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Mission of Mercy

Nurse Journeys to Asia to Provide Care

Monday December 8, 2008
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When duty calls, Joann Fitzell, RNC, BSN, is ready to pack her sea bag and ship out as a Commander in the Nurse Corps, U.S. Naval Reserve. For 60 days last summer, that meant deploying on a medical mission aboard the USNS Mercy to ports of call in Vietnam and Timor-Leste in Southeast Asia.

For the mother of four, it meant leaving her young children in the good care of her husband so she could use her nursing skills to care for some of the most medically underserved children and families in Asia.


The USNS Mercy visited Vietnam and Timor-Leste.
(Photo courtesy Joann Fitzell)
"It was strictly a humanitarian mission to provide medical care, build relationships, and spread goodwill overseas," says Fitzell, who is also a NICU nurse at Anne Arundel Medical Center in Annapolis, Md.

The mission specifically targeted politically sensitive areas and those known to have suffered from numerous terrorist activities.

"Vietnam was a unique experience because it was the first time a medical ship had been allowed back there since 1975," says Fitzell. "Up until the moment we pulled in, we weren't sure how extensive our mission would be and whether the government would let us do it."

The mission in Vietnam turned out to be a complete and heartwarming success. Fitzell's orders included working as a pediatric staff nurse on the USNS Mercy, a ship that functions as a floating hospital. The ship is similar to any large land-bound hospital facility in the U.S. and includes a pediatric unit, a perioperative department, and an ICU. At full staff, which includes everyone from medical personnel to cooks to engineers, the ship can accomodate up to 1,000 patients.

A Smile Makes the Day
One large facet of the mission included partnering with Operation Smile, a nonprofit organization that provides surgical correction and medical care of cleft lips and cleft palates for children in some of the poorest areas of the world.

The USNS Mercy and staff provided Operation Smile with perioperative space and extra healthcare staff. Together, they corrected about 30 cleft lips and palates a day.


On her journey overseas, Joann Fitzell cared for patients and families in underserved regions while working in a floating hospital known as the USNS Mercy. Many young patients had suffered burns from cooking accidents and homemade fireworks, while others had cleft lips or cleft palates.
(Photos courtesy Joann Fitzell)
"In America, you never see a teenager with an unrepaired cleft lip or palate," says Fitzell. "But Southeast Asia has the highest incidence of these conditions, and they often go untreated and are seriously life-affecting."

People born in Asia with these deformities are often treated as outcasts. Fitzell recalls the story of one 16-year-old girl who had been shunned from her community because of her severe cleft lip and pallate. After plastic surgery repair, the girl and her sister-in-law cried.

"Her teeth were inside her lip instead of sticking out of her face, and she looked so beautiful," says Fitzell. "They were so happy that she would be accepted into her community."

Healthcare professionals on the mission also performed surgeries to correct disabling scarring from severe burns.

"In the Asian culture, they do a lot of cooking with both oil and water, which is a very volatile mix," says Fitzell.

This method of cooking has resulted in many accidental childhood burns with scarring and serious mobility restrictions.

Homemade fireworks also are common in Asian cultures, and it is not uncommon for children to suffer severe burns from them as well.

One teenager treated on the ship had been burned extensively when he was 2 years old by a "fire rocket" made with bamboo and kerosene. His hands had been most affected, and as he grew up, his fingers had contracted into unusable, claw-like fists from the scarring.


Joann Fitzell's duties on the USNS Mercy involved working as a pediatric staff nurse.
(Photo courtesy Joann Fitzell)
The boy's treatment included plastic surgery to release the scars, along with splints and physical therapy. Though he still had recovery time ahead of him, by the time he left the ship, his life had changed dramatically.

"You should have seen the smile on his face when he looked at his fingers and was able to straighten them out for the first time!" says Fitzell.

Another aspect of Fitzell's mission was traveling into the local medical communities and teaching healthcare skills such as CPR and ACLS to Asian nurses and physicians. She also worked with local healthcare professionals to set up miniclinics in the local orphanages and schools to treat routine conditions.

This included dispensing medications and eyeglasses and providing physical therapy and dental work. Patients needing more extensive care were sent to the ship, often by helicopter.

"People would come from hundreds of miles away for care, and they would often walk or were carried," says Fitzell.

One of the wheelchair-bound patients who received care at a miniclinic had been a North Vietnamese officer during the Vietnam War. After being treated, he wheeled himself home, then hurried back to the ship just as Fitzell and the staff were packing up to leave.

The man carried a medal he had earned in the war and insisted on giving it to the physician who cared for him.

"He said, 'This is how relations are built and how Vietnam and America have become brothers. It is everyday people taking care of everyday people,' " says Fitzell. "It's so reassuring because you often hear that the whole world hates us, and that's not true. There are so many places where they are thrilled to have us come."

Catherine Spader, RN, is a contributing writer for Nursing Spectrum.

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