After I returned from Chiang Mai, I began focusing my work on two new projects: KDHW’s Trauma Management Program (TMP), and Back Pack Health Worker Team’s 10 Year Report.
KDHW’s Trauma Management Program was founded by GHAP and KDHW in 2001 in response to the prevalence and severity of trauma injuries in Karen State, Burma. Eastern Burma is one of the most heavily mined areas in the world, and landmine casualties account for 5% of all deaths in this area (1 in 1000 residents die per year of landmine injuries—the same rate in New York City, for instance, would mean that over 8300 people die of landmine injuries every year). A survey of human rights violations in eastern Burma found that households that were forcibly displaced were four times more likely to have a household member become a landmine victim. Villagers have also reported "atrocity demining" whereby the Burmese Army forces locals to walk in front of soldiers as human minesweepers. For the adults and children that survive the initial blast, rapid access to care is critical. Injuries are severe— approximately 1 in 3 survivors requires amputation.
The Trauma Management Program consists of two parts: training and equipping medics to triage patients in the field, and providing emergency and longer-term care including amputations and blood transfusions at mobile health clinics in more stable conditions. There are now 17 fully supplied and funded mobile trauma teams in Karen State who are able to travel to the site of injured patients in most cases.
What amazes me about this program is the incredible success rate of these medics despite the challenging circumstances that they face. They are able to save most patients despite treating them in low-resource settings that barely resemble an OR, and they are able to learn advanced, life-saving, surgical techniques in a fairly limited amount of time (TMP trainings last about 7-10 days, and are held only once per year; the rest are taught by senior medics in the field).
The blood transfusion program, however, is one of the more amazing aspects of the TMP program, in my opinion. Because the resources don’t exist to maintain a normal blood bank in the jungles of Karen State, a “walking” blood bank has been established. Medics routinely screen residents of villages in their area for blood type and blood-borne diseases, and mark their location and blood type on a map. When a trauma victim needs a blood transfusion, the medic finds a donor with a compatible blood type, tests again for diseases, and completes the transfusion. It’s pretty phenomenal.
As the TMP fellow, most of my work has been assisting the KDHW TMP coordinator with supply orders, budgets, and training preparations. I also work as the liaison between the US GHAP emergency physician Larry Stock (who helped found TMP) and KDHW. In December, I had my first experience writing a donor proposal-- to the International Rescue Committee for TMP funding in 2010—which we just found out was successful (yay!).
Along with TMP, I have been spending a lot of time working with Back Pack Health Worker Team (BPHWT) on their 10-Year Report. BPHWT is a locally-based NGO working to provide primary health care to Internally Displaced Persons (IDPs) and vulnerable populations in eastern Burma. Burma’s overall health system has been ranked the second worst in the world, and the situation is even worse for IDPs. IDPs and vulnerable populations face harsh living conditions, and have no access to the limited health programs that do exist. Malaria accounts for almost half of all deaths, followed by diarrhea and acute respiratory infections. Malnutrition is prevalent, and the maternal morbidity rate ranks amongst the highest in the world.
Back Pack Health Worker Team currently sends 81 teams of 3-5 Back Pack medics into IDP areas of Karen State to provide much-needed primary health care to over 180,000 people. In addition, the organization has trained local Traditional Birth Attendants and Village Health Volunteers in these areas to empower and enable the local populations to begin to provide health care for themselves. You can check out Back Pack’s website at: www.backpackteam.org.
As a GHAP fellow, I am currently assisting BPHWT with outlining and writing their 10-year report. It has been an incredibly educational and valuable experience so far—not only for my work-related skills (putting together 10 years of information is no small task!), but also for learning more about the people that I work with. As I sat down with Mahn Mahn, the director of BPHWT, to talk about the introduction to the report, I found myself basically conducting an interview about why BPHWT was started, and what Mahn Mahn envisioned for the future of Burma. It was quite an interesting meeting.
Because this post is already getting super long, I’ll just mention some highlights of December:
-I attended my first Karen wedding at Mae La refugee camp! Although the bride and groom (one of the KDHW staff members) barely looked at each other throughout the ceremony, they at least smiled and held hands at the end (phew!). Other notes: the pastor accidentally dipped his arm in the cake during the ceremony, and cheesy American love songs accompanied the recessional.
The happy couple
The wedding party
-Karen New Year fell in late December, and I went to a big celebration at Mae Tao Clinic in Mae Sot. Below are a couple of pictures of the traditional Karen dancing (“Don”). Karen nationalism was everywhere--I even got a Karen national flag pin.
"Don"--Karen dancing
"Don"--Karen dancing
-I joined the Back Pack Health Worker Team women’s soccer team for a couple of games against other local health organizations. My soccer skills were a bit rusty, but most of my teammates had never played before, so it worked out just fine. We even got a big crowd to watch us for our big game against Mae Tao Clinic!
-I was able to travel to Mae Sariang for a day of the KDHW Mobile Health Clinic in Charge meeting. For this meeting, the Clinic in Charges from each KDHW-run Mobile Health Clinic in Karen State come to Thailand for several weeks to be trained in up-to-date treatment protocols and to discuss programmatic and security issues. A few pictures below:
me and Eh Kalu, KDHW director
me, Heiku Wah (VHW program coordinator), Beth, Thart Kler (the newlywed!), and Hser Nay Moo, founder of the VHW program
-The Thai King’s birthday carnival in Mae Sot lasted for a week in early December, and was replete with games, shopping, carnival food, even a Ferris wheel! My favorite activity was watching Muay Thai, or Thai boxing.
Muay Thai
-On World AIDS day, I found myself at Mae Tao Clinic watching educational skits about safe sex, but performed entirely by lady boys (If you’re not familiar with that terminology, lady boys are born male but are anywhere from cross dressers to full transsexuals in the feminine direction—and are fully accepted in Thailand).
-On Chanukah in a Buddhist country, I made a makeshift menorah out of aluminum foil and used Buddhist monk candles. My roommates and I also hosted a homemade potato latke and applesauce extravaganza!
Makeshift aluminum foil menorah with Buddhist candles
Latke party at our house
Homemade applesauce and potato latkes!
-My roommate adopted two street dogs in September, which you may or may not have known. There are many street dogs around Mae Sot (in fact, so many that I can only go running on the highway so as to avoid getting chased), and almost none of them are spayed or neutered. So we were very displeased when Gremlin went into heat in December, and our house turned into a live episode of Animal Planet. A particularly eager golden retriever even charged our front gate and knocked it off of its hinges. Needless to say, I was happy when those couple of weeks were over and I no longer had to listen to howling packs of dogs outside our gate at night, or pour buckets of water on male dogs trying to mount our poor little Gremlin.
Our dogs--McGoo (left) and Gremlin
-I enjoyed a wonderful 5 weeks at home in the States visiting with family and friends, enjoying American food, and finding it much easier to conduct my daily life when everything was in English! I’m now picking up Thai again…
-One final note: I added a sidebar for links to learn more about Burma and what I’m doing. I’ll keep adding sites as I find them.
I’ll be at Trauma training in Mae Sariang this coming week, and will give you a report when I return!
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