Fleet Hospital Dallas: WATC 02, Ghana, W. Africa

The sound of my projectile vomiting into the grass brought the hammering sounds along the construction project within the Army Recruit Depot in Ghana, W. Africa to a temporary standstill. Quickly, a couple of my ship-mates moved toward me and began to assess for signs of heat exhaustion. As part of Advance Party for Fleet Hospital Dallas, approximately a dozen of us had been in the field working in an intensely hot environment for five days preparing for the arrival of the Main Body. This group had been winging their way around the Horn of Africa in a C-130 along with the flight crew, load master and all of our supplies; their expected arrival to our base of operations was to be within a few minutes. And here I was, puking onto the African dirt. The temperature climbed above ninety degrees by eight a.m. every morning. We had been on mandatory canteen breaks every fifteen minutes, but my hydration had faltered at night with the exhaustion of physical fatigue from long and hard days in the sun. I just slept and didn't think to drink.

Stripping me out of my blouse, and loosening my cargo pants, one of the men began to sponge my neck, arms, face and abdomen with water from his canteen, as my blood pressure was checked in both a supine and seated position. I was suffering from tachycardia, was quite sweaty and my legs felt rather weak. The clinical picture was confirmed and an I.V. was inserted after five attempts. My venous system was a bit collapsed. I watched as a stake was hammered into the ground next to me, a nail placed in the stake and a life-nourishing bag of Lactated Ringers I.V. fluid was hung. I knew the drill. Only a couple years prior, I had provided the same level of care for U.S. Marines at a live-fire, combined arms exercise (CAX) at 29 Palms, California. Many a heat exhausted or field injured Marine found their way to Fleet Hospital operations which were set up to provide medical support for the exercise. The Marines moved through triage and the Emergency Department tent on into the areas where Navy Nurses and Corpsman continued their care and used hydration protocol for dehydration and heat exhaustion. I found it exhilarating to be a part of that exercise. Lying on my back looking at the blue African sky, receiving the same care, I found it damn depressing. How in the hell had I managed to become a casualty of the environment? And that, in only five short days? Maddening enough, that Ghanaian nationals just returned from a peace-keeping mission in the Congo had stood within two feet of me with their weapons slung casually over their shoulders commenting about, “The white woman throwing up in the grass.” Embarrassed enough, because you sure don’t wear your best underwear in the field, ya wear your worst and then just toss it in the garbage each night. And now the whole world knew I purchased my undies for the trip at Wal-Mart.

My journey into the land of self-pity was short-lived. We had a mission to accomplish. And as one of 54 members of this operation, I was expected to rejoin the ranks. The next morning found me loaded onto the bus with other members of the team to our first off-site location to set up a clinic to provide care for a vastly underserved population. When our bus pulled into the first village, a stunned silence overcame our group. Several hundred people were standing in line awaiting the arrival of the Americans to give them a helping hand. For two weeks Fleet Hospital Dallas moved across the landscape surrounding the capital city of Accra. Every single day, hundreds of people (and on a couple of days, more than one thousand) awaited their one shot at healthcare. We provided immunizations, dental care, eye exams and glasses. We did physicals and dispensed thousands of medications from our pharmacy. We ended up doing several minor surgeries using dental equipment and lidocaine for a regional block because the need was so great. Every third night, officers such as myself also stood a two hour watch after working eighteen hour days. And my experience with heat exhaustion? It became a minor problem to face compared to the complicated medical pictures which we dealt with while in Ghana.

Across the world, from year to year, military medical teams such as the one to which I belonged reach out to extend a helping hand to those in need. We are Americans. We always reach out to others. And when it comes to field medicine, the military healthcare professionals who support our troops are the best within their areas of specialty in the nation. This gift, is also extended to people in Ghana, Togo, Honduras, the Philippines and other underserved areas of the world.

LCDR Tammy Swofford