Be Still and Know that I am God

It was a great Sunday yesterday! For many of us Church is an all day event over here. We went in the morning to the FLC small church. It is great and translated to three languages. The Barefoot Drs sang a couple of songs and one of them even played the drums for the band! A talented group. Then the fellowship meal. It takes like three hours and all of it good.
Then in the afternoon I went to the english speaking church. When i say english I mean England english. It is large church and calls itself a "multi-denomination church" rather than a non-denomination church. It was a needed day of prayer and recharging my batteries. I had been feeling the stress of running out of time here and still having so much to do. I did not think I could get it all done. I have been trying to connect with many people and often having limited success: two doctors in particular I had wanted to meet with this week. I gave it up to God and one of the themes of church was "be still and know I am God." I need the reminder that I am only responsible for my part. I can not do it all on my own and should not worry about it. God will make it happen or not. If not, it may not have been his will but our will. So I walked into the english speaking church by myself and wouldn't you know one of the dr's is right there in the back of the church where i was going to sit? So I got a chance to connect and set up a dinner meeting later this week. Then on the way out of church I met the other Dr and got to connect with him! In addition, I met another member of that church very interested in the Barefoot drs program who works in a related field. She may be able to help us as well. In closing let me just say, sometimes we forget God and try and run ahead of his plan. If you are truly doing his will it will work out. We all need reminders to keep our faith and seek God so we stay on course.
Now back to school today. God Bless you all.
Rick

Mortality statistics for the students siblings

There are only 2 weeks left in the medical training program. We are now in the process of making a list of exactly what we need as far as medications and additional equipment for the Barefoot Dr students. Since we had some donated supplies from USA and Canada it has been a little difficult to know what we have and what we do not have. For things we do not have we are getting prices so everyone knows what the specific needs are and how much individual items will cost. We are very short on funds for medications right now but many have already asked how they can help. Once the list is finalized people can donate for general fund and know exactly how much medicine or cures that will buy. For example, we figured out this morning that one course of penicillin, to cure say pneumonia, costs ~$1.37 USD.

This week we also collect some more date on death rates of children in the students' families. We found out some very interesting and sad facts. Of the students' brothers and sisters there were 29 deaths as children out of a total of 202 children (ya I know, big families). Adult deaths of their siblings was 34. Most of these deaths in both categories were preventable with simple medications that any of the Barefoot Doctors will have. 8 of the 9 deaths in the 1yr to 5yrs category were preventable if a Barefoot Doctor with their usual medications had been present. Here is a copy of the data with more details. Sorry for the messy presentation. The blog would not let me put in a spread sheet or chart. Hopefully you can still make sense of the information.

Student's Parent
2/10/10
Infant Mortality, Child Mortality, Overall Mortality,
99, 144, 312,

Student Number, Liveborn, Deaths 0-1 yr, Deaths 1-5 yrs, 5+, Cause of death
1- 9, 1, 0, 1, newborn, tetanus @ 15yrs old
2- 9, 2, 0, 2, unknown age, unknown cause
3- 6, 0, 0, 0,
4- 1, 0, 0, 0,
5- 10, 0, 1, 2, malaria & bomb & measles
6- 7, 0, 1, 0, unknown 15 yrs typhoid
7- 6, 0, 1, 0, fever
8- 9, 1, 0, 0, fever
9- 10, 0, 0, 5, unknown
10- 10, 0, 0, 2, malaria typhoid
11- 7, 0, 0, 2, gastric ulcer, stomach problem
12- 8, 2, 0, 0, unknown
13- 3, 0, 0, 0,
14- 15, 5, 0, 2, unknown
15- 4, 0, 0, 1, soldiers beat to death
16- 8, 0, 1, 3, 2 malaria, 1 alcoholic
17- 5, 1, 0, 0, post delivery
18- 10, 2, 0, 1, malaria and unknown infant
19- 6, 1, 0, 3, unknown, cancer, malnutrition, jaundice
20- 3, 0, 0, 2, HIV, cirrhosis alcoholic
21- 10, 0, 0, 5, unknown
22- 6, 1, 0, 0, premature
23- 4, 0, 1, 0, fell into well
24- 1, 0, 0, 0,
25- 8, 1, 2, 1, unknown, tetanus, unknown, typhoid
26- 8, 1, 1, 1, unknown, diarrhea with blood, drowned
Traslator 1- 8, 1, 1, 1, unknown, malaria, typhoid
Translator 2- 11, 1, 0, 0, high fever & convulsion
Total: 202, 20, 9, 34,

