Stories From the USNS Comfort
Students at Ross University School of Medicine (RUSM), by virtue of the school’s integrated curriculum and unique setting, already have ample opportunity to gain early clinical experience and an in-your-backyard taste of what global medicine really means.
But the July 2015 visit to Dominica by the USNS Comfort, a US Navy hospital ship, ratcheted up this part of the RUSM experience to a new level. About 900 RUSM students joined Comfort medical personnel to participate in and observe a wide array of health services provided to the people of Dominica.
The USNS Comfort is an enormous mobile medical vessel equipped with 12 operating rooms and specialized trauma centers. It’s as long as three football fields and as tall as a 10-story building. From July 27 to Aug. 6, the Comfort docked in Roseau, the capital city of Dominica, to provide screenings, patient education, surgical care, and other healthcare services to local residents. It’s all part of Continuing Promise, a six-month Navy medical mission that launched in March 2015 and has included stops in Jamaica, Costa Rica, and other countries on similar initiatives.
When the Comfort docked on Monday, July 27, the Navy carried medical technology and supplies from onboard down to mobile screening clinics in the field, setting everything up in unused classrooms in two Dominican schools—Roosevelt Douglas Primary School in Portsmouth and the Dominica Grammar School in Roseau. These satellite clinics were geared toward a multitude of specialties—one for women’s health, another for radiology, a third for pediatrics, and so on—and students had the opportunity to shadow physicians both in these clinics and on the ship itself. Although all students observed, many took the opportunity to practice interviewing patients, perform blood pressure checks, or perform other minor procedures.
In an interesting twist, students served as a valuable liaison between Dominican citizens and the Navy. Dominican citizens generally keep a “medical book”, a composition notebook filled with pages and pages of prescriptions, conditions, and medical data. The Navy had no way of knowing this, but RUSM students, many of whom work in community clinics, did know, and that information helped the Navy physicians do their jobs.
Though security to the interior of the ship was tight, some students actually got to board the Comfort itself. Some Dominican patients had been pre-screened for surgery on July 27, and those surgeries were performed later that week onboard the ship in one of its 12 operating suites. Students got to scrub in, observe, and ask questions as surgeons removed tumors, repaired foot injuries, conducted some plastic surgery, and more.
For the medical personnel aboard the Comfort, the visit to Dominica was part of an ongoing humanitarian mission. But for the RUSM students who participated, it was much more: an eye-opening experience to what it means to be a doctor, and for many, a greater lesson than books or lectures, or even standardized patients, can provide.
I never experienced this kind of trip before. It’s amazing. We see people on this island who don’t have American healthcare. They don’t have laproscopic surgery. I’m interested in surgery. The numbers of people showing up, needing care!– Salman Emran, 3rd semester
How the US Navy Brought Comfort to Dominica
The USNS Comfort, at first glance, is as unassuming as an enormous, 10-story-high seagoing vessel can conceivably be. In fact, if you overlooked the giant red crosses that dot the ship’s exterior, it would probably be pretty easy to mistake the Comfort for just another ship.
But that’s just from the outside. Board the Comfort—like some of our first-year students did—and you’d be hard-pressed to call it anything other than what it is: a mobile, floating hospital equipped with enough technology and personnel not only to conduct onboard surgeries, but to set up multiple mobile healthcare clinics to diagnose and treat patients throughout medically underserved communities.
It’s all part of Continuing Promise, a six-month humanitarian medical/dental mission that the United States Navy has run since 2007. This year, the Comfort made stops throughout the Caribbean, Central America, and South America, providing screenings, diagnoses, patient education, and treatment at no cost to underserved citizens.
In Dominica, the Comfort’s arrival collectively drew thousands. And RUSM students got to play a part in what they and medical school faculty are calling a once-in-a-lifetime opportunity to see how medicine is actually practiced on a global scale.
Students Out in the Field: Working in Navy Medical Clinics
The Navy physicians chose two sites in Dominica for their clinics—Roosevelt Douglas Primary School in Portsmouth, and Dominica Grammar School in Roseau. Personnel converted classroom space into clinical settings, swapping out desks and chairs for medical instruments, X-ray tech, and supplies. Patients who came to the sites chose the clinic that fit their own situation best—whether that was general health, pediatrics, or another—and sat down with Navy physicians, who were often flanked by RUSM students clad in white coats.
