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US military medical teams try new approach in Central America

(CENTRAL AMERICA) — U.S. military medical teams have carried out medical missions in Central America for decades, but a recently completed mission to Honduras and Guatemala may set a new standard for future health care missions.

During what was known as HEART 22, the military’s acronym for Health Engagements Assistance Response Team, about 50 military medical personnel worked out of major medical facilities in Honduras and Guatemala, working alongside local doctors and medical staff who will provide enduring medical care to the patients treated during the mission.

HEART 22 was a departure from previous medical missions carried out solely by the U.S. military at rural medical facilities. About 50 U.S. Air Force and Army medical professionals and support staff participated in the two-month mission that began in July providing eye surgeries, dental care, and orthopedic surgeries for a month in Honduras and two weeks in Guatemala.

“We see it as a great opportunity to really enhance and cooperate in collaboration with the host nation and more on one on one basis, sharing experiences sharing knowledge, and providing excellent quality of care for the population in the area,” Dr. Richard Aviles told ABC News. Aviles is a Honduran doctor who for the last 30 years has helped organize the U.S. military medical missions run by Joint Task Force Bravo in Central America.

Based in Honduras since 1984, JTF Bravo, as it is more commonly known, is one of the U.S. military’s longest lasting overseas military missions but little known to the American public.

Established at a time when the U.S. was concerned about Central American insurgencies backed by the Soviet Union, the mission evolved into a counter-narcotics mission and now focuses on humanitarian and disaster relief. JTF Bravo is made up of 500 U.S. military personnel and 500 American and Honduran civilians operating at an airbase in central Honduras.

Originally planned to take place before the COVID19 pandemic, Heart 22 was a new initiative by U.S. Southern Command to address requests by Central American governments for a different type of military medical mission.

It “allows us to have some targeted engagement with regional partners at their request, helping them meet the needs of their specific country and their health systems,” Col. Phillip Brown, JTF-Bravo’s commander, told ABC News in an interview.

“It was a very tangible way for us to demonstrate that we are the trusted regional partner and you get to see it in action in a very local level in these hospitals,” he added.Addressing previous concerns about the need for follow-on care in remote locations after U.S. teams left smaller medical facilities, HEART 22 focused on larger hospitals in major cities in Honduras and Guatemala.

For example, at San Felipe Hospital in Tegucigalpa, Honduras, U.S. military ophthalmologists worked with Honduran doctors in what Aviles characterized as a “win-win for both sides.”

“Because patients are guaranteed that they’re going to have their follow up,” said Aviles. “That’s something that we have learned throughout the years with JTF Bravo in where it’s critical for us to guarantee that.”

Aviles said JTF Bravo had stopped doing ophthalmology in Honduras in 2009 “[s]imply because we were not finding the volunteer ophthalmologist that will do the follow up for the patients,” which is something they had tried to guarantee.

“The first rule in medicine is don’t do harm, and that’s important for us,” he added. “That’s why we’re happy that we now have this concept like in HEART where we can work side by side with the ophthalmologist and it actually encourages them as well to participate.”

“There’s ownership by the host nation instead of just coming in serving just the people,” he said. “We still serve the people in need, but there’s a participation and degree of bigger degree of responsibility from the host nation providers.”

About 1,200 patients were treated by HEART 22 medical teams working at four major hospitals to help alleviate a surgical backlog that had built up since the pandemic.

“We helped out a lot of people that didn’t have access to certain funds in regards to orthopedic cases, ophthalmologic cases ,and dental,” said Capt. Alexandre Rogan, the U.S. Air Force officer in charge of the mission in Guatemala.

That meant bringing in surgeons and dentists proficient in medical techniques that shorten recovery times, as well as equipment and supplies that were left behind.

“Because we have more time than just a day or two on ground, we’re able to then truly identify those that are in need, provide a continuity of care for them, and then ensure that continuous follow up happens,” said Rogan.

The medical team that served as part of HEART 22 adjusted to different working scenarios in Honduras and Guatemala.

“It gives you a more well-rounded opportunity because you got a different experience in each country in a way,” Sr. Airman Alexsis Green, a dental assistant stationed at Minot AFB in North Dakota, said in an interview.

Green explained that because of the large dental program at Tegucigalpa’s Hospital Escuela “they had us jump right on in so we were working hand in hand with them” while at the hospital in the western Guatemalan city of Quetzaltenango the U.S. team carried out most of the dental procedures because the local dental team was much smaller.

To enable long-term care at the hospitals they worked at the HEART 22 team left behind medical equipment and supplies they had brought with them.
Green said that included several dental chairs that would be used at Hospital Escuela that would enable the treatment of additional patients.

The dental assistant described her HEART 22 experience as an “awesome opportunity” where both the U.S. and local teams learned from each other.

“I hope that this mission continues throughout the years and allows other people that opportunity,” she said.

“We’ve been asked to come back,” said Rogan. “Our partner nations would love for us to do this again.”

But details about how that could happen remain to be determined as the original planning for HEART 22 was for it to be a onetime mission.

JTF Bravo commander Col. Brown understands the interest by Central American nations in replicating the new mission but knows that will come with challenges.

While smaller medical missions like the ones carried out by JTF Bravo for decades will continue, Brown sees the value in another HEART mission.
“I don’t think we can close the door on whether we can do HEART 2.0 again that makes sense.”

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