Journal 103014

Vol. 26 No. 44 www.cnic.navy.mil/bethesda/ October 30, 2014

By Sharon Renee TaylorWRNMMC Public Affairs

staff writer

Walter Reed Bethesda andAndrew Rader U.S. ArmyHealth Clinic staffers partici-pated in a medical readinessexercise Oct. 24 to test the pre-paredness and response to a pa-tient presenting with suspectedEbola Virus Disease (EVD).

Emergency and incidentofficials at Walter Reed Na-tional Military Medical Center(WRNMMC) who led the exer-cise that began at Joint BaseMyer-Henderson Hall, Va.,called the aligned efforts withthe Army Office of the SurgeonGeneral, the Old Guard and Ar-lington County, Va. emergencymanagement services an over-all success. The exercise was aculmination of education, prep-aration and discipline in thefight to contain what has beencited as the largest Ebola out-break in recorded history.

“The goal for our facilitywas to test our current plansand procedures for acceptinga patient — in this case it wasa planned consult and ambu-lance transfer of a patient withsuspected Ebola Virus disease— that was our overall goal,”explained Chris Gillette, Wal-ter Reed Bethesda’s emergencymanager. “This exercise wasa success because we got thekey players together,” he saidabout the third official drill atthe medical center since Au-gust when planning for the ef-fort first began. The facility hascontinued to train with a num-ber of unofficial walk-throughsand practice sessions.

Subject matter expert evalu-ators like Angela Michelin, aninfection control consultant inhospital epidemiology at theNational Institutes of Health,

joined experts from the ArmyOffice of the Surgeon Generalfor Biodefense, Uniformed Ser-vices University, along with au-thorities in critical care, infec-tious disease and other areas toobserve the staff ’s execution ofplans and procedures as well asidentify areas for improvement.

“Anytime you can bring thekey players together in order torehearse plans, you’re not onlygoing to see clear evidence oftraining and education, you’realso going to see some things

that you might have missed,”said Gillette, who explained thatmultiple experts “have to be en-gaged daily because there are somany moving parts to tying ourplans and processes together.”

The colleagues who workedwith Gillette in the planning ofthe exercise, agreed.

“It’s absolutely true,” saidDr. Margan Zajdowicz, a re-tired Navy Medical Corpscaptain who serves as inci-dent commander for the Ebo-la planning team and as the

public health emergency offi-cer for Naval Support ActivityBethesda.

“This is an incredibly com-plex endeavor and we’ve beenplanning from the very begin-ning, since August, but it hasgotten evermore complex andso we rely on many, many ex-perts in getting this right, andthat includes infection control,infectious disease, emergencymanagement, clinical medicine,legal, logistics, housekeeping —almost every part in the hospi-

tal is involved in the planningfor this,” explained Zajdowicz.

Melissa Knapp, programmanager for Emergency Man-agement Plans, Training andExercises at WRNMMC, ex-plained a small group of nursesand physicians will provide di-rect care to patients who maybe exposed to the Ebola VirusDisease. Continuous trainingand attention to detail about

Medical Center, Clinic Conduct Ebola Exercise

Complex Endeavor Went Well, Officials Say

Photo by Sharon Renee Taylor

Sarah Krajnik, a registered nurse in the Simulation Department and observer in the Oct. 24 Ebola VirusDisease exercise at Walter Reed Bethesda, watches as Navy Hospitalman Sedrick Watkins, a corpsman inthe Emergency Department, assists Navy Lt. j.g. Brent Pavell, a registered nurse, in removing his personalprotective equipment during the medical readiness exercise.

See EBOLA page 8

2 Thursday, October 30, 2014 The Journal

Published by offset every Thurs-day by Comprint Military Publi-cations, 9030 Comprint Court,Gaithersburg, Md. 20877, aprivate firm in no way con-nected with the U.S. Navy,under exclusive written con-tract with Naval Support ActivityBethesda, Md. This commercialenterprise newspaper is an autho-rized publication for members of themilitary services. Contents of The Journalare not necessarily the official views of, norendorsed by, the U.S. Government, theDepartment of Defense, or the Departmentof Navy. The appearance of advertising inthis publication, including inserts or supple-ments, does not constitute endorsement bythe Department of Defense or Comprint,Inc., of the products or services advertised.Everything advertised in this publicationshall be made available for purchase, useor patronage without regard to race, color,

religion, sex, national origin,age, marital status, physicalhandicap, political affiliationor any other non-merit fac-tor of the purchaser, user,or patron. Editorial contentis edited, prepared and pro-vided by the Public AffairsOffice, Naval Support Activ-

ity Bethesda, Md. News copyshould be submitted to the Pub-

lic Affairs Office, Building 17, first floor,across from PSD, by noon one week pre-ceding the desired publication date. Newsitems are welcomed from all installationsources. Inquiries about news copy will beanswered by calling 301-295-1803. Com-mercial advertising should be placed withthe publisher by calling 301-921-2800.Publisher’s advertising offices are locatedat 9030 Comprint Court, Gaithersburg, Md.20877. Classified ads can be placed bycalling 301-670-1700.

