Army Medicine ENTs Answer Call to Provide Humanitarian Aid to Pacific Republic

By Ms. Valecia Dunbar (Army Medicine)July 2, 2013

Humanitarian Aid
(Photo Credit: U.S. Army) VIEW ORIGINAL

A team of Tripler Army Medical

Center Ear, Nose, and Throat (ENT)

physicians and Department of the

Army Civilians recently completed a

humanitarian mission to the Federated

States of Micronesia (FSM) where 407

outpatient visits and 234 audiologic

evaluations were provided to a

population in need of care that was not

affordable or accessible to those living in

the region.

"These things are very rewarding,"

said Lt. Col. (Dr.) Philip D. Littlefield,

an otolaryngologist in the ENT Clinic,

Department of Surgery at Tripler Army

Medical Center (TAMC). "These

missions and deployment are the most

satisfying parts of being in the Army

for me. I see myself doing something

meaningful for the world. It certainly

beats the daily grind of email and online

training," said Littlefield. And, he is

certain that the rest of the team agrees.

The Pacific Regional Medical

Command/Tripler Army Medical

Center (PRMC/TAMC) ENT team

members included otolaryngologists

Littlefield and Capt. (Dr.) Kelly L.

Groom, in addition to Department of

the Army Civilians (DAC), Audiologist

Dr. Denby Fukuda, and Physician

Assistant Jeffrey M. Robin.

The mission arose because of past

successes of ENT physicians who have

completed multiple humanitarian

missions in the Pacific region over 10

years, especially to the Republic of

Palau, a larger island group neighboring

FSM. The current mission was

to provide aid to two of the four

Micronesian states, Chuuk and Yap, at

the request of the FSM Department of

Health and Social Affairs on behalf of

the U.S. Department of State.

"Nearly every surgery we did would

have required the patient to go to the

Philippines or Hawaii for

treatment, something the FSM

government cannot afford,

and probably the reason they

were not treated already," said

Littlefield.

The initial visit was to

Chuuk for a week, then to

Yap, which is located about

1,000 miles west. The

conditions in Chuuk were

far more austere than Yap.

Overall, the team performed

27 operations between the

two different locations, as well

as multiple clinic procedures,

including 52 neck ultrasounds.

"Some cases do stand

out," said Littlefield. "We

did five thyroidectomies

for large masses. We also did two

mastoidectomies for cholesteatoma.

Cholesteatoma is a serious ear disease

that requires complex surgery, and it

is eventually fatal if left untreated for

many years," said Littlefield. "We also

did a tracheotomy on a lady with a

larynx scarred closed by an infection,

and it took all her effort to breathe in.

She looked absolutely miserable, but was

obviously a lot happier when we were

done."

Littlefield says the vast majority of

patients are very grateful for the care of

U.S. medical providers. They are very

respectful of American surgeons and as

members of the U.S. Army. "They think

we are the very best doctors and are

excited to see us," said Littlefield.

This was not the team's first mission

to FSM. They previously provided aid

to the island of Yap in 2009, but the

current mission was longer and more

focused. The team plans to continue

their humanitarian assistance whenever

they can.

"It is very unusual for civilian doctors

to do this, especially for ear surgery, said

Littlefield. For one, they lose money by

leaving their practices. Also, they tend

not to have the planning and organizing

skills (for these things) that comes with

working in the Army for a while. We

are good at moving gear around the

world and then making it all work in

a rough environment," said Littlefield.

"It's challenging, but fun."

FSM is a grouping of 607 small

islands in the Western Pacific about

2,500 miles southwest of Hawaii,

lying just above the equator. Generally

speaking, the FSM comprises what

is known as the Western and Eastern

Caroline Islands. Chuuk and Yap

are two of the four island states that

comprise the Federated States of

Micronesia. Chuuk state has a total land

area of 49.2 square miles and includes

seven major island groups. Yap state

is made up of four large islands, seven

small islands and 134 atolls (coral reefs),

with a total land aread of 45.6 square miles.