Friday Quiz and student presentations

Student presenting to the class on a medication.

2/16/18

We started out the day with a student presentation on a medication they will have access to when they go back to Burma. One student presentation everyday. They do amazingly well talking in front of the group compared to past classes or even western college students.  Then the lecture continued with Genitals and STD’s. This subject is taking longer than we planned but so very important as Burma is exploding with more sexual exploitation and sexually transmitted diseases due to it opening up to outsiders a few years ago. An influx of western tourist with lots of money has increased the risk of related dangers.

Student teaching on medication.

Overall this group is doing extremely well. We are starting to focus more on problem-solving rather than just learning book knowledge. For example, this morning the book recommended a particular antibiotic but it is not one they will have in their medical kits. They were asked to figure out what would be a comparable medication that they will have in their kits. It took a few minutes but they arrived at the correct answer! This indicates they are starting to put it together and we will continue this focus for the rest of the program.

A different student presenting on a medication. 

Taking the quiz

In the afternoon was the Friday quiz. This is not just to test the knowledge level but used as an additional teaching tool. All the questions are reviewed right after the test. The audience response system is used to instantly show all the students answers on the projector. This leads to some great heated discussions about why students picked the answer they did. This fosters a deeper understanding of the material and critical thinking skills.

Taking the quiz

Today we had everyones full attention

Home cooked Asain buffet every day!

Lunch !

2/15/18

Things are going well. After some encouragement and working in small groups the students seem to be in much better spirits. Psychological counseling tips were helpful for the students and will be as they go back to their villages after the program.

The teaching today started on the genitals and basic sex ed. This is always a subject of much interest, and this year is no different. 

We always hear interesting things from the students. For instance, this year one of the students told us that there was a belief in some of the hill tribes that if someone had twins that they were evil so they would kill them. Nurse Betty eloquently explained that no baby is born evil. To back this claim up from a biblical perspective she pointed out that the devil cannot create human life and therefore cannot cause an infant to be evil. Only God can create life and He does not create evil things. Since the students are all Christians this seemed to make since on spiritual level. Teaching the medical side of how twins come about will help demystify the rare occurrence and help explain away any dangerous superstitions about twins.

Week 3 of Medical Training is Halfway Done

Week three is halfway done. The Barefoot Dr. students are doing great. Monday they learned about the dangers of Cholera and Dehydration. This directly relates to their country right now because there are several refugee camps. The most recent, and by far the largest, is the Rohingya camp on the Bangladesh side of the Burma border to the north.  

Some estimates say there are almost a million refugees crowded in this camp. This situation is high risk for major health issues like Cholera, which can sometimes kill its victims in less than a day by severe dehydration. Fortunately, there is actually a Cholera vaccine. 

Cholera vaccines are vaccines that are effective at preventing cholera. For the first six months after vaccination they provide about 85 percent protection, which decreases to 50 percent or 62 percent during the first year. After two years the level of protection decreases to less than 50 percent. With this simple knowledge the Barefoot Dr. students may be able to save thousands of lives by encouraging those in at risk situations to take the vaccine.

Today the focus was on emotional, psychological health issues and addictions. This seemed fitting for Valentines Day after all. This far into the program, and with a few weeks left, many students do start getting the “blues.” They miss their homes and families. For many of them this is the longest trip away from home they have ever done. Betty, a teaching nurse from Newfoundland, led the training on psychology and emotional help and had a lot of interest from the students. We all did our best to encourage the students today at this mid-point in the program.

 We will try and post blogs more regularly now that we are catching up on our sleep and adjusting from the time change. It is 15 hours earlier here than my home in California. It is truly a blessing to all us instructors to be here and empower the students as well as learn from them.    Rick

Lung sounds and shots and more

Below are some of the pictures we were sent to show what is happening in the Barefoot Doctor classes.

 Some of them show the students learning how to discern various lung sounds.

A series of them show one of the female students being the patient while another female student gave her first shot to someone else. What a series!

Dr. Jove Graham and his wife have been there two weeks, as have Dr. Susan Parker and Lynda Audia.  Dr. Jove noted:

The students really have had to buckle down for some intense learning over the last half of the week. Lynda keep the class entertained as she taught important fundamental nutrition concepts, which the class seemed to pick up in quickly. Susan continued with treating patients while discussing proper intention technique. She even led the class in giving each other (and the staff) tetanus vaccines! Jove faced the colossal task of going over chapter 10, Medical Emergencies. Fortunately, many aspects of the chapter overlap with others, because it has a ton of information! The class seemed particularly entertained and disgusted by videos of proper joint reduction techniques.