Naval Support Activity (NSA) BethesdaCommanding Officer: Capt. David A. BitontiPublic Affairs Officer: Ron InmanPublic Affairs Office: 301-295-1803

Journal StaffStaff Writers MC2Ashante Hammons

MC2 Christopher KruckeSarah MarshallKatrina SkinnerJulie SmithSharon Renee Taylor

Managing Editor MC2BrandonWilliams-ChurchWRNMMC Editor Bernard Little

NSABethesdaFleet And Family Support Center 301-319-4087

Walter Reed National Military Medical CenterOffice of Media Relations 301-295-5727

NSAB Ombudsman

Michelle Herrera 240-370-5421

Sexual Assault Response

Coordinator Hotline 301-442-2053

Visit us on Facebook:Naval Support Activity Bethesda page:

https://www.facebook.com/NSABethesda

Walter Reed National Military Medical Center page:

http://www.facebook.com/pages/Walter-Reed-

National-Military-Medical-Center/295857217111107

Uniformed Services University of the Health

Sciences page:

http://www.facebook.com/pages/

Uniformed-Services-University-of-the-Health-

Sciences/96338890888?fref=ts

Disability Awareness Month EventThe Walter Reed Bethesda Multi-Cultural

Committee will host a Disability AwarenessMonth event today at 11 a.m. in Building 62.The event will include music, employers recog-nized as “disability-friendly,” and representa-tives of the Ride to Recovery program. For moreinformation, call Hospital Corpsman 2nd ClassJose Martinez at 301-295-0381.

Daylight Saving Time EndsDaylight Saving Time ends at 2 a.m. on

Sunday. Remember to set your clocks back onehour and refresh the batteries in your smokeand carbon monoxide detectors.

Lung Cancer Awareness MonthThe John P. Murtha Cancer Center of

Excellence at Walter Reed Bethesda will host twoevents in observance of Lung Cancer AwarenessMonth. The first event, Lung Cancer ScreeningDay, is Wednesday from 11 a.m. to 2 p.m. inthe Building 9 center mezzanine. It will includeinformation tables and guest speakers. The sec-ond event, the Annual Lung Cancer Summit(registration required), is scheduled for Nov. 14from 8 a.m. to 3:45 p.m. in the National IntrepidCenter of Excellence Building, first floor audito-rium. For more information, call William Mahrat 301-400-1492

Staff Talent ShowThe next Walter Reed Bethesda staff tal-

ent show is scheduled for Nov. 19 from 11:30a.m. to 12:30 p.m. in the lobby of the AmericaBuilding. Potential participants should reservetheir space on stage by Wednesday. Trophieswill be awarded to the 1st, 2nd and 3rd placewinners. Refreshments will be served. For moreinformation, contact Vivian Murga at 301-295-651 or at [email protected], or DonnaO’Neill at 301-400-0584 or at [email protected].

Bethesda Notebook

In keeping with our vi-sion of a world class pa-tient centered healthcaresystem, our market busi-ness plan initiatives arefocused on four areas:

• Implement and Sus-tain Patient Safety andQuality Measures

• Implement Standard-ized Referral Manage-ment Processes

• Improve PopulationHealth through Imple-mentation of Primary Care MedicalHomes

• Optimize Surgical and OperatingRoom Utilization

The goal of these initiatives is to pro-vide the best care to our very deservingmilitary members and their families.That is our bottom line.

We are making progress on all ofthese initiatives, and it is gratifyingand very encouraging to be able to workwith the stellar leaders and staffs at ourmarket Military Treatment Facilities(MTFs) to accomplish these actions andposition ourselves to provide even betterhealth care to our patients.

Enhanced patient safety and qualitymeasures are paramount to quality pa-tient care. I am relying on you, our pa-tients, to make sure we are hitting themark with these initiatives. Quality isnot only how well we are performing tomeet and/or exceed national standards,but how it is defined by our patients aswell. In this regard, we need to under-stand what makes health care impor-tant and valuable to you. Our goal is toprovide open and transparent dialoguewith you so that we can continue to im-prove our healthcare system.

Standardizing our referral manage-ment process will enhance the abilityfor our patients to obtain specialty careconsultation and treatment within ourmarket system in a responsive and time-

ly manner. We are strivingto meet your specialty careneeds, where you need it,when you need it.

The Patient-CenteredMedical Home (PCMH) isour primary care accesspoint into our healthcaresystem. This initiativeinvolves understandingwhere our patients are lo-cated, and making sure ourPCMH teams are there,prepared to provide the

best organized and coordinated caresupported by resources for self-caremanagement. Our goal with PCMH isto deliver continuous, accessible, high-quality, patient-oriented primary care,virtually through Relay Health or inperson when necessary.

Our fourth initiative supports oursurgical specialties to ensure we opti-mize use and availability of our mainoperating rooms. Working with ourmarket MTFs that provide operativeservices, our goal is to ensure you can re-ceive operative care where it best servesyour medical and personal needs whileensuring we capitalize on the outstand-ing centers of excellence within WalterReed National Military Medical Centerand Fort Belvoir Community Hospital.

We have the highest engagement andcommitment of our market MTF lead-ership to ensure our initiatives come tofruition. We are already beginning tosee improvements in many areas. Mostimportantly, I encourage you to becomepartners with us in achieving our goals— partners in your care and advancingthe attributes of our world class health-care system.

Thank you for your service and sup-port,

Rear Adm. Raquel BonoDirector, National Capital RegionMedical Directorate

Director’s Corner

The Journal Thursday, October 30, 2014 3

By Mass CommunicationSpecialist 2nd ClassChris Krucke

WRNMMC Public Affairsstaff writer

“I’m going to tell you a story; Africa’sstory; America’s story; A universal sto-ry; Mankind’s story…”

These words made up the openingmonologue of Dr. Robert L. Jefferson’s,“A Spiritual Journey, Songs and Spiri-tuals from Slavery to Emancipation,”which is a musical performance that in-cludes songs and narrations tracing thehistory of the African American frompre-slavery through emancipation.

Jefferson performed on Oct. 15 aspart of this month’s installment of theWalter Reed Bethesda’s “Stages of Heal-ing” offerings at the medical center.

The audience first heard his deepbooming voice from behind the stage,followed by a tribal beat, as Jeffersonrhythmically stomped his way on stagesinging Babethandaza, a traditionalZulu song, which was his opening forhis performance.

