Category: Uncategorized

Treating a Serious Bone Infection

Aiy Thongsy was brought to Lao Friends Hospital for Children with a condition that doctors diagnosed as Osteomyelitis of his right leg. The condition, which is an infection of the bone, left the 10-year-old boy unable to walk.

A surgical team performed an external fixation for his leg to keep his bone in line to grow properly. Aiy then began a treatment regimen of antibiotics to fight the infection. His doctors used a series of X-rays to monitor his progress.

It took some time for Aiy to become accustomed to the external fixation, which he would need for several months. He still cannot walk, he moves around the hospital in a wheelchair with the help of his father.

While he recovers at the LFHC, the hospital’s nutritional team has been addressing his malnutrition to ensure that he continues to improve.

The LFHC team discovered that Aiy enjoys attending the hospital staff’s English classes! He has already learned some English and has become more confident about his recovery.

Some children, such as Aiy, require extended hospitalization to recover from injury or illness. However, the average length of stay for children at LFHC this year has been less than six days.

Battling Malnutrition with Therapeutic Food Program

Recognizing the high incidence of malnutrition in Lao PDR, administrators at LFHC are initiating a malnutrition care program that they hope will dramatically reduce the need to hospitalize children for long periods to treat the condition.

LFHC doctors and nutritionists have begun to treat malnourished children with eeZeePaste, a ready-to-eat therapeutic food that has been endorsed by UNICEF. The product contains a mixture of peanuts, milk powder, oil and vitamins – everything a child needs to recover from malnutrition.

LFHC has purchased a two-year supply of eeZeePaste.

Acute malnutrition is attributed to about half of all childhood deaths worldwide. In Laos, acute malnutrition rates are poorly reported but are believed to be between 5 percent and 9 percent. Chronic malnutrition rates can be as high as 50 percent in some provinces.

Until now, children suffering acute malnutrition required extended hospital stays, sometimes for months, to be treated with fortified milk. For many families, that wasn’t an option because they needed to return home to tend farms and care for their other children. Malnutrition patents removed too soon from the hospital risked death from such childhood diseases as diarrhea and pneumonia. They also faced lifetime consequences of stunted physical growth and reduced intellectual capacity.

The hospital’s new malnutrition care program will enable families to treat their children at home. If a malnourished child passes an “appetite test,” described by UNICEF as the child’s ability to eat the paste, the patient will be discharged and sent home with a two-week supply of eeZeePaste packets. Most malnourished children recover in 4-8 weeks by eating two or three packets of eeZeePaste a day.

LFHC administrators say they plan to grow the program by collaborating with other groups in Luang Prabang Province, including the Swiss Red Cross, which is already conducting home-visits of children being treated in the program. The Red Cross is also screening children for malnutrition in remote villages for treatment at LFHC if necessary.

The Lao government is rolling out community-based malnutrition programs using eeZeePaste throughout the country. LFHC pledges to support the government’s efforts be providing training and mentorship opportunities.

Neonatal Doctors and Nurses Save A Newborn’s Life

Doctors at Luang Prabang Provincial Hospital delivered Airnoy Xong in mid-August by performing a cesarian section. His mother had been rushed to the hospital because she was bleeding and doctors had diagnosed placenta previa, a pregnancy complication in which the placenta covers the woman’s cervix.

Born after a 32-week pregnancy, Airnoy Xong weighed less than four pounds. His family was told that the infant had very little chance of surviving.

He was immediately brought to the Neonatal Unit at LFHC, where a doctor administered CPR and ensured an oxygen flow to his premature lungs. The medical team subsequently treated Airnoy Xong with IV fluids, antibiotics, phototherapy and nasogastric feeding. Airnoy Xong has been gaining weight and the prognosis for survival has greatly improved.

Neonatal care is critically needed in Laos. Expansion of LFHC’s Neonatal Unit will soon be completed. The project will doubled the number of neonatal beds currently available.

Saving Another Malnourished Child

Six-month-old Airnoy Silivong appeared weak and listless when she arrived last month at Lao Friends Hospital for Children.