For example, Odira Obiaju, a third-semester RUSM student who originally hails from Texas, sat in the general health clinic with a Navy physician who was able to diagnose and treat individuals at a rate of one patient every five minutes. What really struck her during her shadowing experience, she says, was that she was able to connect what she’s learning in the classroom to real-life patients in the field.
“We went over mostly GI (gastrointestinal) cases during my time in the clinic—which was really cool, because we had just finished with GI a week before in the classroom,” Odira says. Laughing, she adds: “It’s really cool to know that all of the time spent in lecture isn’t because the faculty hates us and wants to punish us—it’s because we actually need to know this. It’s out there in the real world.” Patients were treated for dysphagia, reflux, and other GI-related conditions, among many others.
Like many student volunteers, Odira mostly observed Navy doctors during her experience. Others, though—depending on the physician and clinic they were in—were able to jump in and perform simple tasks, like measuring a patient’s blood pressure. And some had a chance to use technology and perform procedures that they’ve never done before, like electrocardiograms.
For more firsthand accounts from the field, explore our Student Stories section.
Onboard the Ship: Scenes from the Comfort’s Operating Suites
Meanwhile, other Navy medical personnel (plus RUSM students) were onboard the Comfort itself, where most of the more elaborate surgical procedures took place in one of the ship’s 10 operating suites. On Monday, July 27—the first day the Comfort pulled in to Dominica—surgeons and surgical techs spoke with some prescreened patients, determined what surgical procedure those patients wanted, and decided whether the patients actually qualified for surgery. Those who did were brought on to the ship for surgery over the course of the Dominica campaign.
RUSM students, mirroring the physicians they were observing, scrubbed in after boarding the ship. A few students ended up spotting patients they had seen earlier that week during the pre-screenings. One patient, whose surgery was observed by RUSM students Gretell Gomez (second semester) and Shoma Sanyal (third semester), had something called a keloid, a type of skin growth made up mostly of collagen. People prone to developing keloids have wounds that don’t heal normally—the scar tissue around the wound becomes overgrown, extending past the boundaries of the wound.
“It’s benign, but the keloid was roughly the size of a fist, and it was right up against the patient’s ear,” Gretell recalls. “The surgeon took it off right there—we were able to get really close up. We saw everything.”
“I’d seen him come in [for the prescreening], and I thought it was really cool to see these cases from start to finish,” adds Shoma. The same thing happened later: another patient, onboard the Comfort to have a cyst removed from his left hand, recognized Shoma. “He recognized me, and it was a friendly face,” she says, smiling. “We sort of had a moment there.”
Both students agreed that they came away from the Comfort campaign with an understanding of medicine that they couldn’t necessarily learn from books.
“We have the medical mission field literally in our own backyard,” Gretell says. “First-year medical school students don’t get this clinical exposure, but we’re in a place that, thankfully, makes a big deal about it. Volunteering for this was a thousand percent worth it.”
“We get the opportunity to take it from the books to real-life practice,” Shoma adds. “It really was a once-in-a-lifetime opportunity that I’m honored and fortunate to have had. I don’t think you would get this at any other medical school, anywhere else. It truly is the international experience.”
Want to read about more student experiences onboard the Comfort? Check out the Student Stories section.
What Clinics Did the Navy Set Up in Dominica?
Patients were able to visit clinics for:
- General health
- Women’s health
- Dental services (run by Operation Smile)
- Patient Education
What’s Onboard the USNS Comfort?
- Intensive care unit
- Physical therapy and burn care
- Casualty reception
- Main laboratory and satellite lab
- Radiological services
- Central sterile receiving
- Dental services
- Optometry/lens lab
- Two oxygen-producing plants
- Medical photography
- Four distilling plants to make drinking water from seawater
The USNS Comfort, By the Numbers • 80: Beds available in intensive care wards • 20: Beds available in recovery wards • 280: Beds available in intermediate care wards • 120: Beds available in light care wards • 500: Beds available in limited care wards • 1000: Total patient capacity • 12: Number of operating rooms onboard