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AFTER-ACTION REPORTS:
Thailand-Burma March 20-April 5 2007 Dates: (Thailand local): 20 March through 05 April, 2007 Personnel:
Mission Location: Thailand-Burma (Myanmar) border Mission Objectives: 1) Instruction of Module II of four modules of the General Medical Officer (GMO) course; 2) To begin immunization of the children of the internally displaced refugee population of the Karen nation. Background: Refugee Relief International, Inc. has been working with the Karen National Union Committee for Internally Displaced People for 17 years. Our service has encompassed everything from trauma surgery to tropical medicine to teaching. We recently committed to training a general medical practitioner for the internally displaced refugee Karen population. As the Karen are victims of ethnic cleansing by the Burmese military junta, they are stateless and have no opportunity to attend medical school. RRII has designed a 4 module course to be taught over 2 years, taking into consideration the limitations placed on the Karen by terrain, guerrilla warfare, and lack of sophisticated medicine and medical services. In late 2006, some very generous people in Silicon Valley, CA, attended a fund-raiser entitled “Shoot the Children”, in reference to RRII’s attempt to provide shots for the Karen children living in denied areas; children who were dying of communicable childhood diseases. A previous RRII team had established that a “cold chain” could be maintained to keep vaccine viable long enough to get it to the Karen homeland. Enough money was raised to begin the vaccination project. Narrative: Refugee Relief International, Inc. Team 07-1 (minus 1 pax) departed the United States on 19 March and arrived in Thailand at approximately 2345 local. Baggage count correct, the team proceeded to the hotel in Bangkok where it would locate in preparation for the mission. Time in Bangkok was spent in securing the vaccine and supplies necessary to begin the vaccination series for the Karen, and contracting for transportation. The vaccine supplier, not wanting to order the vaccine prior to the arrival of the team, required 2 day’s lead time. Team member Gieseke joined the group in Bangkok on the 3rd day. With a complete team and supplies, the team departed for the NW Thailand border town of Mae Sot.
In Mae Sot, the team rested overnight and replaced ice for the vaccine. Before dawn the next day the team departed for the Area of Operations (AO). After travel by 4WD, boat, and foot, the team reached the AO the following morning. Karen medical counterparts were met and briefed, and work was begun immediately to set up an area to administer the vaccines and an area to teach. Village elders began rounding up families with children. The students for the GMO course checked in.
Within an hour of arrival, the two parts of the RRII team were at work in their respective areas of assignment. The GMO course began with a review of the previous module, and with the help of Karen nurses and medics, the immunizations were begun. Module 2 of four of the GMO
course consisted of courses in Dermatology, Endocrinology, Urology,
the Head/Eyes/Ears/Nose &Throat (HEENT),
and the musculoskeletal system. Prior to the discussion of diagnosis
and treatment, a review of the anatomy and physiology of each system
was conducted. The students were given case scenarios and practice
patients with each block of instruction. The nearby Karen dispensary
was a source of patients to illustrate several types of problems.
The General Medical Officer training program is intended to raise the
Karen practitioners to a new level of competence, but, unfortunately,
not everyone who began the current session of training was able to successfully
complete it. Three students failed to maintain a passing average on their
tests and practical evaluations, and were returned to their duties as
medics.
RRII team members were able to keep a viable “cold chain” for the vaccine for 3 days, enough to dispense all of the vaccine brought to the AO. 512 children were vaccinated with measles, mumps and rubella (MMR) vaccine, and with diphtheria, tetanus, pertussis and hepatitis B (DTP-B). Polio vaccine was also supplied to a limited number, due to limited availability.
After finishing with the vaccinations, the shot team then assisted in the teaching of GMO Module 2. The Karen students who successfully passed the second phase were able to add new skills to their practices, and have begun using them as of this writing. When the instruction was complete for this phase, the team departed the village, reversing its path along the river and through the jungle. Karen logistics turned us over to Thai commercial transportation in Mae Sot. The team returned to Bangkok the day after leaving the field, and returned to the US after a day’s rest. Team Leader’s Comments: RRII Mission 07-1 went very well. Vaccinations were provided to 512 Karen children who have never had any. These are 512 children who will not die of communicable diseases that could have been prevented. The train-up of the Karen GMO candidates is proceeding well, thanks to the dedication of the instructors and the hard work of the students. There is still much to be done. The remaining 2 modules of the GMO course are yet to be taught, and include such topics as trauma, tropical medicine, and sanitation, as well as a course on how to instruct. There are thousands of more children who need the basic series of vaccine, as well as boosters to insure immunity. RRII continues to rely on the support of its donors, without whom we could not continue. The team humbly thanks all those who made this mission possible, and requests your continued support.
Refugee Relief International, Inc.
2995 Woodside Road #400-244 Woodside, CA 94062 email: info@refugeerelief.org |
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