Indonesian Marines and U.S. Navy "Seabee" engineers construct a three-classroom school during the 43rd Indonesian Navy medical and civic action operation called Surya Bhaskara Jaya (SBJ).

The Indonesian Navy has provided humanitarian, civic assistance, and medical civic action programs to remote islands within its vast archipelago for many years. Each quarter, the Indonesian Navy's Eastern and Western Fleets alternately sail to islands far-removed from major population centers. These operations are called Surya Bhaskara Jaya, or SBJ. The 43rd SBJ was conducted in the southeastern Maluku islands, over 1000 islands stretching across the Seram and Banda Seas between Irian Jaya and the island of Sulawesi.

The eye medical team performed a large number of cataract surgeries. Maj. (Dr.) Hadi Soesilo (center) performs an eye surgery assisted by U.S. Navy ophthalmologist Cmdr. (Dr.) Karl Holzinger (right) and Indonesian Navy ocular technician Sgt. Suwitno (left). U.S. Navy dentist Cmdr. (Dr.) Bill Wright behind Dr. Hadi observes.

In March 1999, medical and engineering personnel from the U.S. Navy joined the Indonesian Navy in providing care and assistance to people of the Malukus. This was the second time the U.S. assisted in the Indonesian Navy program. The first U.S. participation was in late 1998, assisting the Western Indonesian Fleet on Nias, an island west of Sumatra.

Indonesian Navy Capt. Vrento Marino, who conducted the area survey prior to SBJ 43, poses with a medical corpsman from the U.S. Navy.

For the 43rd SBJ, the U.S. Navy personnel gathered in Surabaya, home of the Indonesian Eastern Fleet, to prepare for the operation on the island of Yamdena, in the Tanimbar group of 66 islands. It took two days of travel by light aircraft just for the Americans to get there. The U.S. team arrived 11 March and worked until 27 March. The mission to Yamdena Island was an opportunity for the United States to work in support of the humanitarian projects that Indonesia's armed forces have undertaken over many years.

Indonesian Navy dentist 2nd Lt. (Dr.) Rachman provides dental treatment for a young boy from Saumlaki.

Three combined Indonesia-U.S. teams were gathered for the project: an eye team for cataract surgery and eyeglasses manufacturing, a dental team and a construction team. The Indonesian portion also involved a separate Indonesian Navy landing ship (LST), which sailed to many sites in the southeastern Malukus with a full complement of surgical and medical specialists. The LST contained compartments for surgery and intensive care, and the necessary medical personnel on board to provide that sophisticated care.

Some of the 125 eye surgery patients pose with members of the Indonesian Navy medical team. L To R: Maj. (Dr.) Hadi Soesilo, Sgt. Suwitno, and the dentist, 2nd Lt. (Dr.) Rachman.

Indonesian Navy Capt. Vrento Marino from the Eastern Fleet performed a site survey 45 days prior to the U.S. arrival, in coordination with U.S. Navy Cmdr. Lee Langston from the Office of the Military Attaché for Defense Programs, and U.S. Navy Hospitalman Senior Chief Harry Stowell from Naval Medical Research Unit #2 (NAMRU-2) based in Jakarta. NAMRU-2, under its Commander Capt. H. V. Petersen and Executive Officer Cmdr. James Burans, was instrumental in developing the U.S. role in the Indonesia-U.S. (INDUSA) missions. They also arranged for procurement, staging, and delivery of all the medical supplies. The site survey team determined that the most efficient use of U.S. resources was for the U.S. Navy team to remain in one area for the entire mission, rather than accompanying the LST, thus avoiding the need to repeatedly set up and break down the U.S. equipment. Saumlaki, with a large population base and a small community hospital, was selected as the site for the U.S. medical and dental teams. Saumlaki also had a public school that needed more classrooms, which provided a worthwhile project for the U.S. construction team.

An Indonesian military nurse fits one of a pair of 2,040 eyeglasses, newly made by the U.S. Navy optometrist/optician team, to a local patient.

Capt. Vrento and Cmdr. Langston worked on this project from the initial site survey through its completion, serving as liaison officers with local community leaders and as interpreters. Capt. Vrento, a native of Ambon in the Malukus, was perfect for the job since he understood the local language, culture and customs.

