Thank you all!

Barefoot Doctors Class 2010
Well we made it home safe and sound. Although, i am still recovering from Jet lag.

To the left is the Barefoot Doctors at church, notice the feet. To the right is me (Rick) with the homemade crutches.

This may be the last entry for awhile. I wanted to get a few more pictures on and also thank all of you for your support. There are few other opportunities in the world where you can make such a profound difference with so little of an investment. The Barefoot Doctors program already has the volunteers to go do the really hard work. The Barefoot Doctors have accepted the challenge to be the Hands and Feet of God. They go where outsiders are not allowed. They can save a life with the knowledge and training we give them and a few pennies worth of medication! All of us that support this program in one way or another are directly responsible for helping to save lives! And in areas very few can go. I feel personally blessed and honored to be able to be a part of this miraculous project.

I also want to point out that this would not be possible without many others all around the world helping in various ways. This was not accomplished by one person but by a team. It was the whole “body” that enabled the Barefoot Doctors to do their part as the hands and feet. They are the feet in walking where others cannot and they are the hands in the medical care they give. They offer spiritual healing and guidance as well as physical. Many of you have contributed prayer, money, medical equipment, your valuable time, and your expertise. It was a team that completed this mission under the direction of God's plan. There were far too many “coincidences” that happened all throughout this program that turned out to be critical for its success. There is no doubt in my mind that this was God's hand at work guiding this project along. All He asked from us was to be available to answer his call. For some of us this was more intimidating than for others because of the level of involvement asked. The amazing part is that every one who gives to this gets so much more back in return. The rewards are in things much more valuable than material objects. The benefit of the patients the Barefoot doctors will see may be their very life!

Until next year.
Thank you and may God Bless you all!
Rick

Medication Donations Needed, Please!

The teaching for this year's Barefoot Doctors School is over, and now our students are headed home to help the people in their villages. We are still quite short on our funding for medications, but we hope those of you who have been following this blog can help us.
I thought it would be helpful if everyone could see the prices on some of the drugs we are going to be using. This is based on the last two years of pricing data and should be accurate. It does not take much money to help save a life. The drugs are relatively cheap, the Barefoot Drs are eager to deliver treatments, and the need for treatment is extremely great. For most of their patients there is nowhere else to get medical help.
Please search your heart and pray about this. If you are prompted to give, it will be a great help to our Barefoot Drs. Even a small amount can be used to save a life. Here are a few examples.

COST PER TREATMENT/CURE: MALARIA $0.62
COST PER TREATMENT/CURE: MENINIGITIS $2.50
COST PER TREATMENT/CURE: PNEUMONIA $0.25
Yes, that is right. It only cost $0.62 to cure a case of malaria! And just $0.25 to cure pneumonia! That is not just one dose. That is the entire treatment!

There are more details below for those interested in helping meet this need.

To donate any of these medicines, please note clearly on your donation that it is for the Barefoot Doctors program.
You can donate online at the FLC website: http://www.frontierlabourersforchrist.org/
Or you can send your donation to one of these two addresses.
In The USA:
Frontier Labourers for Christ
Barefoot Drs. Program
Kevin Eldredge, Treasurer
P.O. Box 630382
Highlands Ranch, CO 80163

In Canada:
Frontier Labourers for Christ
Barefoot Drs. Program
David Kindy, Treasurer
P.O. Box 194
Selkirk, ON NOA 1PO

Here's the complete list of medicines we need. Sorry the formatting will probably be hard to follow on this blog.
2009 Medicine Unit prices as of 12/12/2008

