1. LT Racquel Stephenson, MPH, REHS COF Symposium EHO Category Day June 21, 2011

2. Background  Four month duration (July-November 2010)  Mission: Provide medical care and infrastructure improvements in eight nations Provide humanitarian assistance and disaster response SMEEs; aid in the event of a disaster

3. History  5 th mission in four years to the region  Previous missions: over 270,000 patients treated numerous infrastructure projects completed millions of items donated hundreds of thousands educated Information Source: United States Southern Command: Continuing Promise 2010 (http://www.southcom.mil/appssc/factFiles.php?id= 155)

4. USPHS Involvement  Invited by US Navy  Previous involvement in CP09  Coordinated by OFRD  OIC: CAPT Maurice Sheehan, FDA

5. The Amphibious Ship USS Iwo Jima (LHD 7) Information Source: United States Southern Command: Continuing Promise 2010 http://www.southcom.mil/appssc/factFiles.php?id=1 55)

7. Background  Diplomatic mission  Direct care and public health Primary care, optometry, surgery, ob/gyn, dentistry dermatology, pharmacy, veterinary, prev med, health ed  Engineering  Training Information Source: United States Southern Command: Continuing Promise 2010 (http://www.southcom.mil/appssc/factFiles.php?id= 155)

8. Background  Crew: 1700 U.S. Uniformed Service personnel ○ DOD ○ USPHS NGOs (40+) International Partners

9. CP10 PHS 2 nd Rotation Costa Rica and Guatemala  PREV MED CAPT Rossanne Philen, Medical Officer, Translator/ Health Educator, CDC CDR Carma Ayala, Health Educator/ Translator, CDC CDR Michael Schmoyer, Health Educator/ Translator, CDC LT Racquel Stephenson, EHO, ATSDR  DENTAL CDR Cristino Gavarrete, Dentist, ICE  PHARMACY LCDR Yon You, Pharmacist, CDC LT Lisa Tung, Pharmacist, FDA

10. Daily Life  12-16 hour days (0530 - 2200)  Meals (Wardroom or MREs)  Transportation LCU or Helo to/from shore (if no port) Vans  Clinic hours: 0800 – 1600  Cleaning stations (if not manifested)  Team briefs  Mission briefs  2 minute showers!  Drills

11. Pharmacy Health Education Environmental Preventive Medicine Dental

12. Preventive Medicine  4 drinking water facility assessments  2 solid waste site assessments  2 safety assessments  1 restaurant inspection  3 dw assessments at private establishments

13. Health Education  Basic hygiene  Point of use drinking water treatment/storage  Vectorborne disease prevention  Chronic disease prevention CVD Diabetes

14. Other Prev Med Activities SMEEEntomology

15. EHO Lessons Learned  Prev Med Bring supplies/equipment for chlorine testing Bring supplies for testing to provide to host nation (HN) Bring health education materials, preferably ones that are interactive for kids Limited photocopy/printing Limited computer access

16. EHO Lessons Learned  Prev Med cont’d May be viewed as expert if only EHO Limited ability to provide concrete/tangible solutions to HN ○ Awareness and Education Challenges with follow-up

17. EHO Lessons Learned  Health Be prepared for daily exercise Hot/humid, no AC at clinics Hydrate Bring snacks MREs are tasty at first, but… Malaria prophylaxis Stress relief (day off, gym, recreation) Bring hand sanitizer/wipes and toilet paper

18. EHO Lessons Learned  Cultural Competency Attend mission briefs Pre-conceived ideas about US, HN, and mission Considerations when approaching HN counterparts Considerations when devising health education messages/interventions Bi-lingual team member(s)

19. Questions?