By Maj. Matthew Lawrence, 807th Medical Command (Deployment Support)September 30, 2011
TEGUCIGALPA, Honduras, Sept. 30, 2011 -- The scene at Hospital Escuela is crowded. People stuff themselves into the lobbies and hallways of the hospital, waiting to see medical professionals for problems from earaches to gunshot wounds. The emergency room is packed with patients waiting to be seen, family members, and even a disoriented patient holding his own IV bag.
Hospital employees scurry about the crowds, quickly doing what they can to process everyone through. It is hard to see the order through the chaos. This is where the 807th Medical Command (Deployment Support) biomedical repair team has decided to help make a difference.
This 1,200-bed public hospital has a lot of equipment -- most of it donated from hospitals and countries around the world. The problem is, a lot of it doesn't work, and the Hospital Escuela doesn't have the money or the training to repair it all. The yearly budget for repair parts at the hospital is $20,000, less than is needed to fix a bulb on an X-ray machine -- and the hospital has several inoperative X-rays alone.
"We could spend a year here with this team of 10 repairmen, and still not be done [fixing everything]," said Chief Warrant Officer Fred Hodges, Senior Biomedical Repair Technician for the 807th.
Donations to this public hospital are plentiful, so it has been easier in the past for the doctors and biomedical repair technicians to push the inoperative systems aside and start using a new one. Add to that another issue -- just because a piece of equipment is donated does not mean it arrives operational and with all its components. Many pieces of donated equipment arrives broken or without manuals.
There are several rooms full of broken equipment throughout the hospital, and also storage containers outside. And for a hospital this large, space is at a premium. For example, of the several x-ray machines the hospital owns, only two are operational (and one of those only intermittently), and many of the broken systems occupy entire rooms themselves. This ratio repeats itself through every department.
"The E.R. has two full closets of equipment that is either broken, or they don't have the proper manuals to fix them or the manuals to even operate them," said Sgt. 1st Class Anthony Saunders from Westminster, Calif.
The age of much of the equipment is also an issue. The average age of medical equipment in the hospital is 15 to 20 years, which often makes repairing them difficult.
"The majority of them [machines] are old equipment, and some of them are even obsolete. We call the vendor, and they don't provide any more service or parts for that type of equipment," said Capt. Nahum Reyesperez, the team's chief translator and coordinator.
While the hospital employs 10 equipment technicians (plenty for a hospital this size), they have very little tools with which to do their job, and the little electronics they do possess are not well maintained. The technicians, when the 807th first arrived in July, would only attempt to fix the critical equipment that was broken. The situation is critical.
"I was surprised of the fact that the biomeds didn't have any tools, not a screwdriver of any kind, and they were just working with what they had -- what was left over, borrowed stuff, and things they brought from home," said Saunders. "They were still trying to maintain a 1,200 bed hospital with barely anything."
The 807th sent a survey team to the Hospital Escuela in July to examine the equipment the hospital had and order parts to fix the most critical items. They also did an assessment of the hospital's maintenance team and their processes, which were all but non-existent.
"There is no maintenance program," said Reyes.
But the story of Hospital Escuela is not of a third world hospital that cannot give quality care to anyone. It is an inspiration to see how much the hospital's nearly 1,700 medical employees can accomplish with what they have for so many people. And in the maintenance department, one man is making a drastic improvement. In the short time he has been there, his leadership has made a difference.
Samuel Medina-Aguilar is a portly, energetic man with a dark complexion. He arrived at Hospital Escuela in late August and immediately went to work. There is no mistake, he is a maintenance and logistics professional, well-versed in the fundamentals of the trade. His formidable task is to establish order where there is none.
"The main problem is the lack of preventive maintenance. It's just not being done," said Medina through a translator, agreeing with the U.S Soldiers' assessment.
Medina's presence has several benefits. His position as a director at the hospital gives the maintenance visibility that it didn't have before. His challenge is to successfully manage and record the activities of the biomedical maintenance section so that the hospital can increase the budget and enable them to make major repairs.
The importance of Medina's presence is not lost on the U.S. Soldiers here.
"Now there's somebody in charge, whereas before, nobody wanted to take responsibility for the department," said Saunders. "There's more of an attitude of wanting to do good work for the hospital. They're more visible in the hospital now. They're getting out of the shop and going to departments and visiting with the directors and doctors and nurses to see what they can do with what little they have."
The 807th biomed repair team hopes that they can return in three to six months to monitor the progress of the maintenance team at the hospital. For the moment, the future looks promising, but only time will tell if new leadership and some training from U.S. Soldiers make a lasting improvement at Hospital Escuela.