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.
Thalassemia is a serious problem in Northern Laos that until now hasn't been a focus of the country's health care system. Friends Without A Border opened the Thalassaemia Clinic at LFHC to specifically treat this blood disorder. Children with thalassemia become quite anemic and suffer debilitating effects.
The last 12 months have been full of activity at Lao Friends Hospital for Children. Read below to learn about some of the most important achievements and developments your donations have made possible at LFHC in the last year.
1. INPATIENT NUMBERS INCREASE BY 250% IN 12 MONTHS
The increase in patient numbers has been driven by “word of mouth”, community demand and the expansion of services such as the neonatal unit and the Operating Theater. Outpatient attendances are also up by around 33% over this time. This substantial increase in activity demonstrates local confidence and acceptance of our hospital. Maintaining quality of service during this increase has been achieved by opening new beds, employing new Lao staff to manage these beds (4 more doctors and 4 more nurses) and increasing efficiency in many areas.
2. OPERATING THEATER OPENED AND NOW PERFORMING 40-60 OPERATIONS PER MONTH
An international standard Operating Theater has been fully operational within LFHC since July 2016. It is run by a Lao Theater Manager and staffed with Lao nurse anesthetists and theater staff. There has been a considerable amount of training invested in these staff and they are currently supported by an Australian volunteer theater manager and International Anesthetist. Surgery is performed by Lao surgeons from the Luang Prabang Provincial Hospital with preoperative and postoperative care provided by LFHC staff. A true “shared care” model that contributes greatly to the care of children with complex surgical problems.
3. NEONATAL STAFF TRAINED AND NEONATAL UNIT OPENED WITH 8 BEDS
An 8-bed neonatal unit was opened in October 2016. As the staff of LFHC had very little experience with dealing with neonates, months of training occurred before this unit could be opened. Neonatal nurses from Thailand conducted extensive training prior to its opening. Neonatal staff now attend high risk deliveries within the Provincial Hospital and bring neonates directly to this unit.
The continuing education of the neonatal nurses is provided by an experienced long term volunteer neonatal nurse.
4. STAFF LEADERSHIP TRAINING PROGRAM COMMENCED
In recognition of the fact that to develop and mature a hospital not only requires excellent clinicians but also leaders and future executives, a staff leadership training program has been launched. Potential leaders in all areas of the hospital were identified, interviewed, given senior roles and commenced on the training program. This program involves both internal and external facilitators and prolonged mentorship.
The first session of a special training program delivered by Global Health Services Network was possible thanks to the donations of many volunteers and supporters through our ongoing crowdfunding campaign.
5. INTEGRATED TRAINING OF LAO PEDIATRICIANS
There are currently only 120 pediatricians in Laos. These are trained in Vientiane by the Lao Pediatric Society through the Lao Pediatric Residency Program. Last year one of our LFHC doctors, Dr. Dorkeo, was accepted into this program. She will train there for three years before returning to LFHC. This year another of our doctors will join her.
In addition, two pediatric trainees from the Lao Pediatric Residency Program will rotate to LFHC for 2 months to train with us. This exchange of trainees between LFHC and Vientiane will promote strong ties and establish LFHC as a center of pediatric training for the country. LFHC also sponsored two pediatric trainees to attend the Lao Pediatric Society meeting in Vientiane this year.
6. THALASSEMIA CLINIC OPENS
Thalassemia is a major problem in Northern Lao that until now has not had a focus within the health care system. Children with Thalassemia would become quite anemic, be inadequately transfused and consequently suffer debilitating effect of their disease. In conjunction with a hematologist in Vientiane we have opened a clinic especially for these children. This clinic offers regular care, specialized blood testing, an optimized transfusion regime, a chelation (iron removal) program, and, most importantly, support and education for the family of our patients.
7. DEVELOPMENTAL ASSESSMENT AREA FULLY EQUIPPED WITH TRAINED STAFF
In the next few months a developmental clinic will open for children with developmental problems. In preparation for this a developmental assessment area has been designed and equipped. All medical, nursing and physiotherapy staff have undergone specific training both in normal childhood development and screening tests for abnormal development. This clinic will offer multidisciplinary assessment and intervention for children with developmental problems with continuity of care and family support.
8. IMPROVED RADIOLOGY
Together with our colleagues at RAD-AID the medical imaging capabilities of LFHC have improved enormously over 12 months. The number of imaging procedures has more than doubled. A number of RAD-AID volunteers have worked closely with our staff to improve their abilities both in plain film imaging and ultrasonography. A new Sonosite with Doppler capability has taken this to a new level.
