When LFHC first opened its doors in 2015, one of its first patients was a 7-year-old boy named Bounsaweng Bouadichith, who was diagnosed with thalassemia when he was an infant.
He arrived weak and pale and LFHC doctors promptly started treating him. During the past four years, he has had frequent medical appointments and is one of the Thalassemia Clinic patients who received blood transfusions once or twice a month.
Bounsaweng was also diagnosed with an enlarged spleen. One of the functions of the spleen is to filter old or damaged red blood cells. Thalassemia destroys a large number of red blood cells and as they are filtered by the spleen, it becomes enlarged and has to work harder.
After extensive planning by a multidisciplinary team, Bounsaweng was wheeled into the Operating Theater on Feb. 20 and underwent the first elective splenectomy for a thalassemia patient at LFHC. Volunteer Dr. Mark Saxton and Lao surgeon Dr. Kuaneng Lao performed the procedure, along with LFHC’s Operating Theater team.
The Thalassemia Clinic team of doctors and nurses prepared Bounsaweng and his family during the months leading up to the surgery. Child Life therapist Kongmeng Sialee helped the family understand the procedure’s risks and benefits. The Laboratory team was also essential in preparing the Luang Prabang Provincial Blood Bank to ensure that a large supply of cross-matched blood would be available for transfusions during and after surgery.
Splenectomy for Thalassemia patients increases life expectancy and decreases blood transfusion requirements, but comes at a high risk for surgical complications and infections after surgery.
Bounsaweng remained at LFHC for nearly a month after his surgery. His recovery was complicated by inflammation in his lung due to pancreatic juices leaking out during surgery, but he eventually responded well and was able to return home feeling much better.
He and his family have come for follow-up appointments in the Thalassemia Clinic and he has not required a transfusion since his splenectomy. His family reports he has much more energy and is able to go back to school and thrive as a happy young man. The LFHC team is very happy to see how much progress he has made.
Guidestar, the world’s largest source of information about nonprofits, has awarded its 2019 Platinum Seal of Transparency to Friends Without A Border. Platinum is the highest level of recognition offered by GuideStar.
The Platinum Seal means that Friends Without A Border has demonstrated that it is focused on measuring progress and results. It also means that millions of people will be able to see information about Friends Without A Border on the GuideStar website and its network of more than 230 websites and applications.
GuideStar states that its website receives 9 million visitors each year.
|*** RED COLOR INDICATES MOST URGENT NEEDS ***||as of March 2019|
|Item||Details or other comments|
|General Medical Consumables:|
|Burns dressings||Particularly useful are: paraffin gauze dressings like jellonet or bactigras, acticoat, or grassolind.|
|Alginate dressings||Aquacell, Kaltostat or similar. Squares or ribbon|
|Paediatric/neonatal PICC lines|
|Umbilical catheters/lines||Size 3.5 preferable|
|Phototherapy eye protectors for neonates|
|Dermabond or similar skin glue for closing lacerations||Note, this is not the same as the mastisol that is on the list – that is for securing dressings on wet skin|
|Simple non-adhesive dressings (eg. melolite, telfa, simple post-operative dressings)|
|Idoform packing gauze – ribbon strip (aka iodine soaked ribbon gauze)||Please ensure expiration date is OK|
|Cleaning wipes||e.g. Clinell and Caviwipes|
|EZIO Pediatric Needle Sets 15mm and 25mm (05301PD)|
|Collar and cuff arm sling|
|Seldinger chest drain kits||Size 12G and 18G|
|Frosted microscope slides|
|Stat Strip Express Nova Glucose Strips||Reference number: 42214|
