The return of the Joneses.

We were blessed to have Dr. Paul Jones and Jan Jones with us for over a week. The Joneses ran the Barefoot Doctors program since 1989 until 2009 and have graduated around 100 Barefoot Drs! It was great to see them in action with this class and collaborate on ideas. It was also a blessing to hear their encouragement and approval of this current Barefoot Drs. program.

Dr. Jones covered many important subjects including Malaria, Dengue fever, Epilepsy, Tetanus, and Stroke. He even had a fake seizure on the floor!

Malaria is the number one disease they saw. Last year alone the Barefoot Drs. saw 473 cases of Malaria.

Jan Jones covered other important mother and baby, women's health, prenatal, pregnancy care, and

nutrition. Jan also has a special skill at getting inside information out of the women students that I could never accomplish. In addition, the Joneses brought a warmth and encouragement to students and other teachers alike. It was obvious that they really cared about the students and this program and that kind of love does not need translation.

Have a great day.

Rick

Creative Teaching

I am way behind on the Blogs but I will try and catch you all up. Last Thursday and Friday we had Dr. Jim Buie, Gail Buie do most of the teaching. They used a lot of creative teaching techniques that worked great with the students and are much more fun for everyone. They also made use of their friends, Regi and Kim who were observing, by giving them mock diseases. Dr. Paul and Jan Jones were also afflicted with the Buies pretend illnesses so the students could evaluate and prescribe treatments. In this picture you see in order from right to left our translator Abraham, Dr. Jim Buie, Jan Jones, Kim, Gail Buie, Regi, and Dr. Paul Jones.

Gail reviewed worms and we were all impressed at how well the students identified and answered questions about the different kinds of worms. This is a big problem in most villages in the developing world.

The three girls also did a great demonstration about germs and how they spread. They used powder that only shows up under a black light and preformed a short skit. Then they illuminated the power that had spread from one person to all over two others and all the stuff she touched.

Thats all for now.

Rick

A Huge Week is Coming Up!

As we head into the last week of our medical training, we want to ask for special prayer support. It's going to be a BIG WEEK! From February 27th to March 2nd, the 26 Barefoot Doctor students will be working harder than ever to complete the requirements of this course.
A team from mPower ministries will be with us to teach the students basic dentistry skills. They have waited almost three years for this hands-on training, so they are very anxious to learn everything they can. The mPower strategy is to teach these skills with live patients, so there will be many people brought to the school to have their teeth worked on during the week.
On Friday, March 2nd, is Graduation!

These pictures show graduation ceremonies from 2005 and 2009, and the graduation of the Class of 2012 will be just as momentous! Many sacrifices have been made over the past three years to bring our current students to the point of being certified as Barefoot Doctors. It is going to be a glorious day!

Our 26 students will be SO EXCITED to finally graduate! Then they will continue with their Bible training for two more weeks before they return home to Myanmar to serve as Barefoot Doctors.
On Saturday, March 3rd, the new dormitory at the Kalnin Learning Center will be dedicated. This building will allow FLC to host larger training events than ever before, and this is another important milestone for God's work in Southeast Asia. The Governor of Chiang Mai and other important guests will participate in the dedication, and many of the local churches will join in a full day of activities and celebrations.Thank you so much for your prayers! If you want to make a donation to the medical supplies needed for the Barefoot Doctors ministry, please note the sidebar to the right of this blog. We really appreciate anything you can give.

Another Week Begins!

Well, we have started another week. So much has been going on I don’t know where to start. I guess some of the big things are that I have heard that our dental team has arrived and has been able to get all of their equipment through customs. This is sometimes a huge problem so this has been a big concern of mine. Also, Alice Davis, my fiancé, arrived safely back in San Diego although she is not yet over her jet lag.

Friday we said good-bye to Dr. David Brumwell. He was a big help in emergency medicine issues like starting an IV, Foley catheterization, poisoning issues, and CPR. Dr. Brumwell's picture is on the right.

We are honored to welcome back two icons of the Barefoot Drs. program, Dr. Paul Jones and his wife, nurse Jan Jones. They have developed this program from its infancy up until Dr. Bjorn Nilson and myself took over as Medical Director and Dean of the school three years ago. The Joneses have served in medical missions around the world before committing to build up the Barefoot Drs program many years ago. Dr Jones started teaching last week from his vast experiences in tropical medicine with particular emphases on Malaria and Dengue Fever. He continued that discussion today and added other issues like headaches and Typhus.