In other good news, we were finally able to complete the modified tic tac toe we had started earlier in the week. Each table of students gets to put a mark on the board if they answer a question correctly, but the dialogue we have opens up so many other questions that it's taken five days to finish!

Finally, the class celebrated the end of the week, and gave the instructors a big send off party by having a Burmese barbeque in the yard. So delicious!

There were also some tearful goodbyes on Friday as several of the teachers were leaving.  Lynda wrote the following:

We were so inspired by these beautiful students. They bonded so closely with one another and with us. When God is in the midst special connections happen. Instead of being conscious that they're from different tribes they are focused more on their relation as brothers and sisters in Christ. They love one another. Many rich memories to cherish and hold in our hearts until we meet again, next year. 
Lovingly, Lynda

San Kamphaeng Hot Springs!

The Saturday before their more challenging medical training began, the Barefoot Doctor students (and some of the FLC staff) went for a day trip to the San Kamphaeng Hot Springs not too far away.

The springs are a beautiful place to visit, and everyone had a relaxing time.

The ladies all lined up for this beautiful picture in front of one of the many landscaped areas in the park.  There are trails to follow and several hot springs to see.  In one of them people boil eggs in the hot sulphur water!

Most of the men took a swim in one of the natural hot mineral spring pools.   The weather was perfect, and it's obvious they were having a good time. The next few pictures are compliments of Timothy's selfie-stick!

At noontime, everyone also enjoyed a nice picnic lunch on site.

Eating together is always a good thing.  It has deepened the friendships that were started just 3 or 4 weeks ago.  It's hard to believe how far the students have come in such a short time.

One night last week the cooks brought out the outdoor grills which I didn't even know they had hidden away behind the kitchen.  Everyone enjoyed a nice dinner outside.  Some of the students got in on the cooking, too.

Thanks again for your continued prayers.  New posts are coming out frequently showing the new medical skills they are learning.

Barefoot Dr. Students are loosening up.

The barefoot doctors have kicked off the new week, even sneaking some education in over the weekend. One of the resident dogs had a bite wound to his belly that had become infected. The instructors gathered all the students together Saturday morning to discuss wound care and care of infected wounds, while Jove cleaned out the wound and started antibiotics. Lynda has been very creative in getting the patient to take his medicine, but little Rocky still holds a grudge against Jove for washing out his wound. 

Dr. Jove with patient

Wound care on dog.

wound care on dog

Starting Monday, Susan and Lynda continued through Where There is No Doctor, discussing care of the sick patient with and without medicine. Blood pressure and other vital sign measurement seemed to hold the student's attention best, but various games pitting the student's knowledge against each other keep them (and the instructors) engaged.

Given the abundance of dental disease in rural Myanamar, we were pleased to find most of the students do not floss their teeth on a regular basis. This was a great opportunity for educating the class, demonstrating good flossing technique, and giving them knowledge that will impact the health of people in their homes. 

Practicing flossing.

We've also started discussing the mechanics of giving medicine - which sometimes can involve a little math! Luckily, the student's fractions were up to speed and we were able to train on giving medicine through various practice scenarios instead of lecturing on something as riveting as pill division. After discussing giving the right quantity of medicine, the students made up sugar solutions and practiced injecting oranges, practicing pharmaceutical compounding and safe injection technique at the same time! Of course, almost all of the medicines that the students take back to the village are oral only, and it is heavily emphasized not to inject medicine when oral medicine will work. However, some medicines such as epinephrine, used for treating severe asthma and anaphylaxis, are only effective in injection form.

Injections lab

We've still got an enormous amount of material to cover, but the class is learning quickly and building trust between themselves and the instructors.

Medical Training Continues

Medical education continues for the new Barefoot Doctors, with Lynda and Susan leading the way with discussions of caring for sick patients and the physical exam. Boxes of medical supplies donated by CURE are being processed by Thai customs, in the meantime students are sharing stethoscopes and blood pressure cuffs to learn the basics of the physical exam. Jove and Bjorn continue to pepper the class with questions, eliciting feedback from a clicker based audience response system. 

Students have begun researching and presenting on the medications with which they will return to their villages. With each student presenting one drug, backed up by faculty, the entire pharmaceutical armamentarium should be covered by the end of this first year.  

So far, it seems that they have been most interested in complications from childbirth. One student relayed a story of a woman who had been transported to the regional hospital for a C-section, but later died of a post partum infection. This led to many questions regarding other complications of childbirth, what the students could do to avoid and treat these problems, and when to attempt to send patients to larger cities for help.  

Everyone seems to be progressing better than expected, but I'm sure they will enjoy the break over the weekend!