’t there. Well, the US military could easily put a surgical team on a C-17 to come to Haiti and perform simple surgeries like the Chinese did. In fact the Army 82nd Airborne field hospital is operational. The media doesn’t say that the Chinese and Russians and Cubans are all holding their serious patients THEY CAN’T HANDLE for the Comfort to arrive. The Comfort will have the capability to take in 1100 Haitians at any time. That takes a staff of 1300 blue suit Navy professionals with all the medical supplies… and food and water for all those people.

Last Tuesday morning the Comfort was sitting at pier 11 in Baltimore with no power or people or supplies. A big chunk of cold steel. From the time the President said go, in 66 hours we were turning knots. That means getting all the people and supplies and getting the ship seaworthy. This was a major accomplishment!

We sailed with almost 500 crew on board. The remainder of the crew will be flying into Haiti over the next few days. Some crew members will be hot racking. That means two people will share a bed on different shifts. For the first two days the crew ate MREs. We’ve got meals now as they’ve brought up the galley.

When the ship has its full compliment, with the water requirements of the patients and the water making capabilities of the ship at anchor, the crew will probably not be able to shower every day. And when we do it’ll be a ‘Navy shower.’ Turn the water on and get wet then turn it off. No more than 15 seconds. Soap down and wash, then turn it on and rinse. No more than 30 seconds. And by the way, the water may not always be very warm… oh well.

I started to write, “So that’s the bad side.” But that’s not the bad side. It’s just the way things are. And I’ve not heard a single complaint from anybody on this ship. I say again these are professional caregivers. The best the country has to offer.

The bad news you probably know better than me right now because we’ve seen no news. We know people are dying. We’re getting there as fast as we can but that’s only about 12 knots. And people will be dying here on the ship.

Personally, this isn’t OpSmile with cute kids we can fix. This’ll be people with severe injuries: amputations, brain injuries, etc. We’re going to be dealing with newly orphaned kids. And what do we do with everybody after their medical treatment? Especially the orphans.

Being in the news isolation bubble is sort of strange. We don’t know what we’ll see when we get to port. We’re chugging along preparing and rehearsing. But it’s going to hit the fan soon. I don’t know what to expect.

It’s Monday evening now and we just had the 1900 briefing. We’re about 36 hours out so we’ll be arriving Wednesday morning. When we’re within range of the Carl Vinson (CVN-70) some MH-60’s will begin lifting the most critical patients here and the pace will change. They’re talking about thousands of patients going through here over the next few months. We’ll be going to 24/7 operations. Flight operations can’t fly at night [gee… my dear old friend Mike Stratton flew LOTS of night dustoff flights around Hui Ba Den in Viet Nam! I miss him.] so the casualty receiving will slow down at night but the ORs will keep cranking.

So what is it I’m doing you may ask? I’m working for the Skipper on how the Comfort will work with Non-Government Organizations to replace the blue suiter to go home for…. a break. Project HOPE has a long list of doctors, nurses and other folks who have volunteered. With the Navy taking close to 1,300 of their people out of the Navy medical centers, those left behind are stretched very thin. So we can’t maintain this many blue suits on the ship. After a couple weeks we’ll start bringing in those Project HOPE people. I’m working on planning that. American Red Cross is sending 100 Haitian-Americans here as translators. I’ll be assigning them to wards, OR, ICU, CASREC, etc. Including 2 for the chaplains. The chaplains said their job is “To help the Haitians die and to keep the sailors alive.” A chilling look at what may be in store.

We’ve gotten lots of email from Church of Christ, Latter Day Saints, Catholic Relief, Rotary Club, and others about people already on the ground in Haiti. We need to put teams on the ground for triage. But we don’t have enough blue suits to run the hospital AND do triage. So one thing we discuss in staff meetings is who and how to mesh all this together. And my friends, I sit in these meetings and just wonder how the hell I got here. One of the biggest GOOD things our country has done in a very long time and I’m involved in the planning… and they listen! What an unbelievable honor it is to be here with these people and be part of this. I’ll carry it the rest of my days. You all know I’m not a religious man and lots of you aren’t very religious… maybe not as much a heathen as I am, though. I ask you to pray for these good people. And if you don’t pray, just think of them. They’ll need strength physically and mentally. One of my roommates has a master’s degree in disaster medicine and he briefed about care giver PTSD. I knew nurses from Viet Nam with that problem.

