USNS Comfort
In partnership with the U.S. Navy, the Alliance for Rabies Control has joined the United States Naval Ship (USNS) Comfort in providing humanitarian aid throughout Central America.
Over three months time, the Alliance will sail to Colombia, El Salvador, Nicaragua and Panama to provide much needed information and resources on various zoonotic diseases with special emphasis on rabies. 
This effort would not be possible without the help of numerous partners and the Alliance would like to thank the American Veterinary Medical Association, Ministry of Health of Chile and the One Health Initiative for their support.
Click here to view the USNS Comfort Scheme of Maneuver.
Date: July 13. 2009
Location: NICARAGUA
We are finishing our mission in Nicaragua and are in the process of returning to the boat. The Nicaraguan Ministries of Agriculture and Health seem very proactive in rabies control in this country. They vaccinate all dogs yearly, so there was not a great need for us to vaccinate the dogs here. Cats are uncommonly kept as pets, because Nicaraguans "don't like cats." Hence, they do not receive vaccination by the government. The entire time we were there, we saw probably 5 cats.
Veterinary students from the vet school draw blood from dogs in field. We helped show them restraint techniques
According to one of the instructors at the veterinary college in Leon, government officials are in the process of eliminating the vampire bat which is one of the principle rabies vectors in Nicaragua. Rabies from vampires is now only found in one area in the north of the country. The last known human case of rabies occurred in 1996.
The sign outside the vet school
While I was ashore, one of the Nicaraguan health officials came onto the ship to give our crew a lecture on rabies which was very informative and comprehensive.
Horses are an important animal in this country, and we saw horses being ridden for transportation, pulling carts, and helping herd cattle. We vaccinated and dewormed a large number of horses. Unfortunately, many horses are turned loose to graze the highway shoulders, and get hit by cars.
Vaccinating a horse for rabies
Date: July 5. 2009
Location: NICARAGUA
We are getting a lot of good receptivity with the rabies pamphlets, and I see people reading them at every place we go. The animals here are very thin and have poor hair coats. The horses are small in body size, and the same goes for the dogs and cats. Sometimes I think I am dealing with a kitten or puppy, and in reality it is an adult.
Pet owners read the rabies prevention pamphlets with great interest
The cattle seem to be in a bit better condition, although some of them are thin as well. Many farmers don't have adequate pasture for their cattle to graze, so they take them to graze by the side of the roads and other common areas. I haven't seen much quality grass here; instead, the cattle are eating broad-leafed plants and weeds.
The pigs, on the other hand, seem fairly well fleshed.
Some farmers believe that a red cloth wrapped around the cow's neck will help prevent vampire bats from biting
The Surgeon General of the United States made a brief visit to the ship to learn about Operation Continuing Promise and visited us at our work site.
Date: June 26. 2009
Location: EL SALVADOR
The mission in El Salvador is much the same as in previous countries, that is, vaccinating and deworming cattle. We also vaccinate other animals as the people bring them to us. One observation of interest in this country, as compared to the other countries we´ve visited, is the fact that domestic animals run loose and species mix indiscriminately. We see horses untethered by the side of the road, cattle walking down the highway, pigs on the beach, packs of dogs roaming free, and of course chickens and turkeys everywhere. Surprisingly, though, I have seen very few stray or free roaming cats here.
A pig at the beach, and geese presiding over cooking hamburgers at a roadside restaurant
Date: June 17. 2009
Location: Tumaco, COLOMBIA
Summary of our mission in Tumaco, Colombia
Tumaco is an area of Colombia where many factors favor the transmission of rabies to humans. One factor is large numbers of stray (and unaltered) dogs come in contact with children. Most of these dogs are not vaccinated for rabies; of approximately one hundred dogs we saw, only two had a current rabies vaccine. Children carry the local dogs by grabbing the front legs or both the front and back legs, and haul them bodily to the desired location (pictured below). This positions the dog's head at the level of the child's face, making it easy for a bite to occur.
Children observing animal vaccinations
Additionally, the country of Colombia is in a state of "civil war" due to well-organized and well funded narcoterrorism. This constant unrest causes disruption in the villages, so that local people leave their homes and animals while seeking safety.