Mid Term Exam

That’s right, we gave them a mid term exam. It was a difficult test but it was open book. The book we are basing the curriculum off of is "Where There is No Doctor." This book is the gold standard for medical professionals working in areas where there are no doctors.
There is no way most people could remember all this information but they do need to know how to find it in the book. The same is true for medical students in the USA. Most of the Barefoot Drs will not have access to email or cell phones. They are on their own until we see them next year. So they need to know how to fully utilize the book and make decisions on their own. I got some good pictures of the intensity during the test. They did very well with an average score of 75%. A few had scores below 70% and we will see why next week then take steps to address the issue. We suspect it may be a translation issue. The class is translated to Burmese but for many that is a secondary language. Even if they speak it, reading and comprehending may be another story.



Notice the guy in the middle totally looking at the other students book. We will be having a little talk on Monday. Actually it is probably not what it looks like. A few of the students don’t have their own books yet.

Take the test in English yourself and see how well you do.


Barefoot Doctors Mid term Questions

1. A 47 yr old male just started TB treatment. He comes to you very worried that his urine looks bloody and red. What is the most likely cause?
2. 12 yr old girl had a sore throat and fever 2ws ago. She now has joint pain, fever, shortness of breath, and chest pain. What are you most worried that might be damaged?
3. Children should be vaccinated against measles at what age?
4. You are seeing a child with a cold, fever, headache, and sore throat. There is a yellow-grey membrane in the back of his throat. What do you suspect?
5. A Breast-feeding woman who develops a hot, swollen and painful lump on her breast. True or False: she should stop breast-feeding?
6. When would you not use an Artemisinin?
7. If you suspect you have been bitten by a rabid dog you should kill the dog immediately? True or False?
8. If a baby has high fever, stiff neck, and convulsions and you suspect he has meningitis, What antibiotic would you use? How much? How often?
9. For treatment of snakebite you should…. Pick the correct answer below.
a. Wrap up the limb with a bandage?
b. Cut the skin around the bite to drain the venom?
c. Tie anything tight around the bite?
d. Try to suck the blood and venom out of the bite?
10. Write down a normal pulse for
a. Adults . . . .
b. Children. . . .
c. Babies . . .

Extra Credit questions:
11. How long after the bite of an infected mosquito does it take for dengue fever to begin?
12. An eight month old child weighs 6 kg. Is he on the “road to health?” as outlined in the book?

The Answers tomorrow,





After class the boys like to play Takraw. It is like volleyball except you cannot use your hands or arms. You can only hit the ball with your head, feet, knees, etc. It is pretty cool seeing someone spike a ball over a volleyball net with a overhead kick!

Dr. Bob Liu last day

Today we say good-bye to Dr. Bob Liu. He has focused his time on training the Barefoot Drs how to use different teaching methods. The students had a lot of fun as he had them break up into small groups, make up songs about hygiene, do skits, and present short ideas in front of the class.
It was valuable teaching for us all not to just try and jam as much information into people as humanly possible. Rather, focus on relationships, respect, and different ideas on how to teach others new information. We pray he will have a safe journey home. We dropped him off at the train station after class for a 14 hr train ride to Bangkok then a flight to Phuket before he returns home to China.



A skit on healthy living.



The newly invented Burmese "Toothbrush Song"

Barefoot Dr students drawing healthy villages.

