A Stitch inTime

Before Dr. Jove left for the states he had a bit of stitching to do.

The doctors wanted our ER doc to give them a refresher.

A few students have attempted suturing in their villages.

Chan Peram is demonstrating his 

technique using a pig foot.  Dr. Jove looks on.

It seems that a dose of confidence will help.

 Before Dr. Jove left we required his services for "stitching" on our own real live Dr. Susan.
On entering a yellow taxi, she hit her head on a metal hand rail causing a blunt force traumatic laceration. "Out at the land"  we have no xylocaine or sterile environment, but we had Dr. Jove, our ER physician.  With a little ice for numbing, and suture material (like we used on the pig's feet), Dr.Susan is looking as good as new!  What a trooper!! Peram, Yawhan and Ahdang watch the procedure while Nurse Lynda assists. The next day, Dr. Susan was our case study patient.

It was sad saying goodbye to Dr. Jove.  He has been here for

 five weeks and really bonded with the students.  They were

impressed with his 100 mile almost daily bike trips,

 with his sense of humor and medical knowledge. 

 In bidding farewell he indicated that he might just be seeing 

them in Myanmar in the near future.

Decked in Tribal Dress to say farewell

are our seven women Barefoot Doctors

Stress, Skin and Silliness

Nurse Lynda Audia from Toronto taught a session 

on Stress Management and the role of the Barefoot Doctor

in treating the patient. She  explained how the brain, 

and ultimately the body, responds to stress.

       Dr. Susan Parker and Nilar role play.
  Dr. Susan is a "patient"who just learned that
 her only child has been severely injured in a 

  motorcycle accident.  Nilar is demonstrating
how she would comfort her patient and help
 her deal with the stress in her life.

Yawhan and Chan Peram

 Nurse Lynda talked about how laughter
reduces stress.  Proverbs 17:22 "A cheerful
heart is good medicine, but a crushed spirit
dries up the bones."

Nurse Lynda hands out clown noses to cheer everyone up!

Dr. Jim and his grandchildren

Dr. Susan teaches an afternoon session on Skin Diseases

Nang Kham presents a case of a child with a skin problem.

He has an itchy rash behind his ear.  The conclusion? The child

probably had ezema that was scratched and is now infected.  

The Cases Keep Coming!

Dr. Jove starts a morning review of THE EYE.  If a staple in the eye
doesn't wake you up, nothing will.  All the students agreed that this
was a bit outside of their expertise!

Dr. Jove is leading Chan Peram through his case presentation on a patient with malaria.  Notice how the students work through the symptoms of the patient.  It is a 30 year old male with fever (102 degrees) and headaches for a week.  The other students then were given some questions and a survey was taken. What do you think the patient has?  How will you treat it?  Does your village have mosquito netting?

Mosquito netting helps to protect against malaria

Dr. Bjorn enjoys our instant response system

The students say goodbye to Dr.Susan McDowell. 

 Dr. Susan has been with the class all three years and San San Win is sharing about the tremendous impact she has had on their lives. 

 The skills and instruction she has given them has been invaluable.

  But the love she has shown and the friendship she has given will remain with them forever.

Doctors Coming and Going, Teaching, Loving

The Students had a wonderful couple of weeks with Dr. Charles and Dr. Jeff.  The team of physicians and nurses from the United States and Canada have worked hard to bring their best in skills and teaching to the Barefoot Doctors.  They would all agree with the Apostle Paul in I Thessalonians 2:8 "Having so fond an affection for you, we were well -pleased to impart to you not only the gospel of God, but our own lives, because you had become very dear to us."  Teaching medicine is an important and practical aspect of the ministry, but sharing lives is the heart of it.  Here is Bolu in his tribal costume saying goodbye and thank you.

Dr. Bjorn and Dr. Jeff show the students a picture
of a young boy who was seen by Khaw Taik.
 His chief complaint was ear pain. Below Dr. Susan, jet lag and all, helps Sarep Pung.
  Dr. Jeff has been very helpful in organizing the case presentations.  The main benefit is hearing the train of thought used by the doctors to come up with a differential diagnosis.  What is the problem?
Does the child have a foreign body in the ear?  Is it a simple ear infection? How did you treat the patient?

 Dr. Jim enlisted the help of Elizabeth to discuss the difficulty of treating high blood pressure as a chronic disease.  The students are not equipped to give long term antihypertensives or to have frequent follow up due to the long distances they travel. Elizabeth gave a report on hydrochlorothiazide and its effect on HBP.  Following this discussion, Dr. Jove  reviewed stroke with the students.  It was concluded that many patients have no symptoms of high blood pressure and they were reminded that the only way to know is to check.  Diet, exercise, low sodium and decrease stress was also reviewed. One student had a patient with a blood pressure over 200 systolic and was apparently in a coma.  It was a good chance to discuss our inability to help everyone, but also to recognize their position in providing end of life care and comfort.

Dr. Susan once again joins the Barefoot Doctor Team.  

The students were so excited to see her again.  Dr. Susan is also engaged to be married

this spring.  She and Nang Kham have a lot in common.  Nang Kham's wedding is March 24th.

Life in Myannmar

In October , the Myannmar government signed a ceasefire agreement with eight guerrilla groups to end more than five decades of conflict.  There are still about ten more rebel groups in the country.  Aung San Suu Kyi's National League for Democracy Party said that peace in the country would be the first priority of the new government.  It will come a little late for one of our Barefoot Doctors, but it is promising for Myannmar.  

