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 New Mexico National Guard medics share knowledge with Costa Rican Coast Guard members By 2nd Lt. Anna Doo
                New Mexico National Guard
 QUEPOS, Costa Rica - Twenty-two Costa Rican Guarda Costas attended a recent two-day workshop conducted by Sgt. 1st. Class David Muniz and Sgt. Michael Marfia, medics from New Mexico National Guard, as part of the National Guard Bureau's State Partnership Program. The Subject Matter Expert Exchange, or SMEE, aims to deepen the shared knowledge of the partners on topics of benefit for both. New Mexico and Costa Rica have maintained a state partnership since 2006 and conduct bilateral training on medical expertise, armorer information, border security and aviation topics, among others. This first responder medical exchange was slightly different than those previously conducted as it was a group from one service instead of a mixed class. Typically, police, border security, firefighter and coast guard personnel all fill the available slots for each exchange. For the first time in about nine courses, the exchange was held at the Guarda Costa Academy here and was filled solely by coast guard members. The New Mexico National Guard experts, Muniz and Marfia, offer a baseline level of medical response information to the participants during these exchanges. Marfia said he could see the benefit of individual services attending another level of medical information and modifying the content toward the unique issues. "The class was able to work together as a group on the group exercises because of them all working together in general," he said. "Possibly for future iterations when you have classes from the same type of unit, you can tailor the training to their specific needs." The class was full of interaction, collaboration, questions and hands-on learning. Muniz, a full-time medic and operations sergeant with the 515th Regional Training Institute in Santa Fe, New Mexico, was the lead instructor and is fluent in Spanish. Even so, he relied on one of the Guarda Costa personnel to fill in the translation gaps as needed. Aaron Acevedo Artavia translated the English medical terms, techniques and explanations into Spanish for his fellow classmates. His comprehension of the concepts was invaluable and vital to the success of the exchange. "We try to find someone to help out during each class," said Muniz. "Acevedo was probably the best English speaker we've had so far so that just elevated the course. He was even able to help with the infectious disease topics and I was able to get all the points across that I wanted to." In addition to sharing knowledge on infectious diseases, Muniz and Marfia conducted a basic anatomy lesson, demonstrated how to clear a blocked airway, assess a patient, stop bleeding, apply a tourniquet, and move a patient, among other topics. Muniz said, "It was really good teaching the infectious disease portion as this was the first time we did that. It was surprising how much they didn't know. They live in an area endemic to Dengue, chikungunya, and all this other stuff but they really didn't know the history of it, just that it's caused by mosquitos. They are part of public readiness so they need to be able to identify cases and teach other people how to prevent it." Acevedo also translated the thoughts of fellow students on the course and the instructors. "It was really helpful and interesting learning how to treat sick people," said Mabel Dittel Mora through Acevedo. "The instructors are experienced people who helped to show us and explain the concepts." Another student found the medical instruction to be helpful and said it was his first time learning the topics. "I learned how to treat an injured person and be the first response," said Juan Ulloa Salazar through Acevedo. "I think we have to share this information with our partners, families and friends." Each of the participants was urged to take the lessons learned over the course and share them with their units and fellow Guarda Costa personnel. As for Acevedo, he said this was the first medical instruction he's received and found it to be valuable. "It was really helpful because now we know how to respond to some troubles. We know how to save a life first and then treat other injuries," he said. "The instructors really know how to explain to us and they know how to do [the medical] response. It was a great first course." The instruction was a mixture of explanation, hands-on and evaluation. The culminating exercise was a simulated mass casualty scenario. One event was the aftermath of an earthquake with numerous people wounded sustaining various injuries. The added element of aftershocks was an extra level of challenge. The participants had to be able to assess the situation, triage the priority of casualties and safely relocate them to a staging area for further medical care. The students swapped roles and prepared for the second scenario. The scene was more stable thus the need to move patients immediately was not a concern. The injuries were severe and varied, but the Guarda Costas smoothly and calmly went from patient to patient rendering what aid they could and identifying what higher level of care was out of their realm of expertise. Grinning, some covered in bandages and tourniquets, and dripping sweat in the humid Costa Rican sun, the participants recapped the scenarios and discussed what could be done differently in similar situations. They all seemed to grasp the necessity of practicing these new skills in order to fully understand them and be able to help their fellow citizens in times of need. "The biggest takeaway for them was not necessarily any specific skill we shared, but more so the mental attitude to have towards emergency situations," Marfia said. As the State Partnership between Costa Rica and New Mexico celebrates its tenth year, planning is already underway for the next decade of shared knowledge and expertise. The program has been a proven benefit for both entities with scores of personnel learning from one another and building upon the well-established relationship.
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