Thursday, June 28, 2012

‘Beyond the Horizons’ Clinic Fosters Health, Goodwill


By Donna Miles
American Forces Press Service

POCOLA, Guatemala, June 28, 2012 – Thousands of local residents in this remote mountain village are getting what for many is one of their first experiences seeing a doctor, nurse or dentist during a five-day medical readiness training exercise being conducted here during Beyond the Horizons 2012.

U.S. service members, working hand in hand with Guatemalan doctors and health and agricultural officials and several Canadian and Colombian medical officers, are sponsoring the clinic as part of U.S. Southern Command’s largest annual humanitarian civic assistance mission. This week’s exercise is the third in Guatemala since Beyond the Horizons kicked off in April.

The crowds began assembling yesterday hours before the clinic moved into its third day, forming a line that extended miles beyond the tiny school that had been temporarily converted into a medical clinic. Young and old, all clamored to receive one of the 700 coveted tickets that served as the price of admission to preventive medical classes and sessions with military medical professionals specializing in internal medicine, women’s health, pediatrics, dentistry or optometry.

“We try to increase it each day, to give as much chance for as many people to get seen as possible,” said Army Capt. Sherry Kwon, an Army reservist from the 352nd Combat Support Hospital serving as officer in charge of the clinic. “When you have people willing to come and wait hours and hours for a bag of vitamins, it’s so humbling that you want to do everything you can to help as many as possible.”

The first stop for all patients was a preventive medicine class, where Army Capt. Gloria Graham, a 352nd CSH nurse, reviewed along with a Colombian military doctor the basics about washing hands, boiling water to sanitize it, keeping food, utensils and toilet facilities covered to keep insects away, and practicing oral hygiene.

These lessons are critical in a region where periodontal disease and intestinal parasites are the leading killers, explained Army Sgt. 1st Class John Williams, the 35th Engineer Brigade’s operations noncommissioned officer for the clinic.

Graham periodically strolled to the back of the room to chat in her native Spanish with children seated around a table with sheets torn from a coloring book and crayons in hand. Holding up a poster of a smiling girl, she gave each a chance to demonstrate how to use the toothbrushes she had given them, drawing shy giggles as she gestured the techniques herself.

Across the courtyard, Army Col. Theresa Mercados-Sconzo, a nurse administrator and 352nd CSH battalion commander, and Army Maj. (Dr.) Mike Crownover, an emergency room physician, consulted with a steady flow of patients suffering from vitamin deficiencies, abdominal issues, worms and other ailments.

Meanwhile, dozens of people waited outside the busiest clinic, where a team of dentists from the 133rd Medical Company in Colorado and dental technicians from the 185th Dental Company in California performed extractions and minor dental surgeries.

Studying the mouth of an elderly woman, Army Maj. (Dr.) Ricky Harrell, a professor of orthodontics at the University of Colorado, prepared to extract the tooth that had caused the woman so much pain for so long.

In an adjoining room, Army Maj. (Dr.) Jennifer Fiatreau, an active-duty optometrist from Tripler Army Medical Center in Hawaii, evaluated eye tests. In the adjoining room, Army Capt. Brian Kuruc from the 256th CSH kept the pharmacy humming to keep up with the demand for medications.

As they treated one patient after another, the service members said they were overwhelmed by the need for medical care and the appreciation patients extended for care they received.

“What we are seeing here is like nothing we see at home,” said Army Maj. Wayne Musgrove, a registered nurse. “Many of these people have had no or minimal medical care, so they really appreciate what we provide them. You can see how happy they are that we are here.”

“They are simply ecstatic to be getting this care,” echoed Mercados-Sconzo. “They couldn’t be more thankful.”

While providing a vital need, medical readiness training exercises serve as a learning experience for everyone involved, she said.

“They’re getting valuable training, similar to what they would get during a deployment,” she explained, as the exercises involve preparing for the mission and setting up operations in austere conditions. “But it’s also a learning experience across cultures. That’s one of the biggest takeaways: developing understanding and respect for other cultures.”

For Army Spc. Riyaz Jahn, a 352nd CSH medic, knowing the impact he and his fellow service members are able to make on people’s lives makes the mission one of the most satisfying he’s ever experienced.

“This is absolutely awesome. I love this,” he said. “It’s helping out the locals who need help and can’t afford it, and you have the gratification of knowing what this means to the people. You can see it in the kids’ smiles.”

“These missions are very important, and all of us are enthusiastic about coming because we feel like we are making a difference,” agreed Graham. “There’s no question that people appreciate what we are doing.”