“It’s an African [way of perform-ing], to use your body as a drum forthe rhythm,” said Jefferson, who hasperformed with such notable organi-zations as the Houston Grand Opera,the United States Air Force Pacific AirCommand Ensemble in Tokyo, Japan,as well as the Soldiers’ Chorus of TheUnited States Army Field Band, Wash-ington, DC.

According to Jefferson, the purpose ofhis performance is to bring Americanstogether and “to show Americans we areone world, one people, united. Our mu-sic unites us and this is our music thatgoes across different countries. We areambassadors of American music. We areone people, not divided into races. Weare all Americans.”

During his performance, Jeffer-son presented his renditions of Ne-gro spirituals, such as H. T. Burleigh’s1917, “Deep River” and Moses Hogan’s1927, “He’s Got the Whole World in HisHands” and “Give Me Jesus.”

Jefferson also performed eight origi-nal songs.

“It was excellent and totally differ-ent. I didn’t expect it to be that elegant,”

said Terry Thompson, who works in De-partment of Logistics.

Thompson continued, “His voice wasawesome and it echoed of slavery. It wasa great experience and it was healingfor an African American.”

“Being a black American, I couldrelate and I felt what he was saying,”Thompson added. “I think it’s very im-portant in a diverse work place that wedo more of this so we can understandand relate to one another and havemore respect.”

James Miller, a supply technician,in the Department of Logistics, said “Ithelped me. It calmed me down and I feelmore relaxed and we want to see himback.”

“He really hit home with the musicabout slavery,” said Miller. ”He reallyarticulated what African people wentthrough. I really enjoyed it.”

What Jefferson said he gets most outof his performances, is noticing after-wards, that “it doesn’t matter their eth-nic background, people say, ‘I can relateto this. I can understand personally howthis affects me because I feel like I amconnected.”

Jefferson said, “Actually, this isAmerican music, it’s our music. Itdoesn’t matter if you are Irish Americanor African American, this is our music,American music about our spirituals,developed here in America just like jazzand just like country.”

Jefferson started playing when hewas 7 years old, he explained. His moth-er would take him to churches to playfor events throughout the Arizona Na-tional Baptist Convention. “They calledme a child prodigy,” he said.

He eventually started teaching privatepiano at age 14, and has been teaching orplaying music for over 40 years. Jeffersonsaid he has been fortunate to be involvedin music his entire life.

Jefferson said, “With the things thatare going on around the world in thenews it kind of shows that we are a verysmall world here and we are all con-nected. That is what this show is about.It’s our spiritual journey of man kind’sstory.”

For more information about WalterReed Bethesda’s Stages of Healing pro-gram, call Lt. Cmdr. Micah Sickel at301-294-2492.

Stages of Healing: A Spiritual Journey

By Mass CommunicationSpecialist 2nd Class Brandon

Williams-ChurchNSAB Public Affairs

staff writer

Naval Support Activity Bethesda(NSAB) is leading the way for energy con-servation in the 21st century.

At the Oct. 21 NSAB EnergyAwarenessQuarter event, the base received its secondMaryland Governor’s Citation, awardedto innovative and successful energy pro-grams in the state. In a letter from Gov.Martin O’Malley, NSAB was again recog-nized for its forward-thinking projects.

“Be it known that on behalf of the citi-zens of this State, in recognition of theexemplary work in energy initiatives andleadership that has been demonstratedon behalf of the Naval Support Activityenergy efficiency program goals relatedto energy within the public and privatesectors, and in honor of the 2014 Na-val Support Activity Bethesda EnergyAwareness Educational programmingevent; … our citizens join in expressingour gratitude, admiration and sincerecongratulations for a rewarding and suc-cessful program … ”

NSAB was also awarded the Secretaryof the Navy 2014 Gold Award for Energy,further proof of the base’s exemplary ef-forts in energy initiatives and conserva-tion.

NSAB Commanding Officer Capt.(Dr.) David A. Bitonti thanked Instal-lation Energy Manager William Ortega-Ortiz and Public Works Officer, Cmdr.

Joe Stavish and his staff for, “their re-lentless efforts in the year-round plan-ning and implementing of energy ini-tiatives that have kept Naval SupportActivity Bethesda ahead of the Navy’senergy goals. This has resulted in re-ducing our energy footprint on the in-

stallation every year for the past fiveyears,” Bitonti said.

“Their efforts really make a differenceand help us be responsible with our energyconsumption. It’s critically important thatwe continue to work together and join forc-es not only at the installation level, but we

must continue our efforts with the state ofMaryland and our local industry and util-ity partners,” Bitonti emphasized.

“We have a number of initiatives cur-rently underway that will increase ourefficiency, utilize alternative fuels andsources and upgrade our facilities so thatwe can be more energy conscious,wise andefficient here on the installation.”

Another highlight of the event was keynote speaker Abigail Ross Hopper, directorof the Maryland Energy Administration.Hopper used the Naval District Washing-ton Energy Pillars, which are the region’senergy strategy focused on conservation,leadership and behavioral change, to dis-cuss similar focuses and strategies thatthe Maryland Energy Program is takingon in comparison to NSAB, saying the basesets the business model for energy conser-vation. “The work that you do here hashuge implications not only for your bottomline, but for [Maryland] and the country asa whole,” Hopper said.

After the quarter event, representativesfrom all major commands onboard NSABtook part in an Energy ConservationBoard roundtable brief, led by Ortega-Or-tiz.The brief covered topics including utili-ties, energy program objectives and goalsas well as energy project developments forthe base.

“Energy conservation is not a one per-son, one office or one command job for thebase, but a joint effort for everyone,” Orte-ga-Ortiz said. “All of the commands aremission energy partners. Energy is morethan Public Works and Facilities, so wetake an all hands approach to energy andwater efficiency within our installation.”