NO. DESCRIPTION PACKING QTY UNIT/PRICE AMOUNT UNIT/TX COST/TX COST/TX
(BAHT) (BAHT) (BAHT) (BAHT) $ US
A. Medicines

A1. Pills
1 Aluminum Hydroxide 500 mg tablet 2000 0.17 340 40 6.8 $0.21
2 Amoxicillin 250 mg capsules 3000 1 3,000 80 80 $2.50
3 Aspirin 300 mg tablet 2000 0.18 360 10 1.8 $0.06
4 Artesunate tabs 480 12 5,520 1 12 $0.38
5 Buthylscopolamine (Buscopan)10 mg tablet 200 0.99 198 10 9.9 $0.31
6 Chloroquine base 150 mg tablet 1000 0.5 500 0 $-
7 Chlorpheniramine 4 mg tablet 1000 0.03 30 20 0.6 $0.02
8 Ranitidine 150mg tablet 500 1 500 30 30 $0.94
9 Ciprofloxacine 250 mg capsules 1000 1.24 1,240 20 24.8 $0.78
10 Cloxacillin 250 mg capsules 1000 1 1,000 49 49 $1.53
11 Co-trimoxazole 80/400mg tablet 3000 0.4 1,200 20 8 $0.25
12 Diazepam 5 mg tablet 200 0.7 140 0 $-
13 Doxycycline 100 mg tablet 1000 0.65 650 12 7.8 $0.24
14 F.B.C caps 1000 0.32 320 0 $-
15 Ferrous Sulphate 200 mg ANB tablet 1000 0.1 100 60 6 $0.19
16 Folic Acid 5 mg (CP) tablet 2000 0.2 400 100 20 $0.63
17 Hydrochlorthiazide 50 mg (NOT LASIX) tablet 500 0.14 70 50 7 $0.22
18 Ibuprofen 200 mg tablet 1000 0.25 250 20 5 $0.16
19 Mebendazole 100 mg tablet 1000 0.4 400 3 1.2 $0.04
20 Metronidazole 250 mg tablet 1000 0.26 260 80 20.8 $0.65
21 Multivitamin tablet 1000 0.19 190 100 19 $0.59
22 ORS packs 27,9g/750ml sacht 200 2 400 5 10 $0.31
23 Paracetamol 500 mg tablet 4000 0.18 720 10 1.8 $0.06
24 Prednislone 5 mg tablet 200 0.26 52 20 5.2 $0.16
25 Pyridoxine 10 mg tablet 500 0.2 100 0 $-
26 Quinine Sulphate 300 mg tablet 2000 2 4,000 0 $-
27 Vitamin B 1 100 mg tablet 1000 0.23 230 0 $-
28 Vitamin B Complex tablet 1000 0.1 100 0 $-
29 Albendazole 200mg tabs 250 2 500 0 $-
30 Cindimycin 150mg tabs 100 6 600 0 $-
31 Erythromycin tabs 250mg tabs 500 2 1,000 0 $-
32 Fluconazole 50mg tabs tabs 100 7 700 0 $-
33 Vit A 25,000IU tabs 1,000 0.38 380 4 1.52 $0.05
Total 25450

Thanks so much for any help you can send us!

Tetanus Vaccines

First of all I want to remind everyone that Sunday March 14th is the Global Day of Prayer for Burma. Please pray for the people of Burma that are in desperate need.

Secondly, I wanted to share some more pictures from last week with you all. Thursday we practiced giving injections. 15 of our students had Never had a Tetanus vaccine! Since we never see or hear about actually getting tetanus in the USA I had to get some information on it. It is a particularly nasty disease. It is basically a neuro toxin that causes all your muscles to contract until people end up arched backward from the spasms. Sometimes the muscle contractions actually fracture the spine. Eventually you smother yourself because your contractions are so strong you can no longer breath. There is not a good treatment once you have the advanced stage of the disease. All the time the victim’s mental status is unaffected.
With proper vaccinations it is easily prevented and now our students have that protection. In addition, they got to practice giving injections to their classmates. The students that did not get to give an injection to a person had to settle for an orange.

WE FINISHED!

The Barefoot Dr students. In the front row from left to right is Dr. Vegas Coleman, Dr. Lauren Hansen-Welches, Dr. Elise O’Connell, Dr. Bjorn Nilson, Rick Astone MPT, Timothy and Abraham our translators and Barefoot Drs themselves.

