LFHC has initiated a Child Health Foundation Course for the Lao doctors on staff at the hospital. The one-year course is the first stage of a new four-year Pediatric Training Program at LFHC.
Although experienced doctors from many different countries have served as volunteers to teach and mentor Lao doctors, there has been no formal pediatric training for staff physicians.
The curriculum for the new program was developed by Medical Education Director Dr. Rathi Guhadasan, who designed a similar training program 16 years ago for doctors at the Angkor Hospital for Children in Cambodia.
Dr. Guhadasan proposed the LFHC program last year, noting that only three of the 22 doctors on staff had received structured training in pediatric care. A national pediatric training program accepts only 1-2 doctors from LFHC per year.
The long-term aim is to build intellectual sustainability, such that the Lao staff can manage the hospital independently and continue to train future generations of doctors.
The LFHC Pediatric Training Program will offer four years of academic and clinical instruction in pediatrics. Participants must pass the LFHC Child Health Foundation Course to qualify for the next three years of training. The foundation course addresses the medical team’s current learning needs in medicine and English.
The program also features an online learning component. This is added because there is less face-to-face protected teaching time available at LFHC, but it also helps to strengthen self-directed learning skills, processing and application of information and critical thinking. For many of the staff doctors, personal internet is limited and their only personal device may be a smartphone. In order for this component to be effective, the hospital is adding five computer workstations to the library.
Friends Without A Border and hospital administrators are pursing negotiations with Lao Health Ministry officials to establish a nationally accredited pediatric training residency for physicians at LFHC.
As 2019 came to an end, Lao Friends Hospital for Children reached a milestone: The hospital has now provided more than 100,000 medical treatments to children in northern Laos since opening its doors in 2015.
Nearly one-third of all those treatments happened in 2019, making it the busiest year the history of the hospital.
LFHC doctors and nurses handled 32,973 medical cases last year, according to year-end data. That’s a 24% increase from 2018.
The largest increase in caseload ocurred in the Emergency Room, where doctors and nurses handled 11,801 medical emergencies, an increase of nearly 77% from 2018.
Fourteen-year-old Khamsouk first visited Lao Friends Hospital for Children after developing unusual skin rashes. He typically responded to treatment, but the rashes eventually reappeared.
In August, his family once again brought Khamsouk to LFHC, but this time the rash was very different and included painful sores in his mouth which made it difficult for him to eat and drink. He was treated with steroids and showed some improvement during a five-day hospital stay. He returned home with his family, but returned less than two weeks later with worsening symptoms.
Khamsouk was again admitted and this time his hospitalization would span nearly three months. During that time, he battled through coma, seizures, lung infections, bleeding, hypertension and weight loss. LFHC doctors worked tirelessly to treat these problems, but struggled to identify their root cause.
A battery of tests eventually led doctors to conclude that Khamsouk was afflicted with lupus, an autoimmune disease in which the body’s immune system becomes hyperactive and attacks normal, healthy tissue. There’s no cure for lupus. Treatment focuses on controlling symptoms and minimizing flare-ups.
Khamsouk gradually responded to treatment and received physiotherapy and appropriate nutrition to support his rehabilitation. His family was always at his bedside and was eager to participate in his care. Thanks to LFHC’s comprehensive care, Khamsouk’s condition was stabilized and he was able to go home with his family. He continues to return for follow-up visits and the staff is closely monitoring his recovery.
LFHC recently provided training for 10 nurses and medical assistants from health centers in Phonxay District, Luang Prabang.
The two-week training session, titled “Right Diagnosis, Right Treatment,” was commissioned by the Provincial Health Department (PHD) and Swiss Red Cross and conducted at LFHC. It focused on common pediatric conditions that these practitioners regularly face in their health centers, such as respiratory infections, thiamine deficiency, dehydration from diarrhea and seizures.
LFHC Medical Education Director, Dr. Rathi Guhadasan, developed the curriculum and content for the course in conjunction with our senior Lao doctors. The course included 22 hours of classroom-based teaching and 91-95 hours of clinical practice per participant. The classroom-based tutorials included case-based scenarios, giving participants time to process and apply taught theory.
Participants were paired with Lao doctors for the clinical placements, which gave them intensive one-on-one coaching and many opportunities to practice basic but essential skills such as evaluation and diagnosis of acute problems, how to give oxygen and accurate drug and IV fluid prescribing for children.
