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Vital Signs with Dr. Sanjay Gupta
Former Oil Tanker Ship Provides Mobile Health Care to Countries around the World; Mobile Hospital Ship Visits Jamaica. Aired 2:30-3p ET
Aired September 05, 2015 - 14:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
[14:30:21] DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: With more than 700 medical personnel, 5,000 units of blood, and 12 operating rooms, you're standing in one of the largest trauma facilities in the United States.
Except, this isn't your average hospital. And we're not even in the United States. I'm Dr. Sanjay Gupta, and this is "Vital Signs."
Right now, we're on the USNS Comfort, part of a mission called Continuing Promise. In fact, we're in Jamaica. This is the third of 11 stops that will take place over the next five months, and the staff aboard the ship during that time will take care of more than 100,000 patients. We've decided to go along for the ride.
Marlene Maxwell hopes to be one of those patients. She's 56 years old from Kingston, Jamaica, passionate about her family and her faith. For eight years now, she's also been dealing with an overactive thyroid. The thyroid is a gland near your windpipe that produces hormones to help keep your body in check.
MARLENE MAXWELL: It pains on this side. And sometimes it will come up, like it will block off an airway.
GUPTA: Marlene says the health care in Jamaica is good, if you can get it.
MAXWELL: Well, I would say it's good health care, but it's just a time plan. You wait longer.
GUPTA: In Jamaica, nearly half the population lives in the Southeast region of the country. That includes the capital city of Kingston. A population boom has put a big strain on the health infrastructure here -- not enough doctors, not enough resources or operating rooms. It all means less urgent operations like Marlene's to remove her thyroid get moved down the priority list. She's been waiting to have this operation for three years.
MAXWELL: Presently, I'm not on any medication. You know, so the appointment -- apparently it can be on this ship.
GUPTA: You heard Marlene correctly. She said a ship. Against the blue Jamaican sky, you can't miss it. Bright white with large red crosses, this is the USNS Comfort. It's the largest hospital ship in the world. It shares that title with its sister, the Mercy. The twin ships are actually oil tankers turned floating hospitals, each the height of a 10-story building and the length of three football fields. The Comfort is currently on a humanitarian mission around South and Central America and the Caribbean, the sixth mission of its kind.
CAPT. SAM HANCOCK, MISSION COMMANDER: It's a bit overwhelming. There's a lot of moving parts and pieces, as you can imagine.
GUPTA: Overseeing all of this is Captain Sam Hancock. He's been in the U.S. Navy for almost 25 years, but a mission like this is a first for him.
HANCOCK: I've talked to a lot of folks that have done previous missions, and all have said it's probably one of the most rewarding things we'll do in our career, and that's happening right now for sure.
GUPTA: With the ship now in port, the scramble begins. In addition to the operations that will be performed onboard, there will be mobile medical sites on shore. The Comfort brings all those medical supplies along, so the mobile clinics come from these crates. Each country gets roughly 30 to 40 palates of supplies, and whatever is left over is donated to the host nation.
This massive undertaking is funded by the United States government at a projected cost of $40 million. NGOs also donate money, supplies, and volunteer time.
These are expensive missions. They obviously take a lot of resources and personnel. Is this an obligation of the United States to engage in missions like this? How do you explain the value of this mission?
HANCOCK: It is an obligation. It's part of our overall military strategy, the partner nation building, working to develop the relationships with the countries in this region of the world. And with the personnel, whether it's the medical ministries of health and everything that we work with coming into each country, but the relationships that are established will pay dividends in the future.
GUPTA: All of this was arranged months in advance, part of the collaboration with the host country, the U.S. State Department, and the U.S. military.
[14:35:07] The team responsible for supplies has the ship stocked for this continuing promise mission and for wartime response. The Comfort responded to the Haiti earthquake in 2010 and operation Iraqi Freedom in 2003. The ship can go from restricted status to fully operational for deployment in as little as five days.
HANCOCK: We have about a thousand folks embarked right now across the spectrum for this full Continuing Promise operation. A majority of this crew has been brought in just for the mission.
GUPTA: A few hours after the ship docks, Captain Hancock and his team get a tour of the planned medical sites, first, at a large gymnasium, empty and dark now, but soon to be filled with doctors and patients. Next is a clinic in a more residential area of Kingston. The comfort
crew will take over operations of this clinic for the time that they are here. Services provided will range from pediatric care to women's health, cardiology, eye exams, general surgery, and everything in between.
The health care system in the United States has gone through an evolution, obviously, over the last several years. But there are many places in the United States that still have inadequate health care infrastructure. When I was talking about the story, people said, hey, we would love to have that sort of thing in the United States, in our own country. Have you heard that? How would you provide this level of service and care to your own citizens? Has that ever been part of the mission?
HANCOCK: We have heard some of that. On social media, we have a lot of -- a site for that. And I've seen comments on there, like, hey, why don't you come bring this and park it off of one of our cities and help provide that. And there's services in the United States that can help provide that. This ship, though, and the funding is to go out and work in the countries that we're going out into. Now, we can provide and have in the past emergency response in the United States.