We finished! Somehow we got everything done by the end of the medical program. It was only possible by the grace of God. The program came to a very successful close Friday night and ended with a dinner and celebration after class. There were a few speeches, a lot of singing, gift-giving, and of course PICTURES. We concluded the celebration with everyone forming a circle and praying out loud in their native language for the guidance and safety of the Barefoot Dr students as well as the teaching Doctors. It was a powerful and special evening.
One of the Barefoot Dr students, Thin Bey, shared a testimony of an event in his village when some fully trained Barefoot Drs saved a man's life after the man was sent home from the local medical clinic to die. The villagers had already dug his grave and made the coffin for this guy! They had filled out the head stone and just left the end date blank to be completed at his actual death. This dying man was unconscious when a team of Barefoot Drs went to see him. Thin Bey does not know exactly what they did but he told us they drained a lot of fluid from his abdomen. In two days the man was on his feet and now he is back to work in the fields and doing just fine. Thin Bey had lunch with him a few months ago before he came down to the Barefoot Drs training. I should also mention there was a lot of praying going on for this sick man as well. Whole villages and churches were praying for him as well as the Barefoot Drs themselves. So who knows exactly how he was healed but he was healed. The credit goes to God either way but most believe that God healed this man through the Barefoot Drs medical treatment.




The last day of class was jammed full of last minute things we had to complete. Dr. Nilson went through scenarios, diseases, and drugs. We gave them a final exam that was compiled by the three visiting Doctors, Elise O’Connell, Lauren Hansen-Welches, Vegas Coleman.
We also had the students get familiar with their new field books they will use to document all their patient treatments. The book also has some medical coding and drug formularies in it for easy reference and documentation. Dr. Bjorn Nilson did an outstanding job compiling this field charting booklet for the students. We also need to thank our friends in the local medical community for their help and ideas for making this field booklet.
In addition to all that, we handed out their new waterproof medical bags and all the equipment we had. They are still short on many items and almost all the medicine they will need but this is a good start. They can get everything else fairly easily in Thailand or Burma once the money comes in. Of course there was more gift-giving and pictures even before we headed across the lawn to the celebration dinner. We gave them each a signed class photo collage Bjorn had put together on his computer and some dried fruit and nuts grown in California. Of course they gave each of us teachers gifts at the celebration as well. They had hand carried very special bamboo tea cups from their homes in northern Burma. These cups are handmade and cannot be bought in Thailand. It is humbling to be given gifts and prayed for by the students who have overcome greater obstacles to get here than we have. We Are Not Done With The Blog Yet! I will continue to post over the next few days to catch up on some other pictures and stories I did not have time to update you all on as they were happening. So stay tuned.

Sprint to the Finish

It has been a crazy couple of days here. We are in a mad dash to the finish but somehow we are getting things done. Last night I got class pictures developed for everyone, and bulb syringes for the class. Today, I went to two different malls to find the waterproof bags we need for each of the barefoot doctors and I cleaned them both out of the size we needed. Rita picked up and delivered 15 tetanus vaccines for the Barefoot Drs who have never been vaccinated. The students practiced injections with the above and also on some defenseless oranges. Sarep Pung finished the field paperwork booklets for the students complete with coding tables and medication formulas for different age groups etc. The Teaching Drs. finished up on the curriculum. They also quizzed the students on diseases and drugs as well as organized our supplies to make up the medical kits the students will go home with.

In addition, we started off the day early with a hike up the hill behind the training center before class. Abraham and Thinbey guided Vegas, Lauren, Elise, and me through the woods to the top of the mountain overlooking the training center but Bjorn stayed back to get the students started off in the classroom. After class we all went out to a great “cultural dinner” with a show of traditional dancing and music. It was really quite amazing!

Tomorrow we will wrap up the program by issuing the students the final items and reviewing everything they have learned. After class, of course, there will be a closing celebration dinner at the training center. This will likely involve some speeches and some tribal dancing as well as gift giving. I will get some pictures up when I have more time. For now I have to get some sleep. Thanks for your prayers and support!
Rick

Three New Teaching Drs Arrive.