The participants were divided into two groups and pre- and post-course testing showed an improvement in scores by 24% and 32% for the two groups. The participants’ feedback was very positive, citing the quality of the teaching and the patience and attentiveness of the teachers, who would take extra time to ensure that the students understood. The feedback from the PHD was also positive.
LFHC plans to provide follow-up training at Phonxay District in the future, to ensure that the participants are able to implement what they had learned when they are treating children.
A newborn infant admitted to our Neonatal Unit typically spends less than a week there. However, some babies cannot survive without a lengthier stay. Airnoy Sounie needed more than two months of the intensive care provided by the unit’s doctors and nurses.
Airnoy Sounie was born prematurely at only 28 weeks gestation. The LFHC team was asked to attend his delivery at the neighboring Provincial Hospital and immediately provided resuscitation and the care necessary to help him survive. He weighed less than 1 kg (about two pounds) at the time of his birth.
In the Neonatal Unit, he was placed on a CPAP machine to help him breathe, given IV fluids and fed by a nasogastric tube. He was also given many medications to help treat infections, prevent apnea and help close a PDA (patent ductus arteriosus, an extra blood vessel found in newborn babies that could cause blood to flow into the lungs).
After several weeks, Airnoy Sounie gained the ability to breathe without support and learned to breastfeed. His weight nearly doubled and he was about to be sent home with his parents, who were always with him at the hospital.
The family lives in Luang Prabang and expressed their gratitude to the hospital staff for all the care and support of their baby.
More than 150 people gathered on Oct. 18 at the Pullman Hotel in Luang Prabang for the Lao Friends Third Annual Gala Dinner.
The event, which benefits Lao Friends Hospital for Children, featured a special musical performance by JoJo Miracle and a welcoming dance performance by Puang Champa Cultural House.
Attendees included Miss Universe Laos 2019 and Miss International Laos 2019 as well as Laotian Pop Star Tot Lina.
Friends Without A Border presented its Best Friends of Friends award to Team We Run, which competed in the half marathon fundraiser two days later. The organization presented its Making a Difference award to Linfox, an Australian logistics and supply chain company.
Friends of Friends New York celebrated its 20th annual fundraising event on October 12 in Manhattan. Proceeds from the event benefit Angkor Hospital for Children, the first pediatric hospital built by Friend Without A Border.
The parents of a 9-month-old child named Malisa became very concerned when she experienced bouts of vomiting for four days and had lost her appetite.
They brought their baby to the LFHC Outpatient Department, where the staff conducted an evaluation, which included recording her weight, height and upper arm circumference.
The staff compared Malisa’s weight and size to what would be expected for a child her age and determined that she was suffering from severe protein-calorie malnutrition.
The hospital’s nutritionist participated in Malisa’s examination and performed an appetite test.
The nutritionist instructed Malisa’s parents about proper nutrition and how to care for their daughter with RUTF (ready to use therapeutic food). Melisa was prescribed two packets of RUFT per day and her parents were given enough packets to last until they returned for a follow-up appointment.
All children brought to the Outpatient Department are assessed for malnutrition. Nearly 15% show symptoms of moderate or severe acute malnutrition.
Like many of these children, Malisa began to gain weight, thanks to the care of the doctors, nurses and nutritionist at LFHC. After several months, she had gained enough weight to leave the severe malnutrition program.
Last year, more than 150 children were treated for severe or moderate malnutrition. The hospital’s therapeutic food program is designed to dramatically reduce the need to hospitalize malnourished children for long periods.
Nurse anesthetist Si Lee recently returned to LFHC after visiting the U.S. to observe anesthesia procedures at medical facilities in Pittsburgh.
Si received a Warfield Scholarship from Health Volunteers Overseas, a Washington D.C. nonprofit, to observe clinical activities at University of Pittsburgh Medical Center-Presbyterian, West Penn Hospital and UPMC Children’s Hospital.
Si also presented a lecture to anesthesia students and faculty at the University of Pittsburgh School of Nursing and attended the annual American Association of Nurse Anesthetists Congress in Chicago.
Joining Si on the trip was Hor Eng from Angkor Hospital for Children, who also received the scholarship. Richard Henker, a professor at the University of Pittsburgh and a committee chairman with Health Volunteers Overseas, guided both nurses during the U.S. visit.