NSAB Leading the Way for Energy Conservation

Photo by Mass Communication Specialist 2nd Class Brandon Williams-Church

Naval Support Activity Bethesda (NSAB) Commanding OfficerCapt. David A. Bitonti accepts the Governor’s Citation for energyawareness from Maryland Energy Administration Director AbigailRoss Hopper during the NSAB Energy Awareness Quarter eventOct. 21.


By Sarah MarshallWRNMMC Public Affairs

staff writer

Approximately 170 medicalstudents from the UniformedServices University of theHealth Sciences (USU) recent-ly experienced the demands ofcaring for patients in a simu-lated combat environment,complete with mock explosions,operational problems, reality-based missions and numerouscasualties.The fourth-year medical

students journeyed to Fort In-diantown Gap, Pa., this monthto participate in a field trainingexercise known as “OperationBushmaster.” Graduate Schoolof Nursing students also par-ticipated, along with severalinternational military medicalofficers from Mexico, the Unit-ed Kingdom, Israel, and Japan,according to Navy Cmdr. (Dr.)James Palma, an assistant pro-fessor of Military and Emer-gency Medicine at USU.The goal is to prepare stu-

dents for their first opera-tional assignment when theygraduate from medical school,

Palma explained. They mightcomplete a one-year internshipand then immediately deploy,or they might go straight intoa residency and not deploy foranother three or four years, hesaid. “Our goal is that they arewell prepared for their first op-erational assignment, and that

they’re going to be life-longleaders in our military health-care system,” he stated.Prior to “Operation Bush-

master,” the students gothrough a two-week MilitaryContingency Medicine course,during which they are present-ed operational problems and

receive pre-deployment train-ing, just as they would in reallife prior to a deployment, Pal-ma explained. This classroomphase includes lectures and isfocused on team building. Theybecome a cohesive unit as theyprepare to deploy to a fictionalcountry facing challenges fromrebel forces, he continued.The students were divided

into two groups. The groupswere sent, sequentially, tospend four days at Fort Indi-antown Gap, a large NationalGuard base nestled in themountains just north of Her-shey, Pa. There, students wereassigned to one of four platoons– all undergoing identical sce-narios, planning and executingmissions, while simultaneouslycaring for a variety of casual-ties, ranging in severity fromfatigue to gunshot wounds.During the course of the exer-cise, there were nearly 1,000encounters with “patients” intotal, Palma said.While patient care is a large

part of their training, leader-ship, communication skills, andlogistics are also just as impor-tant, Palma continued. If you’reunable to obtain the necessary

supplies or manage logistics,then you’re not going to be ef-fective, he explained.Students were assigned vari-

ous roles during the exercise,such as patient administrator,triage officer, medical logistics,or litter bearers transporting“patients.” They frequently ro-tated positions, allowing everystudent to practice each role,Palma said. The students werealso graded on how well theyperformed key positions, in-cluding platoon leader, ambu-lance team leader, surgeon, andcombat stress control officer.They were graded on a numberof factors, such as communica-tion and leadership skills, asthey were observed by morethan 60 faculty members fromUSU, as well as from across thecountry.Dr. Art Kellermann, dean of

the F. Edward Hébert School ofMedicine of USU, noted whilethe exercise is focused on lead-ership and enhancing theirpatient care skills, studentsare also interacting with local“host-nation” citizens, practic-ing cultural sensitivity, and

Military Medical Students Learn to Care for Combat Injured

Photo by Sarah E. Marshall

Fourth-year medical students work on a high-fidelity“patient,” presumed to be undergoing diabetic keto-acidosis, when the body has no insulin. The trainingwas part of “Operation Bushmaster,” a field trainingexercise conducted at Fort Indiantown Gap, Pa.

See CARE page 9

10431921042798


By Bernard S. LittleWRNMMC Public

Affairs staff writer

Walter Reed Bethesdaofficials hosted threetown halls for staff mem-bers last week, discuss-ing preparation the medi-cal center has made to re-spond should the hospitalreceive patients suspect-ed of having the EbolaVirus Disease (EVD).

Navy Capt. Sarah Mar-tin, WRNMMC chief ofstaff, said the town hallswere held to give person-nel “information aboutwhat we know aboutEbola at this point andtime; what our responsi-bility will be as a facilityhere at Walter Reed Na-tional Military MedicalCenter (WRNMMC); andto let [staff members]know we will continueto have updates as wemove forward, or if thereare changes in practicesand protocols, as we havethose.”

She added staff train-ing will be continuous,and the medical center isbeing “diligent to makesure our processes arevery secure so our staffand patients are safe.”

“Above all, stay calm,”said retired Navy Capt.(Dr.) Margan Zajdowicz,incident commander atWRNMMC for EVD pre-paredness operations.She said the medicalcenter has been prepar-ing since August to pos-sibly receive personssuspected of having EVD.She briefed staff and an-swered questions dur-ing the town hall alongwith a panel of expertsfrom the medical center,including the staff judgeadvocate, public affairsofficer, medical intensivecare unit (MICU) servicechief, infectious diseasechief and program man-ager for emergency man-agement plans.

“Without direct con-tact, you can’t get Ebola,”Zajdowicz said, explain-ing the “small” likeli-hood of anyone on theWRNMMC staff contract-ing EVD. “If a person hasno symptoms, he or shecan’t transmit Ebola,” shecontinued.

“Transmission oc-curs with contact withblood and other body flu-ids (breast milk, sweat,urine, vomit, feces, semenand saliva) contaminatedwith EVD,” Zajdowiczcontinued. “If one hascontact with sharp ob-jects contaminated withthose body fluids, onecan be at risk for the dis-ease. In addition, if onehas broken skin, or onesplashes some of thesebody fluids on unprotect-ed mucous membranes,that constitutes a modeof transmission.”

Airborne transmis-sion of EVD has notbeen shown by currentscientific data, Zajdow-icz explained. She addedit is possible for EVD tobecome airborne withintense aerosol exposuresuch as aerosol generat-ing procedures, such asbronchoscopy, intubation,ventilation [and] suction.

