Category: FWAB News

Staff Treats Girl for Serious Burns

One day in mid-December, 6-year-old Xiasee strayed too close to a cooking fire at her home in Bokeo Province and the flames ignited her clothes. Her skirt was quickly extinguished, but the little girl suffered burns to her legs and lower abdomen.

The family tried to care for Xiasee’s burns, but could do little to help their daughter who was experiencing a great deal of pain. They rushed her to the Bokeo Province Hospital, but eventually brought her to Lao Friends Hospital for Children — about 10-12 hours away.

Our doctors and nurses recognized that Xiasee needed to be hospitalized – she had suffered second- and third-degree burns to roughly 12% of her body. They immediately administered morphine for her pain and cleaned and dressed her wounds.

Xiasee required frequent dressing changes over the next several weeks. She was sedated during these painful procedures and given intravenous doses of the antibiotic cefazolin to treat infections, which likely occurred because of the delay in getting her proper medical treatment.

After spending a month at LFHC, Xiasee’s burns had begun to heal, but it became clear that she needed a large skin graft – an operation beyond the capabilities of local physicians. LFHC transferred Xiasee to a hospital in Vientiane, where a specialist performed the skin graft with the help of a plastic surgery team from Interplast, an Australian nonprofit organization.

Xiasee returned to LFHC following her surgery and continues to receive care from the nurses and doctors who have been involved since her initial admission, as well as the hospital’s nutritionist, physiotherapist and outreach team. She is making an excellent recovery and the staff loves seeing her smiling again!

New Medical Records System Initiated

Hospital staff members have begun using an upgraded medical record-keeping system that is designed to improve clinical decision-making.

Twenty-six doctors and 55 nurses have been trained to use the system, the Bahmni EMR system. The new system integrates data from clinical, radiological, pharmacy and laboratory sources and presents it in a logical and intuitive way. It enables quicker improved clinical decision-making, a reduction in medical errors, more efficient use of doctor and nurse time, and contributes significantly to better patient outcomes.

The Bahmni EMR system presents patient histories in a clearer and more accessible interface. It enables doctors to monitor progress on requests for such things as lab work, pharmacy, radiology. It also allows staff to order and document medication, fluids, feeds and such procedures as the administration of blood products.

Furthermore, the system allows LFHC and Luang Prabang Provincial Hospital to instantly share patient records and lab management information.

The time saved by using the system ultimately means more efficient and effective care for patients.

Denis Martin, a member of the Friends Without A Border Board of Directors, was instrumental in the acquisition and implementation of the Bahmni system.

Our system serves as a model for hospitals and clinics throughout the Lao PDR.

Doctors Save Life of Child in Motorbike Crash

An unconscious toddler suffering seizures was rushed to the LFHC Emergency Room on Dec. 10. The ER staff didn’t know the name or age of the child, but instantly noted his cuts, bruises and fractured arm. They quickly stabilized him, assessed his injuries and obtained a CT scan.

The staff then learned that the boy’s family had been in a motorbike accident. His mother was taken to the nearby Provincial Hospital. His older brother didn’t survive the accident.

The CT scan revealed that the boy, Tolex Vannadeth, had sustained a head injury that produced bleeding and pressure on his brain. Doctors administered several medications to reduce the pressure, control seizures, prevent infection and manage pain. His condition remained critical for the next few days.

Tolex gradually responded to treatment and despite his condition, he let everyone know that he welcomed the company of the staff and his siblings who later came to visit. He found comfort in holding the hand of a staff member and enjoyed hearing his siblings sing to him.

Tolex slowly improved and began working with the hospital’s physiotherapist. His mother also improved and three weeks after their accident, both were able to go home.

Tolex continues to receive therapy and the staff is excited to see his ongoing recovery.

LFHC Celebrates 5th Anniversary

Representatives of the Lao PDR government joined Friends Without A Border board members and supporters on Jan. 23 to celebrate the fifth anniversary of the opening of Lao Friends Hospital for Children.

Mark Gorman, the hospital’s Executive Director, welcomed guests to the event and FWAB Founder Kenro Izu introduced a video produced for the celebration by Adri Berger (which can be viewed here).

FWAB Executive Director Nicole Pagourgis thanked the local community and the organization’s many donors for their support during the past five years.

The event, which featured traditional Lao and Hmong dance groups, was attended by representatives of the Lao Ministry of Health and Ministry of Foreign Affairs. Officials from the Luang Prabang Provincial Health Department and Provincial Hospital also attended.

Click here to view a video that was screened at the celebration.

Pediatric Training Program Underway

From its inception, LFHC has had a tradition of providing continuous education for its medical staff, both in classrooms and during every clinical shift, ably assisted by numerous foreign doctors.

This approach has now been consolidated into a structured curriculum-based training program that is designed to give all of our doctors a good foundational knowledge in pediatrics, enabling them to practice evidence-based, child-centered, pediatric care safely, ethically and competently. It also encourages them to continue their professional development through self-directed learning.

The first stage of this training, a one-year LFHC Child Health Foundation course, is underway and will be followed by a three-year Certificate of Pediatrics program. These are internal courses; LFHC will continue to utilize the country’s national pediatric residency program for the hospital’s highest performing doctors.

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. The program is being financed by a generous grant from Moving Child, a foundation based in Munich, Germany.

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 pursuing negotiations with Lao Health Ministry officials to establish a nationally accredited pediatric training residency for physicians at LFHC.

 

 

Milestone Achieved!

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.

One-third of all those treatments happened in 2019, making it the busiest year the history of the hospital.

LFHC doctors and nurses handled 39,944 medical cases last year, according to year-end data. That’s a 27.6% increase from 2018.

The largest increase in caseload occurred in the Emergency Room, where doctors and nurses handled 11,801 medical emergencies, an increase of nearly 77% from 2018.

Doctors Solve Mystery of Teen’s Persistent Skin Rashes

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.

Khamsouk’s family eagerly participated in his care.

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.

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 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.

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.