GUPTA: Day two, the first time potential patients will be seen. Surgical screening is taking place at the Kingston public hospital to identify candidates for surgery onboard the ship.
UNIDENTIFIED FEMALE: You did a good job. All done.
GUPTA: That includes Marlene Maxwell. She's here with her daughter Tracy. Marlene is selected for surgery and scheduled for the following day. That means she and Tracy will be spending the night onboard the Comfort.
UNIDENTIFIED FEMALE: So those two families, if you'll go ahead and load here.
GUPTA: All surgical patients send the night before their surgery on the ship to get comfortable and acclimated.
There is anxiety and excitement as they ride through the city toward the ship. A drive through the commercial port and the Comfort comes into sight for the first time.
UNIDENTIFIED FEMALE: You have to line up here in front of this young lady.
GUPTA: Not one of these selected patients has ever set foot on a ship before. They go through security screening, then more testing. And every step of the way, making sure they are still fit for their operations.
MAXWELL: You cannot tell any friends.
HANCOCK: After her vital signs are checked, Marlene and Tracy are escorted to another part of the ship. This will be their home for the night. A few more tests, and it's time to get settled in.
MAXWELL: That's my bed for tonight.
GUPTA: Tomorrow will be a big day.
[14:42:22] GUPTA: It's 7:00 a.m. on a Wednesday in Kingston, Jamaica. All these people are here for an hour early for the chance to get free health care.
You get an idea what it's like to try to organize 10,000 people roughly in 10 days and try and give them medical people. It starts off with people walking now into this sports gymnasium.
Two days ago, this gym was completely empty. It has since been transformed into a mobile clinic by the crew by the USNS Comfort, a massive floating hospital ship. In addition to the United States Navy personnel, there are military members from other U.S. branches, and even other countries. They've set up stations for dentistry, pediatrics, cardiology, optometry, lab work, a pharmacy, even more. And all of this came off the ship.
CAPT. CHRISTINE SEARS: Good morning. How are you, sir? Good morning.
GUPTA: Captain Christine Sears knows all about patient care. She's a urologist and she's the chief medical officer for this mission. It's her first on the comfort.
Is it always positive? Are there cultural differences? Like the Americans are coming here to save us feelings or sentiments at all?
SEARS: It seems to vary country to country. It really depends on where we are and what their sentiments towards Americans are and what their sentiment personally is about health care.
GUPTA: And how about with the local medical officials, those interactions, because you're not just taking care of patients, you're often helping train doctors. Not just in terms of procedures, but also follow-up.
SEARS: Absolutely. And we're partnering with them, so that does involve close coordination. So for example, with the surgery screening, close coordination, not just with the ministry of health but also with Kingston public hospital. And we do enable that post- operative care to be seamlessly integrated back into the host nation health care.
This is a wonderful venue we have here. Large space, cooled space, which is good for the patient comfort as well as ours. Good morning.
GUPTA: When you talk about these numbers, maybe up to 10,000 patients showing up, does it mean that a country like Jamaica there's not enough health care, there's not enough personnel, resources? Why would so many patients show up like that? SEARS: So sometimes it's hard to tell. Some patients are wanting a
second opinion. Some are wanting some specific care, like a pair of glasses, or some vitamins or something that's very finite. So it really varies by patient.
GUPTA: This is one of two mobile medical sites the Comfort crew has set up on this stop in Jamaica. The other one is across the city at the Maxville clinic. It's in a more residential area, easily accessible for people who might not have been able to make it to the sports arena. Registration lines are long, but spirits are high.
[14:45:16] In all, 9,744 patients will be treated at the two sites. But today, back on the ship, Marlene Maxwell and her daughter Tracy find themselves waiting once again.
MAXWELL: Hi, Sanjay. How are you?
GUPTA: I'm doing fine. How are you?
MAXWELL: Well, just bored.
GUPTA: You're bored?
They spent last night onboard the comfort, and today Marlene is having her thyroid removed. It's an operation she's waited three years for. It's finally going to happen in one of the 12 operating rooms on the ship.
GUPTA: Are you excited? Are you nervous?
MAXWELL: I was nervous, but not anymore.
GUPTA: If you didn't have this operation ever, what would happen to you?
MAXWELL: It would turn into cancer and kill me.
GUPTA: That's what they told you?
MAXWELL: No, me say that, because it gets bigger. I can't control it and it turns to cancer.
GUPTA: I wish you luck. You look like you're in good spirits.
MAXWELL: Yes, man. They treat me nice up here.
GUPTA: They treat you nice?
MAXWELL: Nice, nice, nice. Kimberly is very nice.
GUPTA: Kimberly is very nice?
GUPTA: Kimberly is Lieutenant Junior Grade Kimberly Stoops, Marlene's nurse. She's 27 years old and on her first deployment with the Comfort.
