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The Honolulu Advertiser
Posted on: Sunday, March 16, 2008

COMMENTARY
Medics treat sick, and much more

By Richard Halloran

Over the next few months, teams of U.S. Army doctors, nurses and support staff will head out from Hawai'i to remote areas in Bangladesh, Cambodia, Indonesia and Malaysia on what the medics call "Sight, Sound, and Smile Missions."

In each team, an eye doctor will remove cataracts to restore sight to an afflicted Asian. Ear doctors will seek to cure hearing losses in patients who have suffered from infections. Plastic surgeons will repair disfiguring cleft palates and facial tumors that, in many Asian nations, cause citizens to shun and discriminate against their impaired neighbors.

An Army doctor, Col. Thomas Crabtree, is a plastic surgeon at Tripler Army Medical Center who has been on several missions and operated on many Asian cleft palates and facial tumors. "When you pull that kid's face together," he said, "you pull his whole life together."

While the medical missions are genuine humanitarian works, they have a wider, more subtle motive, which is the application of "soft power" intended to win friends and deter potential adversaries.

At $70,000 for a weeklong mission to cover travel, living expenses, and medical supplies, they are relatively inexpensive investments in gaining influence, providing training for medics and gathering intelligence on the local scene. In a week, the medical teams can perform 100 cataract surgeries, restore hearing to 30 patients, and operate on 30 cleft palates.

The regions in which the teams work are among the poorest in Asia, remote places where people rarely see a doctor and have little access to hospitals. They are also areas targeted by Islamic terrorists such as Abu Sayeff and Jema'ah Islamiyah as prime sources of recruits. A young man whose health has been restored — and his family and friends — is less likely to respond to recruiting tactics.

In addition to the Army teams, the Pacific Air Force, at its headquarters in Honolulu, is planning a mission tentatively to be called "Pacific Angel." It may be ready to go out in May, possibly to Cambodia and Thailand, to render medical and dental assistance, along with some engineering programs.

In addition, the Navy, which deployed the hospital ship Mercy to Southeast Asia for five months in 2006, is planning to send the ship to the same region again in May. Medical teams performed 50,000 procedures, treating goiter, examining eyes for glasses, soothing burns, setting broken bones and giving shots. The amphibious ship Peleliu, modified as a medical ship, did 30,000 procedures on a similar voyage in 2007.

Mercy's doctors and nurses held seminars for local medical people. Technicians repaired respiratory ventilators, anesthesia machines, X-ray equipment and operating room lights in the Philippines, Bangladesh, and Indonesia. Seabees from Navy construction battalions fixed generators, repaired roofs, and painted hospitals.

All told, the Mercy mission cost $25 million.

Adm. Gary Roughead, who commanded the U.S. Pacific Fleet at Pearl Harbor in 2006 and has since become chief of naval operations in Washington, said then: "What Mercy does is to allow a force of good to go someplace, do good work and show people that there are alternatives to some of the forces that are in play in their part of the world."

Beyond the dispatch of military medical teams on visits, several more lasting ventures have developed, the largest of which is, surprisingly, in Vietnam. For years, the U.S. and North Vietnam fought each other and not until 1995 were diplomatic relations opened. Low-key military exchanges have taken place in recent years.

Today, the biggest U.S. medical mission in Asia is in Vietnam in a program that costs about $6 million a year. The U.S. helps Vietnam build clinics and laboratories, assists in education and training programs for medical staffs and provides a modest amount of lab equipment. A former Air Force lieutenant colonel and nurse is the permanent medical representative of the U.S. in Hanoi.

A regional medical training center established by the Thai government in Bangkok receives financial support from the U.S., and American military medics meet with counterparts from all over Southeast Asia there. That center is particularly concerned with preventing or responding to an outbreak of avian flu and is engaged in the struggle against HIV and AIDS.

China, which is almost always suspicious of U.S. military activity in Asia, has been reluctant to engage in medical exchanges with the U.S. until recently. U.S. officers at the headquarters of Pacific Command at Camp Smith say, however, that the Chinese have recently shown interest in measures to combat HIV, AIDS and avian flu.

Richard Halloran is a Honolulu-based journalist and former New York Times correspondent in Asia. His column appears weekly in Sunday's Focus section.