Tuesday, March 25, 2014


The Barefoot Dr. training program has come to a close for 2014. All the instructors have returned safely home and the students are well on their way. It was a very successful program that was able to cover the entire book “Where There Is No Doctor,” a week of CHE (Community Healthcare Education) training, and a wealth of additional knowledge from all the instructors.  In addition to medical skills they attended night classes on how to use computers and the internet. For many of the students it was the first time they had touched a computer, not to mention the internet. As Burma develops, computer skills may prove to be just as life changing as the medical skills.  The students also received a starter kit of medicine including many potentially life saving drugs. Their medical kits contain 23 of what we believe to be the most needed medicine in their areas, medical equipment such as stethoscopes and blood pressure cuffs, digital cameras and log books to record their work. They also received many other useful devices for the treatment of their patients and a backpack to carry it all. We fully expect that this group will save lives this first year. Not only by treating life threatening illness but also in knowing when to advise patient to make the long trek to the closest hospital and in preventative medicine. This program emphasizes that in the long run they will save many more lives by community healthcare development and preventative medicine than by simply treating those already sick. We cannot wait to see them all again next year and hear their stories!

Putting this program on is a team effort and it would not be successful without all those who support it locally and globally. Our trainers came from all around the world including multiple areas of the USA, Canada, Thailand, India, and New Zealand! The financial and equipment donors are from hundreds of individuals, a handful of churches, and a few medical companies around the world. Of course, the students came from all across Burma in some of the most remote and under-served areas left on the planet. They included many different ethnic groups all working together for a greater good. Their Christian belief in God gives them incredible dedication and drive to do this important work often times at great sacrifice to themselves and their families in the form of time, travel, and physical effort.

Fundraising is always stressful and this year it looked like there would not be enough to get it all done. However, as providence would have it, in the last week of the program some extra funds came in. They were just enough to complete the necessary tasks. It was far less than we had originally hoped for but thanks to some incredible cost saving efforts from our Thailand and Burma team, the program ended up fully funded!

The plans for the second year of this three-year program have already begun. A start date is set for mid January 2015. We hope to have enough funds to include the very necessary dental extraction training in the next class. Please pray for the success of the Barefoot Dr. students in the field and for next year’s program.

Thank you all for support in so many different ways and may God Bless you.

Rick Astone
Picture from Feb 20th, 2014 the day Alice and I returned home. The students are holding badges they received as gifts and some of the instructors are wearing the tribal ties they received from the students. 

Thursday, March 6, 2014

March 6, 2014- Cooks, Cookies, and Class

     Today the students finished presenting their chapters and medicines to the class. Dr. Nilson also reviewed medicines today in preparation for the final exam tomorrow. He demonstrated for the students how to use Google to find interesting pictures that showed different medical conditions. He also showed them a picture of a eucalyptus tree. All of the students recognized the tree, and learned how to use its leaves to treat cold symptoms. We also spent some time reviewing for the final exam that will be given tomorrow. 
     This morning we weighed all of the students before breakfast, and they have all gained weight! In Myanmar, they usually only eat one to two meals per day and their diet is lacking in protein and other essential nutrients.   While they have been here, they have received three meals a day, and have gained weight.  All of the meals here have been very healthy and very tasty.  (We did have ice cream bars one day and some yummy cookies yesterday though).   We try to use every opportunity to teach so we used their weight gain while eating healthy as a great teaching tool.  We revisited the chapter on nutrition and reviewed the necessary nutrients for physical health and the weakened state of health with poor nutrition.  We compared it with their spiritual food, as well.
     At lunch today the class president shared a few words of thanks to all the instructors and requested that they all return for the next two years.  The Physicians were each presented with ties made in north Myanmar.  Lindsey and  Gayle were given a purse and woven basket, respectively.
Dr. Nilson receiving his Burmese tie and wall hanging

Dr. Nawrocki with his gifts from the students
Dr. Jim Buie and his wife Gayle Buie with their gifts from the students

     During the afternoon, the team took the opportunity to thank the cooks by giving them a night off and to prepare a special spaghetti dinner for the students.  They kept asking if it was American food – didn't know how to explain it was Italian/ American.    They do understand pizza!  We feasted on spaghetti with rice noodles, tossed salad, sourdough garlic bread and Coca Cola.   Dinner was topped off with Lindsey’s no bake chocolate oatmeal cookies. In most Thai homes, there is no oven and “no bake” was our only option.   

 We had trouble keeping the cooks out of the kitchen, but mainly because they were so interested in how we were making the food.    Wish you could have seen them chow down!  We wrapped up the evening with a few games  and singing, then off they went to study for their exam.  

March 5, 2014 Skin amiss and what if

     This morning, Dr. and Mrs. Buie taught the students basic dermatology. Dr. Nilson also got to imput as well. We discovered that the students see a lot of goiter and rashes. Some of the issues discussed were chicken pox and scabies. We are amazed that they do not see much, if any, leprosy. The problem is not on the skin, but the symptoms are, so the students learned how to keep others from being infected. we also learned that they do see a lot of burns. Part of that problem is that they cook on an open fire, so if they lose their balance, or trip, they fall into the fire.
     After lunch, Dr. Nilson asked them an important question… “What if?”. He asked if they were given $100 USA dollars, what would they do to improve their community? All of the students had very ambitious ideas. One of the groups wanted to create the first bathrooms in their village to help control the waste and create sanitation. Yes, I did just say that they wanted to bring the first toilets to their villages.


