Healing Our Soldiers — Hawaii’s MRPU

Circa 2006

There are too many stories for Major Edna Smith to narrow it down to just one.

Selecting one single soldier’s rehabilitation testimony is like picking which child has left a greater impression on a mother. Each is unique. Each is heart-wrenching. And each is about strength.

None of the soldiers Smith encounters at Schofield Barracks on the island of Oahu, Hawaii, are forgotten.

“We care about the individual soldier’s outcome,” says Smith, a family nurse practitioner who serves as commander of the Army base’s Medical Retention Processing Unit. “We strive to see each soldier succeed and transition back to the civilian sector as seamlessly as possible.”

Transition is the key word.

What happens when soldiers get injured? How do bills get paid? Where do they live when their rehabilitation time in the hospital is finished? Where will they work after spending their whole lives striving for a career they may no longer have? What mechanism gets them back on track?

That’s where the Medical Retention Processing Unit at Schofield Barracks comes in.

“What we do for the soldiers is prepare them to return to civilian life,” says Smith, who has been in the Army for 12 years. “We make sure they have adequate housing, are getting paid appropriately and have meaningful work to perform when not in medical treatment. The MRPU soldiers get extensive training on VA benefits, including job training in the event their injuries do not allow them to return to their previous civilian or military occupations.

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“We help them with financial planning and management,” Smith explains, “And we provide workshops on family reintegration, which is a big concern since the soldiers have been gone from their families for over one year on deployment.”

Schofield Barracks is home to one of 23 MRPUs currently located in the United States. Soldiers who opt to stay at an MRPU receive outpatient treatment for illnesses and injuries with the goal of returning to their units if they can, or discharging from the Army Reserve or National Guard if they can no longer perform their military duties.

Even during war-time, the majority of injuries Smith sees at Schofield’s MRPU are non-combat related, ranging from sprains and muscle strains to torn ligaments and burns. But the problem lies in the way these injuries affect and are affected by the soldiers’ work afterward. Smith notes that many of the injuries are minor at first, but after the daily routine of the soldiers’ lives in the Global War on Terror, the treatment becomes much more complicated. To illustrate, she asks readers to imagine a carpenter injuring his shoulder. If he could stop and rest completely, his shoulder might gradually heal. But if it’s a crucial part of his job to keep swinging a hammer, the end result may require surgery.

Soldiers who become ill in a combat zone, Smith says, are often stabilized on location or sent to Walter Reed Army Medical Center in Washington DC. After that, if the soldier cannot return to duty within a short time, he or she may be sent to an MRPU.

While at Schofield Barracks, the daily routine for the rehabilitating soldiers is anything but light.

Soldiers spend on-duty time in full uniform and report at 6:30 a.m. for accountability formations. Those who have the ability then go to physical training (PT), where running routes are clearly outlined for the soldiers. Only after PT is there time for a shower and breakfast, just slightly after 7:45 a.m.

Medical treatment follows breakfast.

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“Medical treatment is first priority for all of the soldiers,” Smith says. “Everything else is secondary.”

When the soldiers are off duty—mostly evenings and weekends, Smith says—Schofield offers a wide range of recreational activities, both on and off post.

Physical injuries make up most of the regular cases at Schofield’s MRPU, but mental treatment is sometimes needed as well. When asked if her experience supports the studies suggesting about 10 percent of soldiers returning from Iraq have post-traumatic stress disorder, Smith says she is not aware of the exact statistics. She emphasizes, though, that the MRPU ensures soldiers receive mental health treatment along with their physical rehabilitation when such treatment is necessary.

“For those soldiers who need mental health treatment, we facilitate their progression through comprehensive, holistic mental health services provided by Tripler Army Medical Center and Clinics,” she says. “Our soldiers have nothing but positive comments for the individual therapy and group therapy they receive.”

Upon completion of their rehabilitation, Smith says, more than 80 percent of MRPU soldiers are again fit for duty and return to their civilian lives, which include returning to the Army Reserve or National Guard.

But the advancements don’t stop there.

Many of the medical and rehabilitative therapies now commonplace in civilian medicine have come from advances in the treatment of solders and veterans.

And that, Smith says, proves that achievements in the Army span much broader than the front lines.

“In the MRPU, we see the results of military medicine advances manifest in many ways,” Smith says. “Reserve component soldiers all have improved prognoses for all types of injuries as technology improves and rehabilitation becomes more efficient.

“Having MRPUs all over the U.S. is certainly a big advantage. The U.S. Army is taking care of its soldiers and investing in the future at the same time.”


Not many college students know exactly what they want to do after graduation.

Major Edna Smith did.

In her fourth year of nursing school, she decided she wanted to take her practice into the Army.

“I was fortunate enough to be selected and commissioned before graduation,” she says. “I entered the U.S. Army Nurse Corps just a few months after finishing my bachelor of science in nursing. I served on active duty from 1994 to 1998. Utilizing my GI Bill, I also completed my master of science degree in nursing and am a board-certified family nurse practitioner.”

After her years on active duty, Smith stayed with the Army, moving into the Reserve. Since 1998, interspersed among her civilian work as a nurse practitioner, her exciting tours with the Reserve have taken her all over the world. The Reserve provides a wide range of assistance— including health care—to communities across the globe, and Smith saw much of the Pacific Rim before landing in her current position on the island of Oahu, Hawaii, in 2004, as commander of the Medical Retention Processing Unit at Schofield Barracks.

“While in the Army Reserve I have had the opportunity to go on deployments as a healthcare provider to the Federated States of Micronesia, the Philippines, East Timor, Japan, Australia, Singapore, Korea, Indonesia and Mongolia in the past five years alone,” says Smith, an advocate for choosing the military medical career path.