It has been another busy week. We have three new doctors that arrived over the last few days. They are all from Indiana University (IU) and are doing an outstanding job. We are all enormously appreciative of their willingness to take time out of their extremely busy lives to help pass on desperately needed knowledge to the Barefoot Doctors. Ironically, we have not had one teaching doctor leave yet that did not tell us how impacted they were from this experience. Some felt like they had gotten even more out of it than the students themselves! There is no doubt it is a powerful experience.


Dr. Vegas Coleman got in Sunday afternoon and began teaching Monday on Psychological disorders, drug addiction, and PTSD (Post Traumatic Stress Disorder) among other things. Vegas is a Doctor of Psychology and doing a fellowship right now. He offers a badly needed specialty to these Barefoot Drs. The need is much greater than we had initially anticipated but almost all the students have seen a lot of addiction, PTSD, and other psychological disorders. The Barefoot Drs are a tough crowd when it comes to joke-telling, mostly due to translation issues, but somehow Vegas had them all laughing hysterically. He has a great, animated teaching style that needs no translation. It seems God has truly called him on this mission and I am sure great things will come from it.


Last night Deezi and I went to the airport at 12:30 AM to pick up Dr. Elise O’ Connell and our Otoscopes! It went smoothly except we had a new Customs agent and he had to call the contact info we had for the FDA agent after hours. Then the Customs agent raised the price of the tax! We worked it out and it is done now. Elise is an Internal Medicine Dr and began teaching bright and early Tuesday morning. Elise was teaching on how to examine a sick person. She had some great slides of graphic pictures to help the Barefoot Drs. see what diseases look like and how to diagnose and treat different problems.


Our third new arrival is Dr. Lauren Hansen-Welches, an ENT resident from IU. She arrived at 7:25 am and got a ride out to the training center at lunchtime to help teach the afternoon session and to teach the Barefoot Drs how to use their new OTOSCOPES! It was a fun afternoon but it is definitely getting hotter. It was about 100 degrees today. Our poor new Doctors held up well, but they must have been dying after coming from the cold weather in Indianapolis, in addition to the jetlag.

Otoscopes and Last Doctors Delivered Safely!

This is just a quick note written by Jon. Rick is very busy, but he wanted everyone to know the otoscopes and the final teaching doctors all arrived safely and passed through Customs without a hitch (the otoscopes AND the doctors). He will be writing more later, but things are so busy right now he doesn't have the time.
Rick said they are not only finishing all of the teaching they need to accomplish, but they also have a lot of medicines and supplies to purchase and pack before the students head home to Burma next week.
Thanks for remembering in your prayers both the doctors and the students in this final week of medical training and Bible lessons.

More Fun at the Airport

Today it was church in the morning (after sleeping in a bit) and then off to the airport to pick up our new Medical Resident who will be teaching tomorrow. Dr. Vegas Coleman arrived safely with a few medical supplies. The supplies themselves were more of a difficulty. Last week I had gone to the airport twice to get approval for the supplies. They only okayed about a fourth of them. Today they wanted to charge a higher tax than we should have to pay. All we had with this load was vitamins and some odds and ends after they denied so much of it. Then they were claiming it was worth like $400.00 USD. So they asked for 2,100.00 Baht. I nicely complained and soon the tax was 1,500.00 baht. I complained a little more but did not want to push my luck so I got out my wallet and all I had was 980Baht. They had to redo the “official” paperwork but that was okay. We ended the meeting with a few laughs so things will be fine for our next meeting on Tue for the Otoscopes. The Otoscpoes should go smoother based on their reactions and the scopes I have the actual receipt so they know the exact value to tax. We will chalk this year up to many valuable learning experiences. Next year we will buy everything here I think.

Trip to the Border

Bjorn and Rick entering Myanmar (Burma).

Yesterday we went to Burma! Bjorn and I needed to get an extension on our visas to Thailand and one of the easiest ways is to just cross the border and come back. You get a 15-day extension by doing this. When Timothy, one of our translators and a Barefoot Dr. himself, found out he invited us to his home in Burma for lunch. Timothy lives relatively close to the border. One of the FLC staff members/ friend offered to drive us all up as long as we could do a little shopping. So the 4 of us headed off about 9:00 Am and did not get back to our hotel until 1:30 Am the next morning. It was actually a great day but very long. It is about 3.5 hrs each way. We did get to do some site seeing and shopping but the highlight was eating at Timothy’s home. It is modest but a nice home on a dirt road. They have a well outside for water but he treated us like royalty. We had a great meal with his wife and a visiting Burmese evangelist. Timothy often puts up visiting guests in his home.

