JOINT BASE SAN ANTONIO-FORT SAM HOUSTON, Texas -- A medical team from Brooke Army Medical Center made a lasting impact in Honduras last month during a two-week urology medical readiness training exercise.

A team of BAMC doctors, nurses, technicians, residents and anesthesiologists screened 200 Honduran patients and performed 84 surgeries -- the majority pediatric and adult reconstructive procedures.

With three operating rooms and a larger team, this urology medrete was the largest one BAMC has conducted in Tegucigalpa so far, noted Army Maj. (Dr.) Steven Hudak, a BAMC staff urologist and specialist in traumatic, reconstructive, and prosthetic genitourinary surgery. This was due, in part, to a helping hand from a medical team with Madigan Army Medical Center in Tacoma, Wash., he explained. With their assistance, they were able to add a third OR and take on new procedures.

While the BAMC team handled the pediatric and adult male reconstruction procedures, Hudak explained, the Madigan team treated women with incontinence and other debilitating issues.

The trip was worthwhile on a number of levels, noted Army Lt. Col. (Dr.) Thomas Novak, medrete mission commander and a pediatric urologist at BAMC.

"Staff surgeons are able to provide care in an austere environment in a focused time period with a high volume of patients, which sharpens their skills," said Novak, who has served on four Honduran medretes. This exposure to a variety of complex cases also benefits residents, anesthesiologists, surgical technicians and the support staff, he added.

These sharpened skills have a direct impact on BAMC patients, said Novak, citing Wounded Warriors as an example. By treating a host of complex post-trauma cases in Honduras, providers are able to better treat similar cases here, particularly service members wounded downrange.

"We benefit every bit as much as the host nation," he said.

The team also provides surgical skills training to Honduran doctors and residents, in some cases, year round. Novak has been an ongoing mentor to Dr. Enrique Tome, a Honduran pediatric surgeon who provides pediatric urology care for a good portion of the country.

"We communicate regularly about the ongoing follow up of patients we have cared for together and new patients that he is seeing in his day to day practice," Novak said. "The patient follow up is crucial for my own development as a surgeon and promotes the sense of trust that our involvement extends beyond the time that we are actually in country."

From the patient standpoint, the team is treating conditions that have left Hondurans -- many with tubes emanating -- debilitated and unable to support their families, Hudak said. "Many are young men, the only breadwinner for their family," he said. "Being able to fix them for life in many cases is very satisfying for us. It makes a huge impact on their quality of life."

The challenge is turning people away on screening day, Hudak noted. With limited time and resources, the team can only take on a certain number of cases.

"You wish you could do more but we exhaust everything we have for those two weeks," he said. "At some point, we run out of time to operate and resources."

Still, Hondurans are grateful, whether they're seen that week or asked to come back the following year, Novak said. "Their gratitude is humbling," he said. "They really make the trip worthwhile."

Army Capt. Jennifer Husbands, the mission's executive officer and BAMC's D Company commander, said the medrete was a life-changing experience. She recalled hearing about one patient, a child, who expressed his sincere gratitude for his doctor.

The doctor was "like an angel coming from the sky to make me better," the child said in Spanish.
"That was really, really touching," Husbands said.