We completed week one!

We spent most of the week hearing from the students on their experiences over the past year. We needed to know what they have seen and treated. We also wanted to know what they had questions about, now that they have been using their skills for a year. We reviewed some of their cases briefly in class and will go more in depth on the needed subjects now that they have been identified. They also turned in the pt log books and are in the process of sorting out the data. This is a very brief “chart note” on each patient they treated. This also tells us what they thought the diagnosis was and what medicine they used to treat it.

Although they still have a lot to learn they did well and did not over step their training. They often referred patients to health clinics or more experienced Barefoot Drs. if they did not have the skills themselves to deal with it. This is much better than being over confident. As I mentioned a few days ago, two of the students saved patients by sending them to the health center even though it was not easy for the patients to get there. I initially forgot to ask them how far the patients had to travel but I have since gotten that information. It turns out the appendicitis patient I mentioned a few days ago only had to go 2 miles on the back of a motorcycle over rough terrain. That is not only very uncomfortable but also dangerous. They could have hit a big bump and burst his appendices. This situation would be unthinkable in the U.S., but where they are from it is actually extremely fortunate there was any clinic at all close by. The other patient I had mentioned was a young girl with tetanus. This is a horrible disease that usually leads to death even if you get to a hospital. This young girl was already to the point where the muscle spasms were arching her backwards. This poor family had to hand carry this girl 12 miles! They used a bamboo stretcher to get her to the hospital and, amazingly, the girl lived!

We started teaching some review lessons of last year and new lessons on community health issues. We have also assigned each student to do a short presentation of a subject we assign. So far we have heard about Goiter from Thin Bey, and Gout from Moses. I have a picture above of Moses giving his very professional presentation. Although, I could have sworn it was a sermon had I not known better. I guess that is his evangelical roots coming out.

One of our struggles has been getting them to understand how disease is spread. Germs are a relatively new concept to them. They are much better this year than last but we have to repeatedly go over what are simple concepts to you and I. Just imagine if you did not already know about germs and no one ever told you about them. It would be a difficult concept to grasp. These things we can not see spread and cause disease?

We had one great but disgusting example. As many of you know I am a “germaphobe” myself so this is near to my heart. The students are staying in a bit overcrowded dorm with only two communal bathrooms. So there are about 13 people using each bathroom. The problem was that when we went in the bathroom there was only one towel! Now that was bad

enough but to make it worse there was no soap! Dr. Nilson made a theatrical example in front of the class by throwing the towel in the trash. It is better to just air dry then spread the germs around. Yes, they now have soap in both bathrooms and we are addressing the other “community health” issues as well.

We start back up tomorrow so please keep up the prayers.

Thanks,

Rick

We had another good few days since the last update. We have been very busy getting organized, adjusted, and started with the course. We also have difficulty with our internet connection at times, which limits how much I can keep everyone updated.

Dr. David Brumwell joined us for a couple of days before his scheduled teaching time in a couple of weeks. He wanted to learn more about the students before he was scheduled to teach. He ended up helping us teach the last few days! It was a huge blessing to us to have someone else help do some of the teaching. Up until that point Dr. Nilson had done most of the teaching and I was doing more administrative tasks.

Dr. Dave did a great job and had some real life patients for demonstration as two of the students had tooth infections. It was a great teaching example for the class and they have been started on antibiotics. We may have a Barefoot Dr that completed training years ago come to extract the teeth if needed. Dr. David also taught about other things that cause a swollen neckand used me as an example. It is disappointing that no dentists are coming to teach this year but there is actually a lot we have been able to teach them and still more we can teach.

Another highlight is that we issued all the students a new book. The “Burmese Border Guidelines” will be the secondary text for the remainder of the course. It is much more technical than the original text we use but has some really good medical information.

Oh yes, Dr. Dave also thought it would be a good idea to run his own little medical experiment on how much an American stomach can handle of authentic Thai food. He ordered “young bamboo worms” for us all to eat at dinner! As you can see from the picture they are not the most appealing dish but actually quite good!

That is all for now.

Rick

The First day of Medical training is underway!

The much anticipated 2011 Barefoot Drs medical training started today. These second year students started off by sharing a little about their experiences over the last year. This gives us a good idea of what we need to focus on and how much they retained from last year. It also provides a great real life learning opportunity for all the students to learn from each others experiences. We are only about ½ through the interviews but we already have some great stories.

Keep in mind this year is the second year of a three year program. The experiences they are sharing from this last year is after only their 1^st year of training and already they are saving lives!

One student came across an acute appendicitis and correctly told the patient they needed to go to the hospital. Thankfully this situation was near a hospital and the Doctor there told our Barefoot Dr student that had he waited one more hour the patient would probably have died.

Another life saving diagnosis by a Barefoot Dr student was when he was called in to look at a young girl who cut her thigh on a rusty nail. Her symptoms started with severe pain in the thigh but then spread to the entire body. Within a few days she was having severe spasms pulling her body into extension. Fortunately the Barefoot Dr recognized that there was nothing he could do and that the patient needed to go to the health clinic no matter how difficult that may be. The Doctor at the clinic successfully treated the Tetanus and saved the girl's life. The doctor told the Barefoot Dr that the girl would have died if he had waited to bring her in any longer.

The last story for the night is not of life and death but definitely unusual and relates to rehab, a subject close to my heart as a P.T. This Barefoot Dr student had a patient who’s leg was permanently damaged years before from a Tiger bite! Because of his leg injury this man walked with a crutch. Unfortunately this patient’s crutch had broken so our Barefoot Dr student made him a new one with the knowledge he learned in class last year.

It's very exciting and encouraging for us to hear that this first year class is already making a difference.

There was also a prize given out for the student who filled out the most patient contact forms. It is basically a brief record of patients they have seen over the year. Just like students around the world, getting them all to fill out the proper paper work can me a challenge. Well, the winner by a long shot was Ester Mai Mai with 101 logs’s completed. The next best was 55. So she won a very nice digital camera! This can also be used in her work and to send pictures of her work back to us.

I hope to have more interesting stories for you over the next few days.

Thank you all for your support.

Rick Astone

Year Two Begins January 24th!

Rick and Bjorn have just arrived in Thailand for the beginning of the Barefoot Doctors School on Monday, January 24th. We are very excited about launching this second year of the school!
24 of our 26 students are already here and anxious to continue their medical training. Two of our students have not been able to come so far (one due to heavy snows and the other due to family problems), but we hope they will yet join us.
We are grateful for the teachers from America and England who will be joining us for medical and Bible teaching throughout the weeks of study, January 24th to March 5th.
Several things have been improved since last year, including the fact that the new dormitory at the Kalnin Learning Center now has space for our students and our instructors! This will make it possible for our teachers and students to have more time this year to communicate with each other on a personal level. This will greatly enhance the learning experience, and we are grateful to FLC for working hard to complete this dormitory.
We have added another medical book to our teaching curriculum this year, the Burmese Border Guidelines book. If you are interested in seeing what this book is like, you can read it online at the Hesperian Foundation or even download a pdf version of it for free. We will also be reviewing last year's text, Where There is No Doctor (which is also available at the Hesperian website). Both of these books are available in Burmese and English.
Please be in prayer for us as God brings everyone back together on Monday, the 24th, as we begin six weeks of intensive training.