New Partnership with mPower Dentists!

We are very excited to announce that we are entering a new partnership with a dental ministry based in Louisville, Kentucky. It's called mPower and their teams travel the world doing short-term training programs of indigenous Christian workers in both dental and medical services.

Burmese Evangelist Timothy and Jon Ulm attended the Global Health Missions Conference at Southeast Christian Church in Louisville back in November of this year. At the conference, God led us to Dr. Charlie Vittatow and Linda Webster and others of the mPower mission. We began telling them about our need to have dentists come to help with our training. We told them how critical this training is to the ministry of our Barefoot Doctors, but that we were becoming anxious about being able to find someone to train our students in basic dental skills before they graduate in March. Their response gives us no doubt but that God is putting our two ministries together!

Since November we have been in close contact with Linda Webster of mPower to better understand their training methods and to work out the details for them to fit into our schedule. It is obvious God wants this partnership to happen, and we can already see that the three mPower dentists who have committed to coming to Chiang Mai are going to be a God-send to our program. In addition, we have another dentist coming from Denver that same week, Dr. Robert Gardiner, who will help with the training also.

The picture at the top of this post shows mPower dentists doing this kind of training elsewhere. If you want to know more about mPower, please visit their website at: http://www.mpowerapproach.org/

You can also watch the following video online: http://youtu.be/0x73Sje-eow?hd=1

We are busy raising funds for the training modules that will be used by mPower while they are with us. These include the dental tools and supplies our students will take with them when they return home to Myanmar. We want to supply each of our 26 students with the tools and supplies they need, but that will cost $25,000 or more! Since we are already scrambling to have the funds necessary to bring these students to Thailand and keep them there for 8 or 9 weeks, this is a very big challenge!

Please consider making a donation to Frontier Labourers for Christ, earmarking your gift for the Barefoot Doctors program. The address for our treasurer is in the sidebar of this blog. Thank you for your gifts and for your prayers!

Year Three is Just Around the Corner!

Every winter, FLC holds a medical training school for village leaders from the most remote parts of Myanmar where there are no medical facilities. In each of three consecutive years, students receive six weeks of medical and dental training before graduating.

The third year of training for the 26 students you see pictured above will begin at the end of January. Then graduation will be on March 3, 2012.

At the Barefoot Doctors School, physicians, dentists and other health care professionals from America and Europe train village leaders how to perform diagnosis and treatment of tropical diseases such as malaria and tuberculosis, and to provide dental care. Trained leaders are then sent back to their villages with medicines and supplies provided through FLC. Over 180 trained Barefoot Doctors have been credited with saving thousands of lives and opening doors for evangelism in otherwise closed regions.

Our Barefoot Doctor students are from nine different ethnic peoples in Myanmar (Naga, Ngochang, Rawang, Lahu, Akha, Mru, Kachin, Lisu, and Chin) and from five different states. They are already employed in many different occupations (Bible translators, pastors, youth ministers, evangelists, Sunday School teachers, music composers, government officials, educators, office workers, and farmers), but their new medical skills will open new doors for sharing Christ with their people.

Pray for their medical and spiritual ministries this year to the desperately sick and disheartened people of Myanmar!

Look at those teeth!

Meet the kids of Huai Biong School. They have great looking teeth, don’t they?

This was not the case just one year ago. Last year our medical team took a weekend trip to visit this small village school. We wanted to get a better idea of what life in a remote village was really like. Huai Biong village does now have a paved road and it got electricity a few years ago, but life here is still much the way it was before these additions. They still cook over an open fire inside their houses. They still sit and sleep on the floor. They did put in an outhouse with a toilet seat just for western guests but that was about as modern as they got. On our trip a year ago we also took a look at the health of the village and gave health related advice. We asked to see the top 6 worst

medical complaints of the children first. I am not sure what we expected but it was not what we actually got. All 6 worst complaints of the children were dental! On that trip we had an ENT resident, a pediatrician and global health expert, and a physical therapist but no dentist. As we tried to understand the problem better we realized the problem was much more basic than ever crossed our minds. As it turns out most if not all the children had dental complaints. So we asked, “How often do they brush their teeth?” We got a blank look coming back at us. Our first thought was poor translating but we then realized they had no clue about brushing their

teeth! We asked, “How many have tooth brushes?” and only a handful of 50 kids even owned a toothbrush! We immediately assembled all the children and the teachers and gave a talk on the importance of brushing your teeth and what food should be avoided and so on. When we returned home I printed out copies in Thai on dental hygiene in a village setting and sent it back to the village with 50 toothbrushes. The teachers were given instructions and were to teach all the children.

