By Mr Jeffrey M Soares (Army Medicine)November 22, 2011
Bangkok, Thailand, is partially flooded, and the city is reeling with anxiety.
It hasn't happened in nearly half a century, but it isn't very surprising considering that the past year's weather pattern has given the world earthquakes, typhoons, tornadoes, hurricanes, extreme heat, frigid cold, and monsoon-like rain -- yes, lots and lots of rain -- in record numbers.
The Armed Forces Research Institute of Medical Sciences located in downtown Bangkok carries on, business as usual, despite the fact that practically all staff members face possible flooding in their homes.
As a Special Foreign Activity subordinate command of the Walter Reed Army Institute of Research, and ultimately the U.S. Army Medical Research and Materiel Command, AFRIMS plays a critical role in helping to protect both warfighters and civilians against potentially deadly diseases including malaria, Japanese encephalitis, dengue, bacterial diarrhea, and HIV.
"All research and our mission continues," said Col. Robert Bowden, commander of AFRIMS. "We have been educating our staff to be very careful and set good examples for the community members by being alert and aware of waterborne diseases -- such as Leptospirosis, Cholera, and Hepatitis A -- and to use precautions as much as possible."
Although wading through water about 1.5 meters deep may seem like a trivial task to most, it becomes quite significant when the painstaking work of many scientists and military personnel is threatened with destruction.
AFRIMS maintains three large warehouse spaces in the Rangsit province, just north of Bangkok, and one of these spaces has 100 freezers that hold nearly 1 million research samples. If the waters were to reach the freezers and shut down the cooling system, the efforts of hundreds of studies would simply be washed away by the flood.
But the commander and his team refuse to let this happen.
"Several teams of scientists and technicians from each department along with their Royal Thai Army colleagues collectively moved all of the research samples to 'boxcar'-like freezers that have been stationed in front of the AFRIMS VetMed complex, which is about 20 kilometers [12.5 miles] from the original location in Rangsit," said Bowden. "Elevated by 3 meters, these freezers are operational, on back up with generator power, and have dry ice stored on sight if one fails and immediate transfer is required to another unit."
Bowden holds the members of his staff in very high regard, with good reason.
"Maj. Paul Watkins, Chief of Logistics, Sgt. 1st Class Corey Powell, non-commissioned officer in charge of logistics and motor pool NCOIC, and Staff Sgt. Jeffery McDonald, NCOIC of medical maintenance were key in providing the leadership and establishing the resources for the AFRIMS rescue efforts," said the commander. "Capt. Trent Peacock, a newly arrived Medical Service Corps microbiologist in the Department of Enteric Diseases, along with a team of medical maintenance technical specialists and volunteers from each department are to be most credited with the brick walls, tarps, and ingenuity that led to the protection of the entire freezer farm from flood waters no more than a half-inch deep inside the farm. Their proactive efforts allowed for no loss in property, no loss of electricity and, above all, no injuries."
As perhaps an affront to the existing threat, the entire AFRIMS staff is pressing forward to ensure that neither current nor future work will be affected.
As Bowden said, "We continue to conduct our Phase III clinical trial in Northern Thailand, as well as all other IRB [Institutional Review Board] and IACUC [Institutional Animal Care and Use Committee] protocols. We continue to write proposals to MIDRP [Military Infectious Disease Research Program], GEIS [Global Emerging Infections Surveillance] and all other agencies. And all staff continues to perform temporary duty and other functions to conduct ongoing or future protocols."
"In conjunction with III Marine Expeditionary Force medical augmentation team, 5th Preventive Medicine Unit from the Eighth U.S. Army, Korea and the Royal Thai Army, Navy and Air Force, AFRIMS is supporting the flood recovery effort with subject matter expertise in dengue, malaria, insect (vector) control and assessment, diarrheal disease , respiratory illness, and veterinary services (human-animal disease interface). The III MEF Medical Team and AFRIMS met with the Royal Thai Army Medical Department Surgeon General and his staff, and together they have proposed a plan to join the Royal Thai Army military medical teams that attend patients affected by the flood currently residing at any one of six of the Royal Thai Army military evacuation shelters. This plan will include AFRIMS staff and III MEF medical forces as the mission requires. AFRIMS has suggested and facilitated a meeting of the III MEF medical team and the Royal Thai Navy Surgeon General and Royal Thai Air Force Medical leadership to discuss needs and a plan-ahead strategy for infectious disease prevention and surveillance."
All this seems rather impressive, but it doesn't end here.
Bowden says that AFRIMS currently is poised in support of other likely disease outbreaks that may occur subsequent to the flood waters receding in the Bangkok region. There are also reports of diarrheal disease in Nonthaburi, an area northwest of Bangkok.
Nevertheless, the AFRIMS team is ready to help the surrounding Thai community with whatever is necessary, primarily because of the "fantastic" bond between the two.
"We have a strong relationship with our Thai hosts and colleagues … [and] we stand ready with clinicians and laboratory support staff to help them," said Bowden.
"We would not abandon them in search of 'higher ground.'"
Celebrating its 50th anniversary, AFRIMS is the successful result of a collaboration involving the United States and Thailand governments to create a joint medical research laboratory in Thailand, initially formed to combat the spread of cholera throughout the country. Today, AFRIMS works to create vaccines, drugs, and diagnostics for tropical infectious diseases that affect millions of people each year. Without the efforts of this focused group of partnering individuals, the lives of many thousands around the world could be lost annually.
The partnership is so strong, in fact, it dictates how the AFRIMS team takes care of its host community.
"If it floods here [inside the campus], we'll clean it up and make it shine. We'll mitigate against mold or other issues that arise from long-term stagnant water collection. We'll refurbish what may be damaged," said Bowden. "We stand with our colleagues to assist."
While the damage to the AFRIMS facility is minimal at this point, the commander notes that a few items are still needed in anticipation of the recovery effort that lies ahead. These include 15 portable pressure washers, 50 mattresses for affected staff who are currently staying at AFRIMS, and sheets, towels, and blankets for these displaced staff members.
Although the current outlook is positive, with electricity flowing, hospitals functioning, and no widespread disease, the AFRIMS team still must anticipate a worst-case scenario, and all plans are in place to mitigate extensive damage and illness in this unlikely event. Despite this, it's probably safe to say that Bowden and his AFRIMS colleagues won't let a little water get the best of them. Or even a lot of water.
It hasn't in 50 years.