Harrell, who joined the military at age 52 and has since deployed to Iraq and Afghanistan, said being able to provide a desperately needed service gives him a new perspective on life. “Being a part of this, I know that I’ve helped a few hundred people who wouldn’t otherwise have gotten help,” he said.

Kuruc, who deployed for similar missions in El Salvador in 2004 and Peru in 2007, said he shot up his hand to volunteer to participate in this one. “It’s very humbling to know we are here on a mission that is providing so much for so many people,” he said. “It may be a small band-aid to a big problem, but it’s very rewarding, and that’s why I came back.”

As they take pride in helping others, participants in the medical readiness training exercise said they recognize that they also are conveying an important message about the United States and the U.S. military.

Entertaining the local children as their parents awaited their medical care, Army Master Sgt. Gary Adamek of the Missouri National Guard’s force protection element blew up latex gloves into balloons and drew funny faces on them. He also staged a contest, giving the children plastic trash bags and challenging each to bring back the biggest load of trash strewn across the nearby hillsides to win the loose change Adamek and his fellow soldiers had thrown into a kitty.

“We realize that in everything we do here, we are ambassadors for the United States,” he said. “That’s everything we do -- whether it’s helping get rid of trash, or something as simple as blowing up a balloon.”

“I feel good knowing I am representing the United States,” said Army Spc. Scott Doney, a member of the 304th Engineers who volunteered to support the medical clinic because most of the engineering projects for Beyond the Horizons are now complete. “When I leave here, I want to be able to say that I came here and helped make a difference.”

Army Capt. Kwon said that difference will go a long way in U.S. Southern Command’s efforts to forge a closer, long-term partnership between the United States and Guatemala. “We’re forming a relationship between our two countries, and showing that we are friendly forces,” she said. “We are here to help, working together, united.”

Frontline Psych with Doc Bender: Treatment Options for PTSD


By Dr. James Bender, DCoE psychologist

Dr. James Bender is a former Army psychologist who deployed to Iraq as the brigade psychologist for the 1st Cavalry Division 4th Brigade Combat Team out of Fort Hood, Texas. During his deployment, he traveled through Southern Iraq, from Basra to Baghdad. He writes a monthly post for the DCoE Blog on psychological health concerns related to deployment and being in the military.

Posttraumatic Stress Disorder, or PTSD, can occur after someone experiences or sees a traumatic event. However, treatments for PTSD exist and work for most people. The sooner you receive treatment, the sooner you can learn skills to manage PTSD symptoms — many of which significantly worsen a person’s quality of life and ability to function over time.

The two main types of treatments available for PTSD include psychotherapy (e.g., prolonged exposure therapy or cognitive processing therapy) and medication (e.g., selective serotonin reuptake inhibitors).

Prolonged Exposure Therapy
 This treatment focuses on the body’s physical stress reaction (racing heartbeat, sweating, nervous feelings, etc.) along with ways to control this reaction. You and your therapist will identify situations where you feel these reactions inappropriately such as in crowded shopping malls or at the rifle range. You’ll then expose yourself to these stressful environments armed with skills that help you relax and manage distress. With time and practice, stress-related reactions will diminish, and you’ll be able to function better in everyday life. There are two reasons why this works. First, you learn how to consciously control your reactions to stressful memories, a skill that comes in handy in many situations. Second, as you become more exposed to stressful conditions, your body will naturally start to change its reaction.

Cognitive Processing Therapy
 You’ll examine thoughts and feelings related to the traumatic event and how it changed your thinking. For example, many people with combat experience may start to think that the world in general is a bad place. This thought will understandably lead to negative moods and attitudes toward the world, yourself and others. The goal is to replace this faulty thought with another, more realistic thought, like “certain parts of the world and certain people are bad, but there are a lot of good places and good people in the world. Right now, I’m in a good place.” This works because there’s a very strong connection between your thoughts and moods. When you identify and challenge thoughts and feelings associated with poor moods, the moods will usually change.

Selective Serotonin Reuptake Inhibitors
 These are in a class of medications initially used to treat depression but two medications in this class are approved by the Food and Drug Administration for PTSD (Paxil and Zoloft). These medications work by allowing your brain to use a certain neurotransmitter called serotonin more effectively. Serotonin has been linked to anxiety, which is a core symptom of PTSD.

So, which treatment is best? That really depends. Some people respond very well to one treatment and not well to others. Some people use a combination of medication and psychotherapy. Medications usually have to be taken for a year or longer while therapy usually lasts eight to 12 sessions with one session per week. The main points to remember are that treatment works and you have options.

For more on PTSD treatment and how it can help you or someone you know, view resources below. Thanks for reading, and stay safe.