Indonesian military and health officials greet the visiting HQ, U.S. Pacific Command Surgeon, Rear Adm. Dennis Wright; Cmdr. Lee Langston, from the U.S. Embassy Office of the Military Attaché for Defense Programs; and Fleet Medical Officer of the Indonesian Navy's Eastern Fleet and Chief of the Dr. Ramelan Naval Hospital, First Adm. Tito Sulaksito.

For the U.S. medical and dental personnel, the program provided the opportunity to work in unfamiliar conditions, with limited supplies, learning how to prioritize the needs of an almost overwhelming number of patients. For the construction team, it provided an opportunity to learn new methods and to complete a project with the limited tools at hand.

Cmdr. (Dr.) Karl Holzinger (author) poses with some of his cataract surgery patients and nurses at the hospital in Saumlaki, Indonesia.

One of the main goals of the medical program was to help treat blindness in rural areas. Cataracts are the leading cause of treatable blindness throughout the world, and the problem of blindness from cataracts occurs overwhelmingly in poor areas or where specialized medical care is not available. The supplies for surgery are expensive, especially when considering the great number of people in need. The U.S. Navy team was able to assist the Indonesian program by providing supplies and a cataract surgical team.

U.S. Navy Seabee construction engineers arrive on one of the three Indonesian Navy aircraft which flew U.S. personnel and equipment to Saumlaki.

Two U.S. Navy ophthalmologists, Cmdr. Jim Tidwell and Cmdr. Karl Holzinger (author), and an ocular technician, U.S. Army Sgt. Shawn Wofford, worked with Indonesian Navy ophthalmologist Maj. Hadi Soesilo and ocular technician Sgt. Suwitno. The Indonesian-U.S. team screened 609 patients over 14 days and performed 125 eye surgeries. Cataract operations accounted for 106 of the surgeries. The numbers were nearly twice those expected, as more and more patients continued to arrive when the success of the earlier surgeries became known throughout the villages. Many patients arrived after boat rides as long as 12 hours.

"This was a great chance to help people," said Dr. Hadi. "I look forward to the next SBJ to help people see again."

The U.S. team initially planned to work in both Saumlaki and the town of Larat (on Larat Island), but a shortened schedule prevented them from going to Larat. Since the people had been told to expect the Americans, the team made a special effort to reach out to the village. An Indonesian patrol boat took Cmdr. Holzinger to Larat to screen patients for cataract surgery, while the rest of the team continued to work in Saumlaki. He took six patients back to Saumlaki where they underwent surgery. The patrol boat then returned the patients to Larat three days after surgery.

Indonesian Marines and U.S. Navy Seabees construct a new three-classroom school in Saumlaki, combining their construction techniques.

As if the ocular technicians weren't busy enough, they became surgeons in the evenings. Sgt. Suwitno removed lipomas (fatty growths under the skin) with Sgt. Wofford assisting. Many people eagerly came hoping to get their growths removed.

The second part of the eye program consisted of fabricating eyeglasses for needy Indonesian villagers. A U.S. Navy optometrist, Cmdr. Robert Aitken and two opticians, Petty Officers Andrew Hand and Christopher Boyce, composed the team. This very popular and successful part of the program resulted in 2040 pairs of eyeglasses. To handle the large numbers, many local volunteers worked as translators, vision screeners and crowd controllers. Cmdr. Aitken said, "I particularly enjoyed the chance to experience the culture, to see each patient as an individual, even though the number of patients was so great. It was most rewarding to give sight to children and teenagers who had always had blurry vision." The opticians were inspired by all of the happy faces. "It kept us going," said Petty Officer Boyce, "and we accomplished more than we thought we could."

U.S. Navy Seabees put finishing touches to a concrete walkway built for the school.

