On Sunday, we visited the gorgeous Kuang Si waterfall. We all left for the trip in trucks that we sat in the back of. At the waterfalls there were some interesting items for sale at the local market (boiled eggs on a stick anyone??) and there was also a bear sanctuary for bears that have been cruelly treated or born in captivity. At the actual waterfalls, the scenery was just beautiful. There were several small waterfalls and a crystal clear, blue lagoon that we could swing from a tree rope into. Many photos were taken underneath the waterfall by those that had waterproof cameras as you can swim under the fall. It was AMAZING!
On Monday, we visited the PLQ medical training college and experienced an exchange of ideas that included community health, cpr and manual handling. The training college is quite basic and the nurses and health workers welcomed us with open arms. We broke into groups, with some discussing community health whilst others looked at CPR and other health education topics. It was very interesting and the conversation lead into a demonstration of the different ways in which we practice as nurses on issues such as manual handling.
In the afternoon, we visited the hospital in Luang Prabang. The hospital provides care to Luang Prabang residents and the residents of the surrounding villages. It is set up in a surprisingly similar way to how our hospitals are set up in Australia eg they have an emergency room, pediatric ICU, a sort of ‘GP’ clinic etc but a huge difference is that the people do not pay for the room as such, they pay for the healthcare and equipment that is provided. Unfortunately though, with many families living off a wage of less than AU$1 per day, even just coming to hospital and paying for the equipment is simply out of the budget for many families. We were very lucky whilst walking past the pediatric ICU to be shown a set of conjoined twins. The hospital in Luang Prabang is a small hospital though and it is currently trying to send the babies to another hospital for more specialized care.
On Tuesday, we packed up our things, loaded the trucks and made our way to the village ‘Ban Napho’, about 2 hours drive on dirt roads outside of Luang Prabang. We were greeted by the village children who gave us ‘love flowers’. The accommodation is very basic, with mosquito nets covering wadded mattresses set out on the floor. The houses have electricity inside the house and the wealthier families have a TV and a stereo. Many have a house phone. Internet is not common and in fact, they do not seem to own computers in general. All cooking is done outside the house on a fire in ‘the kitchen’. The ‘bathroom’ is also outside the house, consisting of a squat toilet, a bowl for washing and a bowl for storing water for ‘flushing’. It has been an interesting experience for those of us learning to use these to say the least… still on our “L” plates at this stage actually with many of us needing to discreetly wash our feet as well as our hands after using the squat toilet… That night the villagers welcomed us with a ceremony to commemorate our arrival. They did it in ‘the lodge’, a beautiful, open community hall that was a donation made from a previous Antipodeans group.
It was made from local materials as it helps to keep money spent on the village in the village. In the lodge, they danced and sang for us and also showed us some fun traditional Lao games. When asked to perform a traditional Australian song for them (on the spot by the way…) we gave them a roaring rendition of ‘Home Among the Gum Trees’. A fun night enjoyed by all. On Wednesday, we woke up at the wonderful hour of 5am by the roosters in the community crowing and squawking to tell us that the sun was coming up. We all ate breakfast together under the beautiful lodge and group B was split into two separate groups. Group number 1 set up our first health clinic with Group A, whilst group number 2 worked on the construction of a toilet block and kitchen with group A for the local health clinic in ‘Sop Jak’.
In the afternoon, Group B went on an exciting river raft ride down the Sueng river. It was soo much fun! Our bottoms may have ended up a little wetter than they began but the scenery was just gorgeous. We ended our day with a wash in the river, a delicious meal and an early night in bed. On Thursday, group 1 and 2 swapped roles with group 1 working on the Sop Jak clinic kitchen / toilet construction whilst group 2 set up the health clinic with Group A. Setting up the clinic with group A’s In the afternoon, Group B continued with the construction whilst Group A enjoyed the river rafting experience.
