Thursday, March 5, 2015

It is hard to believe we have come to the last week of the 2015 Barefoot Doctor School. Soon the students will return to Myannmar and begin to put to use all they have learned. The teachers will return to their different lands far from Myannmar and continue to share the news of the Lord and His work through these students. The wonderful staff at the Kalnin Conference Center will take a much needed rest.

We may be close to the end, but we are far from done! Monday and Tuesday morning we continued with the students case presentations and reports on their assigned medicines.

Monday after Dr. Susan covered the Health and Sicknesses of Older People, including stroke, insomnia, hypertension and gallbladder disease; Nurse Lynda taught a session on Healing without Medicines, for conditions such as minor coughs, colds and diarrhea. "Sometimes, clean water for prevention and treatment does as much good as medicine," said Lynda.

Monday dinner the instructors invited the students and kitchen staff to our 2nd Annual Spaghetti Dinner. We cooked and served spaghetti (with gluten-free pasta), garlic bread, tossed salad with Ranch Dressing and Coca Cola. Following dinner and devotions we enjoyed an evening of singing, games and laughter (did you know that you could laugh in any language?).

Tuesday and Wednesday
emphasis was placed on reviewing medications. Dr. Bjorn, Dr. Susan and Dr. Jim each covered four of the 24 medications the students are receiving. It is imperative that they understand what the drug is used for, how and when to administer it and the duration and side effects. The medications cost $10,000.00 U.S. dollars and Dr. Bjorn has offered a challenge-he will donate the first $1,000.00 with a donor match of $1,000.00 from nine others. Perhaps, you would prayerfully consider this challenge.

We will also be purchasing five new cameras for the students who don't own one. It has been an unbelievable teaching tool, as the students take photos of their patients and present cases complete with a visual picture. (If you feel that $1,000.00 is a little steep, but would like to contribute, the cameras are $60.00).

Tuesday afternoon Dr. Susan and Nurse Lynda once again split the teaching session. Dr. Susan had some very interesting information on the problem of addiction, complete with slides and statistics. Dr. Susan was able to find the AA 12 step program in Burmese. Nurse Lynda facilitated an informative visual power-point
presentation on smoking and the related health effects on the body. Lynda encouraged smokers to smoke outside, as it's a common practice for them to smoke indoors and expose their families to the health hazards of second and third hand smoke.

They are acquainted with smoking, drug use, sexual promiscuity and alcohol. They also recognize the great need in Myannmar for the Lord. It is their prayer that as they address the problems of addiction, that they may also see many come to Christ.

Nurse Lynda facilitated an interactive discussion with the students on the emotional needs of patients and family dealing with chronic illness, particularly HIV/AIDS. It was agreed that grief takes many forms. Loss of Life, limb, job and perfect health cause pain that medicine cannot fix.   Lynda gave the students an interactive exercise in role play, addressing real life scenarios - a father who lost his wife, a friend sharing with another about her HIV positive test results, etc. Students learned what to say and how to say it, as well as what not to say.
 Mee Pwe responded later, "it was a very helpful session. I feel more confident now in dealing with situations like this. Before, I didn't understand my role as a counselor, but now I do.

Than Zaw Oo and Yawhan graciously volunteered to be Dr. Jim's patients on Wednesday afternoon to demonstrate the physical exam. San San Win took Than Zaw Oo's vital sign's and all of the students modeled the head and neck exam. They each had the opportunity to use their new otoscopes to check the ear of their neighbor. Dr. Jim had a "real life" patient when Nangbey, a Kalmin staff member, sat in for the thyroid exam. Nangbey has a thyroid goiter which she developed after her first pregnancy.


It is imperative to interrupt this blog to bring you some most important news. Real time is Friday morning and the result of the final exam are in...
The class average-93%!!!!!!  Six students scored 100%  

Returning to the regularly scheduled blog...
Dr. Susan and Dr. Jim continued the P.E. with examination of the abdomen.
You might notice something a little odd while Dr. Susan is using Yawhan as her patient(:

On Thursday, the students once again reviewed medications with Dr. Jim discussing asthma and its necessary treatment.

David Crist came by the classroom to deliver a gift to the students. He gave each one a book entitled "Where There is no Vet." Many of the students are farmers and raise pigs and chickens in order to provide food and finances.

Thursday evening following dinner goodbyes began with the students presenting gifts from their local area to all the instructors, Paul and Mary Lois Ferraro and Melissa and Jodi.