After lunch he asked if I would take a look at his neighbor's teenage son who had an old foot injury they were concerned about. I was glad to be able to contribute and as it turned out the boy is doing very well. He had severed a toe tendon playing soccer but had received medical treatment and the tendon has healed. There is a big lumpy scar but no pain or loss of function. The mother was just concerned because they had no access to minor medical care in this city. Here is an exiting note about this boy, this is the same boy Timothy cured of T.B. two years ago! The family came to him when their son was week, skinny, and had a chronic cough. He was way under normal size and skinny for his age. The boy was sickly and not growing due to his illness. With his Barefoot Dr training, Timothy was able to recognize and treat the TB appropriately. Now the boy is obviously strong, healthy, and back to playing soccer!



Bjorn, Rick, Timothy's wife and son, Timothy, and Rita in front of Timothy's home

Leprosy Lecture with Dr. Trevor Smith

This is a picture of a Beggar in Burma yesterday who may have had leprosy but hard to tell with out actually examining him more closely.














Friday Dr. Trevor Smith finished up on Dermatology issues. He is also a specialist in Leprosy! That is right, Leprosy. Dr. Smith is an Australian Dr. who has worked and lived in Chiang Mai for the past 32 yrs. He is in charge of a leprosy hospital just outside of town but they don't have many patients anymore. The treatment of leprosy is very good and very few people get the disease in the first place. So with a lot of good treatment available in Thailand Dr. Smith and his hospital are changing their focus to a rehab hospital. They are changing the old leper colony housing into assisted or independent living facilities. However, in Burma leprosy is still a problem. There are active leprosy colonies and almost no treatment available. The patients have a negative stigma attached to them and are usually rejected by their communities and even their families. Perhaps with the knowledge our Barefoot Dr students now possess there will be a few more patients that get the proper diagnosis and treatment. This may then prevent the horrible deformities that can happen.
Dr. Trevor Smith teaching with Abraham translating.

Otoscopes Approved!

We had a mixed outcome at the airport today. The otoscopes were approved! Which, as Dr. Mark Royer our past ENT resident would say, they were the only important equipment coming in this week. We had planned on another suitcase full of miscellaneous medical supplies in addition to the otoscopes, but most of it has been denied. The Main guy for medical supplies approval was not there either time we went to the airport, and this younger customs agent would not approve any medicines, or needles, or any thing in large packages (like 300 exam gloves), or anything he did not really know what it was. That is okay because all that stuff we can get over here at relatively inexpensive prices. It is just a shame some of the donated medicine and supplies will not be able to be used for this year's Barefoot Drs class.
Thanks for your prayers!
Rick

Customs approval difficulty

I am having trouble getting approval to bring our next suitcase of medical supplies. One customs official said no problem the other said no. We go back today to see what the final answer is. Please pray that God will soften their hearts and let us bring in the supplies without a hassle.
Thanks
Rick

Dr. Susan McDowell

Some sad news today. One of our female Barefoot Dr students, Seng Thawng, has to return home today. Seng Thawng is the one in the picture above with the white shirt and pink/white dress next to the obvious American Dr. Susan McDowell in the middle of the photo. Seng Thawng's father is very ill. The “hospital” in her area sent him home to die saying there is nothing they can do for him. There is no information on what exactly is going on except that he has abdominal swelling and maybe hepatitis. We just dropped her off at the airport. She will fly to Yangon and then probably have to wait a day or two to get a flight farther north to Putao. Once she gets there, it is a three-day walk to her parents' village. She was very upset and worried about leaving the Barefoot Drs program early. I assured her that it is okay. We will make up what she missed next year. For now it is important she return home to be with her family. She is the only child making the stress and responsibility on her that much greater.
Please be praying for her and her family.