This particular day was also Australia Day and as the true blue aussies we are, we chose to celebrate in style. Hazel set up the lodge with Aussie flag decorations and we came dressed to impress with many Aussie T-shirts, shorts, thongs, flags and tattoos on display. Group A met Group B at the lodge and we all enjoyed a marvelous feast together. On Friday, we all attempted to have a sleep in until 7 o’clock for an 8 o’clock breakfast. We were separated into groups within the village and learnt how to cook traditional Lao style and also how to weave. We all enjoyed the meals we had made for lunch and then packed up our things and got ready to leave for Luang Prabang On Saturday, a large percentage of the group went to ride the elephants. I am told it was ‘the best thing ever’, ‘a really awesome experience’. Group B Blog, Week 2 Sunday, January 29th.
We again packed up our things, checked out of our hotel and made our way to our next village ‘Ban Pakeng’, situated about an hour and a half by dirt road outside of Luang Prabang. We were told that the village is a much larger village than the one we stayed at in the first week, housing about 800 people or so, consisting mostly of farmers and gardeners. In the afternoon that we arrived in the village we took a little walk through and had a look at the river so that we would know where to go to wash ourselves in the afternoon. On the way to the river some of us were lucky enough to see a tiny baby pig being born right before our eyes! That was really special.
Later, we were greeted by the village chiefs and welcomed into the community with a ceremony and dancing. The village chiefs told us how grateful they were to have us there providing health care in the villages. The group was then split into two’s and we were shown to our home stay. The accommodation was again very basic, with mosquito nets covering wadded mattresses set out on the floor, electricity inside the houses, a TV and a stereo. All of the cooking in our homestay was done in an outside room of the house on a fire in ‘the kitchen’. The ‘bathroom’ was again, also outside the house and was once again a squat toilet, but by this stage most of us had gained our squat toilet ‘P’ plates and we are getting better at the technicalities of it all... Monday, January 30th.
On this day we set up our very first health clinic on our own without Group A’s help in Ban Haukeng. We decided on the previous night that there would be a designated role for each person on the clinic and who would be in each role. The roles were: reception (including height and weight), clinic and pharmacy. The reception area was given a translator for the first few minutes to get the hang of how to ask for a person’s details in Lao, then left to their own devices to work the language out. Each of the three clinic areas had a translator, a Lao health worker, 2-3 Griffith University students and a facilitator. The Griffith students worked together as a team to do vital signs, a clinical assessment and a clinical diagnosis with an appropriate pharmacological aid and patient education provided when necessary. All information was run past the Lao health work who ultimately made the final decisions about the diagnosis and drug prescribed. The pharmacy also had a health worker to check the dispensing of drugs, but no translator.
In the afternoon when the clinic was a little quieter, we used the time for health promotion of things like tooth brushing, hand washing and wound care. We also ran an antenatal clinic with the help of our two nurse facilitators (who are also qualified midwives) involving pregnancy care, birthing and baby care. We even had a full pregnancy suit, complete with a full term baby ready to demonstrate birthing positions!
After the first day in the clinic on our own, as the well behaved, ‘reflective practice’ nurses that we are, we assessed how the day went. Overall, we felt the clinic ran very well, but it was decided that there was a need for an additional role as a ‘crowd controller’ tomorrow.
At the end of the day, I asked each member of the group, what, from their point of view was the thing or something that they enjoyed the most from the first health clinic day. Here are the responses: Aimee: The child with the cleft palate really stood out to me, I was surprised at how calm the baby was. I really enjoyed learning the drugs and the disease that it goes with it. We were able to refer the child to operation smile and hopefully in the future, the child will get the cleft palate fixed. Darcee: I really enjoyed caring for the person that got hit in the eye with a paw paw 3 days ago. It was black, red and swollen. I cleaned it with saline, administered antibiotic eye drops, patched it and explained to him how to care for it.
Fiona: I really enjoyed doing the health promotion or health ‘mobbing’ as it has become known as. The kids get so excited because they get free stuff! They were shoving it down their pants and then coming back for another toothbrush.