Dr. Bob Liu and Healthy Villages

Bob Liu teaching the Barefoot Drs. about a healthy village. He had the students draw pictures in groups and then discuss potential problems.

Back to the class room

Back to the Classroom today. Dr. Nilson started off the day with a talk on TB and finished the morning with instructions on how to use a infant growth chart. He used a visual aide to show how you can simply measure weight gain with a rudimentary scale. Dr. Nilson probably would have bought the scale he found at the night market even if he couldn't have used it as a teaching aide. He collects that kind of thing but teaching baby weight made a good excuse.
In the afternoon Dr. Bob Liu began teaching on village health. He has been involved with the Barefoot Drs. program since the mid 1990's. I will try and get some pictures of him tomorrow. I had some meetings this afternoon to try and get some connections with some local hospitals, doctors, and pharmacists. I could not have even begun to set up these meetings without the help of Rita. She has been a huge help and resource. Thank you, Rita!


Dr. Bjorn Nilson using his new "treasure" to demonstrate a simple way to measure infant weight gain. He found this antique scale at the Sunday market for about $30.00 usd.

Sunday was a day of celebration more than usual. The church service was held at the training center and not the church building this week. This was to accommodate over 300 guests who came out to honor Chris and Rebecca’s wedding and to worship and fellowship as a church. It was spectacular! There was a lot of tribal dancing and singing. Many different tribes put their best foot forward in song and dance to honor the new union. About 10 different tribal peoples came together for this event; all of them Christian. The message was also very good from one of the church leaders who accompanied us up to his home village two weekends ago. Of course after church there was a lot of food and we all ate together. They actually slaughtered a pig and a cow the day before just for this occasion. We also had a prayer for Chris and Rebecca. All the church pastors and the parents of the new couple laid hands on them while the rest of us stood and prayed together, out loud, in all our native languages for this marriage.
Here is a picture of me with several of the Barefoot Doctors in their traditional costumes before church.

The Barefoot Drs gave a great singing performance in all their traditional costumes. They represent 7 different tribes this year from the farthest reaches of Burma. I hope you enjoy the pictures as much as I do. I will keep you updated as we go.
Sawadee Krup
Rick

East meets West Wedding

It has been a fun filled weekend. We had a chance to catch up on email, paper work, and sleep Sat morning. Then at 3:00 we were picked up and taken to Chris and Rebecca Kalnin’s wedding. It was a true East meets West ceremony. We had a traditional wedding at Beverly Kalnin's home then we were transported to a resort for the reception. That is when things got interesting. The Barefoot Drs put on quite a show. They did a long dance in the traditional dress and custom of the majority of the class. I wish I had more pictures but my camera could not handle the poor lighting conditions. Then, just amazing food intermixed with some traditional American style speeches.
Chris was given leader status by this tribal people with the traditional costume, a sword, and gong. Then they had a ceremony that is traditional in Thailand where you make a blessing and hold a burning paper lamp. When the lamp paper fills with enough hot air you let it go and it floats up to the heavens. It was surreal watching what looked like Chinese lamps floating into the night sky with a crescent moon in the background. Also knowing that with each lamp a blessing had been sent. If that was not enough, then there were fireworks! You could never get away with any of this in California! You would burn the whole state down. Here it was no problem. Seriously the fireworks were so close directly overhead I thought someone was going to get burned. The best part was all the stories and to know that these are two great people that seem to truly belong together. There is no doubt in my mind they are blessed and will be a blessing to others in far greater ways then they were as individuals.

Second week of Medical done!

We have completed week two of the medical portion of the barefoot drs program. Today (Saturday) is our 1^st day off since we got here. We are looking forward to the time to catch our breath and catch up on emails and some paperwork. This afternoon we have been invited to Chris Kalnin and Rebecca Gibbs wedding at the Kalnin residence. Chris’s parents, Daniel and Beverly Kalnin, started this mission 31 yrs ago. I should be able to post some pictures tomorrow.

