Spit spots, hand sanitizer, sick call

Published April 3, 2012
By Master Sgt. Tracy L. DeMarco
376th Air Expeditionary Wing Public Affairs

TRANSIT CENTER AT MANAS, Kyrgyzstan -- One might think with a weekly average 11,000 people coming and going and a daily average 4,000 meals being consumed, sanitation and sickness would be primary concerns for the Transit Center at Manas. And they are.

The Transit Center can reasonably be compared to any major international airport - an airport without long halls, shopping malls and, well, walls. An outdoor airport would be a better description.

It has aircraft, lots of passengers and tons of cargo. There are several places to eat and instead of rows of uncomfortable chairs where people take naps with headphones on, Airmen, Sailors, Soldiers and Marines lay their heads down in tents while they wait for their flights. Of course headphones are allowed.

As with any major air transportation operation, a support staff is key. The Transit Center is home to approximately 1,300 permanent-party military members who manage security, logistics, medical support and so on. Additionally, nearly 700 local Kyrgyz Republic citizens clock-in for work at the Transit Center filling roles like grounds maintenance, construction, food service and translating and interpreting.

Unlike commercial airports, the Transit Center doesn't have fancy moving walkways, escalators or those annoying trolleys that always seem to want to drive where people are standing. Rather, the concrete sidewalks here are littered with uniform-wearing, bag-dragging military men and women.

But when the sidewalks are empty, spit spots remain. In the winter, the spit spots actually freeze into flea-sized skating rinks.

Saliva contains millions of bacteria per drop. This might be a grotesque subject to ponder, but the medical professionals at the 376th Expeditionary Medical Group Public Health section do just that.

"If they're not spitting at you and you're not touching the spit, it's really not going to make anybody sick," said Staff Sgt. Jennifer Finch, Public Health NCO in charge, who is deployed here from Wright-Patterson Air Force Base, Ohio.

Public Health is tasked with disease prevention and containment. They do this by focusing on four mission areas - education, inspection, surveillance and control, which function in a cyclical manner.

"That's basically what we do - break the cycle of disease," said Maj. Juan Leon, Public Health officer in charge, also deployed from Wright-Patterson AFB.

Education includes briefing every person who steps foot onto the Transit Center whether they are permanent-party or just passing through. Inspections ensure the standards of cleanliness are being followed throughout the installation, from food service to shower stalls.

"It's like being a mom and reminding everyone to clean up after themselves and wash their hands," Finch smiled. "Washing your hands is probably the best way to prevent the spread of disease."

Every facility at the Transit Center is armed with hand sanitizer. A truly remarkable invention, hand sanitizer allows people to clean their hands with the possibility of killing 99.99 percent of germs. Since it is a well known fact that peoples' hands transfer the most bacteria, it is no wonder that this clear gel is strategically placed in this grand outdoor airport.

As far as surveillance is concerned, Public Health doesn't take a passive posture watching people to see if they wash their hands. Rather it's a very active part of disease control. Finch not only looks at medical records and database notes to verify individuals' health status, she tracks illness statistics.

So far in 2012, upper respiratory infections average 70 a week at the Transit Center, and the weekly average for gastrointestinal infections is 14. With approximately 2,000 new people on the installation every day arriving stressed, sleep deprived, and perhaps hygiene deficient, these numbers are well within normal.

"They're enclosed in an airplane where they're all re-breathing the same air and they have enough time to incubate," Leon said. "If you have one person with the flu, it may become five in that plane and five can become 50 on the ground."

So how does the Transit Center Public Health team maintain a less than one percent weekly average for gastrointestinal infections and a less than two percent average for respiratory infections?

The success is in the design.

"Most dining facilities back home don't have sinks as you walk in," Leon said. "The fact that the dining facilities here have hand-washing sinks at the beginning, combined with peer pressure or herd mentality - that takes care of some of the problem."

Just as it is not coincidental that sinks are strategically placed in the dining facilities, there is no accidental placement of transient sleeping quarters either. Both transient sleeping areas are located a good distance away from permanent-party dormitories.

While the physical design of the installation clearly contributes to disease control, the design of Public Health is to partner with agencies inside and outside the 376th EMDG to mitigate illness. Some of the individuals they work with are facility managers, the clinical team, bio-environmental (who test the water supply), commanders and first sergeants.

"During my transition, my predecessor took me to every facility and I personally met with every facility manager," Leon said. "By the time I had been here less than a week, everybody knew who I was. That's the other success; most of the managers are very responsive. Whatever we say, goes."

Most airports have either an infirmary or clinic to help travelers who have taken ill. The Transit Center is no different. Sick call is available every day no matter the hour. On average, the 16-person 376th EMDG clinical team diagnoses and treats 500 patients a week.

However, if Public Health has their way, the uniformed men and women who live or transit through here will clear security with a clean bill of health, wait at their gates with their headphones on and fly downrange or home, strong and in good physical condition.