Wednesday, March 5, 2014

March 4, 2014 - Presentations and Translations

     Today was full of student presentations. The students, even the few shy ones, stood before the class and individually taught the class about the medicine they were assigned to learn about, or the chapter they were assigned to present to the class in preparation for the final exam on Friday. With Dr. Nilson’s input, a few of the students bravely presented their chapter to the class. The women were definitely more reserved about the project than the men. Part of their reserve is due to the culture. In Mynamar, women are not on equal social standing with the men.
     Lindsey and Bjorn made miniature quizzes on the audience response system for each presentation. To our chagrin, the translators, Timothy and Abraham, laughed at some of the misspelled words that Lindsey missed when imputing the questions into the system. We, yet again, helped the students develop the critical thinking and reasoning skills that are required to be a good barefoot doctor by only guiding them in the correct direction when they answered incorrectly. After a while, they would figure out who, among them, was answering incorrectly, and use the same reasoning skills to persuade their fellow classmates to understand the information, and change their answer to the correct one.

     We were very interested to understand the value of the audience response system (ARS). During one of the presentations, one of the students said that the drug she researched could cause both constipation and diarrhea. The instructors were all confused until one of the translator read the Burmese textbook’s section on the drug, and started laughing! The translators of the book wrote that the drug could cause both symptoms, and we would have never known if we hadn’t used the ARS system.
Lindsey and Bjorn working the ARS system

Monday, March 3, 2014

March 3, 2014- But WHY?

     Today was an interesting day. This morning Dr. Nawrocki continued his discussion on serious illnesses and how to prevent them. This afternoon, we reviewed the test from Friday to see how much material the students retained over the weekend. We were surprised at the range of knowledge remembered. Using the audience response system to record their answers and receive live feedback, and we refused to tell them what the right answer and helped them develop the critical thinking skills required in order to become a good barefoot doctor. We asked them “why” a lot. “Why is that the correct answer” and questions similar to that. It took them a while to understand that we wanted them to think. In Myanmar, they are given correct answers to repeat back to the instructor. They are not taught to analyze the material presented. In order for them to reach a diagnosis, they will have to do more than guess. They will have to observe the patient's symptoms and analyze the data they collect from the symptoms in order to provide the correct treatment. We also had the opportunity to continue with the student presentations of medicine, the project that keeps being mentioned where each student studies a medicine that they will be carrying in Myanmar, and presents it to the class.
Dr. Nilson and Dr. Nawrocki teaching

Feburary 28, 2014

     This morning, Dr. Nilson continued his discussion on sicknesses and illnesses of children. His discussion included malnutrition, rashes, scabies, and ringworm and their respective treatments. The students learned a lot from him. We learned that they see a lot of scabies and even more malnutrition. The Maringa tree was discussed yet again because of its highly nutritional properties. The students say that they have easy access to this tree. Listening to their stories about sick children and the hunger that they see was very enlightening to the teachers.
We learned that they will maybe get two meals per day, and it usually only consists of rice and something green. They do not eat much meat because it is very expensive, and most of the people cannot afford the luxury of having meat even once per day. It makes me realize, as an American, how blessed we are in the western world. We have meat, and three meals per day. These students do not. It has been interesting watching them as they have been here. They are so thrilled to have three meals per day. They are thankful for everything that they are given, or can learn.
Also, we learned that when a person gets sick, they do not give them food while they are ill. The thought behind it is "they are sick, and the food will make them worse". They learned about how to treat these people, and how to enlighten the other people in their villages. The students were very surprised when we explained that food (nutrition) is important to make people well.
Dr. Nilson discussing digestion and malnutrition

     In the afternoon, the students took the fourth exam. When reviewing it, Dr. Nilson had them discuss the test questions among themselves if they got the answer wrong. Through discussion amongst themselves, they eventually came to the correct answer. Teaching them this way is important because it teaches them to self-learn and ask questions of each other. We ended the week with a time of worship, which is something to behold. The students worship God wholeheartedly and focused only on Him.
Worship time at the end of the day!

Thursday, February 27, 2014

February 27, 2014

     Today was day two of Dr. Nawrocki’s lecture on serious medical conditions and illnesses that need special treatment. This morning, his discussion included illnesses such as Malaria and Dengue fever. He had the opportunity to discuss with the students the importance of preventative medicine. Dr. Nilson interjected with information about pre-treated mosquito nets, and told the students that if Malaria is prevalent in their village, that these nets are a low cost way to prevent Malaria. They do not have 100% success with malaria prevention, but these nets prevent many cases of Malaria.

    Thursday afternoon Dr. Buie tackled The Urinary and Reproductive Systems.   The students were understandably uncomfortable with the topic, particularly in mixed company.  In their culture, sexuality is rarely discussed openly among the Christian villagers and never between men and women.  Not until recently have schools begun to teach human sexuality.  When some of our team visited a Christian village outside of Chiang Mai a few weeks ago, they noted that men and women even sleep on opposite sides of their houses.

     Dr. Jim presented the anatomy and physiology in a direct and professional manner, putting them at ease.  He explained that they would encounter patients with sexually transmitted diseases and breast cancer.  He reminded them that as health care workers they have a responsibility to educate the people and they would need to become comfortable with uncomfortable topics.  HIV is prevalent in Myanmar and they will definitely be asked to see patients with complications associated with it. They need to teach about the dangers and health issues of unprotected sex.
Lindsey and Gayle