I spent my day in a meeting with a local doctor, a trip to the pharmacy to see what is available and how much it will cost, making some copies, and getting Toothbrushes for the village children we visited last weekend. We will be sending 30 toothbrushes to the children with written instructions for the teachers on how to instruct the kids on brushing their teeth. We should be able to give this to one of the guests at the wedding today and the kids should have them by Monday of next week.

Yesterday we said goodbye to Dr. Naga Pannala. There were a lot of pictures and goodbyes. I think she was surprised at how much of an impact the students had on her and how much you can connect with people in such a short time. The students really learned a lot from her teaching and really benefited from her presentations. She actually downloaded and presented actual heart sounds, lung sounds, and animated images of how the heart and lung work. We can only imagine what is going though the students' heads seeing advanced modern technology at work when some of them come from where they don’t have electricity!

Catching up on the past week

The Barefoot Drs. Training is going great! Yesterday we taught them CPR. Only one person in the class had ever even heard of it! They pick things up so fast and they have CPR down. Unfortunately we did not have a CPR Dummy so it is impossible to feel exactly what it is like. We are hoping next year maybe someone will be able to donate an old dummy from the USA. Another project for me today is to locate 30 toothbrushes for the village kids and training materials for the teachers to instruct the kids on how to use them properly.

It has been a very busy week and I have fallen behind on the Blog updates. So I am posting some info from last weekend at the village.

Church was great with a lot of children. We especially enjoyed seeing the kids singing in their traditional Karen outfits.

On Sunday they asked one of us to say a few words of encouragement to the villagers and I got “voluntold” as my military friends in the USA would say. Actually it was a privilege and honor to speak to them. I took examples from the Bible and tied them to health applications and being an example for your children and to the world around them. I explained to them that one of the reasons our medical team had come to the village was found in the Bible. 1 Peter 4:10 says, “Each one should use whatever gift he has received to serve others, faithfully administering God’s grace in its various forms.” We were attempting to do this but they should also follow this advice.

This is a picture of the house we stayed at, the stairs/ladder to get in, and our bedroom. The pic of the blankets on the floor is where three of the 5 of us Americans stayed. It got surprisingly cold at night in that little mountain village.

Oh ya, remember the lady a few days ago (picture below) with the black teeth? That is from years of chewing on beetle nut. It gives you a pretty strong “buzz” from what I understand.

So long for now, Rick

Equipment Given to Students!

Woo Hoo! Got the stethoscopes!!! The Barefoot Dr students are so excited and appreciative for the new equipment! Thank God everything worked out.

Dr. Pannala teaching childbirth/pregnancy

It has been an exciting week so far. Dr. Naga Pannala joined us this week. She got here in the middle of the night on sun night and started teaching Monday afternoon. She did not miss a step after her adventure with customs at the airport on arrival. She was bringing us all the stethoscopes, BP cuffs, and thermometers for the Barefoot Drs students. It took us two days and a lot of effort to get the equipment back. In the meantime, Dr. Pannala was doing a good job teaching all her scheduled classes without ever complaining. She has been a blessing to the students and I get the feeling that she feels the same way about them.

Yesterday she showed them a video clip of childbirth and an animated video on what happens internally during childbirth. The Students were amazed! It turns out only a few of them had ever seen childbirth. They were literally on the edge of their seats.

We Got It !!

Praise God!

We got the medical supplies. It took 2 full days with Deezi and me along with some appearances from our new Dr. and Beverly. It also cost us 3400.00 Baht for tax and "shipping fees." That equals about $106.25 usd. Yesterday they were throwing around unofficial numbers around $300.00. It is a two day long story but one highlight was at the end when they finally brought a bill it totaled 4597 bt (~$143.00 usd). When I protested this they eventually told me they could discount the price a little but then they would not be able to give me a receipt. Hmmmm, but I took the deal. I think I hung them up when I did not just throw the money at them and run off with my bag. After two long hot stressful days I think they expected me to just pay anything. So all that seemingly wasted time haggling in Mexico was good for something.