Wednesday, February 25, 2015

Prevention, Parasites, Presentations and Play

Finishing Week 5 Dr. Susan taught the students about the Prevention of Gum Disease and Good Dental Hygiene.  The photo of Khow Taik's patient with dental caries and gum infection certainly substantiated her lesson.  She also spent some time discussing gout, which is on the rise worldwide.  Dr. Susan showed some impressive photos of "gouty tophi".

Nurse Lynda gave a refresher on cleanliness and disease prevention, which included a review of Parasites.  She gave each student a nail care kit to remind them of good hand hygiene and the fact that pesky worm eggs often stick under the nails.  The students were asked to role play on the subject of cleanliness with the express purpose of educating the villagers.  As is often the norm, the students were excellent teachers, using creative skits and puppets to make their case for cleanliness.

          When it is Friday afternoon, the end of a long week of instruction, with the sun shining brightly and the temperature nearly 95 degrees, teaching and listening become difficult.  So what is the solution?  Play games!!
 Not wanting to lose precious teaching time, all games were educational.  The students played "Missing Matchup", a game that matches medical conditions and their correlating symptoms.  Dividing into 4 teams, we played "Who Wants to be a Barefoot Doctor?"  The competition was fierce.  After spinning a wheel to select an easy, moderate or difficult question  team members conferred to give their "best answer."  Points were awarded for correct answers and and two teams ended with a tie.  The instructors provided a "bonus" question to break the tie, but at this writing the game must be continued.  Both of the two teams answered the bonus questions correct!  It is rewarding to see them working together and coming up with right answers.

It was a wonderful weekend at the Kalnin Conference Center.  Dr. Jim Buie delivered the message on Sunday entitled "When Trouble Comes."  The Barefoot Doctors led in music worship and communion.  Special guests were Paul and Mary Lois Ferraro from Denver.  Paul is chairman of the board for FLC.  A surprise Presentation, complete with cake and gifts, was made following lunch in honor of Paul and Mary Lois to celebrate their 50th Wedding Anniversary and many years of service to FLC.  Daniel Kalnin's daughter, Sonia and her family, were on present for the event.  CONGRATULATIONS PAUL and MARY LOIS!

Thursday, February 19, 2015

Packing it in... and Packing it up

     Thursday morning began with an interesting case presentation by Daham Dee. A 37 year old man presented with a traumatic paraplegia after being hit in the back by a large rock.  He had a serious wound infection at the site.  Dr. Buie is shown checking reflexes on translator Sarep Pung as they discussed paralysis and spinal injury.
 The rest of the afternoon was spent on what we are calling Anatomical Felt Art. The students were divided into three groups and began to construct a human body with all the anatomical parts out of felt. Using one member of their group they traced the body outline and starting adding organ systems. We hope you enjoy the pictures of their work.

Packing it up for the night! Thank you for your prayers and support.

Packing it in.... and packing it up

   Following a delicious and nutritious lunch of chicken, rice and tossed salad, Nurse Lynda "packed" the afternoon with lessons on nutrition and our Grow, Glow, and Go foods.  The students have certainly been eating well here.  Our kitchen staff is fantastic!

   Wednesday morning Dr. Jim reviewed the Respiratory System and spent time teaching the most effective way to make a case presentation.  His "17 year old patient" had a runny nose and asthma.  It seems she is allergic to her new cat.  Bye-bye kitty!  Much emphasis has been placed on the importance of the history in the patient exam.  Dr.Bjorn led the afternoon session as four students presented their reports on their assigned medicines.

Ram Tang discussed Amoxicillin while Khin Sein, Ma Ma Naing and Nilar reported on Artesunate, Adrenaline, and Aluminum Hydroxide. 

 Khaw Taik gave his case presentation on a six year old boy with severe dental caries and diesease.  It seems his parents run a small market and he has been eating more than his share of the candy.  This is a good illustration of how effective it has been to have the students take photos and bring them back the following year to share and gain more information and instruction.

 Dr. Susan, Lynda and Melissa went trekking through the surrounding neighborhood on Wednesday and met an elderly Thai woman who invited them into her home. Lynda, being a public health nurse in Canada, soon had Dr. Susan examining the woman. Good Job gals!
Packing with a Capital "P" was on the docket for Wednesday evening as the students spread out all over the Ferraro hall and began to package their supplies from project cure. Timothy, one of our translators, left this am to travel home preparing to receive the boxes a few at a time in preparation for the students arrival there next week.