“It is important toknow also, although theEbola virus replicates it-self very readily, it is nota very hardy virus,” thedoctor said. “It is killedeasily. It is an envelopevirus, and the envelopeis easily disrupted by or-dinary hospital disinfec-tant and bleach,” Zajdow-icz said.

The Ebola virus sur-vives on dry surfaces forseveral hours and in bodyfluids up for up to severaldays at room tempera-ture, Zajdowicz stated.

Signs and symptoms ofEVD include fever; severeheadache; muscle pain;

weakness; diarrhea; vom-iting; abdominal pain;and unexplained bleed-ing. Zajdowicz said thesymptoms may appearbetween two to 21 daysafter exposure, but on

average, eight to 10 daysare when symptoms gen-erally begin to appear.

“Recovery depends ongood supportive clinicalcare, and how quickly thepatient is able to mount

an immune response,” Za-jdowicz continued.

Discussing WRNMMCEbola preparedness andmission, Zajdowicz saidthe medical center is amajor referral centerand needs to be readyto receive possible EVDpatients. She addedWRNMMC will be a fo-cus for service memberswho return from provid-ing assistance in WestAfrica as part of Opera-tion United Assistance.“Although the vast ma-jority of those troops willnot be involved in directpatient care as far as weare aware, and certainlymajor precautions will betaken of them, it’s con-ceivable that there willbe some exposure and wewill be asked to receivesuch patients, and wehave to be ready to re-ceive them.”

Dr. Jonathan Woodson,assistant secretary of de-fense for health affairs,said defense departmenthealth affairs is doingeverything it can to pro-tect troops deployed toWest Africa from beingexposed to Ebola. “Theywill have personal pro-tective equipment (PPE)and be trained in how touse it, don it, and take itoff [safely]. There will besupervisors, battle bud-dies who will be watchingout for these exposures,and I think we can mini-mize any chance of expo-sure and risk with thatstrategy.”

Zajdowicz said shouldWRNMMC receive a pa-tient with possible EVD,the number of staff mem-bers who will have con-tact and provide care to

Walter Reed Bethesda Hosts Ebola Town Halls

Medical Center Officials Answer Questions Regarding Preparations, Precautions

Photo by Bernard S. Little

Retired Navy Capt. (Dr.) Margan Zajdowicz, incident commander atWalter Reed Bethesda for Ebola Virus Disease (EVD) for prepared-ness operations discusses the medical center’s preparations should apatient present with possible EVD, during a town hall Oct. 22.

See SAFE page 10

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By Ron InmanNSAB PublicAffairs Office

Brave girls and boys enteredthe haunted crypt that was theWarrior Café for Naval Sup-port Activity Bethesda’s (NSAB)Morale, Welfare and Recreation(MWR) Spooktacular Brunch,Oct. 25.

After passing through theportal which was inhabited byspooky ghosts and a witch withglowing eyes, the brave littlesouls dressed as everything froma butterfly to an Oktoberfest zom-bie hunter to Captain America,found friendly volunteers fromOperation C.H.A.M.P.S., a trio ofhappy clowns who did amazingthings with balloons for them,and MWR staff who welcomedthe adventurous kids to a funtime and even some candy.

A total of 120 adults and 60children attended the event, in-cluding active duty military per-sonnel, wounded warriors, familymembers and volunteers.

Operation C.H.A.M.P.S. (ChildHeroes Attached to Military Per-sonnel) representative DebbieFink explained that the dozenor so C.H.A.M.P.S. volunteerswho came to the brunch to talk

play games and wear their owncostumes while having fun withthe younger kids - were all stu-dent volunteers from WinstonS. Churchill and Thomas SpriggWootton High Schools.

According to the organization’swebsite, Operation C.H.A.M.P.S.engages civilian communitiesin giving back to military andveteran families. OperationC.H.A.M.P.S. is devoted to sup-porting families at local militaryinstallations and from the sur-rounding military communitiesthrough volunteerism; providingsocial services; and developingawareness and cultural under-standing in order to bridge thegap between the military and ci-vilian worlds.

“We’ve been out here (toNSAB) for several events, andit’s a wonderful time,” Fink said.“The volunteers for OperationC.H.A.M.P.S. receive basic train-ing so that they understand mili-tary culture; for many of themit’s their first exposure to themilitary.”

Judging by the squeals of de-light, laughter and the smiles onthe faces of ninjas, fairies, robotsand other assorted characters,the brunch was a ‘spooktacular’success.

Little Ghouls, Goblins Have Scary Good Time at MWR Spooktacular Brunch

Pumkins were carved in frighteninglyoriginal ways for the brunch.

Air Force Capt. Peter Yarney and his son Matthew,6, pose for a picture during the Spooktacular BrunchOct. 25.

Clown Judy makes balloon animals forchildren in attendance at the Spooktac-ular Brunch Oct. 25.

Photos by Ron Inman

Volunteers for Operation C.H.A.M.P.S. pose for a picture in the Warrior Cafe.

Carla Zimmerman andher daughter Mallory, 3,pose for a picture duringthe Spooktacular BrunchOct. 25.


By Mass CommunicationSpecialist 2nd Class

Chris KruckeWRNMMC Public Affairs

staff writer

More than just a Festival ofLights, it was a festival of cul-tures as hundreds of servicemembers, civilian employees,friends and families attend-ed the annual Walter ReedBethesda Diwali celebration onOct. 17 atWalter Reed NationalMilitary Medical Center.The celebration, held in the

Memorial Hall, included danc-ing, singing, food and musicalperformances.Diwali, also called the Fes-

tival of Lights, is the largestand most celebrated nationalholiday in India, Nepal, SriLanka, Myanmar, Mauritius,Guyana, Trinidad and Tobago,Suriname, Malaysia, Singaporeand Fiji.Army Maj. Anantha K. Mal-

lia, director of the Medical In-tensive Care Unit, gave theopening “Puja” or invocationprayer at the Diwali. In Hinduculture, all important eventsbegin with the Puja in honorof Ganesha, deity in the Hindupantheon known as the remov-er of obstacles.According to Mallia, the

Puja’s intent is to praise and

glorify God, ask God to sanctifythe proceedings of the eventand bless those in attendance.

