U.S. Army South mission brings light to seeing-impaired

By Eric R. Lucero, U.S. Army South Public AffairsSeptember 14, 2011

U.S. Army South mission brings light to seeing-impaired
Lt. Col. Darrell Carlton (right), an ophthalmologist based out of Womack Army Medical Center in Fort Bragg, N.C., and officer in charge of the U.S. Army South-led medical readiness training exercise eye surgical team in El Salvador, briefs a group of... (Photo Credit: U.S. Army) VIEW ORIGINAL

SAN VICENTE, El Salvador, Sept. 14, 2011 -- During the early morning hours of Aug. 26, 92-year-old Maria Josefa Aguillon Hernandez made her way to the hospital as the sun rose for millions of other people, but not her. For Hernandez, the world was still dim. She, along with hundreds of other Salvadorans who visited the Santa Gertrudis Hospital in San Vicente that day, suffered from impaired vision due to cataracts.

However, this day was special. She was scheduled for surgery to correct her condition. For Hernandez, this would be the last day the sun would rise and she would not see it.

Six U.S. Army doctors were waiting for her at the hospital as part of the U.S. Army South-led medical readiness training exercise, or MEDRETE, eye surgical team. The team, which completed its mission Aug. 31, was composed of active duty medical personnel from the U.S. Army Medical Command as well as Reserve Soldiers from the 807th Medical Command (Deployment Support).

While typical MEDRETEs can focus on anything ranging from general care, to dental and veterinary medicine, this mission focused on ophthalmology. Specifically, the eye surgical team targeted patients with sight-impaired disabilities due to cataracts.

The patients were selected by Salvadoran ophthalmologists, who then referred them to the U.S. doctors. Once selected, the patients were screened by an advance party of the MEDRETE team to ensure they were viable candidates for cataract surgery.

Upon arriving in El Salvador, the Army doctors had 253 eager Salvadorans waiting for them. The MEDRETE team determined 133 patients were considered viable candidates for surgery. The patients ranged in age from 15 to 92 years.

"The mission provided a permanent medical solution to a condition that El Salvador does not have enough of a capability or capacity to fix, given the number of people with a cataract problem," said Lt. Col. Chad Nelson, U.S. Army South medical operations and plans. "It also provided an opportunity for the Salvadoran hospital staff as well as some of its military medical professionals to work alongside U.S. Army medical staff during the entire exercise."

The MEDRETE team understood how important its mission was in regard to improving the quality of life for the patients, but it also wanted to reduce the impact on its Salvadoran counterparts as well. With most surgeries, follow-on care can prove to be just as important as the procedure itself. To alleviate the need for follow-up care, the team performed a surgical technique that would benefit both the patients and the Salvadoran doctors.

The procedure, known as small incision sutureless cataract surgery, proved to be ideal for the MEDRETE mission due to its need for minimal follow-up appointments and care.

"Sutures cause problems," said Col. William R. Wilson, chief of the eye surgical team based out of Walter Reed Medical Center in Washington. "They take time to heal, and there's always risk of infection. When we leave, we want to make sure the problem is gone and we don't leave behind a larger burden."

With less risk of infections, and a reduced need for follow on care, the MEDRETE was able to provide maximum care during a short time with limited resources while leaving behind a lasting legacy for the people of El Salvador.

"The mission was a significant training opportunity for the personnel that deployed to El Salvador," said Nelson. "This is just one of the many types of activities that are tools in the medical engagement strategy that strengthens our relationships with partner nations in the ARSOUTH area of responsibility."

According to Wilson, prior to the surgical team arriving, many of the patients could only see some light, while some could not even see their own hand in front of them. After receiving care, most patients' vision was restored to 20/20.

"You always know when the surgery went well," said Wilson. "When you take off the bandage and you see a huge smile on the patient's face, you know it's a good outcome."

With plenty of smiles on the faces of its patients, the legacy left behind by the surgical team will have a profound impact on the 15-year-old who can now see his friends, the 92-year-old who can finally see what her great-grandchildren look like, and everyone in between. For Hernandez, being able to see the sun rise in the morning brings a bright, new outlook on life.

"Restoring sight to the blind is a very powerful humanitarian action," said Wilson. "I am sure this mission has left a very favorable impression of the United States. I like to think of this as medical diplomacy."

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