The Provincial Hospital is currently installing a CT scanner which will be of enormous benefit to our patients. We are currently negotiating how we can assist with the operation of this unit and exploring how we can create an integrated Medical Imaging Department across the two hospitals that utilizes the expertise and equipment of both departments to the fullest extent.
9. CHILD LIFE INTRODUCED AS A CONCEPT TO IMPROVE A CHILD’S HOSPITAL EXPERIENCE
Employing and training a full time child life therapist has added a new dimension to LFHC’s aspiration to provide compassionate care at all times. Child life involvement with children on the wards, especially those who are undergoing surgical procedures, has seen a steady improvement in pain management and the reduction of anxiety in children. Child life as a discipline is not known in Lao so we have taken primary school teachers and trained them “on the job” with the help of international volunteers.
10. BUILDING A COHESIVE AND VIBRANT TEAM
LFHC is a young hospital that has experienced enormous growth in a very short period. Many people from Luang Prabang, Lao PDR, and around the world have contributed to its growth and successes. The hospital is now entering a phase of consolidation, putting in place solid infrastructure, robust processes and well trained visionary people who will lead the hospital forward over the next 10 years. Achieving our aims of “treatment, education and prevention” requires “teamwork, leadership and dedication.”
These achievements would not be possible without you. Thank you for trusting Friends Without A Border and joining us in our mission to build a healthier future for Lao children!
Since opening its doors in 2015, Lao Friends Hospital for Children (LFHC) has treated over 25,000 patients from different areas of Northern Laos. On January 25th, the hospital welcomed over 80 guests to celebrate its second anniversary including Friends Without A Border’s Board members, supporters from the US and Europe, representatives from partner organizations, Lao ministry representatives and children from the local international preschool. There was much to celebrate this year with the opening of the neonatal unit, operating theater and the growing education program for our medical staff!
We began the anniversary with remarks from Dr. Simon Young (LFHC Executive Director), Kenro Izu (Founder and Honorary President), and representatives from Lao P.D.R.’s Ministry of Health and the Luang Prabang Provincial Hospital, all celebrating the success and progress of LFHC and the partnership we have built with one another. One of our speakers, Dr. Amphone, Director of the Luang Prabang Provincial Health Department, gave an encouraging speech highlighting the value of our mission stating that “all children have the right to be healthy. We must look after our children’s health because they are our nation’s future!”
“I will never forget the first day I met Kenro Izu”, Dr. Amphone said. “We talked about his idea of building and managing a project called Lao Friends Hospital for Children. That moment, I immediately knew that Lao children were going to receive a wonderful blessing of having access to world-class medical treatment.” Dr. Amphone shared his memories of LFHC’s Grand Opening, and highlighted the incredible progress made in these two years by the hospital and all its staff.
After the speeches the event was a carnival! We had a world-class juggling performance, which both children and adults enjoyed. Our child life therapy team set up play stations of games for children to become familiar with child-friendly medical equipment. Our nutritionist conducted a workshop for patient families on how to cook a simple nutritious porridge at home and all had a taste of the delicious dish. It was a day filled with laughter and smiles.
Friends is excited to share a new book, published by Nazraeli Press and Friends Without A Border. Experience the beauty of Laos with a hardcover, 112-page book of photographs and texts by: Adri Berger, Monica Denevan, Kenro Izu, Yumiko Izu, Michael Kenna, and John McDermott.
We are proud to share that our new Emergency Room has opened at Lao Friends Hospital for Children! The ER will have a great impact on the lives of many children and families in Laos, treating patients who arrive with severe illnesses, often after many hours on the road. The Inpatient Department (IPD) was simultaneously expanded to 12 beds (with overflow capacity of 16 beds). LFHC will now be open 24/7, able to provide medical care to Lao children at any time, on any day.
On the first day there were 17 inpatients and we have since been consistently at capacity. The IPD has seen an increasing number of referrals from district hospitals, as well as other hospitals in the city and from other provinces. Common conditions being treated include pneumonia and bronchiolitis, typhoid, pyomyositis, severe dehydration, thalassemia, and malnutrition.
Friends Without A Border opened a new pediatric hospital during a Grand Opening ceremony in Luang Prabang, Lao PDR. Lao Friends Hospital for Children (LFHC) will be the first full-service pediatric hospital outside of the country’s capital and, when it opens, will provide free care to all children.