On this years trip I did not have time to go to this village myself but I had one of the locals, Pastor Suradet, who goes to the village regularly, take pictures and deliver some donated school supplies to them as seen in this picture.

He assured me the children brush their teeth every day and have virtually no dental complaints this year! Praise God for this unexpected but very necessary interaction and that we were able to be a part of it!

The problem we stumbled onto can be a common one in the developing world. You see, when a people eat all home grown foods there is little need for tooth brushing. Usually a village people will use some sort of fibrous branch to clean their teeth from time to time and there are substances they can use in place of toothpaste like ashes for one. The Main problem for these kids was modern processed food and the dreaded Soda Pop! Now they have a road so people have easier access to processed crackers and cookies and other foods that are much harder on teeth than home grown food. Soda is absolutely the worst! But no one educated them on these things and of course the soda does not come with a warning label (although I personally think it should). Take a look at these awful teeth from last years trip.

Also of note were the bags of school supplies the teachers were holding in some of the pictures. I was assigned to deliver as many of these supplies to needy children as I could take to Thailand. A wonderful family in California felt prompted to send these supplies with me after seeing pictures from last year. The supplies consisted of pencils, colored pencils, home made note pads with pictures on them, pencil sharpeners, scissors, crayons, some hair ties and a jump rope. These were a huge blessing and help to this poor village school. As you may notice in some of the pictures they do not have much and every bit helps. Perhaps this small gift of supplies will have as meaningful of an impact on these children as the toothbrushes. I hope to check in with them again next year.

Final days and closing Celebration

Well Bjorn and I made it back to California but we are not quite recovered from our trip yet. It takes awhile to get back into the swing of things after being in a different culture so long. Not to mention the time difference. Thailand was 15 hours ahead of California time. All that aside, the last week was so busy in Chiang Mai that I did not get a chance to update all of you on all the activities. I plan on catching up on my Blog posts and doing some summary reports over the next few days. There were some notable events and thoughts that should be shared.

In the last week I had a chance to teach the Barefoot Drs. about low Back pain. This is a big problem all around the world and a very popular subject for the students. In a class this size there is usually someone with actual back pain so once again we used a real life patient to do the training. Fortunately, the patient responded well to treatment and was the perfect example for this condensed P.T. course. Thanks to Bob Bowling for getting a picture of me teaching.

Of course, there is always a celebration when the Medical portion is completed. This involves, food, singing, lectures, and sometimes theatrics. Between Pastor David Tucker from England

and Dr. Bjorn Nilson there was no shortage of drama in the speeches this year. In this slide you can see Dr. Nilson demonstrating how last year the students had commented that the Barefoot Drs training had “Opened the door” for them. Dr. Nilson went on to say this year the second door had been opened.

The Barefoot Dr. students themselves sang some great songs and had some very powerful speeches and testimonies. I will point out that the Barefoot Drs students singing in this picture were barefoot.

One of the students named Peram gave his testimony. I asked him to write it down so I can share it accurately with all of you. He tells an amazing history of how the Barefoot Dr. program transformed the health of his remote village back in the 1990’s and how important this program is today. In just his village the Barefoot Drs cut the death rate from around 35 people to around 10 people per year. This progression happened over about 7 to 10 years but has maintained this improvement since the 90’s. He did make a point to say that they need to have medicine to do their jobs. I believe this was intended for the western medical and mission leaders present because the funds were short last year and they received very little medicine from the mission. This year things are looking much better but the Barefoot Drs in the field need to be resupplied due to the shortfall of last year. I know we have enough funds to get them all some medicine but we are still underfunded to meet our goal and cover all the costs of the training program itself. If you intended to donate and have not done it yet, it is not too late and any amount goes a long way in this program. You can send donations to:

Frontier Labourers for Christ

Barefoot Drs program

P.O. Box 630382Highlands Ranch, CO 80163

There are still a few more Blog entries to come. I am waiting to get back our student survey forms to get some good statistics for you all. So stay tuned and May God Bless you all.