The Indonesian-U.S. dental team also accomplished a great deal. Indonesian dentist Lt. Arif Rachman, with several nurses from Saumlaki volunteering as dental assistants, was joined by Cmdr. William Wright and his technicians, Petty Officers Kanem Sims and Breenan Deleon. From the 853 patients screened, 2360 teeth were pulled. Every patient seen by the dentists had at least one abscess requiring an extraction. Helping the people "was a very rewarding experience" said Cmdr. Wright. "The goodwill we offered is returned to us in developing true friendships." He especially praised the nurses. "They were dedicated and well-trained in infection control and were always meticulous," said Cmdr. Wright. "You could see the pride they had in being able to help their community."

Capt. Vrento noted that "the most important thing is that the Indonesian and U.S. military came to help people. It was so good to see the people of Saumlaki come together to help each other. The local volunteers worked the same hours we worked and showed how much they cared for each other."

The Indonesian-U.S. team builds a new roof for a water storage facility.

"I enjoyed working with the Americans, especially how they planned and set goals. At the end of the day, discussions were held about why goals were reached or not reached. We tend to talk in more general ways, but the U.S. team discusses in more detail. If something worked well, or didn't work well, they tried to learn from that and apply it to the next day's work," Capt. Vrento stated.An Indonesian-U.S. engineering team worked separately from the health care teams. A detachment of 15 U.S. Navy Seabees (construction engineers) led by Chief Petty Officer Donald R. Pugsley teamed with Indonesian Marines under Lt. Helmi Ardiansyah to construct a new three-classroom school in Saumlaki. The ambitious project included building walkways leading to the structure, tiled floors and stucco walls. This same team also replaced a roof over a water storage tank, built a bridge guardrail over a viaduct and enlarged the water storage capacity of a nearby village. They also constructed a new roof, awning and concrete porch for the government hospital and painted the administration building. The U.S. personnel learned a great deal about local construction with limited tools, including how to do post and beam construction with tongue-in-groove techniques. The Indonesian team was particularly interested in the American procedures for laying concrete.

A highlight of the mission was a visit on 19 March by First Adm. Tito Sulaksito, head of the Dr. Ramelan Naval Hospital in Surabaya and Fleet Medical Officer of the Eastern Fleet. He was accompanied by Rear Adm. Dennis Wright, USCINCPAC Surgeon. Both doctors toured all work areas and had lunch at the school. They were impressed by the humanitarian efforts and the enthusiasm of the teams. "This type of program is a great opportunity for us to join with Indonesia's Navy to help the people of Indonesia," said Rear Adm. Wright.

First Adm. Harijanto Mahdi, Indonesian Armed Forces Surgeon General, praised the excellent cooperation between the two armed forces and hoped it will continue in the future. Indonesian Marine Sgt. Ferdi and U.S. Navy Seabee EOCN Barfield proudly finish their job in SBJ 43.

First Admiral Tito said, "The outstanding cooperation between TNI-AL's [Indonesian Navy] medical team, U.S. Navy and Saumlaki hospital personnel produced maximum medical service, especially for patients with eyesight handicaps." The cooperation between TNI-AL Marine and U.S. Navy engineers "in the physical construction of [various projects] produced exactly what the people of Saumlaki needed. Observing the enthusiasm of people in isolated islands, particularly Saumlaki, [this project] could be used as a standard for other isolated islands within Indonesia. Therefore, the necessity of cooperation between TNI-AL and U.S. Navy needs to be followed up in the future."

Both admirals expressed a desire to continue this type of cooperation, one of a number of growing military-to-military collaborative efforts focusing on humanitarian assistance between the Indonesian and U.S. Armed Forces. First Adm. Harijanto Mahdi, the Indonesian Armed Forces Surgeon General said, "The purpose and aim of the Bhakti TNI AL/Surya Bhaskara Jaya is, among others, humanitarian assistance for the people in remote areas, whereas one of the tasks of the U.S. Navy/USCINCPAC is also humanitarian assistance. Therefore, this existing joint operation between the Indonesian Navy and the U.S. Navy/USCINCPAC in the 43rd Operasi Surya Bhaskara Jaya in Southeast Maluku can be classified as a synergistic humanitarian assistance. The result of this cooperation is felt very beneficial for the people receiving the aid. It is hoped that this cooperation could continue in the future and will tighten the relationship of the two nations."