LT. KIMBERLY STOOPS: I know it's scary for a lot of these patients coming on to a ship that they're not familiar with. I mean, a hospital in general is scary, but then coming somewhere where it's not your territory also as much, and then seeing people in uniform sometimes can be daunting. So they'll try and break down those borders, introduce my name, and if they have any questions, please let me know. I'll try to explain things thoroughly before I do them so that I don't try to catch them off guard.
GUPTA: This is five, six weeks into a six-month mission.
STOOPS: Yes, sir.
GUPTA: That's a long time.
STOOPS: That's a long time.
GUPTA: Family, friends, you miss people back home.
STOOPS: Of course, of course. It's hard to be away, but it's also great to be knowing that we're doing really good work here. A lot of mixed emotions. You have those days where you do miss home, but then you come in and see someone's smiling face like Marlene and just so much you can do, and it really brings you up again.
GUPTA: After all the waiting, it's finally time. Nurse Kimberly, Marlene, and her daughter Tracy make their way from the overnight ward to the surgical floor.
UNIDENTIFIED FEMALE: Good luck. Congratulations.
GUPTA: A handover, some goodbyes and well wishes, and Marlene is now in the hands of the operating room nurses. The operation she's waited so long for now just moments away.
[14:51:11] GUPTA: January 18th, 2010, we got a call. Come quickly. A 12-year-old girl broken by the rubble, cement imbedded in her brain.
That video you're watching is back from 2010 above the USS Karl Vincent. I've seen what it's like to operate on Navy ships before. But nothing quite like this, the USNS Comfort. First thing you notice when you're on a ship like this and the operating room and just the size of all the various equipment they have. The little things, if you pay close attention, for example, the tie-downs here on the ground to secure for sea. They have these tie-downs to try and keep things stable in case of rough water. There's no question things are going to be busy here on the USNS Comfort. They plan 10 to 12 operations per day. The first group of patients actually came in yesterday. And one of those patients was Marlene Maxwell.
Consider this -- 24 hours ago, she had never even been on a ship. And today she's going to have an operation on one. Doctors will be removing Marlene's thyroid today. For eight years
she's dealt with pain and discomfort that has just gotten worse. For three years, she's been waiting for this operation. A big part of this mission is collaboration between the United States and each host nation. That includes Jamaican surgeons and nurses coming onboard the Comfort.
First assisting on Marlene's operation today is Dr. Natalie Whylie. She is an ear, nose, and throat surgeon and head of the Kingston public hospital, where the surgical screening took place the day before.
Marlene, who we talked to earlier, said she's been waiting years to have this operation done. Is the problem not enough doctors, not enough space, not enough resources? What is it?
DR. NATALIE WHYLIE: It's a little bit of all of the above. The Kingston public hospital really is the main provider of health care and secondary care, not just for the island of Jamaica, but for the English speaking Caribbean. So we have a lot of patients, and sometimes our capacity for surgical procedures is overwhelmed. So this is why today is such a good opportunity for us to clear some of the backlog of patients that we have.
GUPTA: How would you describe the status of health care here in Jamaica?
WHYLIE: We have some challenges, but I think this year the budget for health has increased and there's been a recognition by the government of the role and importance of health care.
GUPTA: Nothing is perfect in life. What is the downside of having the Comfort come to Jamaica? Does anyone see that as a threat or a concern?
WHYLIE: I don't think so. I think the whole of Jamaica welcomes the U.S. Comfort. If they could see more patients, if they could do more surgeries, if they could stay longer, if they could leave the ship with us.
GUPTA: Leave the ship, I like that.
For Marlene's operation, Dr. Whylie will be scrubbing in with lead surgeon Dr. Michele Morrison. Dr. Morrison is a commander in the United States Navy. They operated together on one patient already this morning.
COMMANDER MICHELE MORRISON, SURGEON: I have her scrubbed in with me today, just kind of showing her how I would do things, and I ask her, what would you do differently here?
GUPTA: What is the interaction like in the operating room?
WHYLIE: Excellent, excellent. We are surgeons. And, you know, the practice of surgery is universal. And she's a girl surgeon like me. So, you know, we were -- it's a really good environment to work and to share as well, to share our expertise as well, because we are working together as a team. And the chemistry was good.
[14:55:02] GUPTA: In the operating room, Doctors Morrison and WHYLIE cut into Marlene's neck and get to work removing her enlarged thyroid. The operation takes several hours. The next day, we visit Marlene in the recovery ward. She's doing well and will be going home the following day. Dr. Whylie and her EMT team at Kingston public hospital will continue with their follow-up care while the Comfort continues on to its next stop. On the docket, El Salvador, Nicaragua, Panama, Colombia, and many, many more, all in all, some 100,000 patients treated over six months time, a remarkable example of what a highly trained hospital staff can do even on the high seas.
Wherever the USNS Comfort shows up anywhere in the world, it sends a strong message. And it means many things -- potential revenue for the host country, a form of international medical diplomacy, and lots and lots of grateful patients, patients like Marlene Maxwell, who had her life-saving operation right here on this ship.
For "Vital Signs," I'm Dr. Sanjay Gupta. Thanks for watching.