In July of last year Yawhan Mdh and his family were falsely accused of planting landmines around their house in support of the Karin rebel army.  Yawhan is not Karin.  He had no knowledge of any landmines and certainly would have destroyed them had he known.  He has a wife and two small children.   The "army" did not believe him and mortared his home and the church where he works.  He lost all his earthly possessions and had to move from the village.  He says " I cannot go back."

Yawhan also lost all of his medical supplies

Recently, Yawhan and his family moved to the village of his in-laws.  He has been able to rebuild and recover things.  He faithfully trusts the Lord to provide and has already been blessed, but there is much need and more healing needed.

Yawhan with Abraham at the Jones Building

Still singing praises to the Lord for the safety of his family

It is still difficult for us to believe and understand the sacrifices of our Barefoot Doctors.  They walk long distances to come to Thailand for training and spend two months away from their families. Then they journey home.  The students come from far north to the very south of Myannmar.  They risk being robbed and persecuted.  Another of our students, San San Win, is in the area where there is fighting with the RakHine and Muslim Rohingya, a stateless people.  And the Kachin Independence Army is also constantly in battle.  It is important for us all to be praying for the new government that is forming and for its desire for peace. The government wants to abolish all of the faction groups and have one military for defence.  Please continue to pray for Myannmar and for democracy and the freedom of religion.  We trust God is opening doors to reach many for the Good News. 

Working Hard

One of the biggest tasks before us this week is calculating the amount of medications that need to be ordered and placing that order so it will arrive in time for the students to divide and pack.  Dr. Jove devised a questionnaire to determine the correct amounts.  The students were ask about each medication they had received-was it enough? too little? right amount?  We also asked if there were medicines that were not on their formulary last year that they would like to have.  The amount of medication they receive is calculated by the number of full courses of medicine that is dosed to a patient.  For instance, a strep throat  patient would receive 21 pills of amoxicillin to be taken three times a day for a week.  The
5, 741 patients that were seen last were given approximately 13, 940 courses of medicine.  That includes antibiotics, malaria medicine, pain relievers, medication for parasites, ulcers, and vitamins to name a few.  That is a lot of medicine to purchase, divide and distribute and put in the hands of these trained health care workers.

Gayle is reviewing medications 

A big part of last week was focused on Case Presentations.  Here Dr. Charles is discussing the patient who has dizziness.  Prior to the presenting of this case the students were asked to pair up and practice their delivery of the history and physical of their patie

 Nilar and Nang Kham look very serious

Ninsungbra and San San Win are quite studious

Peram looks puzzled - what was that again, Khaw Taik?

Ram Tang making sure Ram Bo Kin understands

Elizabeth, Khin Sein and Ma Ma Naing

CASE PRESENTATION

Elizabeth (Mee Pwe) shared about her patient, a 60 year old woman, who presented with dizziness.  If you look closely you also see that she has a goiter on the side of her neck.  Elizabeth saw 421 patients over the last year and supplied them 535 courses of medication. 

Sometimes Nin Ti comes by to say hello, just takin a ride.
Her Mom and Dad help cook our delicious food.

After working hard the students like to relax.  Khaw Taik, Ramsar Dee,
Nang Kham and Ram Bo Kin enjoy a game of Pente

FEBRUARY 2016

It is February 2016 and we are just a little over three weeks from graduation.  Dr. Bjorn, Dr.Jim, Dr.Jove, Dr. Charles and now Dr. Jeff are teaching as fast as they can.  So much to do, so little time.  The students are nose to the grind.  Each day we hear from them in formal Patient Case Presentations.  They will have several opportunities to share about the people they have seen. We find it amazing that collectively they have seen 5,731 patients. Most are people in remote villages that have little chance of healthcare.  We would love to hear each story.

This week began with Dr. Bjorn and Dr. Charles leading a discussion about ways the Barefoot Doctors can generate revenue to keep there practice in motion.  Once they have graduated and received their last year of medication they will depend on other means to purchase supplies.  It is good to hear how they are trusting the Lord for their needs. Aside from donations they might receive Dr. Bjorn challenged them to think outside the box.  One students said he would like to open a pharmacy.  Other suggestions were to  seek government grants and to set up a committee to help them in planning for the future.  Many are encouraged that this month Myannmar will choose a president and the hope of
progress there seems promising.

Suggestions for the Seed Fund

                       

Our seven women doctors showing off their Log Books
It has been a great accomplishment to have the students
record each patient they see and how they treated them

Eczema was the topic of Dr. Jim's Monday morning teaching.  Little Gabrielle began to have
 problems at six months of age
She was diagnosed with atopic dermatitis probably due to food allergies.
Treatment was very tedious, but after she was four years of age her skin began to clear.  The students seemed very familiar with eczema and have seen many such cases, 

Dr. Bjorn and Dr. Jove preparing a questionnaire for the students

Dr. Charles preparing for the day

Group I

Nilar helping Dr. Jim
during our Vital Signs Clinic

Group II

Group III

                                                                            

The students were very excited to welcome back Dr. Jeff Kornelsen
from Vancouver, BC. Dr. Jeff spent several weeks with them in 2015.
Despite a bit of jet lag, he jumped right in to help Ram Tang
with his case presentation.

     Our hearts are sad today as we said goodbye to Saw L Warr.  After hearing earlier this week that his younger brother had passed away in Myannmar and with much prayer and council and discussions with his family, Saw Warr decided he needed to return home. It was a difficult decision as he will not be able to return for the graduation.  Please pray for Saw L Warr and his family.