Medics gain skills during exercise in Nicaragua Published May 13, 2008 By Steve Pivnick 81st Medical Group Public Affairs KEESLER AIR FORCE BASE, MISS. -- Three Keesler physicians recently returned from a medical readiness training exercise in Nicaragua. Col. Kathleen Elmer, Maj. Robert Holmes and Capt. William Pomeroy, 81st Medical Operations Squadron, participated in the MEDRETE in Nicaragua from April 18-May 3. The exercises are conducted under the auspices of Air Force Southern Command, headquartered at Davis-Monthan AFB, Ariz. The exercises are designed to bring humanitarian assistance and free medical care to the people of the host country, stressing the concept of helping others while practicing important military skills in partnership with the host nation. Colonel Elmer, 81st MDOS commander, served as the 15-member team's dermatologist, while Major Holmes, an infectious disease physician, and Captain Pomeroy, an internal medicine resident, handled internal medicine patients. "The MEDRETE missions provide a wonderful platform to display our high regard for partner-nation cooperation and our commitment to improving health-care delivery in these countries," Colonel Elmer said. The Keesler contingent augmented the lead element from the 17th Medical Group at Goodfellow AFB, Texas, where Colonel Elmer was previously chief of clinical services before coming to Keesler last July. In addition to the 81st Medical Group trio, the team was comprised of an optometrist and technician, a dentist and technician, a pediatric nurse practitioner, a pharmacist and technician, a women's health nurse practitioner, three medical technicians and a representative from AFSOUTH. Lt. Col. George Jones, a pharmacist and also the 17th MDOS commander, was the team chief. They flew into Managua, the Nicaraguan capital, April 18 but were based in Matagalpa, the nation's fifth- largest city. "We worked in two locations, La Dalia and El Tuma, which are villages about a 90-minute drive from Matagalpa," Colonel Elmer said. "The local infrastructure and transportation were challenging as we traveled back and forth to the clinics. "We had support from local Nicaraguan medical personnel coordinated through the U.S. Embassy," she continued. "We saw more than 5,000 patients. I encountered a variety of skin diseases including many cases of scabies, head lice, cutaneous ulcerations with some suspicious for cutaneous Leishmaniasis, a parasitic disease spread by the bite of infected sand flies "The pediatricians saw a variety of respiratory diseases, parasitic infections, malnutrition and numerous cases of asthma. The optometry and dental representatives distributed numerous pairs of glasses and toothbrushes. Interestingly, tooth extractions were a popular requested procedure." "Internal medicine had a variety of patients with various musculoskeletal pain, headaches, gastric complaints, etc. Major Holmes ensured that Captain Pomeroy, the internal medicine resident, also rotated through other sections to broaden his depth of patient exposure. As an internal medicine resident, Dr. Pomeroy had a chance to see deployment medicine first-hand and encountered cases not treated on a routine basis in standard U.S. medical facilities. Having an infectious disease expert enabled the staff to review food and hygiene practices more thoroughly. The team provided names of patients needing more urgent follow-up or close monitoring to the medical directors of the local clinics to ensure continuity care. A child with a bleeding disorder after a tooth extraction was referred for care and evaluation at a hospital. Colonel Elmer said, "All team members had a very valuable and rewarding experience through this first-hand encounter with a developng nation's health-care needs."