Thank you again for all of your prayers, encouragement, and financial support. It takes all parts of this body working together to have it function properly.

Rick Astone, PT

Final exam and Leprosy.

Today we had the final exam for this year! Just look at the concentration on the student’s faces. We also handed out course evaluations for the students to grade and give input on how we did. We will find out the results tomorrow.

In the afternoon we had our final guest teacher, Dr. Trevor Smith. He is an Australian born doctor who has lived in Chiang Mai about 35 yrs. He is one of the leading experts on Leprosy. 10 yrs ago he was seeing 200 new cases of leprosy in Thailand every year. This last year he saw 15 new cases in all of Thailand.

Now Burma is a different story. Burma is considered one of the active leprosy areas although no one can get accurate figures out of that country. We

polled our students using the Audience Response System (this is kind of like voting on American idol) and found out instantly that about half of the students have someone with leprosy in their area. Two of the students said they know of new leprosy patients in this last year! These numbers are disconcerting because leprosy is a contagious disease, but it is also totally curable if you catch it early. This is one of those diseases that should not still be a problem anywhere in the world today. Fortunately Leprosy does not effect everyone but the people most at risk are those who are unhealthy or malnourished to begin with. So in countries where health conditions are poor it can be a bigger problem. Now that the Barefoot Doctor students know how to identify and treat it if necessary, there is new hope for those who are otherwise unreachable.

Tomorrow is our last day of teaching! Pray that it goes well and we get every thing completed that needs to be done.

The Weather is getting hot over here. It is in the 90’s and there is no Air conditioning where we teach. We tried moving to the new dorm building but it was not much better. The new dorm has smaller classroom, lower ceiling, and less ventilation so within minutes it was stuffy. Add people closer together and 90 + degrees heat and it is pretty uncomfortable. The heat is one reason we came a few weeks earlier this year and the weather has not been bad until the last couple of weeks. Once air-conditioning is installed it will be much better.

Despite the heat, things are going very well. This week I have had a chance to teach them some basic physical rehabilitation techniques. In these pictures you can see how we used bamboo to challenge their balance and then show how just a little assistance can help. The main point for rehab for the majority of disabled children and stroke victims is to help them help themselves.

The patients should be encouraged to do as much as they can on their own before they get assistance. We also when over ROM, Back Pain, and function. It turns out 16 of the 24 students have disable children in their villages so how to help rehab a CP child for example can make a lifelong improvement to the child and their family.

We also found out at least half of the students ride a motorcycle on a fairly regular basis either

as a driver or a passenger. Motorcycles are the most widely used mode of mechanical transportation. Often there is no road but you can get around by motorcycle. Even here in Thailand there are more motorcycles than cars. However, most people here do not wear helmets! One of our translators, Abraham, has had three motorcycle crashes when he hit is head but fortunately he was wearing his helmet. So to dramatically demonstrate our point we got two small watermelons from the cooking staff and put little faces on them. Then we put one of the melon heads in a motorcycle helmet and dropped it from about chest height.

The watermelon was unharmed. Then we took the melon head and dropped it from the same height without the helmet. The results were tragic for melon head as you can see from this picture. The moral of the story was you should always wear your helmet to save your life or prevent serious brain injury.

Injections and Flannel Boards

It was a busy week here with only Dr. Nilson and I running the program without any additional help this week. To top it off we both got violently ill on Wednesday evening and all day Thursday. We made it back to the training center Friday but we were nowhere near 100%. In fact on Wednesday night and most of Thursday I was so sick I could not even sit up for more than a few seconds at a time. We are both much better now and back to our busy schedule.

The Barefoot doctor’s training this week started off with more quizzes and student presentations. You can see here a few of the students presenting on arthritis and hypertension.

On Tuesday we had the students learn about and practice injections

on oranges. Once they had the technique down for intramuscular injections we had them practice on each other! We

had ordered 15 Tetanus vaccines for about 11 of our students as a booster after receiving their 1^st shot last year. That is right. About half the class had never had a tetanus shot before last year. Three of the extra shots went to students who had one tetanus shot in their life but never a booster and one was a simple booster shot for a student. They all did very well with this skill and now can

give vaccine shots back in their homeland when needed. Some of the students live near clinics that will give children vaccines if the parent brings the child into the clinic. This may involve walking for miles or even days. Other villages do not have a clinic or sometimes the “clinic” does not have vaccines or even electricity. If you do not have electricity you can not properly store the vaccine so it is not much help in this area. Our hope is that now that the students are trained in giving vaccine injections, they can work with whatever government or non-government personnel may be in the area to help get the children and adults vaccinated. Even if vaccines only come through an area once or twice a year, you can get a lot more people immunized with more people power. Additionally, the Barefoot Doctors will have the trust of the people so hopefully the villagers will take their advice on getting their children vaccinated. We have heard many stories of villagers who refused to get their child vaccinated because of fear and mistrust of the government officials giving the shots. We have heard more examples of simply not having any vaccines available in their areas.

