NEWS | July 6, 2010

MEDEL assists Ministry of Health with nutrition study

By Tech. Sgt. Benjamin Rojek Joint Task Force-Bravo Public Affairs

Imagine, if you will, living in a remote mountain village. Some people have small amounts of livestock and farmland. Other villagers must make a five-mile roundtrip trek on foot in order to get any type of subsistence on minimal income.

What kind of food would you buy? How much would you eat? What types of vitamins and minerals are you taking into your body? How does all that affect your health and the health of your family?

The Honduran Ministry of Health, in an effort to educate and improve the dietary needs of its citizens, tried to answer these questions and more by partnering with Joint Task Force-Bravo and South Dakota State University to gauge first-hand the dietary and health conditions of people in remote areas here June 26-30.

The program was started in 2001 with the help of then-Lt. Col. Teri Kemmer, a U.S. Army dietician. JTF-Bravo was going to assist the Ministry of Health while at the same time provide joint training for military pediatric residents. Colonel Kemmer was brought in as a nutrition consultant and decided to bring junior military dieticians along. After retiring from the Army in 2007, Colonel Kemmer became Dr. Kemmer, the assistant professor of nutrition, food science and hospitality at South Dakota State University. Since she had historical connection to the program, JTF-Bravo asked for her continued support.

"Part of the JTF-Bravo mission is to make more linkages with schools and non-governmental organizations to expand the humanitarian mission capabilities offered to the Ministry of Health," Dr. Kemmer said. Therefore, since she joined SDSU, everyone from medical to dietician students has participated in the program along with JTF-Bravo and Honduran doctors.

"It's the perfect fit," Dr. Kemmer said.

House calls

In Barrio El Centro of Los Planes, Honduras, there is one small town center with a few shops, a video game arcade and a couple of restaurants. While people do live in town, many live outside it in small gated communities or in remote areas that can only be reached by horse or on foot. There is one clinic here and when it opens up to provide vitamins and supplements to the residents, locals line up along the porch outside.

This is where the group stopped June 28 to conduct their survey and provide care. Five teams split up the area and headed out to homes randomly selected by the Ministry of Health. The selections are pulled from a list of households that include at least one child more than six months but less than five years old, the age group being studied by the Ministry of Health. Once the team members obtain permission from the head of the household, the team measures the child's height, weight, and the middle and upper arm circumference, as well as the hemoglobin of the mother and child.

"We check for anemia and malnutrition," said Dr. Kemmer. "If we find these problems, we provide treatment and refer the family to their local health care system."

During the June 28 mission, for example, one of the teams found out a child was suffering from seizures. The team then drove the mother and child to a hospital more than an hour away to ensure the child got necessary treatment.

"We identify diseases for referral, acting as a sort of triage," said Dr. Miguel Coello, a liaison officer for the Medical Element here. "This helps the patient and builds trust with the Ministry of Health."

After all the housecalls, the the entire group of students and JTF-Bravo personnel visited a school in La Paz on June 30. They spent 10 hours there, teaching preventive medicine, screening patients for injuries, illness or malnutrition, and delivering medicine to those in need. By the end of the five-day mission, the 22nd since its inception, the teams saw 669 patients.

While addressing the current health needs of the families is important, the information gathered by the teams is vital to the Ministry of Health's nutrition program. Part of the mission is to educate the families on foods that promote iron sufficiency, as well as folic acid sufficiency for women of child-bearing age. A diet lacking these micronutrients can lead to spina bifida.

The teams go into the field three to four times per year, not only conducting health check-ups and education, but also following up with local health care providers. This allows the Ministry of Health to have the most up-to-date information on what areas need the most help and measures the impact of nutrition intervention measures.

"If (the ministry) provides fortified wheat flour to these areas and the people are not using it, they can find out where to better put their efforts," said Dr. Coello, who helps coordinate these missions with the Ministry of Health. "Policies are made based on our information."

Always ready

JTF-Bravo's Medical Element is always standing postured to provide humanitarian relief assistance to U.S. Southern Command's area of responsibility. Whether it's joining Joint Task Force-Haiti or helping victims of the flooding in El Salvador, the MEDEL team is ready to go. A large part of that mission readiness can be attributed to conducting missions such as the Honduran Ministry of Health program.

"We have to remain active to maintain our skill level," said Dr. (Lt. Col.) Joe Bray, the MEDEL deputy commander. "This mission keeps us ready and allows us to do good things while we're here."

Through this mission, medical personnel receive training on doing medicine in an austere environment, malnutrition issues and working with local counterparts. But it's not just the medical personnel who get something out of this: military drivers get a chance to conduct convoy operations; translators get to practice their language skills; communications and medical equipment are tested.

"All of this helps us stay postured for our humanitarian relief mission," Dr. Bray said.

By conducting this mission in these remote villages, JTF-Bravo not only assists the nation of Honduras in ensuring the future health of its people, but it also builds better relations with all of its Central American neighbors.