Without adequate stray dog control and vaccination, rabies will remain a problem for the population in rural Colombia.
Robin Hughes, DVM
Cynthia Hoobler, DVM, MPH, DACVPM Children bringing dog to be vaccinated
Date: June 15. 2009
Location: Tumaco, COLOMBIA
We are preparing to finish our mission in Colombia tomorrow. The Colombian people have been very grateful to have their large and small animals 
vaccinated and dewormed. We also have cared for some sick animals, and done a few necessary surgeries, one of which was to remove a probably screw worm infected lesion from a dog.
We have been handing out Spanish-language rabies information to all pet owners, and the people seem genuinely interested and happy to receive this information. In some cases, they have even come to us asking for it. Overall, I believe we reached quite a few needy individuals, and spread the word about rabies prevention.
Robin Hughes talking through an interpreter to a local resident about rabies and rabies prevention
Date: June 10. 2009
Location: Tumaco, COLOMBIA
We are staying ashore in Tumaco, Colombia. The thrust of the mission here is vaccination of the small and large animals. We are handing out a lot of the rabies brochures as well, and the people seem grateful for the information. Cynthia Hoobler, a Public Health veterinarian from Texas, U.S. has joined us, and we are happy to have her perspective on things. I won´t be able to send any photos until I get back on the ship, which will be another week.
Date: June 1. 2009
Location: Panama City, PANAMA
Today we took a break from our rabies prevention efforts in the local livestock and domestic animal populations and visited the screw worm eradication facility in Panama City. This is a joint effort between the USDA and the Panamanian Ministry of Agriculture. The plant rears screw worms, irradiates the pupae, and releases the flies in mass from airplanes. Recently, there has been a screw worm outbreak in this area, but it appears to be fairly localized.
Bot fly larva (not to be confused with the more destructive screw worm) expressed from a large lump on a cow
Screw worms once caused significant losses in the US cattle industry, because the maggots invade living tissue, burrowing deeply, causing infection and gangrene. Any animal with a skin wound is a target. Humans can even be affected. Screw worms in the US have been extirpated since the 1960s, and the line of extinction has been rolled back to Panama. Thus, the USDA maintains a presence here to safeguard the US and all countries north of this line from recolonization by this fly.
Research is being done on various aspects of rearing the flies, separating the sexes prior to irradiation to target males only, and understanding differences in fly strains from other locales. COPEG, as the organization is called, is hoping soon to get a chance to eradicate screw worms in Cuba.
Date: May 26. 2009
Location: Colon, PANAMA
We are in Colon, Panama. This morning, we visited the Ministry of Agriculture to determine what their needs are for our mission. Their main concerns are bot flies, screw worm, and rabies.
The Ministry, in conjunction with the USDA, carries out the screw worm eradication program, 
whereby adult male flies are irradiated and released, thereby insuring their sterility. In this particular area of Panama, the screw worm is present, and we are checking the cattle, goats, and other livestock for this parasite when we process them for vaccines and deworming.
We are vaccinating all the livestock and small animals for rabies, which is present in this area. Vampire bats are an important vector here. The Ministry practices night-time capture of bats and testing for rabies.
Vaccination of local cattle for rabies and treatment for mastitis
Small animal rabies vaccinations near Colon, Panama
Date: May 16. 2009
Location: ANTIGUA - approaching the USNS Comfort
Operation Continuing Promise is an international, joint military and civilian effort. On board the ship are members of the Navy, Army, Marines, Air Force, Coast Guard, US Public Health Service, Reservists, and Merchant Marines. Additionally, military personnel are present from the Netherlands, Nicaragua, and Canada.
The non-governmental contingent consists of six charitable organizations including Project Hope, Operation Smile, the Rotarians, and the Church of the Latter Day Saints.
The medical capabilities of the ship comprise most procedures except open heart surgery, joint replacement, and transplant surgery. Most patients are seen in an outpatient setting on land, but surgical patients are screened, then brought aboard ship for their procedure. The ship has the capability for 1000 hospital beds.
