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