Lack of medical supplies, poor sterility techniques and language barriers were not what Lt. Paul Obertone was expecting when he reported aboard Naval Hospital Bremerton as a perioperative nurse, but those were the conditions he was helping solve during his recent, 15-month deployment to the National Military Hospital in Kabul, Afghanistan.

As part of a 20-man team sent to train the local medical staff, Obertone spent more than a year not only helping the hospital supply itself and teaching medical techniques, but also helping set the groundwork for the teams that followed to continue the work initially started.

The National Military Hospital sat at the center of a web of regional hospitals which had received visits from U.S. medical training teams in the past.  When Obertone’s team arrived on the scene in August 2007, though, they were the first to tackle the National hospital. 

“Regional hospitals have been getting a lot of attention, but not this one,” he said.  “The ‘Bethesda’ of the Afghan Army had been kind of neglected.”

Obertone said there were some hurdles to cross even before they could get down to the mission of training the hospital staff.  Living arrangements, transportation and supply lines all had to be established first.  Smack dab in the center of Kabul, the team members even had to provide their own security and force protection. 

As a multi-service task force, there was also a lot of work put in to learning how to “do things the Army way,” for example.  According to Obertone, it took more than a month just to lay the groundwork.

“We were the first for the National Military Hospital, so we did a lot of trailblazing,” he said, noting that some of the satellite clinics got mentoring teams, but Obertone and his group were the first to work out of the core building.

The training team itself was made of a variety of hospital specialties such as hospital administrators, surgeons and pharmacists.  Each teamed up with their counterpart from the hospital to mentor them and introduce them to medical advances they might not have seen. 

As an Operating Room nurse, Obertone worked closely with the surgery team to improve their patient care. Cleanliness was his first challenge, ranging from teaching proper hand washing techniques to simply setting up smoking areas outside the surgical areas. 

He also worked with locals to manufacture scrubs in enough quantity that the surgical teams had enough clean sets to go around. All this was done with the mindset of mentoring for future success.

“Teaching them how to fish instead of handing them a fish,” he explained.  “It really is cliché, but it’s to the point.”

“It’s easy to just go in and do it for them, but that’s not mentoring,” he added.  “What I had to do was say ‘how can we best prepare these people to do the best job they can if we had to leave tomorrow?’”

Looking back at his 15 months there, Obertone sees his successes as numerous small victories rather than one big triumph. Even at a year-plus, the team’s time there wasn’t enough to accomplish everything they’d set out to do.  In the long-term, though, their focus on teaching the hospital staff to teach themselves was the main goal.

With that objective reached, there’s a promise that Kabul’s National Military Hospital’s level of care will only get better.