|Nova Stat Strip Xpress Glucose/Ketone QC Level 1 and 3.||Reference Numbers: 46947 and 46949|
|Pipettes tips (small and large)|
|Liquid dispensing bottles (for pharmacy)||e.g.: http://bit.ly/1Sa28RP|
|Hypafix dressing tape|
|Three way IV extension tubing|
|Three way taps|
|Pediatric spinal collars|
|Vacuum for cast cutter|
|Casting materials for spica casts|
|Pediatric bronchoscope||Need both a flexible and a rigid one|
|Acyclovir 3% eye ointment|
|Antibiotic eye ointment||gentamicin, tobramycin, or erythromycin|
|Atropine eye drops|
|Calcium Carbonate (Tums)||Or similar calcium containing product|
|EMLA/Amethocaine cream/Local anesthetic cream for IV cannula insertion|
|Ferrous fumarate (iron solution)|
|Lacri-lube eye ointment, 2.5 g|
|Lidocaine 1% injection|
|Lidocaine 2.5% / Prilocaine 2.5% topical cream||Emla|
|Ondansetron oral dissolving tablets – 4 mg.|
|Pain Ease (topical anesthetic skin refrigerant)|
|Permethin 1% topical shampoo (for head lice)|
|Permethrin 5% topical lotion (for scabies)|
|Polyethylene glycol powder||(Brand name is Lax-a-day or Miralax)|
|Sodium Valproate suspension (bottle)|
|Steroid inhalers (beclomethasone)|
|Tetracaine 4% topical cream||Ametop|
|Tetracaine eye drops|
|Triple Antibiotic Ointment||Polysporin or equivalent; 15 gram tubes|
|Child Life/ Developmental:|
|Simple children’s books||Very basic, easy in English with pictures|
|Washable plastic toys and figures|
|Accessories for girls age +4||Polly Pocket, Sylvania dolls, etc.|
|Simple board games|
|Bubbles||Small bottles are better (party pack size). For less weight, buy a party pack, empty out the liquid and bring us the wands and small containers, please.|
|Medical play kits|
|Stuffed toys||for ages <2 and older girls (6-10 years old)|
|Coloring books including pattern books||for boys and girls|
|Small children’s scissors for crafts|
|Small cellophane tapes, masking tapes|
|Paint blocks and brushes|
|Lego toys||Duplo toys and people for ages <5; base boards; normal bricks (colorful ones for girls, too); people|
|Construction toys||Small sets of magnetic building blocks are great.|
|Jigsaw puzzles||for ages 8+|
|Plastic or wooden activity cubes/ centers||for ages 6 – 24 months|
|Small cars and trucks|
|Bead threading/ lacing blocks||for ages 6 – 24 months, 3-6 years, and 8+|
|Plastic farm/ wild animals|
|Blankets for neonates|
|Colorful Band Aids|
|ESL novels and books for our Lao staff to practice reading|
|Simple high school level biology and anatomy textbooks|
|Paints for handprints at end of life|
While all donations are valued we would prefer that people do not donate things which are not sustainable in this environment; for example, things with consumables which we can’t obtain (eg. glucometers, special feeding tubes, airway circuits, etc.)
Monthly blood drives are a vital component of operations at Lao Friends
Hospital for Children, which has seen an increase in surgeries and thalassemia
Twenty-one people were donors during the February blood drive at the
Friends Gallery in downtown Lunag Prabang.
There always seems to be a shortage of blood in the province and LFHC
encourages local residents, expats and tourists to donate.
Apart from emergencies and surgeries at the area’s district hospitals,
donated blood is critically needed at the LFHC Thalassemia Clinic, which provides
blood transfusions to children afflicted with the thalassemia blood disorder.
The caseload at the clinic has increased to the extent that the clinic is
now open two days a week. On a busy day, as many as 24 patients will visit the
clinic, some for follow-up visits and others for transfusions. The clinic uses
as many as 12 units of blood per day.
Thalassemia is an inherited blood disorder that can cause anemia.
In 2018, the monthly blood drives at the Friends Gallery collected 317
bags of donated blood.
The LFHC staff is ever-vigilant for signs of malnutrition in the children they see.