The bright side is 1. We got the bag. 2. I learned a lot about how things work here in Thailand. It is very different than the american way. However, when we left the lady in charge of this customs station told me I should call her if I have any questions in the future, day or night. She also told me how to avoid this situation in the future. A major point I would point out is that every time before we went in to talk to anyone we would stop and pray. We also had many people from two countries praying for us as well. It was difficult at times for me to keep my cool and not loose my temper because I knew most of this was unnecessary. It is extremely aggravating to me when good people trying to do good works are harassed and squeezed for money. With the power of the God guiding my words and actions Deezi and I were able to make a favorable impression. No doubt this got us a sizable "discount" but also gave us good and favorable contacts inside Thai customs, FDA, and cargo shipping. Including names and phone numbers. After two days they know our faces and that we are nice people but also know we are not total pushovers. These contacts may be far more valuable in the future then the suitcase of medical equipment.

Bottom line: God is Great. His ways are above our ways as the heavens are above the earth. Often we do not see the reason for things at the time but if we are following God it will work out for the best but may not work out according to our ideas or plans. ( ok that was two lines but I am excited).

Thank all of you for your support and prayers! God Bless you all!

Rick

We have an urgent prayer request.

One bag carrying all the stethoscopes, BP cuffs, and thermometers was confiscated by customs two nights ago. I spent all day with Deezi (our local translator and driver) trying to retrieve the bag. We got the royal run around and i am not sure what the actual issue is. We were sent from one department to another and at the end of the day they told us we needed to come back the next day with the Doctor who was carrying the bag. It is frustrating sitting a few feet from a bag of needed equipment that has all been donated and not being able to take it to the students. Please pray that we will get the bag back this morning and that God will soften the hearts of those who are opposing us.

Thank you.

Rick

Trip to Thai village

It was an amazing trip to the Huai Biong village this past weekend. There is more than I can possibly tell on this short blog. This village is about 4 hours west of Chiang Mai. It does have power now but is still very primitive. Our first stop was to a mission supported school for the poor children that are too far from a public school to attend. The team included Dr. Bjorn Nilson, Dr. Mark Royer, Rick Astone, Brian Zeider, Bob Bowling(Media and photo), Sumsak his wife and brother as Liaison, Beepal as driver and interpreter. The kids are relatively in good health but we were surprised to see the most complaints about teeth. It turns out only half of them even have a toothbrush. We did a lot of educating and check ups. There were a few moments of excitement when Dr. Royer got to do a tooth extraction and drain an abscess in two of our adult patients. Rick Astone(Physical Therapist) did a lot of education on arthritis and why antibiotics do not help that kind of knee pain. Dr. Nilson took pleasure in not only helping the local children and adults but also educating our medical team on the various things we came across throughout the weekend.

This is one of the many children with severely bad teeth.

Most of the children in the school are just getting over the chicken pox. This is something you will no longer see in the USA.

After the school we went to the village where we stayed the night in Sumsak's family's home. They still cook over an open flame inside the home! This answered a few questions we had about some of our severe eye and sinus allergy patients we saw earlier.Oh ya, no chairs in the home! You sit and eat on the floor. The only toilet is outside in an outhouse. We ate wild bore one of the men of the house killed while hunting that day.

Mark, Brian, and Bjorn sitting around discussing the amazing day after dinner.

One of the women of the house doing a little weaving before bed.

And that was just Saturday! More tomorrow.

Trip to Thai village

Medical Question of the day. What causes teeth like this? Stay tuned, the answer tomorrow.