On a brighter note, Dr. Susan McDowell continued her teaching on Tuesday and Wednesday covering orthopedic injuries, wound care, and basic neurology. Today she has a day off to recover and hopefully do something fun. Although, it seems to be the general consensus of all the teaching doctors that none of the tourist stuff can compare to the experience of teaching and learning from the Barefoot Dr students. I did not realize until this week how important it is to have some of our female physicians teaching. The handful of female student really appreciate and need that female doctor rolle model. I happened to notice how much our female students really gravitated to Dr. McDowell and it got me thinking. In Burma and Thailand women are respected as people but not so much as leaders. There are a few female leaders but the majority of the society is male dominated and most women are more subservient. It is a bit like old-fashioned America where the men did business and the women took care of the house. So for all these Barefoot Dr students it is great to have some positive examples of women leaders but especially important for the women Barefoot Drs.





















Susan surprised the students gave her a special thank you gift.

Answers to the Test questions

Here are the answers to the test from a few days ago. I know you are all dying to know.
Barefoot Doctors Mid term Questions With Answers


1. A 47 yr old male just started TB treatment. He comes to you very worried that his urine is bloody and red. What is the most likely cause?
A: Rifampicin
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?
A: Heart
3. Children should be vaccinated against measles at what age?
A: 12 months
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?
A: Diphtheria
5. A Breast-feeding woman who develops a hot, swollen and painful lump on her breast. True or False: she should stop breast-feeding?
A: False
6. When would you not use an Artemisinin?
A: During the 1st three months of pregnancy.
7. If you suspect you have been bitten by a rabid dog you should kill the dog immediately? True or False?
A: 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.?
A: Inject Ampicillin, 500mg. Every 4hrs. Or inject crystalline penicillin 1,000.000U. Every 4hrs. if possible, also give chloramphenicol
9. For treatment of snakebite you should…. Pick the correct answer below.
a. Wrap up the limp 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?
A: a.
10. Write down a normal pulse for
a. Adults . . . . 60-80
b. Children. . . . 80-100
c. Babies . . . 100-120

Extra Credit

11. How long after the bite of an infected mosquito does it take for dengue fever to begin?
A: 3-15 days. Usually 5-8 days.
12. An eight month old child weighs 6 kg. Is he on the “road to health?”
A: No

And Still I Was

Monday I was not feeling 100% and by afternoon I was very ill. By the time I got back to the hotel I was incapacitated. I had some sort of stomach bug. I had severe cramps, all over body pain, chills, nausea, light-headedness, the works. I went straight to bed and it was even painful to roll over. It crossed my mind that maybe somehow I had malaria or something. We picked up something like Pepto-Bismol but it did not seem to touch it. I could have taken antibiotics but it may not have helped and could have complicated matters with side effects. I am highly allergic to some antibiotics. So I prayed and I was definitely still. Perhaps I was not still enough after Sunday’s sermon and I needed to be stopped cold. As bad as I felt, I consider it no small miracle that by the next morning I felt well enough to go back out to the training center for another full day. By the next night I was able to eat again and felt a good 90% better! That is why I am a little behind on the updates. Enough about me here is the good stuff.


Monday started off with a new teaching Doctor who is an Orthopedics resident from IU. Dr. Susan McDowell’s flight got in about 12:30 AM and she started teaching on bone and joint injuries at 9:00AM that same morning. The students really benefited from her specialized knowledge and her ability to answer difficult questions on orthopedic issues that Bjorn and I would not have been able to answer without looking things up and maybe not even then. Among many other useful things, she showed the students practical skills like how to set a broken bone or relocate a dislocated joint and how to splint a broken bone using an ace wrap with a Banana leaf stems/ Bamboo / or any solid straight stick type object. I got in on the fun as well with some gait training using home made crutches Me and Adong made on Friday afternoon using only what we had around the training center. Adong is one of the workers at the training center and can do amazing things with a Machete. He speaks fair English and is learning more with the help of our missionaries here teaching English.













Adong Making Crutches out of Bamboo and some other trees behind the training center. He mostly used the machete but we did use a saw for some parts.