Mallia explained the wordDiwali is actually a short formof the Sanskrit word “Deep-

avali,” which literally means“row of lights.” To celebrate theDiwali, many people decorate

their homes, yards and streetswith rows of oil lamps.“The central significance of

Diwali is light,” said Mallia.“Diwali is a celebration of thevictory of good (light) over evil(darkness), truth over false-hood, and love over hate.” Healso said that it is a celebrationof “our inner light — that eter-nal soul that is within us all,which is the source of knowl-edge, love, compassion andright action.”After the Puja, the audience

was treated to traditional Hin-di devotional songs, music anddance, as well as Bollywooddancing. The performanceswere followed by a traditionalIndian lunch of rice, curriesand samosas.Mallia shared that as a kid,

his family would always go totheir local temple in Chicagoto celebrate Diwali, where theywould enjoy the occasion withthousands of other Hindu fami-lies.“People would be dressed up

in their most colorful Indianclothes,” Mallia said. “Therewould be solemn religious ritu-als, followed by lively music,spicy food and way too manysweets. This year is our firstDiwali as parents and we cel-

WRB Celebrates Diwali ‘Festival of Lights’

Photo by Mass Communications Specialist 2nd Class Christopher Krucke

Children perform a traditional Bollywood dance during the annual Walter ReedBethesda, “Diwali: Festival of Lights,” celebration on Oct. 17. Diwali is the big-gest and most celebrated holiday in Hinduism and signifies the triumph of light(good) over darkness (evil).

See DIWALI page 9

By Sarah MarshallWRNMMC Public Affairs

staff writer

For the last several years,Walter Reed Bethesda has beenworking closely with Estonians,as they developed a new ampu-tee treatment facility, which willsupport the country’s militarymembers injured in conflict andcitizens in need of prosthetic care.In 2011, Estonia’s East Tal-

linn Central Hospital and Unit-ed States European Command(USEUCOM) asked Walter ReedNationalMilitaryMedical Center(WRNMMC) personnel to imparttheir expertise. At the time, theEstonians were in the planningstages of renovating their hos-pital in Tallinn, on the northerncoast of Estonia, with hopes ofturning it into a facility capableof supporting amputee care fortheir wounded service membersas well as their civilians. Thefacility would be known as theAdvanced Amputee Patient Care

Center.WRNMMC obliged, send-ing a team to help plan for thecenter’s development and makerecommendations on equipmentand room plans, made possiblevia a shared agreement throughUSEUCOM and Estonia.Estonia again called onWalter

Reed Bethesda’s subject matterexperts in 2013, to provide ad-ditional training for their provid-ers who will be working at thenew center. Through the sharedagreement, and funded by the Es-tonian government, two Estonianprosthetists — one with physicaltherapy training and one, an ac-tive duty soldier injured in Af-ghanistan, were trained by Wal-ter Reed Bethesda providers forseveral months, enhancing theirability to assess patient needs,design, fabricate and fit prosthe-ses for lower extremity amputees.In July, the Estonians opened thedoors to their new facility.Recognizing this herculean

collaboration between the twonations, Estonia’s Minister of

the Interior, the Honorable Han-no Pevkur, visited Walter ReedBethesda on Oct. 16.“It has been a long journey,”

Pevkur said. “It’s a perfect exam-ple of good cooperation betweenEstonia and the United States …it’s amazing to see.”He added it’s important to

keep in mind what the two na-tions have achieved together, de-veloping this center that will alsoassist surrounding countries inconflict.“We’ll remember all of these

good years and good efforts tohave such a center as we havetoday. Thank you very much,”Pevkur said, as he presented aplaque to Walter Reed Bethesdaprosthetists.Dr. Chuck Scoville, chief of

Rehabilitation at WRNMMC,was among those who initiallyvisited Estonia to view the fa-cility in 2011, helping those es-tablishing the facility to move

A Global Impact: WRNMMC Collaborates with Estonians

Photo by Sarah E. Marshall

Dave Laufer, chief of Prosthetics and Orthotics, farleft, explains developments in prosthetics, to the Em-bassy of Estonia’s Minister of the Interior, the Hon-orable Hanno Pevkur, center, and Ambassador EerikMarmei. The Estonians visited Walter Reed Bethes-da Oct. 16, expressing their gratitude for WalterReed Bethesda’s support in the development of a newamputee care center on the north coast of Estonia.During their visit, the Estonians toured the MilitaryAdvanced Training Center, prosthetics lab and occu-pational therapy.See GLOBAL page 10


Naval Support ActivityBethesda Security personnelheld an active shooter drill Oct.27 in order to practice theirskills and response in the eventa hostile active shooter incidentshould occur on the installation.An active shooter drill helps

both non-emergency service (ci-vilian) and emergency servicepersonnel understand theirroles.Civilian personnel are

trained and reminded to followthese three functions: run, hideor fight.“Run when it is safe to do so,”

explained Naval Support Activ-ity Bethesda (NSAB) Security’sMaster-at-Arms 2nd Class SteveLane, NSAB Assistant TrainingPetty Officer.

