JOINT BASE SAN ANTONIO, Texas -- Brooke Army Medical Center doctors, nurses and medics recently returned after being deployed to Puerto Rico for more than a month providing support to the local population in the wake of the devastation from Hurricane Maria.

Emergency medicine physicians, Air Force Col. Mark Antonacci, Army Maj. Daniel Sessions and Army Capt. Melissa Myers along with four nurses and two mobile medics from BAMC joined members of the 14th Combat Support Hospital to provide medical care for the victims of the Category 5 hurricane.

Antonacci, a member of a six-person Air Force Ground Surgical Team, originally went to the U.S. Virgin Islands after Hurricane Irma and ended up in Puerto Rico to help support the mission there.

"My team was helping out in areas where they needed manpower, more than anything else," he said. "We also provided some assistance with evacuations, consultations and hands-on patient care."

Sessions and Myers deployed to Humacao, Puerto Rico with the 14th CSH, 44th Medical Brigade from Fort Benning, Georgia to provide lifesaving healthcare.

"The conditions were very bad when we first arrived," explained Antonacci. There was downed powerlines everywhere, no electricity or cell phone service, and a lack of food and water.
Military personnel hit the ground running.

"We set-up the hospital in a basketball arena," Sessions said. The arena offered limited protection from the torrential rain and winds.

As soon as the field hospital was up and running the people came. Sessions worked the day shift and Myers worked through the night.

"We had one doctor, two nurses and eight or nine medics there doing the majority of the hands-on patient care," Sessions said. "We were seeing up to 200 patients a day. The cases ranged from medical emergencies to primary medical care, preventive medical care and trauma."

Along with environmental challenges, the language barrier played a significant role on the team's ability to provide the much-needed medical support to the local population.

"Only about five percent of the people who came in spoke English," Sessions said.

In coordination with the BAMC Virtual Medical Center, two Mobile Medics, Sgt. Andrea Bloom and Spc. Christian Bark, accompanied the doctors and nurses from BAMC. The mobile medics coordinated with the BAMC V-MEDCEN to establish daily virtual health provider support from the Internal Medicine Clinic located at BAMC and providers at Dwight D. Eisenhower Army Medical Center in Fort Gordon, Georgia.

"This truly shows the versatility of virtual health and effectively eliminates the tyranny of distance that so frequently diminishes the medical community's ability to leverage access to provider support from almost anywhere in the world," said Army Lt. Col. Sean Hipp, BAMC V-MEDCEN director.

"The medics worked side by side with us providing direct patient care," Sessions said. "It was similar to being downrange where you have medics practicing within their full scope. A lot of our job is teaching them to practice within their full scope, which is something we are working on here at BAMC."

The emergency medicine physicians were there to provide training for medics and nurses who weren't used to practicing emergency medicine in that type of environment. The military medical personnel also worked closely with local medical personnel.

As conditions improved, more local hospitals and clinics became available to help support the needs of patients who required medical care.

"As time went on it was more about informing people where to go and what was open, and less about patient care," Sessions said.

All agree that even though they faced many challenges during this mission, they found it to be a rewarding experience with many lessons learned.

"It was absolutely rewarding, as deployments go, it's hard to beat going and helping people who truly need the help," Myers said.

"There were several pediatric patients who benefited from the care we provided," she added. "I can't imagine how terrified it must be to have your child sick and not know where to get help. I think having our facility open provided not only medical care, but a lot of reassurance for families at a terrifying time."

Sessions said they learned valuable lessons during the humanitarian mission about the types of injuries and environmental challenges military medical personnel would see during a severe weather event, such as a hurricane.

"Coming back here, we are able to communicate to our medics and docs, so that when it's their turn to take up this mission, they will know what they need to bring in terms of personnel, equipment and training prior to deployment," Sessions said.