Packing it in . . . Packing it up

    It is truly amazing what has been "packed in" during the past few days.  To start the week off Ahdang "packed" up his wife, Kono, and left for Chiang Mai Hospital where Kono delivered their son, Pong Pong. Ahdang is the maintenance officer at the conference center and Kono helps in the kitchen and dorm.  We are all so excited to have a newborn at the center. They arrived back this Thursday afternoon.
Dr. Susan opened up the Tuesday morning teaching session continuing her discussion of common sicknesses. Hepatitis, arthritis and back pain and seizures were the main topics.  She then showed some impressive photos of gouty tophi.  The students have seen Gout in Myannmar and Dr. Susan discussed identification, symptoms and treatment.

Tuesday, February 17, 2015

Final Day for Three of our Instructors

Posted Monday, February 16, 2015

On Friday afternoon we said our goodbyes to Dr.Joe Nawrocki, Dr. Janet Warren and Anita Terry RN, wishing them safe journeys back to North America.  It was a great privilege to work alongside them and glean from their medical expertise. 
 The student’s particularly appreciated the mental health emphasis and teaching by Dr. Warren (see her previous blog).  Dr. Warren effectively communicated the need for counseling in addition to physical care of the patient.
Here is a picture of Anita Terry, Melissa Fonseca, and Dr. Janet Warren.
Taking advantage of Anita Terry’s nursing skills before she left, Friday morning the students reviewed and practiced taking vital signs. Anita also gave a brief discussion on diabetes followed by instruction on their new glucometers.  Each student performed the “almost painless” finger stick and we are happy to report 100% normal glucose tests.
Dr. Nawrocki left the students with much information to ponder on the Urinary System and First Aid.  The input of these health professionals is invaluable to this program.
A short field trip on Saturday was arranged by FLC and the students and teachers made their way up the mountain to Bhubing Palace, the royal winter residence of the King of Thailand.  Interestingly, the trip itself became a health care worker’s lesson in the care of patients who are stricken with motion sickness.L  A stroll through the beautiful rose gardens and water features was good medicine.  And a wonderful picnic prepared by the kitchen staff was enjoyed by (almost) everyone.
Week 5 of the Barefoot Doctor School has officially begun and the morning started with student, Ram Tang, giving a case presentation of one of his patients.  The cameras that the students received last year have given us the opportunity to see firsthand the faces of many of their patients.  The patient is thought to have TB and his case generated much discussion about his diagnosis, care and treatment.  The case presentations allow for input from the current instructors and advise about follow up and continued care.  Dr. Nilson suggested that Ram Tang accompany his patient to the nearest clinic on his return and have him tested, and if positive, treated for TB.  Other diagnoses were considered and treatments discussed. 
 Dr. Jim Buie followed with an “eye opening” lecture on the anatomy, physiology and diseases of the human eye.  The students practiced their eye exams on each other and received glasses to help those with myopia (nearsightedness) and sunglasses to help in the prevention of cataract.  It has been emphasized by Dr. Nilson and the other instructors this term that the students must practice good health themselves as they prepare to teach others to follow them in doing so.
Arriving from Canada this weekend, Dr. Susan Parker jumped right in teaching her first session Monday afternoon on “Common Illnesses” and their treatments.  The list, being quite exhaustive, is “to be continued” on Tuesday morning. 

Friday, February 13, 2015

Blog Post by Dr. Janet Warren

 Dr. Janet Warren shared her reflections on this week of teaching...

This past week, along with teaching on children’s health, urology, family planning and infectious diseases, students have had some intensive teaching and practice in basic counseling skills. In many of their villages, addictions (heroin especially) and post-traumatic stress are common.
Students requested some extra teaching during their evening devotionals. Using the story of the Good Samaritan, I talked about how Jesus modeled counseling by listening, not judging, and by asking many questions of those he taught.
We discussed the importance of affirmation, empathy and encouragement, reading body language, and guiding people to their own solution rather than giving them advice. We also discussed the similarities between evangelism and counseling in terms of relationship building.
Students especially enjoyed role plays and volunteered readily. They were somewhat reluctant to give feedback regarding improvement, but in general were very open and keen to learn. In one role play, we demonstrated how to defuse an angry person (along with biblical teaching that anger is okay, but not if acted upon sinfully), in another, how to counsel someone in grief, and in another I taught relaxation and breathing techniques.
Students asked appropriately skeptical questions:
“This is easy now but when I really see an addict it is going to be difficult.”
“Someone may get angry if I ask too many questions.”
I emphasized the importance of self-care, having a mentor, and setting limits.
As this is a passion of mine, I enjoyed the opportunity to teach about counseling as well as how to integrate Christian faith with medical care. I was also challenged in translating (culturally and linguistically) my knowledge and experience.

Here is a picture of Dr. Warren singing a song for everyone.
Once again, we thank God for all the wonderful instructors who voluntarily come at their own expenses to teach our students in Chiang Mai.