SIHANOUKVILLE, Cambodia (June 19, 2014) Australian, Japanese, and American service members pose for a photo aboard the Japan Maritime Self-Defense Force amphibious tank landing ship JS Kunisaki (LST 4003) upon arrival in Cambodia during Pacific Partnership 2014 .
ROTE ISLAND, Indonesia (NNS) — Enhanced eye care combined with upgraded eye treatment has led to improved eyesight for residents at Ba’a, Rote Island, Indonesia due to Pacific Partnership 2014 Ophthalmology subject matter expert exchange that included expertise from Naval Hospital Bremerton.
Cmdr. Brice Nicholson, eye physician and surgeon of Naval Hospital Bremerton Ophthalmology and Refractive Surgery clinic was part of the PP14 team that visited Rote Island and helped provide direct medical treatment and aid in diagnosing vision-threatening illness. “I always enjoy working boots-on-ground with the local surgeons and technicians,” said Nicholson, who was on Pacific Partnership 2011, as well as prior missions to Sri Lanka, Morocco and Indonesia, along with several similar civilian missions. “Like us, they are just small pieces of the machine. We are the ones who actually take care of these patients. It makes me feel even better because I know we truly make a difference. Whether it’s me doing cataract surgery, or our optometrist handing out glasses, these people wouldn’t be able to see if we hadn’t come there.”
The Rote mission took Nicholson and a joint PP14 team to Ba’a Hospital in Ba’a, Rote Island. The island itself is located off the southwestern coast of Timor, one of more than 13,000 islands and islets comprising the Indonesian archipelago that stretches across the equator from Sumatra in the Indian Ocean to New Guinea in the Pacific Ocean.
“The patients were generally appreciative. The local mayor had all of us over and they held formal opening and closing ceremonies as well. We felt very welcome and appreciated,” shared Nicholson adding that the toughest part was learning to operate in a completely new, sometimes austere, environment where everything is new.
“New technicians, new sterilization and antisepsis techniques, hot and humid working conditions, new instruments, and surgical techniques that we don’t typically use in the U.S. But that is what makes it interesting and what, I believe, makes a better surgeon,” stated Nicholson.
The proximity to year-round sun-light made for dealing with eye concerns such as pterygia (also called surfer’s eye), which occurs more often among people who live near the equator.
“We had lots of pterygia, some bilateral (both eyes). I actually have a few I am going to do in a couple of hours this morning. I taught the Indonesian surgeon how to do grafts, so their recurrence rate should drop notably over the next months. When we do grafts here, we use sutures instead of glue. If someone thought they had post-op discomfort, its minor compared to what could be experienced here,” said Nicholson
Nicholson attested that the visiting PP14 team also tired to share with each patient that they could help themselves and others in caring for their eyes on a daily basis by protecting them against the prevalent sunlight.
“Sunglasses, sunglasses, sunglasses!” exclaimed Nicholson, also citing that as a visiting eye physician and surgeon, he continually took the time to share and go over with his patients on the type of care he was providing them.
“We used translators for most of our communication. I think the most important thing I shared with the local doc was the idea of fostering patient trust and confidence, and to spend a lot of time talking to their patients about what to expect after surgery. Expectations are a big deal and we have to do our best to at least try to help folks with proper education,” Nicholson said.
The hospital the PP14 team worked out of was the only one on the equatorial island and lacked many of the amenities and equipment associated with a naval hospital. But there was an air conditioning unit in the operating room which kept the temperature in the low 80 degrees area.
According to Nicholson the tropical environmental also meant that malaria and dengue fever were present,
“So prophylaxis and hydration requirements were the biggest differences between tropical and the Pacific Northwest. Almost everyone got some kind of virus or GI bug but, to date, I have been spared. This is fortunate because the only reason my wife has any hesitation for me going on these is because I get deathly ill right before I leave on 50 percent of my missions,” related Nicholson.
Despite being well off the beaten path, Rote Island is also a tourist destination, drawing a number of Australians and Europeans to enjoy the sun and surf in a rustic setting. Nicholson was assigned spartan accommodations but enjoyed the relatively sparse lodging.
“We were staying at an austere, but awesome beach resort, with an outside shower and bathroom, staying in a thatched hut. It’s not for everyone, but I loved it,” said Nicholson.
Nicholson praised the combined efforts of the joint PP14 team and the local medical personnel of Ba’a.
“All services and NGOs (non-governmental organizations) were awesome. It was quite collaboration and we enjoyed each other’s company. I can honestly say it was the most cohesive group I have ever worked with, and I miss a lot of them already. The most fun we had was joking around with the local surgeons and technicians – we are all the same really – and having a cold beer at night on the beach with my U.S. and partner nation colleagues,” said Nicholson, citing that commands should continue to encourage and support individuals for these missions.
“Partnership and working together is where it’s at. I haven’t met anyone who didn’t come away feeling like they have gained something, even if it’s just a life perspective, after these trips,” added Nicholson.
Pacific Partnership is in its ninth iteration and is the largest annual multilateral humanitarian assistance and disaster relief preparedness mission conducted in the Asia-Pacific region. For the people of Rote Island, they understand that.
Some even saw it with their own eyes, due to the care, concern and consideration from a visiting eye physician and surgeon from Naval Hospital Bremerton.
Navy News article By Douglas H Stutz, Naval Hospital Bremerton, Public Affairs
Bremerton-Olympic Peninsula Council Navy League of the US 
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