Category: FWAB News

Phonxay Staff Trains at LFHC

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 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.

Neonatal Staff Saves Life of 1kg Infant

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.

Gala Dinner Attracts 150 Hospital Supporters

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.

 

Saving a Malnourished Baby

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 Observes Procedures in US

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.

LFHC Doctors Begin Pediatric Training in Vientiane

Two LFHC doctors will soon begin training in the Pediatric Residency Program in Vientiane, having finished among the top candidates in a highly competitive, national selection process.

Dr. Bounloth Sordaluck and Dr. Phoumy Manivong were awarded placements in the three-year program.

Dr. Sordaluck is from Sainyabuli Province and has been working at LFHC for nearly three years. Dr. Manivong is from Vientiane and has been working at LFHC for more than four years. Both said they were eager to gain knowledge and experience in pediatrics because LFHC is treating a growing number of children and handling more complicated medical cases.

The two doctors had to pass a written exam and performance review at LFHC, as well as a written examination in Vientiane, to qualify for the program. During their three years of training, they will rotate among three hospitals.

LFHC will continue to pay the doctors’ salaries. They are expected to return to LFHC at the end of their training and will serve as faculty members in a new pediatric training program being developed by LFHC Medical Education Director Dr. Rathi Guhadasan.

Congratulations to Drs. Sordaluck and Manivong!

LFHC Saves Infant with Rare Chest-Fluid Affliction

Immediately after Airnoy Khamyai was born in early June, doctors noticed he was having difficulty breathing. The delivery room summoned help from LFHC and its team quickly treated the infant with positive pressure ventilation and took him to our hospital’s Emergency Room.

A chest X-ray revealed a large amount of fluid in the right side of the newborn’s chest. Ultrasound imaging confirmed the presence of fluid.

The staff drained more than 100 milliliters (a little more than 3 fluid ounces) from Khamyai’s chest and his breathing quickly improved.Doctors continued to drain fluid during the next day and noticed that the amount was increasing and thickening as the infant’s mother began breastfeeding. This prompted the doctors to make a rare diagnosis of congenital chylothorax, a life-threatening anomaly that causes a substance called chyle to accumulate in the chest.

Dr. Shaun O’Dell, a volunteer neonatologist from Utah, helped the LFHC staff provide the specialized care that Khamyai needed. The nutrition team offered recommendations about feeding the infant and the lab techs centrifuged his breast milk to separate and remove the fat from the milk to reduce chest fluid.

Khamyai and his mother recently returned to LFHC for a follow-up visit. They are pictured here with Dr. Toulayang Briaxa (Joy) and Medical Director Dr. Lisa Rynn (holding the infant).


Infants with this condition need a special type of fat-free baby formula, called MCT formula, which is very expensive and not readily available. A very generous donation through the LFHC Outreach Program provided the special formula that Khamyai required.

After a little more than a month of intensive care in the Neonatal Unit, Khamyai and his parents returned to their home. His family will need to continue feeding him with MCT formula, give him his medications and bring him to LFHC for frequent check-ups and ultrasounds.

LFHC Participates in Beriberi Research Project

Thiamine deficiency is rampant among the patients we care for at Lao Friends Hospital for Children, especially among our poorest and most rural children. We see children with severe thiamine deficiency — known as beriberi — on an almost daily basis in children only a few months old.

Without quick treatment, most of these children would die. We often hear sad stories about how a mother has lost several babies in the past with similar symptoms — almost surely beriberi. Beyond these children with very severe disease, nearly every infant has some degree of thiamine deficiency that hasn’t yet become so severe as to risk their life.

Indeed, if there were one single disease that were to define our hospital, it would be beriberi. By caring for hundreds of children per year with a disease that is found throughout rural populations in Asia and Africa, LFHC has the opportunity to become a center of excellence for patient care, education, and research into beriberi and more milder forms of thiamine deficiency. We are thus proud to have partnered with colleagues at the Institute for Global Nutrition at the University of California, Davis and the Lao Tropical and Public Health Institute, to undertake what may be the world’s most comprehensive study into the physiology and pathology of thiamine deficiency in infants. Funded by the Bill & Melinda Gates Foundation, a large team of researchers has joined LFHC to enroll nearly 700 hospitalized children over the course of the next year who have illnesses consistent with severe thiamine deficiency.

We are very excited to take part in this work — the hospital’s first large research study. As a tertiary-care teaching hospital, we feel obligated to help advance the state of knowledge by conducting research studies into diseases that affect children near and far.

The training that our staff will receive as part of the study will also help develop them into independent investigators in the future, helping empower them in yet another way to be the best pediatric care providers in the country.

More information on the study is available at the project web site: https://picn.ucdavis.edu/research/research_proj/lao-thiamine-study