Her mother said the baby girl had been afflicted with diarrhea for a few weeks. Our staff immediately determined that the child was very dehydrated and began treatment with fluids. Doctors also diagnosed the baby as suffering severe acute malnutrition (SAM) and began to treat her with a nutritional formula.

After one week of treatment at the hospital, the baby no longer experienced diarrhea. She also acquired an appetite and gained weight.

The staff discovered that Airnoy Silivong was now flashing a beautiful smile and sent her home with her family.

Malnutrition is one of the top 10 diagnoses at LFHC. About 9 percent of the children seen by our doctors are diagnosed with malnutrition.

Diarrhea is a leading killer of children, accounting for approximately 8 percent of all deaths among children under age five worldwide in 2016, according to UNICEF. This translates to over 1,300 young children dying each day, or about 480,000 children a year, despite the availability of simple effective treatment. Diarrhea is a leading killer of children across Asia, causing approximately 11 percent of deaths in children under five years of age in the World Health Organization’s Southeast Asia Region.

Hospital Sets Outpatient, ER Record

Not only was August one of the rainiest months of the year in Laos, it was also the busiest month in the three-year history of Lao Friends Hospital for Children.

Doctors and nurses working in the Outpatient Department and Emergency Room treated 2,039 children in August, the largest number of patients in a single month since the hospital opened in 2015. The outpatient numbers also have risen more than 200 percent in two years, LFHC administrators reported.

Inpatient numbers also were high, with more than 200 children hospitalized during August. Furthermore, these children have remained hospitalized for longer periods than in the past. Many were treated for bone infections, chronic skin wounds, malnutrition and encephalitis.

June, July and August proved to be busy months for the Neonatal Unit, which admitted 143 newborn infants during that period. Many of these tiny patients were born extremely premature or with serious conditions that required long and intensive periods of treatment. The average length of stay for these infants peaked at 8.35 days in August. The unit now typically has 14 to 16 babies occupying beds. The new, expanded Neonatal Unit will be fully occupied the day it opens, administrators said.

LFHC and Provincial Hospital Share New Imaging System

In another cooperative venture, Lao Friends Hospital for Children and the Luang Prabang Provincial Hospital are jointly deploying a new medical imaging storage system that will save money and give doctors quick access to X-rays and other diagnostic images.

A team from the nonprofit organization, RAD-AID, has installed the Picture Archiving and Communications System (PACS) and is training technicians from both hospitals in its operation.

PACS provides storage and convenient access to diagnostic images. Electronic images and reports are transmitted digitally via PACS, which eliminates the need to manually file, retrieve or transport film jackets, the folders used to store and protect X-ray film.

Phettakoun “Lo” Vannathy, LFHC’s IT manager, worked with the three RAD-AID team members to train our Lao doctors and nurses and the medical staff of the provincial hospital  in how to use the new system.

RAD-AID International, based in Chevy Chase, Maryland, works to increase and improve radiology resources in the developing and impoverished countries of the world.

RAD-AID began in 2008 with a few people at Johns Hopkins, and has grown to include more than 6,100 volunteers from 100 countries, 45,000 web visitors per year, 53 university-based chapter organizations and on-site programs in 20 countries.

Nurse Completes Anesthesia Program

Kuelee Lao Faiyia has successfully completed his comprehensive examination in the LFHC Nurse Anesthesia Program.

As part of the program, he administered anesthesia in more than 600 procedures at the hospital and attended classes in basic sciences, pharmacology, anatomy, physiology, pathophysiology and anesthesia management.

The program has been approved by the Luang Prabang Provincial Health Department and has been submitted for recognition by the International Federation of Nurse Anesthetists.

Kuelee began his career at LFHC in July, 2015, as a nurse in the Outpatient Department. The hospital’s Nurse Anesthesia Program began the following month and Kuelee was selected as a student.

He participated in classroom study and clinical instruction for seven months at Angkor Hospital for Children in 2015 and 2016. He has beentaught by nearly two dozen volunteers, primarily from the Health Volunteers Overseas organization. He also gained anesthesia expertise during a one-month rotation taught by faculty of the Department of Anesthesiology at Siriraj Hospital Mahidol University in Bangkok.