On Wednesday I started them on a flannel board project. This involved a flannel cloth board used to stick other flannel-backed pieces to it with pictures on them. I had them break into 4 small groups to prepare the projects.

The presentations got off to a rough start and I was worried maybe this was a bad idea and going to be a total waste of time. By Friday the presentations were amazingly good! I could follow the story without the verbal translation! The groups who did the best presentation then had to give the 5-person kitchen staff their presentation on how germs are spread and how to minimize this. You can see in these pictures that in the early presentations the drawings are small and unclear, and they put all the pictures up at once and then pulled them off and pointed to them as they talked (very distracting), even though they were clearly presented. By Friday they had great

drawings and cut outs that were large, easy to see, and simple ones, and only one idea at a time was on the board so anyone can follow along. In this way, the story is clearly presented even through language barriers.

The idea of the flannel board is you can use pictures to tell a story in addition to the words you are saying. This is particularly helpful in areas with little or no education or when teaching across language barriers. So this lesson is not only to teach them but also to teach the students how to teach others. By drawing and

preparing presentations the students learn the subject even better. If they feel this technique is useful, it is lightweight, compact, cheap, and easy to take anywhere in your back pack.

I am very proud of all the Barefoot Dr students. They are doing a great job and are passionate about their work.

Until next time Sawadee Krup,

Rick Astone

Border Run

Over the weekend we made a trip to the Golden Triangle so we could cross the border and get a 2-week extension on our visas. An added bonus was getting to go to Timothy’s house on the Burma side for lunch. We had a big crew of Dr. Dave, Cyril, Bjorn, me, and Lydia one of the English teachers for the FLC Mission. Of course Timothy was guiding us around and BeePal our driver provided his van for the long drive up to the border. Moses, one of the Barefoot Dr students also came to see his 3 yr old son in the hospital. His son is fine now and back home but would appreciate your prayers. As for the rest of us we had a great adventure. We got in late and stayed the night in Mae Sai, the border town on the Thailand side.

The next morning we had to cross the border and then go to breakfast in Burma with Timothy. It was actually pretty good but the atmosphere is quite different than on the Thailand side of the border. There was a lot of yelling and running in the busy street side restaurant. This has a tendency to make one a bit on edge but we never felt threatened. Then it was off to visit a pharmacy to see what was available and the prices of meds we will be recommending for the Barefoot Dr. Students. Very interesting for all you medical types. They have a mix of Chinese, Indian, and western medicine with strange rules of what you can buy over the counter and what you have to get from a hospital. For example, you can buy antibiotics over the counter but one of the best malaria drugs available you can only get through the hospital. HIV meds are only available through the hospital but adrenalin injections you can get at the pharmacy. Of course you have to be on the look out for counterfeit medications in Burma as well, but usually the pharmacist can tell what is ok and what is not so good. The poor pharmacist got very nervous with all the questions we were asking. I thought he was going to kick us out of the store when Cyril whipped out his video camera. After we explained who we were and what we were doing the pharmacist was extremely helpful. It was a good example of the underlying tension and fear that exists in that country, and yet there are many good people living there.

Timothy’s house for lunch was a real treat. Fabulous food prepared by his wife and a good time looking at old cross bows hand made from wood and bone Timothy used for hunting in his younger days.

The Doctors got a chance to examine a few patients as well. Timothy had treated the neighbor’s boy for TB last year and he is now totally recovered, but his mother was concerned and wanted Dr. Nilson to take a look at her boy. She also was worried maybe her other boy had TB as well. Both boys are totally healthy and the family’s worries were put to rest after having a pediatric expert like Dr. Nilson examine them. One other fascinating patient at Timothy’s home presented herself with

“Moth – eaten” alopecia! The verdict is still out on that one but a very rare condition to be sure and one that needs more medical work up by a hospital.

