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.
“Volunteering 6 weeks at LFHC in Luang Prabang was a tremendous experience. The people here are amazing. Having worked in many resource-poor regions I can say with confidence that this hospital is doing an incredible job to bring together a variety of backgrounds to benefit this region of Laos. Though we still lack many of the resources we wish we had, the hospital setting is clean, supportive, and carries a positive feeling. The Lao doctors are wonderful, knowledgeable, and keen for learning – they also taught me many things about Lao culture and local disease patterns (many of which you won’t ever see in North America). What impressed me most was how integrated all the services are – nursing, physiotherapy, nutrition, pharmacy, radiology etc – all come together to help care for children in a resource-poor setting. The daily challenges of managing patients with limited equipment and limited diagnostics are met with a caring attitude while respecting the varied cultural practices of the people of Laos. It was a pleasure to be part of this Laos team for a short period. I would encourage anyone willing to volunteer to come and check out life here.”
Dr. Saschy volunteered at LFHC for 4 weeks from November to December 2015. She is a GP and Global Public Health doctor from Australia with a keen interest in child health and tropical medicine. She spent her time in Luang Prabang working across the outpatient, inpatient and emergency departments with the Lao staff (as well as riding her little bike around to the many temples in town and soaking up the serene atmosphere in the historical centre!).
I found out about the Lao Friends Hospital For Children a mere few months after it opened, when I was browsing child health development projects online. After reading about Friends without a Border’s incredible journey over the years with the Angkor Children’s Hospital, and what they planned to do at LFHC in Laos, I swear that my heart skipped a beat! I was instantly touched, and incredibly inspired by the goal they had set out to achieve. Next thing I knew, fast forward only a few months, and I was on a plane from Perth to Luang Prabang, and was soon riding a bicycle on the streets of the old-town, in awe of the beautifully lit temples in the evening, the sound of the gongs, and the mighty Mekong river beside me.
On my first day, before getting started in the outpatient department, I first met the wonderful team of Lao nurses, doctors, lab staff, radiographers, pharmacists and administration staff, as well as the expat team volunteers from all over the world who were there to guide the project and provide much needed educational opportunities within the hospital. I was so impressed by all the staff’s kindness & warmth, their positive attitudes, and their collective dedication to the cause.
The week that I arrived they were just about to open the Emergency Department, and there was a lot of training going on: resuscitation simulations, APLS skills and suturing workshops were all ‘on the go.’ It was great to be involved in some simulations and later see the local staff putting those essential skills into practice in the emergency room.
The medicine I encountered during my trip was thrilling to say the least! You never knew what was about to walk through the door. . . everything from swollen bellies from Ascaris worms and thalassemia in the outpatient department; to cases of acute dengue, TB, and osteomyelitis on the wards; to acute cardiac failure from severe thiamine deficiency (wet beri beri) in the emergency department; and some of the most distressing levels of severe acute malnutrition that I had personally seen.
Laos may seem worlds away from my usual practice as a city GP in Australia, however what I have seen the world over, from Senegal, to Bangladesh, to Peru, to Sydney, and now Laos… is that in order to live a full and healthy life, all children need access to the same fundamental things: safe water/sanitation, adequate nutrition, a roof over their heads, basic preventive health (including vaccines), education, and of course: love.
It really is unacceptable that in today’s day & age, with all our technological advances and wealth and progress, that there are so many children that have access to only 1 of those things: their parents love (which unfortunately is too often not enough to protect them from the cruelty of the environment they were born into).
With the language barriers (unfortunately my Lao skills are still in their infancy! and some families were from minority tribes with very different dialects) some parents maybe could not express in words to our staff what they felt when their child received the care they needed at the hospital, free of cost & free of judgment, but you could certainly see their relief in their faces.
I spoke to many local people in town on my days off , who spoke so fondly of LFHC. Already the people have seen what a difference the hospital is making to their community. LFHC is not just about treating individual children, I can see that there is a very clear effect it will have on current and future public health in Laos. The Laotian people are dealing with difficult uncertain times as they are propelled into the future with technology, and through rapid development, which in fact has had many negative impacts on their communities (such as the Chinese Dam project that will devastate many villages that depend on the Nahm Ou river as their lifeline), however as an outsider I was really struck by the incredible resilience and resolve of the Laotian people, and I do believe that it is projects such as the LFHC that will empower the community, by ensuring the health and prosperity of their children.
I was really excited to arrive in Laos for the first time and to become involved in the early days of a long term project which represents such an incredibly important leap forward for child health in Laos. I am certainly looking forward to returning to Laos again, and of course to following LFHC’s remarkable journey in the coming years.
Lao Friends Hospital for Children embodies what we all strive for – a commitment to improve and maintain the health of children through sharing knowledge and developing lasting resources. It was my first visit to Laos, but certainly not the last. The Laotian people – the staff at the hospital, our patients’ parents posses a gentleness, a serene, inner strength and resolve that’s apparent even in difficult situations. Their generosity of spirit permeated the working days and nights in a way I’ve never experienced in all my years as a professional pediatrician, in the US and abroad.
With each life saved within moments from irreversible arrest, I have seen increasingly bright sparks in the eyes of the training doctors and nurses reflecting their rising level of confidence in their own abilities and most importantly a sense of hope for the future of their hospital, community and the children of Laos. As an emergency physician, to save a life with one's own two hands is one thing but to save the lives of many presently and potentially in the future through the hands of others you have trained, to me is a joy that cannot be surpassed. If you would like to share in this 'gift of empowerment' please join us at the LFHC.
We saw many children touched by challenges with developmental delay, epilepsy, migraines, neuromuscular weakness, genetic/metabolic syndromes, cerebral palsy, etc. Although the level of care is different in Lao compared to USA....the compassion is probably higher at LFHC in Lao! The parents asked the same types of questions that parents in USA ask and the concerns based on love are no different. Absolutely not one iota different – that was somehow surprising to me but perhaps I should not have been surprised at all.
These times are overshadowed by the eagerness of the Lao staff to learn, the way they embrace the model of compassionate care, and all of the random moments at the end of the day when they taught me Lao dancing, about Lao food, and Lao culture. LFHC has grown so much during my time here; I can’t wait to come back and see how it continues to grow. You too should think of coming!
For me the most satisfying aspect of my experience was the feeling that I was part of a new health care model for Laos. Care regardless of ability to pay, compassion, health education, in a setting of an enthusiastic patient care team. I can’t wait to come back in August and be part of this again!