Child Life Specialist to Study in Macau School Program

Child Life Therapist Kongmeng Sialee has received a scholarship to spend September studying at the International School of Macau.

As a participant in the school’s Lao Outreach Program, he will learn how to interact more effectively with patients who have autism, development delay and speech problems. He will also have the opportunity to observe the school’s counselling, speech therapy and occupational therapy departments.

The International School of Macau started the outreach program in 2013 to allow teachers at the school to mentor educators from Lao PDR. The school formed a partnership with GLOBE, a Canadian nonprofit, and My Library in Luang Prabang to facilitate the program.

We are excited that Kongmeng has this chance to learn new skills, network with professionals from other countries and be an ambassador for LFHC.

Read more about Kongmeng here.

The International School of Macau was established in 2002 to provide a Canadian curriculum and accreditation to local and expatriate students. English is the primary language of instruction. Today, it has an enrollment of 1,150 students representing 40 different countries.

LFHC Doctor Selected for Pediatric Residency Program

Dr. Vilayvone Senkeo started working at Lao Friends Hospital for Children in 2015 shortly after it opened its doors and began treating patients. She had just completed medical school in Vientiane and was thrilled to work in a new children’s hospital in her hometown.

During the past three years, Dr. Vilayvone has become a very valued pediatrician, highly regarded by colleagues and patients alike for her clinical skills, enthusiasm and compassion.   She is one of the young LFHC doctors who established the much-needed Thalassemia Clinic at the hospital, in addition to working in the busy outpatient, inpatient and emergency areas.

This year, Dr. Vilayvone was granted a place in the three-year Pediatric Residency program based in Vientiane at the National Children’s Hospital. The Lao Pediatric Society selected her for the program and her tuition and living expenses will be covered by a donated scholarship. She will return to LFHC in 2021.

The hospital administration and staff congratulate Dr. Vilayvone for this wonderful opportunity to continue her training and know she will say hello whenever she visits her family in Luang Prabang.

Sok dee, Vilayvone der! 

LFHC’s “Carry-On” Wishlist for Volunteers

These are hospital supplies that our staff has dubbed the “carry-on wishlist.” LFHC gratefully accepts any of these items brought to the hospital by volunteers as donations.

RED COLOR INDICATES MOST URGENT NEEDS as of August 2018
Item Details or other comments
General Medical Consumables
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
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
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 such as clinell/caviwipes
Steri-strips
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
Pasteur pipettes
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
Thomas Splint
Phototherapy eyes protectors for neonates
Paediatric spinal collars
Vaccuum for cast cutter
Casting materials for spica casts
Pediatric bronchoscope Need both a flexible and a rigid one
Medications
Acyclovir 3% eye ointment
Acyclovir injection
Antibiotic eye ointment gentamicin, tobramycin, or erythromycin
Permethrin cream
Atropine eyedrops
Beclamethasone inhaler
Calcium Carbonate (Tums) Or similar calcium containing product
IV Caffeine
Dantrolene
EMLA/Amethocaine cream/Local anaesthetic cream for IV cannula insertion
Ferrous fumarate (iron solution)
IV Indomethacin
Lacri-lube eye ointment, 2.5 g
Lactulose
Lidocaine 1% injection
Lidocaine 2.5% / Prilocaine 2.5% topical cream Emla
Methylprednisolone injection
Naloxone injection
Ondansetron injection
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)
Ranitidine solution
Sodium Valproate suspension (bottle)
Steroid inhalers (beclomethasone)
Tetracaine 4% topical cream Ametop
Tetracaine eye drops
Triple Antibiotic Ointment Polysporin or equivalent; 15 gram tubes
Vancomycin injection
Zinc tablets
Non-Medical Items
Washable plastic toys
Simple board games
Blankets for neonates
Bubbles
Medical play kits
Cloth Dolls
Disposable Stethoscopes
Colorful Bandaids
Crayons
Coloring books
Simple children’s books
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)