Exercise takes health care to patients in Ecuador Published Oct. 22, 2008 By 81st Medical Group KEESLER AIR FORCE BASE, MISS. -- Seventeen Keesler medics recently returned from a 10-day medical readiness training exercise in Ecuador. Led by Lt. Col. (Dr.) Steve Nelson, 81st Medical Operations Squadron and deployed commander, and Maj. Paul Valdez, deployed deputy commander from the 81st Medical Support Squadron, the team consisted of Air Force specialists providing general medicine, pediatrics, dermatology, optometry, dentistry and pharmaceutical services. From Sept. 16-26, they treated more than 4,700 patients at several sites. Two team members, Lt. Col. (Dr.) Steven Ritter and Maj. (Dr.) Robert Holmes, 81st MDOS, sent e-mails from Ecuador which provided some details about the team's work there. Sept. 19, Colonel Ritter commented, "We're having a great experience, having seen nearly 2,400 patients in four days, a very good showing. We were in Santa Rosa and today started in Cotalo. There have been nine admissions to local hospitals for pneumonia, pediatric traumatic amputated finger and two cancer patients. "We have had great cooperation with the host-nation military. The country is incredibly beautiful and the people very friendly," Colonel Ritter continued. "There's been training with the Ecuadorian doctor and dentist. Colonel Novak mentioned he's learned new techniques with limited equipment and Colonel Gasque said he worked closely with the host-nation doctor with a pneumonia admission." "We're losing track of the days -- all we know is today was the first day at a new site," Major Holmes said. "This one is a school, so at least there were enough chairs to go around," noting that many of the 1,700 patient encounters at the first site were conducted while standing. "There's a breathtaking volcano nearby and the folks are absolutely thrilled and thankful we're here," the major added. "Several of us (including me) suffered a short gastroenteritis but all are improved or completely recovered by now." Sept. 21, Colonel Ritter lauded the talents of Lieutenant Villalobos, "a remarkably talented (physician's assistant) from family practice and a key translator for the team." "We're going to our last site way up in the mountains -- as opposed to just 'up in the mountains,'" Major Holmes reported Sept. 22. "Today it will take over an hour just to get to the site via twisting switchbacks. We'll take two smaller vans, but it may be difficult even then as it poured rain all night long. Half of the road to the site is already blocked by previous landslides and the people will be lining the road to get in." Later he added, "You didn't want to sit next to a window getting to the site today -- elevation of 11,000 feet in a large bus doing hairpin switchbacks. It was most picturesque, though, with the snow-capped Andes visible in the distance." "This was an outstanding opportunity for all members involved," said Colonel Nelson. "The mission afforded us the opportunity to work in less than ideal conditions, providing real experience to practice medicine outside of a medical center in a deployed setting. We were able to promote a long-term relationship between the United States and Ecuador, help populations in need of medical care, train residents and junior providers, test our abilities and knowledge and form friendships within the team and between the nations -- all great reasons to practice medicine within the Air Force. "I've never been prouder to wear the uniform than during this mission, and appreciate being allowed to lead this outstanding group from Keesler," Colonel Nelson emphasized. "I was very proud of this team representing the 81st Medical Group," stated Major Valdez. "The numbers speak for themselves. These Air Force specialists worked out of buildings of opportunity at elevations of 10,000 to 12,000 feet. Some days it was 40 degrees. We used interpreters to facilitate treatment. Although conditions were austere, the team performed exceptionally. There is no doubt that our mission will have a lasting impact Keesler members participating: 81st Medical Operations Squadron -- Lt. Col. (Dr.) Stephen Nelson, chief of pediatric neurology; Lt. Col. (Dr.) Steven Ritter, dermatologist; Maj. (Dr.) Robert Holmes, medical director for infectious diseases; Capt. (Dr.) Melissa Mauro-Small, pediatrician; Capt. (Dr.) Mark Burbridge, internal medicine resident; Capt. (Dr.) Kathyrn Taylor, pediatric resident; 1st Lt. Danny Villalobos, physician assistant; and Airman 1st Class Fabian Consbruck, mental health technician. 81st Medical Support Squadron -- Maj. Paul Valdez, medical logistics flight commander, and 1st Lt. Brett Mazey, TRICARE operations and patient administration flight operations manager. 81st Dental Squadron -- Col. (Dr.) Joseph Novak and Maj. (Dr.) Karyn Young, dentists, and Airman 1st Class Veronica Reesey, dental technician. 81st Aerospace Medicine Squadron -- Capt. (Dr.) Mark Kahrhoff, optometrist, and Airman 1st Class Bradley Louk, optometry technician. 81st Diagnostics and Therapeutics Squadron -- Staff Sgt. William McDuffey, pharmacy technician. 81st Medical Group -- Col. (Dr.) James Gasque, internal medicine support.