Service members assigned to Combined Joint Task Force-Horn of Africa made a series of house calls during a Medical Civic Action project in Ethiopia January 28 - February 13, 2009.

Personnel from each military branch and several occupational fields worked with the local government and volunteers to deliver free care to 5,097 villagers in four remote locations.

"Some of these people have never seen a doctor or dentist before," said mission non-commissioned-officer-in-charge Army Staff Sergeant Scott Regiec. "That's why we need to see as many as we can."

Local residents speaking diverse tongues, including Somali, Oromo and Amharic lined up to see the medical staff. Physicians, corpsmen and medics brought medicine and expertise in 20-plus-vehicle convoys over miles of rough terrain.

"The three-hour drives were really rough, but we helped a lot of people," said Petty Officer 2nd Class Mandy Plante, an Individual Augmentee from the Washington Navy Yard Branch Health Clinic. "I've been to foreign countries before, and I've had a good time doing that, but this is the first time I've gone somewhere and given them medical care. It meant a lot to me that I got to do that."

With the help of force protection and civil affairs personnel, the team set up orderly working sites at Milo, Aydora, Dire Teyara and Germam. Village chiefs prioritized the patients ahead of time.

"This is a proven method for efficiently improving the health of large numbers of people," said Army Major (Dr.) Remington Nevin, a public health physician deployed with the 360th Civil Affairs Brigade. "Reaching as many people, in as many regions as possible, with a proven intervention is key to a successful public health mission."

From there, many saw providers, both those attached to CJTF-HOA and others on temporary assignment.

"I was asked to come here as a pharmacy tech and help manage the operation," said Air Force Master Sergeant Rey Garcia, who works for the United States Air Force Reserve Command Surgeon General's Office at Robins Air Force Base, Georgia as a medical planner. "With every MEDCAP we do, we tailor the medication we bring to the region. For example, we brought multivitamins to help deal with the malnutrition that sometimes occurs in rural areas. These things take about a year to put together, so a lot of planning is involved."

Garcia helped issue the vitamins and other medications including acetaminophen and antibiotics to about a third of the patients seen. Others received dental care from both experienced dentists and enlisted personnel training on the job. This team gave out antibiotics and performed tooth extractions, including multiple extractions for some people. Hospitalman Daniel Badillo, who was on his third MEDCAP, performed many of these extractions.

"Some of the most rewarding things I've gotten to do on these deployments are exercises like this. The people really want the help, and when you give it to them, their faces are just overwhelmed, which makes you want to do your job even more. This made my deployment very enjoyable--it's why I wanted to come to Africa, " said Badillo, a resident of Pharr, Texas.

While it aided the health and welfare of the Ethiopian people, the MEDCAP was primarily a Civil Affairs Mission intended to demonstrate effective cooperation between the Ethiopian government, Ethiopian Ministry of Health and U.S. Africa Command, according to Army Major Michael Wheeler, mission commander. The physicians involved called it an effective way to improve stability in the region and enhance the Ethiopia-U.S. relationship.

"Poor health breeds insecurity, and insecurity leads to breakdowns in public health that threaten millions of lives," said Nevin. "While local governments continue to build on their successes in public health program oversight and management, the assistance of international partners, including the United States, will remain an important part of the solution, particularly in purchasing and supplying medications and in facilitating their delivery."

Garcia has spent the last two years traveling to MEDCAP sites around the world, and he agrees that this is one of the best ways to show concern for citizens where they live.

"These nations are in need, and we basically come to help them understand a better way of living," Garcia said. "You can touch thousands of people's lives by teaching them that something as simple as how washing their hands can help stop the spread of disease. And I think we did that very well here."

As a way of maximizing that good will, every resident who entered one of the sites received a goodie bag containing toothbrushes, toothpaste, antibacterial soap and multivitamins. The goodie bag section, like the others, functioned smoothly thanks to both the military team and the local volunteers who helped at each site. John Tesfay, a sound technician from Dire Dawa, was one of these helpers who provided the labor and interpretation services that made the MEDCAP possible.

"There are no hospitals or pharmacies at these villages-- we are bringing these things to them," said Tesfay. "I am happy to work with the Americans and help my people. I know it makes it easier for them to get help when they see us doing it with the Americans."

The team also coordinated with local government officials, like Hassan Ali Jama, Aydora tribal chairman, who ensured care went to those who needed it most, like sick children and the elderly.

"I really have to thank the Americans on behalf of my people," said Ali Jama. "This helps us so much. From the beginning, the Americans have done more than anyone else to bring us from darkness into brightness. We look forward to more help in the future."

The military team members were also excited to see Ethiopia and interact with its people.

"The Ethiopian people are very warm and helpful to one another and welcoming towards Americans," said Petty Officer 1st Class (FMF) Sheila Biag, a sailor deployed from Naval Health Clinic Great Lakes.

"Ethiopia is awesome," added Plante. "The people are so friendly. When we were leaving one of the villages, all the people were clapping and singing for us, and two women came up to me and gave me a hug. I took a picture with them. That was really nice that they were so happy that we were there."

Provider Army Major Marc Raciti said he was pleased with the team's ability not only to accomplish the mission, but to adapt and overcome unexpected difficulties.

"When you have a complicated MEDCAP mission like this where there are so many moving parts, one of the big things is to maintain your 'hit marks' --time of departure, getting there on time and setting up on time, and we were very successful at doing all that, even though we had problems," said Raciti, an orthopedic consultant.

In addition to the medical assistance, the team gave out shower shoes collected by teachers from Isbell Middle School in Santa Paula, Calif. Petty Officer 1st Class John Johnson, a Reservist currently deployed with CJTF-HOA, asked for help in collecting the shoes and gave them to the team to distribute them at the MEDCAP sites.

"The first time I went to Uganda on a mission, I saw so many people walking around without any shoes," Johnson said. "Flip-flops are cheap and wearing them can keep you from getting ringworms and other parasites, so it's a really easy way to help. I'm glad I got people back home involved-- people who would normally never think about helping folks in Africa."

CJTF-HOA conducts MEDCAPs in several countries in the area of responsibility, including Djibouti, Ethiopia, Kenya, Tanzania and Uganda.