Military Medicine Training Program in Honduras Showcases Life-Saving Expertise

Uniformed Services University and Partners Offer Immersive Emergency Medicine Training in Resource-Limited Honduras

Col. Joseph Maddry, M.D.; Capt. Steven Siemieniak, M.D.; and Cpt. Rebeckah Riordan, M.D., collaborating

with Honduran medical professionals to evaluate a patient using a portable ultrasound machine at Hospital

Escuela in Tegucigalpa, Honduras. (Photo credit: Maria Echeverry, CGHE)

August 13, 2024 by Maj. Noelle P. DeRuyter, USAF Director, Clinical Operations at USU's CGHE

The Uniformed Services University’s (USU’s) Center for Global Health Engagement (CGHE), the Department of Military and Emergency Medicine at USU, Brooke Army Medical Center, and Joint Task Force-Bravo, recently teamed up to implement and evaluate the Military Unique Curriculum in Honduras (MUCH) and Military Emergency Skills in Honduras (MESH) program. This innovative collaboration provides residents and attending physicians with immersive emergency medicine training in challenging, resource-limited environments, enhancing their skills and readiness for  real-world scenarios.  

Air Force Maj. Noelle DeRuyter, director of Clinical Operations at CGHE, helped start the MUCH/MESH program while working in the U.S. Southern Command Surgeon’s office and has continued to work with the program while assigned to CGHE.

The entrance to Hospital Escuela in Tegucigalpa, Honduras. (Photo credit: Maria Echeverry, CGHE)

“A program like MUCH/MESH is multi-faceted. Emergency medical procedures are more frequent, and there is less competition from other medical residency programs as we find in the U.S. teaching hospitals,” DeRuyter said. “Participants learn from the local professionals working day to day in these facilities. Residents can also demonstrate procedures to the hospital staff, and relationships are built with a U.S. neighbor in Central America. I see all of the above as big wins for the Department of Defense.”

The Encounter and KSA (E-KSA) checklist proof of concept component of the program aimed to quantify the knowledge, skills, and abilities (KSAs) of physicians trained under the MUCH/MESH Program. Throughout their training tenure at Hospital Escuela in Tegucigalpa, Honduras, MUCH/MESH participants underwent rigorous evaluations using detailed encounter assessments to meticulously record chief complaints, treatment interventions, and exhibited KSAs.

During the technical demonstration phase, CGHE staff effectively utilized the finalized version of the E-KSA checklist, underpinned by comprehensive training materials and clinical supervision, to meticulously gather invaluable KSA data. The training encompassed a diverse range of medical procedures, highlighting their competence in critical interventions such as intubations, extubations, point-of-care ultrasounds, and central line placements. Notably, the portable ultrasound devices facilitated accurate diagnostics and enhanced procedural capabilities, including the identification of crucial sonographic signs, ruling out severe internal injuries and diagnosing conditions like gallstones.

U.S. Military Medicine Physicians Lt Col Brian Murray, MD; Capt Steven Siemieniak, MD; Col Joseph

Maddry, MD; and CPT Rebekah Riordan, MD, alongside their Honduran colleagues at Hospital Escuela.

(Photo credit: Maria Echeverry, CGHE)

The pivotal moment in a recent rotation unfolded when a patient adjacent to the shock room experienced a sudden cardiac arrest. Without hesitation, the U.S. team of clinicians sprang into action, initiating CPR, providing air via a bag valve mask, and promptly preparing the necessary resuscitation equipment. Their swift and coordinated efforts, in collaboration with local physicians, culminated in the successful revival of the patient.

According to one CGHE team member, the experience underscores the profound impact of collaborative training initiatives. Physicians participating in the program demonstrated advanced medical proficiency and exemplified their capability to respond effectively in high stakes medical emergencies.