Mission of mercy

ABOARD THE USNS MERCY, OFF INDONESIA

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OUT OF the horror of the tsunami, the US armed forces and civilian aid organizations have found a new way to work together. The model for cooperation being shaped day by day on this 1,000-bed hospital ship might prove to be suited only to the specifics of this catastrophe. Or it might, as some of those involved hope, become the template for bringing America's aid to bear in other situations where the manpower limits of the active-duty and Reserve forces and the sensitivities of local politics put a premium on using US civilian doctors and nurses on a Navy ship, with Navy helicopters as ambulances.

That is what has been going on since the beginning of this month off the coast of Aceh province. Ninety-three civilian health professionals, most of whom had never heard of MREs (meals ready to eat) before, have worked alongside Navy doctors, nurses, and corpsmen to provide outpatient care onshore and a high-level hospital for tsunami survivors.

Of the health workers, 41 are from Massachusetts General Hospital, the single largest contingent from the 22 health centers represented. The Mercy mission, with its civilian volunteers, was put together by Project Hope, the international healthcare nonprofit. Its CEO, Dr. John Howe, visited the Mercy this week. Project Hope started bringing US doctors and nurses to the developing world in 1960 on the ship Hope, a hospital ship donated by the US government. The Mercy mission is a return to such deployments, which ended in 1974.

The ship arrived six weeks after the tidal wave swamped the city of Banda Aceh as the aircraft carrier Abraham Lincoln was finishing its yeoman work of sending in water and food across Aceh province. After consultations with the United Nations and non-governmental organizations, the Mercy found a niche for itself in taking on cases beyond the capacity of the Indonesians, Australians, Germans, and others who were on the scene first. Cooperation with the other caregivers continued. The Mercy has no cardiologist aboard and called in a German to read echocardiograms.

Between the military and civilians on the Mercy there were slight frictions at first. Dr. Laurence Ronan, an organizer of the MGH contingent (who wrote the article on the page opposite) likened it to a first date but said tension vanished once work began. The one frustration felt by many on the crew was temporary -- a week's delay in bringing the first patients aboard as approval from the Indonesian government was secured.

"We represent what the American people think our ideal should be," Dr. Harold Timboe, Project Hope's leader on the ship, told the volunteers Monday night. He estimated that the Mercy personnel had seen 1,000 patients onshore and taken in 70 admissions to the hospital. Even "these small numbers" of cases, Timboe said, will be remembered for decades by the children and grandchildren of the Indonesians who benefited.

The Aceh people will remember the Mercy for other things as well, such as honoring the local custom of family members accompanying patients when they are in a hospital. Mercy officials decided to let one relative clamber aboard the helicopter with each patient. Susan Rooney, an MGH nurse, was struck by their hunger and the gesture of fingers to the mouth they made in asking for food.

Timboe, a retired Army major general, told the volunteers Monday: "America has not always been the bright shining light on the hill. We have an opportunity to change that." That is the opportunity Howe had in mind in pushing for a volunteer mission on a Navy ship since before the tsunami. "What it's tapping into is what we're all about," he said. Indonesia, the world's largest Muslim nation, is seeing an America that Osama bin Laden cannot acknowledge.

DONALD A. MACGILLIS