“Working in military healthcare provides one with fascinating challenges and unlimited opportunities for learning, meeting and working with people from all over the world. It is also a great way to serve your country.”

In March of 2006, several recuperating soldiers from Schoffield Barracks’ Medical Retention Processing Unit made the 45-minute journey from base to the town of Waimanalo, lending their spirit and muscle to help build Hawaii’s first ABILITY House. An accessible home built entirely through the efforts of volunteers, the Waimanalo ABILITY House became the new home for the Kamaiopoli family, a grandmother with degenerative back disease and her three adopted grandchildren.

A unique program, the ABILITY House project is a partnership between the nonprofits ABILITY Awareness and Habitat for Humanity and provides accessible homes for families in which one or more members have disabilities. Additionally, the program reaches into the local community, inviting people with all ranges of health conditions and disabilities to join the volunteer team in constructing the homes. As these diverse volunteers work together on the build site, a transformation frequently occurs in both the volunteers with disabilities and their able-bodied counterparts. The tangible, cooperative act of building a house together shatters myths and stereotypes about what people with injuries, health conditions or disabilities can do.

A grant from the Corporation for National and Community Service, a federal agency supporting volunteerism, along with support from Hewlett Packard and founding sponsor ABILITY Magazine, has recently allowed the ABILITY House program to expand its volunteering opportunities for veterans, recuperating servicemembers and college students with disabilities.

One of the most enthusiastic volunteers at the Waimanalo build was Spc. Jerome Amoa, who grew up in American Samoa. Amoa left the island of his birth when he joined the Army, and a year into his military service he went to Iraq.

During one patrol, Amoa’s Humvee was racing to the aid of another unit that had been hit by an explosive device. Suddenly his vehicle flipped over, crushing him under its weight. An unconscious Amoa was flown emergently to the nearest Army hospital with multiple broken ribs, a fractured hip and a collapsed lung. He remained in a coma for three days, and he subsequently spent many months learning to move again, first using a wheelchair and then crutches. Through his rehabilitation at the MRPU, he has progressed from walking independently to running, which he says has brought him “back to my old self again.”

Despite his injuries, Amoa says he is very proud of the service he provided in Iraq and is glad to have gone. “It was the greatest experience of my life—I know it sounds crazy, but I’d like to go back.”

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Of his recuperation, Amoa notes, “At first it was really tough and really painful. It’s still a little hard because I have some restrictions due to my injury. I have to be careful not to do too much.”

Amoa says his experience building the ABILITY House makes him realize how much he can still do. “I can’t lift heavy things any more, but I can get things for other people, and I can dig holes, which I’m pretty good at. I’m glad to just be lending a helping hand.

“This is a really good experience. It’s just like back home—where I come from, we help each other out. We support each other, because your family and your community are important.”

Another volunteer, Sgt. Bruce Walker, agrees: “There’s a sense of accomplishment when you help somebody. It’s very rewarding to see the results of your efforts.”

Walker, who grew up in Ka’a’awa, Hawaii, came to the MRPU after enduring a knee injury during training. “I didn’t even get to make it over to Iraq,” he says. “I fell during a training mission at night, and my rifle went off. The bullet went straight through my knee. It’s always bothered me that I didn’t make it overseas—you train for so many years, and all your buddies go over. They’re out there risking their lives, and I’m stuck here with the job of driving a car. But helping people out like we’re doing today makes me feel better.”

When asked how his injury has affected his career, Walker explains, “I was a firefighter in the Air Force for four years before I left to go to school, where I joined the Army. Now I can’t do firefighting anymore, and that was my career. I also can’t be an infantryman, so the progress I made during seven years in the military—one-third of the way toward retirement—is lost.”

Walker says his recovery process has been long and arduous. “I had five surgeries, and I went through a year and half of physical therapy. The rehabilitation has been very slow.

“In an odd way, I’m glad there were some doctors who told me I wouldn’t be able to do things, because that made me angry and I had to prove them wrong.

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Some doctors told me I wouldn’t be able to walk again, and some said I wouldn’t be able to ride a bike—which I can do now, although not perfectly. They said I wouldn’t be able to dig, but here I am doing some digging today. It’s nice to be here doing something meaningful.”

Walker was particularly inspired by the mission of the ABILITY House project to help people with injuries, health conditions and disabilities become included in community experiences like volunteering. “I know what it feels like to have people leave you out of things, even with the best intentions,” he explains. “For example, I love to go hunting, but each year you have to put your name in for a drawing to be able to go, because they limit the number of people who can hunt for the season. My dad usually puts both our names in, but the past couple of years he wasn’t sure I could do it, because hunting involves going up and down hills and hiking. He didn’t want me to feel bad for falling behind the group, so he never put my name in. I thought I just wasn’t being drawn.

“I know I can keep up with anybody else. I race my sister, and she’s a track and field star. She’s pretty blunt about criticizing me—one time she was laughing about the way I run, so I said, ‘Okay, why don’t you keep your left leg straight and I’ll race you.’ She did, and I smoked her!

“I’d say you shouldn’t push somebody, but you should give them the benefit of the doubt. Whenever I have to deal with somebody else who has a disability, I try not to make any assumptions about what they can and can’t do.”

Walker says the opportunity to volunteer is particularly valuable. “Giving is the best gift. I really enjoy helping out and volunteering. If I can give advice to others, it would be to volunteer—it makes you feel good!”

For more information about the ABILITY House project and other programs of ABILITY Awareness, visit www.abilityawareness.org

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