U.S. Navy healthcare providers from Camp Lemonnier's Michaud Expeditionary Medical Facility (EMF) recently teamed up with Djiboutian surgeons to successfully remove a large lymphatic cyst from the neck and shoulder of a local newborn infant, July 2011. This procedure represents one of many surgeries involving combined U.S. Navy and local medical staffs.

According to U.S. Navy Lieutenant Commander Jason Hollensbe, EMF chief surgeon, the girl was born with the cystic lymphatic malformation which posed potential serious health risks including compression of her airway. The cyst was larger than her head. "It was pretty serious and usually these types of cysts should be removed at the earliest opportunity," he said, adding that the family is very poor, making travelling outside of Africa for surgery not an option.

The surgery was carried out by a combined team including Djiboutian surgeon, Dr Elias Said Dirie and his Peltier General Hospital surgical staff. The one-week-old child recovered quickly and returned home to a welcoming community. "We're confident that we removed the entire cyst. Although she may need a scar revision when she is older, she'll do fine as she grows and with minimal long term disfigurement or serious issues." Hollensbe said, adding, "So, it was a great outcome for what otherwise would have been a very difficult life ahead for this girl."

Two weeks after the surgery Hollensbe and U.S. Navy Commander and nurse anesthetist Patricia Wirth accompanied the infant girl and her mother for the trip home and were greeted by a happy and grateful community. "It was a great experience to be here to see the baby's friends and family," said Wirth. "Everyone was very happy to see her return home and enjoy her smile," she added.

"The assistance from the Navy surgeon was instrumental in this very successful outcome," Elias explained. "The skills and experience provided by Doctor Hollensbe and his team proved very valuable for this and many other life-saving procedures here," he said. "The Navy people going to her home was also very special for the family."

The camp EMF staff is no stranger to unusual cases, assisting the Peltier staff on a regular basis, according to Wirth. "We've become a very adaptable and capable team in a few short months," she said. "This relationship gives us a rare opportunity to share best practices, and keeps us all sharp," she said. Wirth and Hollensbe have participated in more than 400 hours of surgery in the operating room performing over 100 procedures.

According to Hollensbe, the assistance also allows his team to keep their skills current and fresh. "Whether it's routine or something more involved, such as this unusual procedure today, it keeps us tuned and in practice for the demands of surgery," he said, emphasizing that their primary mission is to support U.S. personnel assigned to Camp Lemonnier and from Naval vessels in the area. "We're able to perform these surgeries without any scheduling conflicts on the camp."

Schedule permitting, the EMF team usually goes to Peltier Hospital three days per week and performs up to three procedures a day, according to Wirth. "We always look forward to our trips out in town and have developed a strong professional and personal bond with our counterparts here."

The EMF team departs in September and is currently orienting the new surgical team to the program with Peltier Hospital. "This relationship has been very fruitful for everyone involved for several years," Wirth said, adding, "We're making sure with each deployment rotation that we have a seamless transition and keep up the good work with our gracious hosts, partners and friends here in Africa."