We also welcomed our 1^st dentist of this class of Barefoot Doctors. Robert Gardner, DDS, started teaching some basic dentistry. The students were furiously writing notes as they have been anticipating this training for two years now. The majority of dentistry will be taught next week with the “mPower” dental team, but today was a good foundation for the students. Dr. Gardner's picture is below.

Trip to the Farm

Well, it’s another busy week full of interesting teaching. Dr. Dave Brummwell has enriched the students’ knowledge of emergency medicine. Yesterday he discussed the use of tourniquets in starting IV’s. This required the barefoot doctors to combine their knowledge of pressure systems presented by Dr. Luskin with the concept of elasticity and cardiac flow. Understanding how pressure relates to arterial output and venous return will equip the students for improved assessment and treatment.

The students had the opportunity to practice interosseous infusion on chicken bones in lab time after Dr. Brummwell’s instruction. This is a great tool for patients that have such low blood pressure that a vein cannot be located intravenously (IV) for replacement of fluids.

The afternoon was filled with adventures at the Partners experimental farm. Here, the students learned about how they create a farm based in use of natural microorganisms to balance the ecosystem. This system can be used not only in livestock pens but also as a means of making fertilizer and fuel for cooking. We were all surprised to see and smell that using microorganisms decreases odor and the number of flies buzzing about. Not only was this farm more pleasant to be around, it was healthier for the animals. Boon Sang, the gentleman who guided us around, stated that by using microorganisms to make food for the pigs that the protein content is improved to approximately 19% from pure vegetable matter. This is the amount that pigs need to grow healthy. In a growing and “progressing” world it is great to see science being applied to not only preserve but support the natural ecosystem. In addition, this system can all be done in a village and saves money by not having to buy fertilizer or feed.

Pregnancy tests and teaching cubes

Well, we’re starting another week of teaching at the Barefoot Doctor School. Dr. Dave Brumwell arrived safely yesterday, ready to build on the students’ foundation of emergency medicine. His part of the curriculum will include IVs, poisoning and catheterization.

Highlights from last week include discussion and lab time for over-the-counter pregnancy tests. Due to the nature of remote living, some students did not know such a test existed. This was a new experience for the whole class and only two students had ever seen one.

Additionally, the students were introduced to the use of story cubes for community education. Each student received a cube that outlined prevention, transmission, and treatment of HIV/AIDS. For these oral cultures, visual teaching is an effective tool.

The students also had the opportunity to greet and sing to Dr. Cyril Thomas through skype. His presence is missed as we pray for healing of his back.

Over the weekend, Barefoot Dr. Koram and Adang were married at Beulah church. It was a day of prayer, celebration and singing.

Dr. Mike and Maria Luskin

We completed another busy week and I have not had a chance to blog. It is Sunday now so we are all catching up on rest and paperwork. One important highlight is that one of our students, Chan Ku Sar, had his appendix removed and is recovering nicely back at the KLC training center. He was back in his usual seat on Wednesday after having surgery Friday. This guy is dedicated! Of course we make use of every good example of real patients we can find, and he made a good case presentation that they all saw first-hand. Thank you all for your prayers for him.

To Dr. Mike Luskin and his wife Maria we said so long for now but not goodbye as they left after a week helping us teach. Maria was also a huge help with her computer skills. She demonstrated to the students how to use the Internet and email. I have included a picture of her teaching with this blog. She also helped with a lot of

technical questions we had for her, and she was able to revamp an old computer donated for student use by Bjorn. Maria was able to resurrect this old computer, which is a virtual miracle! Now the students can practice on this computer and see what the Internet can do. Many of the students still do not have electricity in the village, so forget about Internet. Only 2 have email access . . .sometimes. Most had no idea about email and the Internet other than what we may have mentioned in class. Bjorn likes to call the Internet the “great equalizer” comparing it to the six-gun of the old west because it really empowers the people anywhere they have free access to it. It is much harder to take advantage, suppress, or control a population who has so much information at their fingertips.

Sawadee Krop for now.

Rick

Week 3

Week 3 started with three new arrivals to the Barefoot Dr. Medical Training team.