Several times the CO, XO, and head of nursing have stressed that the surgeons are critical and do a great job. But it’s the nurse and nurse practitioner who touches and treats and heals the patient. Or it’s the nurse who holds the patients hand as they leave this world… and wraps them up in a bag. Please pray for our nurses.

It’s Tuesday afternoon. This morning after the Skipper's SITREP briefing, Captain Ware talked about how the pace will change. How although nobody will be shooting at us here on the ship, it will be like a battle with a fast pace of critically injured and dying people. Patients dying and perhaps crew dying ashore. He told us to prepare for the possible loss of a shipmate. I sat there feeling like the ‘war’ was getting ready to start and I was being left out. How was I going to be involved and help people more than just pushing paper and coordinating NGOs. So I talked with the CO of nurses and got his permission to spend my spare time on the 2 Forward ward, pediatrics. I went down to meet the staff and let them know I was available for whatever they needed and while there the chaplains came in. They talked to the staff about children dying. I’ve got to go to the 1400 planning meeting. This will be the last planning meeting before we go into operation so it’s all got to be finalized today. I wish you could see the planning and caring that goes into this. Take all the politician assholes out of the picture and get it down to the people of the United States and we can do just about anything.

Here’s an exchange from the 1400 briefing… “How many bodies can the morgue handle?” “Sir, the morgue will hold 22 bodies. But of course we could stack 4 or 5 babies or 2 or 3 kids into one slot.”

19 January We had our first two patients come aboard at 2130. It’s a woman with a big chunk of cinderblock in her brain and a child with a crushed pelvis whose bladder is pretty much destroyed. The staff on the Vinson had them stable but couldn’t do any more. My roommates are working tonight.

20 January This morning I went to the galley about 0545. Around 0600 the ship shook. A LOT! Some thought it had gone aground and some thought they’d put the screws into reverse. Chiefs told us later this old boat doesn’t have the power to reverse the screws. It was a magnitude 6.5 earthquake. So big it shook a ship over 300 feet long like a toy. Patients are flowing in and the mood of the ship has changed dramatically. Casualty receiving (CASREC) is packed. I’ve talked with the nurses in pediatrics about toys and stuff for the kids. Unlike OpSmile, the Navy doesn’t bring toys on a mission!

I talked with a chief about when we’re going to get the post office working then I’m going to try to order some stuff. They want coloring books and crayons, underwear [what’s that?!], and what they’re asking for the most is Bibles. I’ve talked with the chaplains about that because Bibles printed in Kreyol may be hard to find! Kreyole is not the same as Creole.

Time for the 1900 briefing. It’s Wednesday. A week since I was sitting watching TV. What a ride so far… I hope I can sent this tomorrow.

So it’s not tomorrow yet… We saw 81 patients today. The count will go up once the Haitians learn where the landing zones will be and they start showing up. We don’t have our Marine combat cargo Gunnery Sergeant yet so a Navy chief filled in today. We had 147 helicopters land on the Comfort. Only 81 patients so you can see there were a lot of politicians trying to show the world how important they are. Plus media was all over CASREC today.

Captain Sharpe, one of my roommates, just came in all pumped up about the day. He said, “This is what it’s all about. Helping people.” We talked about how much busier things are going to get. Last night he and I talked about amputations. You chop the limb off clean _ they call it a guillotine amputation _ cover it with gauze, and put the patient in the ward for a couple days. Then you have to bring him back and operate again to take out what’s died, rap it up, and put them away again for a couple days. This may go on 3 or 4 or 5 times until you open it up and nothings dead. Then you can close the skin flap and be done. The point is that a person with an amputation doesn’t get operated on once and done. So he’s concerned with the number of amputations we’ll see the number of surgeries will go thru the roof. We’ll just have to see.

So today was a 15 hour day for me. The medical folks had it a lot harder. Chief Woods was on the flight deck non-stop, except for 5-minute bathroom breaks, on his feet in the sun from 0630 to 1930. And all he could do tonight was smile. I’ll see you all tomorrow. Yeah yeah yeah...

So obviously I have email but it’s convoluted. This morning the Skipper reassigned from NGO support to supporting the Navy Captain and Lieutenant Commander preparing metrics for the ship. Patient Admin keeps metrics for onboard admissions very well but nothing is set up ashore. We have teams setting up clinics. 82nd Airborne is setting up secure perimeters. But nobody is keeping records ashore. Skipper is talking with legal about a civilian [me] doing that and what the liabilities may be. I hope we can work past that so I get ashore and into the action. We’ll see. Take care of yourself and remember my shipmates aboard the Comfort."