LFHC is a project by Friends Without A Border (Friends), a not-for-profit organization based in New York whose mission is to provide high-quality and compassionate health care to children in Southeast Asia. Friends’ first children’s hospital, Angkor Hospital for Children (AHC), opened in 1999 in Cambodia and has since treated over 1.3 million children, trained hundreds of local doctors and nurses, and provided medical outreach and education to communities all over the country.
Friends’ founder Kenro Izu started the organization after witnessing the tragic death of young girl in a Cambodian health care facility. “The little girl was the same age as my daughter at the time. I just remember being so shocked something like that could happen. There she was, in a hospital with doctors and nurses nearby, and yet she did not receive treatment because the girl’s father couldn’t afford to pay two dollars for her care.”
After opening, word about AHC quickly spread. Today, AHC treats an average of 450 patients a day, is a nationally trusted pediatric teaching hospital, and a model in the region for sustainable high-quality care.
In Lao PDR, pediatric health care is an urgent concern. Children suffer from treatable illnesses such as diarrhea, pneumonia, and malaria, as well as from injuries sustained by unexploded ordinances which are leftover from conflicts more than 30 years ago, yet still blanket many parts of the country.
The new hospital in Laos will adopt the same model of holistic care used at AHC, with a focus on treatment, education, and prevention. “When we opened our first hospital, we quickly realized the importance of addressing the education and prevention aspects. We wanted to help create a healthy community, not just provide Band-Aids.” Izu said.
LFHC’s Executive Director, Dr. Jonathan Spector, says, “We are building a hospital to where any of us would feel perfectly comfortable bringing our own children. We will deliver safe, high-quality care with respect and empathy for our patients and their families.”
Recently, Izu and Friends were recognized for their work by the World of Children Award. Considered the “Nobel Prize for Child Advocates”, the World of Children Award named Izu the Health Honoree.
To ensure the future doctors and nurses of Lao Friends Hospital for Children (LFHC) are providing the best care possible, Friends Without A Border is conducting a baseline medical survey (BMS) in the Luang Prabang Province. We are excited to be working with Dr. Jeffrey Measelle, Associate Professor of Psychology at the University of Oregon, who has been published extensively in the area of early childhood development. Dr. Measelle is donating his time and talents for this project.
Overall Goal of BMS: Collect health data to establish baseline child health metrics in advance of patient care at LFHC.
Long-Term Goal of BMS: Over time, repeated assessments will enable LFHC to evaluate changes in the health status of children in Luang Prabang and measure LFHC’s impact.
The collection of both biological and survey data will help to prioritize medical services at LFHC, and will also provide a point of reference from which to gage the impact of LFHC. Additionally, the objective of the BMS is consonant with the UN’s 8 Millennium Development Goals.
As the survey teams closes in on the completion of the first phase of the BMS, Dr. Measelle shares with us a status report:
A total of 4 teams, each with 5 team members – 1 supervisor, 2 interviewers and 2 biomarker data collectors – are surveying the Luang Prabang District, the Chompet District, and the Phonxai District. In all, the teams will be visiting 90 preselected villages, 30 per district. To date, the teams have been active for 2 weeks and have collected data from approximately 48 villages.
The number of households in villages with children under the age of 5 varies widely village to village. When entering a preselected village, the goal is to collect data in 7 different randomly selected households, each with at least one mother of a living child under the age of 5. On occasion, there are multiple mothers and children in a single household; in this case all of the family constellations are interviewed. Using sampling procedures pioneered by the World Health Organization, the goal is to build a representative sample of the 3 targeted districts in this first phase of the BMS.
During the visits, each family is also given tooth brushes. The mothers are very enthusiastic about receiving the tooth brushes, and often ask us for extras for all family members. Thanks to the generosity of Dr. Dilshad Sumar-Lakhani, who provided the survey teams with an ample quantity of toothbrushes, the survey team has been able to provide entire families with new toothbrushes.
Data collection has been going remarkably well on most fronts. Teams report that a clear majority of the children are comfortable with the types of data we are collecting. Although we don’t push children if they are visibly upset, over 90% of the infants and children in the BMS have been able to complete all of the biomarker procedures thus far.
Teams’ reports from completed villages, coupled with early reviews of the data, suggest that many of the children participating in the BMS are clearly sick. Persistent respiratory issues, low weight, and troublingly high levels of anemia are clearly apparent. When our teams enter the villages, many mothers are asking for medical care for their children. The need for pediatric healthcare is very apparent in virtually all of the villages participating in the BMS.
Shira Einstein, a student at Oregon University, is helping with the BMS and has chronicled her team’s progress through her personal blog: Shira’s Blog.