“Find shelter in a place tohide until the threat has beeneliminated.“Fighting is a last resort. If

you do fight, commit to that de-cision because that could [makethe difference between] you liv-ing or not living through thatincident,” Lane emphasized.He went on to explain that

active shooter training is de-signed to provide real-worldpractice for emergency firstresponders. This enables themto establish a timely responseto an emergency, as well astesting evacuation procedures,medical assistance and the ap-prehension of suspects. Evalua-tion of tactical movements and

communication skills betweenthe multiple agencies that as-sist is also an integral part ofthe drill.For more information about

what can be done during an ac-tive shooter, visit the Depart-ment of Homeland Securitywebsite at http://www.dhs.gov/active-shooter-preparedness.

Naval Support Activity Bethesda SecurityTeam Performs Active Shooter Drill Oct. 27

Photo by Mass Communication Specialist Ashante Hammons

Master-at-Arms 2nd Class Robert Baker clears thepassageway during an active shooter drill at NavalSupport Activity Bethesda Oct. 27.

donning and especially doff-ing (removing) their personalprotective equipment, aftertreating a patient, will contin-ue to be a focus according toKnapp, who noted that EVDis only transmitted by a per-son who is sick with a feverand symptoms of the illness— contracted through directcontact with patient bodilyfluids.“[Doffing] is the most criti-

cal stage to protect the healthcare workers,” she said, “tomake sure they don’t contam-inate themselves with anybodily fluids that have EbolaVirus Disease.”Gillette added that ensur-

ing staff are in the appropri-ate level of protective equip-ment for their safety whileat the same time providingsuperb care to the patient, isthe mission.“There are many pieces [to

the effort] and we have mul-tiple subject matter expertsthat have developed a seriesof standard operating pro-cedures. This exercise wasreally taking those variousplans and polices they’ve been

working on and seeing allthat gelled together,” he said.It’s definitely a team ef-

fort, according to Gillette,who explained those expertsthroughout the commandmeet daily, “to make sure thateveryone takes their own in-dividual processes and putthem into the entire, con-solidated plan — so we’re allreading from the same sheetof music.”

EBOLAContinued from pg. 1

Photo by Sharon Renee Taylor

Navy Lt. j.g. Brent Pavellprovides care to a mockpatient during an Ebolaexercise on Oct. 24.

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expanding their problem-solving abili-ties while handling complex issues oftheir unit’s wellness.

“All of this is wrapped into an in-credibly challenging series of unfold-ing scenarios,” Kellermann said. “Theyare constantly being thrown problems.They have to adapt and learn to workwith one another in a variety of waysand a variety of combinations.”

As the exercise progressed, they“upped the ante,” until the fourthand final day, Kellermann said. Theirtraining was then culminated with thelarge mass casualty exercise and, headded, “We try to make it as realisticas we can. We don’t pull punches.”

On the final day, the platoons, withabout 24 students each, responded toa simulated mass casualty. They wereinformed the fictional country’s rebelforce leader was identified, and starteda last effort to take over the country’sgovernment, Palma explained. As theyresponded, they heard loud rapid gun-fire, screaming and explosions boom-ing from a speaker. Smoke billowedfrom the woods, where casualties werecoming from left and right.

“You think you know what you’regoing to walk into, but the sheer mag-nitude, the sights … it’s a shock tothe senses,” said Army 2nd Lt. RowanSheldon, a fourth-year medical stu-dent in the 2nd Platoon. “You have totake a step back and say, this is myplan, this is what I have to do, and ex-ecute the plan.”

Playing the role of a surgeon duringthe mass casualty, Sheldon said hisplatoon worked to find balance. Thosededicated to providing immediate caredid just that, while others remainedfocused on setting up the triage andtreatment areas.

“Within the chaos of the environ-ment, we had to create order. It wasdifficult and very realistic,” Sheldonsaid.

Overall, their experience through-out the training was both challengingand rewarding, he said.

“Every single person out there nowis better than they were four days

ago,” he added. “It was the most real-istic training I’ve ever done.”

Navy Ensign Tony Romero agreed,adding that even though it was simu-lated, it was still very stressful. Dur-ing the mass casualty, playing therole of a medic in the 2nd Platoon, hewalked by people who clearly neededhelp. Though he wanted to delay hisassigned tasks to stop and help, hereminded himself his job was just asvital to meeting the mission – savingas many lives as possible.

Romero said he appreciated thefeedback, while being graded on hisperformance. “The [faculty] are thereto help you, and helping make youbetter will help the entire system,” headded.

He also noted everyone looked outfor each other’s well-being, ensuringthey had taken time to eat and werenot over-exerting themselves, an im-portant aspect of avoiding combatstress.

“It’s incredibly stressful for them,”said Navy Ensign Meghan Quinn. Shewas among the many first-year stu-dents at the exercise, there to helpplay the role of casualties.

During the mass casualty, Quinnacted as though she was exposed toan Improvised Explosive Device blast,unable to hear and very confused.She said she tried to make it difficultfor them to treat her by stumblingaround. She enjoyed watching howthey responded, and to “see them re-ally respond to you as a person and asa patient.”

The training also gave Quinn afirsthand look at the difficult trainingshe will go through in just a few years,when she returns for the exercise as afourth-year student, she said. She rec-ognized the importance of the train-ing, she added, as it tests you in waysyou’re not able to be tested in a class-room. She also said it’s important totrain in this environment, since theywill not always be providing care in ahospital.

After the exercise, students re-turned to their clinical rotationsacross the country, including at WalterReed Bethesda.

CAREContinued from pg. 4

ebrated it in much the same way withour daughter.”

Mallia added that all of our armedservices recognize the “free exercise ofreligion and spirituality is essential formaintaining the strength of the warrior— that is spiritual well-being, is a forcemultiplier.”

He also said that a huge part of re-ligious practice is the celebration ofimportant religious holidays. “And,certainly, having an official venue inwhich Hindu Soldiers, Marines, Sailors,Airmen and Civilians can celebrate Di-

wali, which is one of the most importantHindu festivals, has a hugely positiveimpact on morale and consequentially,force readiness.”