Dr. Mike Luskin started the week off with teaching about shock, after arriving with his wife Maria from their travels in Cambodia and Laos. His experience in the ER department at Kaiser allowed him to educate the students in a practical way. He related shock to plumbing, a system based on the relationship between input and output. This example was one in which the

students could picture how injury can affect the

pressure within the cardiovascular system. The pressure system example proved to be a great segue to discussing hypertension, heart attack and stroke.

The afternoon was filled with a case presentation and discussion based on barefoot doctor’s experience in the past year. Video demonstration and use of anatomical models allowed the students to see the cardiovascular plumbing in detail.

Our third new arrival was a very special guest, Ms Alice Davis PT, my fiancé. It is exciting to have her here for the first time and help out with

the program. With her help I am hoping to post blogs more often to keep all you around the world up to date on our activities.

More soon.

Rick Astone with Alice Davis.

SEX . . . education.

Well Friday was an exciting day. We had a sex education class and then in the afternoon talked about STD’s (sexually transmitted diseases). After that we had a quiz on the week’s lessons. I think the students where all exhausted by the end. In their culture sexual issues are not discussed much and even less in their mostly conservative Christian villages. The down side to this is there is a lack of factual information and a lot of misinformation. We did our best to keep it factual and scientific based but honestly we were shocked at some of the answers we got from some of the students. This is a very delicate subject and we do not want to project our cultural beliefs on them only teach the scientific truth. We deferred many of the controversial social sex questions to the Pastoral staff to follow up on in the next few weeks. To the pastors-Good luck with that, you guys! Some of this is not appropriate to repeat on the blog but to give you an example, when we polled them with the Audience response system we found that 7.69% of the students believed it was a sin to talk about sex! These are important issues and as a health care professional you need to be able to talk about medical sexual issues in a mature and educated manner with your patients. This explains why out of 3383 combined patients seen by the Barefoot Drs in the last year only 2 cases of STD’s were reported! Something is very wrong with this, statistically speaking. The Data we collected is the reason this issue came up in the first place. Had we not had the student keep logs and had we not collected and analyzed the data, we would never had realized this weakness in the Barefoot Drs. Now it has been addressed and we will follow up on it to make sure they are equipped to deal with the tough issues that may come up with future patients.

We had a special treat on Friday at break when we were able to Skype with Pastor Jon Ulm.

He is a huge asset to this Barefoot Drs program and is a critical component to setting this up every year. He will be joining us over here in a few weeks and hopefully he will be one of the pastors that will help follow up on the biblical teaching surrounding sex education and social issues that came up during our medical teaching. Here is a picture of Pastor Ulm talking to the students via the Internet. It was a big encouragement for the students and I believe for Pastor Ulm as well.

We also said goodbye to Dr. Charles Steinberg. In this picture you see Dr. Steinberg on the left, Rick Astone PT in the middle, and Dr. Bjorn Nilson on the right. Dr. Steinberg was a great help and we were blessed to have his expertise on some of the difficult subjects of this week.

We do have a prayer request. One of our students, Chan Ku Sar, had to be taken to the hospital last night for an appendicitis. He has already had surgery and is recovering fine so far. Please keep him in your prayers. Also pray for safety and good health for the rest of the students and staff.

I will try and post more over the next few days.

Rick

TB case

This week we have Dr. Charles Steinberg helping us teach the Barefoot Drs. He is a world-renowned teaching physician on HIV/AIDS. He has worked in many different countries around the world and has seen first-hand many of the medical issues in developing countries. It has been a huge blessing having his expertise in the curriculum. He is also covering TB and skin issues.

We have one case from the Barefoot Dr students I have included below.

Ja Sen Sar- Case Presentation 2-1-12

Chronic cough:

A 45 yr old female with cough for one year. She sometimes coughs up mucus and blood. BP normal. The Barefoot Dr. had no meds to treat so he took her to the clinic. The clinic checked mucus and x-ray. Positive for TB on sputum test.

6 month treatment recommended. Now 3 months later and she is getting better. The Barefoot Dr is helping with “DOTS” (Directly observed treatment short). Any form of formal treatment program is a new development in Mynamar and we are excited that they now have access to these life saving treatments.

This case is very revealing in many ways. This is a good example of the situation they are living with. Our students are from many different areas all around Burma and some have even fewer medical resources than this case.

Thank you all for your interest and support of this program.

Rick