"Guk Guk" and "Squeak Squeaks"

Practicing CPR

Dr. Jeff started the morning off with discussing first aid and CPR.

Triangle bandaging lab.

The students reviewed the steps of assessment and got to practice on a CPR model. Many of the students found it difficult to inflate the chest the first few times during practice. There was also a lab on bandaging and slings. This included a real life demonstration of wrapping an ankle to decrease swelling. The students observed the effectiveness of proper wrapping on one of the instructors swollen foot. One of her ankles was ACE wrapped to show how compression can limit and decrease swelling; many were surprised to see about a 1-inch difference in circumference.

Practicing Ace wrapping. 

In the afternoon, Dr. Nawrocki reviewed the life cycle of a mosquito and its role in the spread of malaria. He also discussed insecticide and medication resistance.

Dr. Bjorn Nilson started review of the log book data we collected. This gives us in depth information on how many patients each student treated, what diagnosis, what drugs, and how many of each the used individually and collectively. There was a long discussion on Malaria and the use of Artesinate. There were only 3 students who do not have Malaria in their areas. Surprisingly the students did not use as much Artesinate for Malaria as was expected. We are still trying to understand exactly why. 

Presenting case with many cuts from "traditional" med.

 The afternoon finished off with a student case presented by Ram Bo Kin. His patient had chest pain and his breathing sounded funny. We all got a good laugh at the description of the breath sounds as “guk guk” and “squeak squeaks.” Not exactly the medical terms we use for breath sounds in the west but very descriptive. The patient received treatment from a “traditional healer” by making many small cuts along the trunk with a razor.  Even our western doctors had trouble identifying what looked like a strange rash but was really this “traditional healer’s” treatment. Ram Bo Kin reported the patient told him this “traditional treatment” helped his pain a little bit, which made for a good opportunity to reinforce the placebo effect. However, the patient needed Ram Bo Kims help because he still had a high temperature and pain. Through a thorough history and physical, the class came to realize this patient had pneumonia. Ram Bo Kin had treated him appropriately and the patient improved! This example reinforces the need for the Barefoot doctors and this training.

Thank you for your support,

Rick