AFTER-ACTION REPORTS:

• Thailand-Burma - February 9-24, 2008
• Thailand-Burma - October 12, 2007
• Thailand-Burma March 20-April 5, 2007
• Tanzania July 4 – July 14, 2006
• Medical and Surgical Assistance: Karen Refugees
• Northwest Thailand, Karen Refugee Village Health Workers

Thailand-Burma (Myanmar) Border February 9-24, 2008
REFUGEE RELIEF INTERNATIONAL MISSION 08-1

General Medical Officer Graduates of GMO Class 1, given by Refugee Relief International, Inc. . These Karen practioners have gone through 2 years of intensive training to qualify them as independent duty practioners.

A five person team from Refugee Relief International, Inc (RRII), traveled to SE Asia in the area of the Thai-Burma (Myanmar) border to conduct medical and surgical treatment and training. The initial objectives of the mission were 1) to provide direct medical and surgical assistance to Karen ethnic refugees; 2) to continue the immunization program begun in April 2007, providing boosters and initial vaccinations as required;
3) to train Karen students in the last module, or phase, of the General Medical Officer (GMO) course.

The team had planned to travel to the Karen controlled area along the border, but realities on the ground forced a change in plans. Basing itself in a Thai border town, the team was able to join up with the students and teach the last portion of the GMO curriculum. With the permission of clinicians at a clandestine hospital, the students were able to practice patient care on medical and surgical patients, as well as observe surgeries and the construction of prosthetic devices, mostly for victims of land mines.

Refugee Relief docs examine border hospital prosthetic making equipment. Karen technicians make artificial legs for the many land mine victims of the genocidal conflict.

The team’s surgeon, David G. Mohler, MD, was able to build a working relationship with fellow orthopedists at the area’s main hospital. This is valuable as the hospital often treats patients with problems too complex to manage at the medical center used as the referral center by the Karen refugees. Team leader John Padgett, PA-C, Ph.D., and nurse Jeff Gieseke also participated in the networking and team building among the Thai and US medical professionals.

Chief instructor Vicki Chan-Padgett, MPAS, PA-C, led the training of the final GMO module, assisted by Leila Poole, MPAS, PA-C, as well as the rest of the team. Subjects taught this time included trauma and emergency medicine, public health and sanitation, field surgery, and a class on methods of instruction. The students were required to prepare classes and teach the same to their fellow students and the instructors.

500 doses of Diptheria, Teatnus and Pertussis vaccine, 500 of Measles, Mumps and rubella, and 200 of BCG TB vaccine were provided to the Karen GMO graduates to continue the vaccination program started in April, 07. As more funds become available, more vaccine will be provided. Because of the lack of electricity in the Karen areas, it is now only possible to keep vaccine on ice, requiring it to be given quickly. The Karen settlements farther from the border, therefore, are currently unreachable with an intact cold chain for the vaccine.

Chief Instructor PA Chan-Padgett discusses a teaching case with GMO students at the border hospital.

As this mission was conducted, the tragic assassination of Mahn Sha, Karen National Union (KNU) General Secretary, occurred a short distance away. The charismatic and popular KNU leader was shot in his home by two young men posing as admirers. The KNU leadership strongly suspects the Democratic Karen Buddhist Alliance, a splinter group off the KNU which now is at war with it, and which is used by the Burmese junta as a surrogate force. The Karen students, while saddened, continued with their instruction.

At the close of the mission, after the graduation of the new GMO, the team met with KNU officials and representatives of the Committee for Internally Displaced Karen People to develop objectives for continuing RRII training and support for the Karen. The Karen want to continue the vaccination program and develop more general Medical Officers to act as the next level of referral for their medics in the KNU controlled areas.

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