CDR Pamella Vodicka, MS, RD
Continuing Promise 2008
Dominican Republic and Trinidad
21 July 2011
Objectives
 Describe the intention of the role of the
Preventive Medicine (PrevMed) Team.
 Identify opportunities for the PHS dietitian in
support of the PrevMed’s community service.
 Describe lessons learned and next steps in the
support of the PHS dietitian’s role in future
mission opportunities.
Opportunity for
humanitarian
participation…
…a door opens
7 JUL - OFRD has opened up an
additional slot for Community
Health Advisors
11 JUL – “You have been
selected to participate as a
member of the USS Kearsarge
detachment Team 2 (SEPT 11 –
OCT 19).”
6 SEPT – MISSION DELAYED
(Gustav & Hannah hit Haiti)
22 SEPT – Team 2’s mission
begins…first stop Haiti…then the
USS Kearsarge.
Assignment:
Preventive Medicine Team (Prev Med)
Directorate: CDR Andrea Parodi, RN
Deputy Administrator: LCDR Bernie MacDonald
 The team’s mission is to work with partner-nation
counterparts to evaluate municipal processes and educate
local citizens in order to increase safety and improve health
and hygiene.
 The education goal is to teach local citizens basic public
health and hygiene.
The Prev Med Team: A dietitian’s role
 I am to team with LTJG
Molly Moffitt, RN (Ob-Gyn
and Pediatric Nurse)
 Materials are limited; first
task is to review what is on
board and determine what
might be of need (as we
wait for the stop in Haiti to
conclude).
Available resources…
 One pagers (Spanish):
•
•
•
•
•
Vomiting & Diarrhea
Water Treatment
Food Allergies
Lead Poisoning
Rules for Eating
Healthy
• Breastfeeding – proper
placement
 One pagers (Spanish):
• Food Pyramid
 Multi-page Booklets
(Spanish):
• Lactation
• Women’s Health
Sequence of Events
 Review Pre-Deployment
Site Visit
 Determine potential Prev
Med opportunities
 Directorate works with ship
and visiting-nation
counterparts to develop
plan
 Once at site, reassess and
optimize the moment
DOM REP ACTIVITIES
22 September – 15 October
 Crafted posters on nutrition
and health, including the Latin
America Food Pyramid;
 Assisted with the fluoride
treatment program;
 Conducted nutrition consults;
 Planned a community nutrition
experience for visitors waiting
for appointments;
 Conducted nutrition education
classes at local schools
TRINIDAD ACTIVITIES
25 October – 6 November
 Expert exchange with local, host nation, dietitian resulting in guest
lecture opportunity at Arima Health Department Clinic
 Antenatal guest lecture
 Pediatric guest lecture
 Participated in multidisciplinary intervention for children with
cerebral palsy
 Team consisted of MD (physician), PT (physical therapist), OT
(occupational therapist), and dietitian (myself).
 Referrals for 41 diet/nutrition assessments and individual counseling
Our results…
…in the words of the Commodore…
 An Act of Diplomacy
 A Humanitarian Civil Action
Our results…
…in the words of a PHS Dietitian…
 Opportunities for the PHS dietitian officer are many
 Who better to have on a team when there is need to put
expectations aside and engage creative thought for an individual
or community in need
Comments from the Ship…
It was great having you aboard the ship and on the mission.
I think the role of the dietician depends largely on the socioeconomic status
of the country we are visiting. In Colombia to some extent, DOMREP and
TandT we saw lots of obesity, diabetes and HTN. People were receptive to
education and dietary counseling.
However, in Nicaragua and Haiti, for example, the problem was access to
food and diabetes was uncommon. I am not really sure what a dietician
could do in those settings. Perhaps they could be involved in teaching
locals what they could grow to give them the biggest bang for the buck. But
you would need to know an extremely large amount about local customs,
growing seasons etc.
So in summary, the usefulness depends largely on the site.
Comments from the Ship…
I think you found a role wherever you went, but I also agree with X
somewhat. You can always teach nutrition, but the question is the ability of
the people to respond to it. Many of the countries we visited – rich or poor –
had problems with diabetes and hypertension. Some had obesity, some did
not. While you could address nutrition issues, to what extent could the
people respond?
Extreme case would be Haiti – we could discuss necessary food groups, but
all people had was rotten rice.
In honesty, I would say there is a role for a nutritionist as a supplemental
person, but if it took the place of a physician I would be harder pressed to
agree that the exchange would be equal.
Lessons Learned
& Next Steps…
 Hurry up and wait
 Sempre Gumby
THANK
YOU