“I really enjoyed the celebration [and]felt very welcome. The performance wasvery pleasant to watch, very colorfuland different,” said David Hollowood,SharePoint Developer/Administrator,Facilities Management Department atWalter Reed Bethesda.

Hollowood said he thinks events likethe Diwali celebration are good for mo-rale. “It lets us celebrate as a commu-nity the diversity in our ranks. It makesme proud to be a part of our culture. Wecan be proud of our heritage, celebrateour differences and know that as Amer-icans that we are all part of somethinggreater.”

DIWALIContinued from pg. 7

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that patient will be minimal. Threeteams of nurses and doctors will pro-vide care. Each team will consist of fiveMICU nurses, one infectious diseasephysician, one critical care physician,and a few others as needed.

“These teams are being trained inproper PPE use,” she said.

Zajdowicz said the likelihood of apatient with possible EVD present-ing at an outpatient clinic “is not veryhigh.” She said if EVD is suspected in apatient who presents at the front deskof an outpatient clinic, staff should puta mask on the patient and place himor her in a private room, preferablya private lavatory, close the door andcall the Infectious Disease physicianon call.

“If a patient calls into the hospitaland says they think they have EVD,take their name, refer them to theEmergency Department, and call theEmergency Department and let themknow the patient’s name and that theyshould expect that person to arrive,”Zajdowicz said.

“Staff members who are caring fora suspected or confirmed EVD patientwill be monitored by the Public HealthDepartment,” Zajdowicz continued.Staff members should also self-moni-tor themselves, checking their temper-atures twice daily.

“No leave, temporary assigned duty,or temporary duty will be allowed dur-ing this time, except in extraordinarycircumstances,” Zajdowicz said. “Ingeneral, they will be asked not to leavethe area.”

“We’ve only known about Ebolasince 1976,” Zajdowicz said. She addedthe current Ebola outbreak is the larg-

est in recorded history, and involvesthe West Africa countries of Liberia,Guinea and Sierra Leone. “Nigeriaand Senegal have contained their out-breaks.”

Zajdowicz added the Centers forDisease Control and Prevention (CDC)has issued a Level 3 Travel Advisory[for those affected countries], recom-mending against non-essential travelto those regions.

“We are leaning farther forwardthan any other military treatmentfacility [in Ebola preparedness opera-tions],” Zajdowicz concluded.

Navy Cmdr. (Dr.) James Lawler,chief of the clinical research depart-ment of the bio-defense research direc-torate, Naval Medical Research Center,Fort Detrick, Md., said, “We’re reallyrewriting the textbook on Ebola VirusDisease, because we’ve seen so manymore cases in this outbreak. I thinkwe’ve tried to capture a lot of the les-sons that have been learned from WestAfrica, and also from the repatriatedpatients who have been treated herein the United States. We’ve learned alot about effective treatment and howimportant aggressive supportive carecan be, and we’ve tried to impart thoselessons to the team here.”

Lawler, an infectious disease spe-cialist who has researched Ebola inlaboratory settings and has workedin treatment centers in Africa as wellas with the World Health Organiza-tion and Doctors Without Borders inthe Ebola treatment unit in Guinea,added, “I think that there’s a better ap-preciation that aggressive supportivecare can make a significant differencein outcome.”

For more information concerningEVD, visit the CDC website: http://www.cdc.gov/vhf/ebola/.

SAFEContinued from pg. 5

forward, and discuss how they and thoseat WRNMMC will work together to im-prove their capabilities.

“We’ve had great cooperation,” Sco-ville said. “We look forward to this rela-tionship.”

Scoville explainedWRNMMCand theEstonians will continue to share knowl-edge with one another in the future, asadvances are made in the field of ampu-tee treatment, to help improve care forall – military and civilians.

Dave Laufer, director of Prostheticsand Orthotics at WRNMMC, echoed thesame sentiment, adding,

“The experience was beneficial to bothsides.”

It’s helpful to instruct others in thefield, to be able to see the process fromtheir eyes, Laufer explained. Having at-tended the opening of the Estonian’s newcenter, Laufer was impressed by the ca-pabilities it has to offer, many of whichmirror those at WRNMMC. In additionto a prosthetics lab, Estonia’s new centeralso offers physical therapy as well asaquatic therapy.

WRNMMC prosthetist Louise Hass-inger, involved in the collaboration, saidshe is also impressed by what the Esto-nians will now be able to provide. She ex-plained how our prosthetists trained thetwo Estonian providers, who were com-mitted to learning as much as possible

during their time atWRNMMC.“We taught them fabrication skills

(how to assemble a prosthesis), and howto assess patient needs,” she said. “Theywere very dedicated.”

Though they came toWRNMMCwitha great skill set, they “improved dramati-cally” while they were here, according toDave Beachler, a WRNMMC prosthetistalso involved in the effort.

The prosthetists agreed it was re-markable to see the Estonians’ improve-ment, and allow them to have the hands-on training from which they greatlybenefited. They were able to observe ourpatient care, and enhance their abilityto assess patient needs, as well as fittingprostheses, Beachler said.

“Just to watch their skill set progresswas great to see,” Hassinger added. Shesaid she was also proud of what they’llnow be able to do in Estonia.

“It was great to have them here,”Beachler said. Their mission was tolearn how we do prosthetics, and theysucceeded, he said.

The prosthetists also felt fortunate tobe involved in this effort, and its globalimpact, they said.The newEstonian am-putee center is the world-class facilityin that area (Baltic States), Hassingernoted, and people in that area will wantto emulate their facility. “That’s reallya neat picture of how what we’re doinghere not only impacts service [members],coming back from our conflicts, but howwe are also impacting other countries,”she said.

GLOBALContinued from pg. 7

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