Last year, more than 150 children were treated for severe or moderate malnutrition. Hospital administrators have started a follow-up clinic that includes test-feeding (under medical supervision) of ready-to-use therapeutic food (RUTF).
Nearly 3 tons of RUFT were imported this year to ensure
an adequate supply of this vital medication for the malnourished children in
The hospital’s therapeutic food program is designed to dramatically reduce the need to hospitalize malnourished children for long periods (Read more here).
Stunted growth, caused by poor nutrition, continues to
be a serious problem in many rural regions of Laos.
In March 2018, the World Bank reported that Laos has reduced poverty and hunger and improved education and health outcomes in recent years. However, the nation lags in the area of child nutrition, the World Bank stated, noting that stunted growth impacts 44 percent of children under the age of five. A recent report by the nongovernmental organization Save the Children cited the same percentage of stunted growth children.
Lao officials issued a report in June asserting that the rate of stunting from malnutrition among children under the age of five had dropped to 33 percent in 2017 from 44 percent in 2011. The officials stressed that malnutrition remains a concern in several provinces, including Luang Prabang Province, according to a report published by Radio Free Asia in July.
Globally, about 45 percent of the deaths among children
under the age of five are linked to poor nutrition, according to a UNICEF
article published in October.
A multidisciplinary team at LFHC recently saved the life of a 2-year-old boy who was suffering from an “acute abdomen,” a medical emergency often associated with ruptured intestines or a perforated appendix.
The boy, Khamphan Nun, was feverish and dehydrated by diarrhea. After much questioning by staff, his family revealed that their son had been bitten by a dog in the scrotum and that he had an unrepaired inguinal hernia.
Khamphan was rushed into the Operating Theater, where a surgical team repaired a part of his intestine that had herniated into his scrotum and was then bit by the dog. The surgeon had to perform an ostomy.
The medical and nursing team then began the task of teaching Khamphan’s family about ostomy care. Child Life Therapist Kongmeng Sialee has been instrumental in helping the boy and his family cope with this major change in his life.
The nonprofit organization Friends of Ostomates Worldwide has donated large amounts of ostomy supplies for Khamphan.
A serious complication impairing Khamphan’s health was his severe weight loss and dehydration caused by a bowel perforation. What made this even worse was that he suffered diarrhea whenever attempts were made to renourish him, as he had lost most of his capacity to absorb complex carbohydrates, fats, and proteins. With special attention from the LFHC nutrition team, which included a complex plan using special formulas with pre-digested nutrients, Khamphan made a slow transition back to a regular diet.
After a little more than a month in LFHC, Khamphan was able to go home with his family. He returns every month to allow doctors to evaluate his ostomy and nutrition progress.
Late last month, Lao staff members at LFHC trained a doctor and nurse from Nambak District Hospital in the care and treatment of thalassemia patients.
The goal of the training is to give thalassemia patients a place to receive treatment closer to their homes. Some families travel long distances every month to bring their children to LFHC, which has the only pediatric thalassemia clinic in northern Laos. These families are spending a large proportion of their income on transportation. Nambak is about 75 miles north of Luang Prabang.
Thalassemia is an inherited blood disorder that causes anemia and can be fatal. Many patients need monthly blood transfusions. Despite the high prevalence of thalassemia in Laos, there are only two pediatric thalassemia clinics in the country – at LFHC and in the capital city of Vientiane.
In training the Nambak staff, LFHC administrators envision them spreading this clinical knowledge to other hospitals and health care professionals across Laos.
The first doctor and nurse from Nambak arrived on Jan. 29 training. They had a half day of theory, followed by two days of practical training and observation in the LFHC Thalassemia Clinic.
Two more Nambak doctors and nurses will be trained over the next few months and their hospital will soon start to receive patients. The patients will be treated at Nambak for two months and then return to LFHC for the third month. LFHC administrators hope this will be the start of a great collaboration between LFHC and Nambak District Hospital.