Last Day of First Week of Medical Classes

It is truly awesome to see what all our students have learned in just a week of medical training!
The last day of the first week of medical classes was just as full as the other four days this week. The students had several important lectures on diagnosing and treating various diseases they will see regularly, including colds and viruses. Dr. Cindy taught also about breast cancer and early detection and treatment. The students also got to try another hands-on experience that was very practical.
At the beginning of the day, while Dr. John Paul continued teaching about interviewing patients to make a proper diagnosis, Jon, Clark, Mark, and Brian took a quick hike to the top of the mountain overlooking the KLC. Jon was the only one that had been there before, so it was a real treat for the other three to see the panoramic view from up there.
When we got back, Dr. Mark Royer taught about colds and viruses and their treatment. Brian even got involved for a few minutes of teaching because, as a Ph. D. student in Chemistry, he is well-qualified to tell the students the difference between bacteria and viruses. One of them responds to antibiotics, and the other does not. Do you know which is which, and why only one of them responds to antibiotics?
While the teaching was going on, Clark was doing important things like taking this picture of the flip flops and sandals lined up outside the Jones Building. His question was: Can you tell which flip flops belong to Jon and Clark?
In the afternoon, the students learned about broken bones and what to do to help their patients heal from them. Dr. Mark taught them about the use of a special bandage to help someone with a broken jaw. Then the students each got to practice this bandaging technique.
At the end of the day, we all knew it was time for the students to say goodbye to Jon, Clark, Mark, and Brian. It was a very emotional time of goodbyes, first as Thinbey expressed for the class their appreciation for us and the teaching we did. The class also presented us with gifts of Burmese bamboo tea mugs, a scrolled map of Burma, and FLC Barefoot Doctors T-shirts. Then they had the four of us sit down on chairs while they surrounded us and prayed for God's blessing upon us. It was both a humbling and amazingly-encouraging experience for all four of us! Several of us were teary-eyed when the prayer was over.
We were glad we got several pictures of the whole class before we left. There were also many other pictures taken. Then we drove a few miles to see the agricultural land the mission has on our way to Beverley Kalnin's house for supper together. She and Rebekah, Chris Kalnin's fiance, prepared us and the other doctors a wonderful meal, probably the best meal we have had since coming to Thailand. The final shot of this section is of Jon, Deezi, and Clark at the side of Beverley's house. Deezi is one of our great friends in Thailand, and he was our driver all week.
On Saturday morning, Dr. Nilson, Dr. Royer, Rick Astone, and Brian Zeider joined men from FLC to drive to Hui Bong village about four hours west of Chiang Mai. There they planned to see the children of the preschool and other villagers who needed a checkup or some medical help. They are spending the night in the vilage and worshiping with the church Sunday morning, and then they will return to Chiang Mai just in time for Mark and Brian to fly home to America. Rick and Bjorn will continue to oversee the teaching for the next five weeks. They will also continue to post blogs to this blogspot, so STAY TUNED! There is much more to come after today!

We told you yesterday that we needed to get blood pressure cuffs and stethoscopes for our 26 students. That need has been met, because a doctor and his wife in the US donated enough of these for everyone! They will arrive with another doctor on Monday when she comes to teach our students. We are very happy to have this donation! Now our limited funds can go to medicines and other medical tools for our students to take back with them. We are checking on prices in Thailand for these things, so in a couple of days we hope to tell you how you can help with these if you wish to. As He has done all the way through this school, God is supplying what we need each step along the way!

On Saturday, Jon and Clark got one last day of sightseeing around beautiful Chiang Mai. They walked into the Old City again and went to the oldest and largest wat in the city, Wat Chedi Luang. The main building is over 500 years old! Some of the top of it was destroyed in an earthquake many years ago, but it is still very impressive. Almost equally impressive is the more modern temple in front of it. Enjoy the pictures!


We, Jon and Clark, will begin our journey home on Saturday evening at 6:00 p.m. We will arrive at Dulles Airport Sunday morning, very glad to see our families again! We will be carrying in our minds many wonderful memories of new friends and great experiences. Our hearts are full as we have seen God at work in unbelievable ways these past two weeks! Once again, we thank you for your support and for your prayers. We are anxious to tell you all about our trip and what God is doing in Thailand and Burma.