On our way home we stopped and saw a few sites in the Golden Triangle including a small opium museum. It was very educational to us and has important implications to our work, not only medically but socially as well.

It was back to work this week. It is just Dr. Nilson and myself from here on out with a one-day exception of help from a local Dr. So pray for us to have endurance.

Thank you all and May God bless you.

Rick

Week 4 completed

We finished up week 4 on Friday and said goodbye to Dr. David Brumwell and Cyril Thomas, PA. They did a great job and were a huge help to us and this program. The students enjoyed all the hands on activities. They really seem to learn best by doing things rather than book learning. We finished up Friday teaching them how to place foley catheters on male and female manikins. This is a relatively simple technique that will allow a bladder to empty if a patient is unable to urinate on their own. Then we said our good byes and of course a lot of picture taking at the end.

As usual, the instructors both had a profound experience through teaching in this program. They were touched by the students' passion and dedication to help others. We all hope and pray they will be able to return next year to contribute again.

After that we headed straight for Burma! More on that trip later.

Help From the ER Guys!

Well it has been an exciting few days with the ER guys here. Yesterday was suture lab using pigs feet. This is always a favorite for the students. It is truly amazing how quickly they pick up hands on skills. Some would even say these students are better at learning skills then American students. Above you can see Dr. Dave demonstrating lancing an abscess after Dr. Cyril showed us how to project live images onto the big screen using the camera in his computer. This is a huge advantage in showing them all a small scale technique. Especially when you are dealing with a language barrier.

Dr. Dave and Cyril have been teaching a lot of exciting and useful subjects including what to do for a patient after a motor vehicle accident, as seen in this picture.

Yesterday after class we made a trip into town to see a local dentist for our two patients with severe teeth issues. Since we have been unable to find any dentists willing to help us teach these students we had to take them into town to get treatment. There is a very nice Christian Dentist in town that was extremely nice in helping us out with this, but he was unable to treat one of the students because of his high blood pressure. We treated this student as a class last year and had his BP well controlled. Like many patients in the USA he stopped taking his BP medicine after a few months because he was not feeling sick from his high BP and felt the medicine was making him a little weak. So we use this as a perfect example to the class of what not to do and why it is important. After spending about 4 hours belaboring this subject from every possible angle I don’t think he will stop his medicine again.

We fond some old pulled teeth in the training center from years past so we put them out for the students to see. Simply horrible teeth! I don’t think you would ever see anything like them in the USA. Just take a look.

That is all for now. We head to Burma this weekend to get our Visa’s extended for our last two weeks in Thailand.

Half way through!

Not only are the Barefoot Dr students halfway through the second year but they are also half way through the entire program! Of course that means Mid Terms! On Friday we gave them their mid term exam and we will grade them Monday. This is good to see how the students are doing but also how we are doing as teachers. If there are any class-wide trends of missed questions, then likely it is do to our teaching and not the students. We will use this information to further tailor the program to the students needs. All the teaching staff ends up learning and growing from this experience as much as the students.

We also had Dr. David Brumwell return and Cyril Thomas MS PA-C join us on Friday. They were not scheduled to teach until Monday the 14th but they were so eager to get going they started Friday. Dr. Nilson and I could surely use the extra help.

Dr. David and Dr. Cyril, as they are known by the students, are both from San Diego. They work at Kaiser Permanente Medical Center ER. Their skills will be very valuable to the students.

Dr. David’s daughter Alexis also joined us for the day on Friday just to see the program. She quickly was recruited as a practice patient as

David and Cyril taught on choking and CPR. In these pictures you can see Cyril 1^st demonstrating and then having the students go through the procedure for an unconscious choking victim, using David as patient. Also, there is a picture of David demonstrating on Alexis the jaw thrust while showing the “look, listen, and feel” of CPR. Alexis was actually a big help in allowing the patients to practice on a real person.

Cyril started out by giving them all a small gift of a T-shirt. They loved the gift as you can see by the picture.

For dinner that night Dr. David requested we return to his favorite worm serving restaurant so his daughter could enjoy the fried bamboo worms for herself. Perhaps this was intended as her reward for helping us in class. I am sure Alexis appreciated the gesture. Doesn't she look happy as she is about to eat the worms in this picture?