Dempseys Discuss Challenges, Benefits of Military Moves


By Lisa Daniel
American Forces Press Service

GRAPEVINE, Texas, June 28, 2012 – The frequent relocations common to military life may be challenging to families, but they also are one way children become resilient and adaptable -- attributes critical to the military of the future, the chairman of the Joint Chiefs of Staff said here today.

Army Gen. Martin E. Dempsey made the comments as part of an informal “fireside chat” at the National Military Child Education Coalition’s 14th national training seminar. He was joined by his wife, Deanie, and retired Army Col. Jack Jacobs, a Medal of Honor recipient and vice chairman of the Medal of Honor Foundation, who asked the couple broad questions about today’s military.

The Dempseys moved 22 times in 36 years of service, they said, and all three of their children have served in the Army.

“In some ways, it is a burden,” the general said, “but it also is how our kids become resilient and adaptable. Part of being adaptable is being introduced to unfamiliar circumstances.”

It is those attributes that the military is “really going to need,” Dempsey said, “because we never [predict] the future right.

“In some ways, the military profession and its values and the versatility you have to have as a military family is really quite strengthening,” he added.

That resilience and adaptability starts with how parents handle the moves with their children, Mrs. Dempsey said. “It starts with the family and if you make each move an adventure -- and you’ve got to really sell some places,” she said, drawing laughter from the audience.

Also, “it’s the fraternity of the military family,” she said. “You can say [to the kids], ‘You will make new friends,’ or ‘You’ll be with Johnny and Susie from two moves ago.’”

Many military children grow up to enter the military themselves, Mrs. Dempsey noted.

“If it were that bad, they wouldn’t serve, too,” she said.

Military families also have more support than ever, the Dempseys said. As demands on military families skyrocketed after the 9/11 attacks and through 10 years of war, Americans have responded, many through public-private partnerships, which the chairman described as the best form of support. He credited the nonprofit education coalition as being one example of such support.

The chairman also credited the “Joining Forces” campaign created last year by First Lady Michelle Obama and Dr. Jill Biden, wife of Vice President Joe Biden, for its efforts to raise public awareness of military families’ challenges and sacrifices and to call on all sectors of society to support them.

Such organizations are “making a difference,” Dempsey said.

“This is about public-private partnerships. This is not the government imposing the idea that we should take care of service members and their families,” he said. “It’s about the government advocating that [support of military members and their families], and about the people of the United States’ communities and corporations stepping up.

“That’s partly a reflection of what we’ve asked our service members and their families to step up and do in these past 10 years, which is remarkable,” he added.

It also has helped, Mrs. Dempsey said, that there are many more programs today to help military families, and fewer divisions among rank.

“It used to be that officers and enlisted wives were separate,” she said. “At the end of the day, we’re all military spouses and we all just want them home.”

Who was this guy?


“He had confidence.  His knowledge about the job and what needed to be done was superior to others.  He had a sense of himself and what he brought to the job.  He had a vision of where he would take the team.” *

This is an excerpt from a US Army officer efficiency report for a certain lieutenant colonel who was serving as a battalion commander in the early 1990’s.  But what I would give if only it could be said about me and I think most of you would like this to be said of you as well.  It almost seems like an epitaph, something I think a lot of folks would like to be said as their eulogy, doesn’t it? 

When you think about the qualities and skills required to be an effective leader, I’ve written about some of these before.  The sense of confidence derives from the next sentence, knowing the job well.  That confidence is spawned because this person worked harder than most to know the job and knowing how to communicate it to his subordinates.  That communication is often done in pieces, yet the leader keeps the gist of the overall plan in play at all times.  By having a sense of himself, he took into account his strengths and weaknesses, knowing, for each task, which to emphasize and which to minimize or improve upon.  And perhaps most importantly, he wasn’t just trying to get the job done or make it until the next payday…he had vision, that extraordinary sense of the next level of accomplishment.  That extraordinary sense of making his team better and, thus, more valuable to the organization.   That extraordinary sense that goes far beyond the routine pluses and minuses of the daily grind of micromanagement.  

So who was this Army officer?  You probably heard of him later in his career when he was promoted to be General David Petraeus, now Director of the CIA.   I think his superior who wrote that OER some twenty years ago was pretty good at recognizing leadership talent.

*From All In, by Paula Broadwell, The Penguin Press, 2012

About the author:
David Ciarella is a Houston, Texas native. He has his bachelor’s from the University of Texas at Austin and served four years as an officer in the U.S. Army. He has experience in leading and building sales teams in the chemical and power industries and has won numerous awards for his work. Ciarella also has a U.S. patent and has written several articles for various publications.   For further information, please see www.TopNotchLeadership.com