Kathryn: I just loved the whole learning experience.
Kymmie: I thoroughly enjoyed watching Teaghen give birth in health promotion today. Would have to say that was my definite highlight.
Teaghen: Giving birth was my favorite part of the day.
Diana: I think getting the chance to syringe a child’s ears was my favorite stand out moment for the day.
Cara: It was a really good learning experience. I liked listening to the Doppler.
Colin: Today it was counting to one hundred in Lao with the children.
Amber: I had a really good learning experience today.
Anna: Holding the babies
Alexa: Hanging out with the village people
Ashley: I really enjoyed speaking to the people and everything really
Marie: I really liked the babies and pregnant women
Ryan: Playing with the kids and trying to organize everybody. Also learning a bit more of the language.
Me: I think the ‘Fracture clinic of back slabs’ stood out for me today. It was certainly something I wouldn’t ordinarily get the chance to do back home.
We continued to set up health clinics in different villages of various sizes for the remainder of the week. On Tuesday we set up a clinic in Ban Hadsangon (population approx 600), Wednesday in Ban Hadhouay (population approx 600), Thursday in Ban Hadsang (population approx 400) and Friday in our own village. Every day we were greeted by a procession of village children, villagers and the village chief, all of whom were just so grateful that we were there to provide healthcare to their village. As a gesture of thanks for allowing us to come into their village, 2 volunteers provided a donation bag of clothes, books toys and useful things to be distributed amongst the people. We also gave each village a bag of school supplies to be used at the local schools. Nearly all of the school children attend school here, but it is not easy for them to attend when they are living off such a small income and the children are often needed in the home to tend the garden or help with housework. Nearly all of the children use broken bags to carry the couple of books that they have to school and most of them have ripped and dirty, dusty clothes to wear. Many do not have any shoes that they wear to school.
Friday 3rd February On Friday we had a crazy morning in our very own village, Ban Pekkeng. Luckily, by this stage we had many of the aspects of our health clinic finely tuned. It did take a lot of organization, crowd control, quick thinking and fast moving BUT we flew through 113 villagers before 12 o’clock! Our facilitators congratulated us on a job well done and we all headed back to our home stays to pack up to leave for Luang Prabang again.
We are currently still in the process of compiling research data to provide a definitive result on this, but just asking around the group, the main complaints within the villagers seemed to be runny nose, coughing (many due to Tuberculosis), colds & flus, gastro, sore stomach and of course the famous ‘Jeplang, jeplang’ combined with a point to the individuals back to indicate back pain. Monday, Tuesday and Wednesday we saw around 170 people each day whilst on Thursday because it was a smaller village, we managed to get through about 100. These were all full clinic days. Some of the main medical highlights from the week of clinics that we set up and were able to help with were:
We patched up 2 boys who had broken arms and sent them to hospital (with money) to fix them up. I know that one was a bilateral radius and ulna fracture, compound and oblique but I’m not 100% sure on the other one… We sent a baby and a mother to hospital because the baby had really bad pneumonia. The mother didn’t want to go because she couldn’t afford to go, but with some reassurance (and some money courtesy of us), we put her in the front of our truck and took her to town with us We took a man with a suspected sub dural hematoma to hospital, but luckily because he was a soldier, we didn’t have to pay for his care The feelings about the health clinics are so hard to put into words.
At the hospitals, they will only take you if you can pay upfront and none of the people that we sent to hospital could afford to go without our help. The money at the hospital is collected everyday by the Dr or nurse who will tells the patient what they need every day and if they haven’t got it, they are out the door. It feels really good to be able to help out the people of the Sueng Valley communities. Really puts things into perspective for us as ‘wealthy westerners’ in a whole new way.
Before we left the village for Luang Prabang, our families gave each of us a ‘Bazi’, which is a ceremony to commemorate our stay in the homestay with the family, to acknowledge our existence as a part of the family and to wish us well on our journey into the future and hope that we come back to visit. The ceremony involved as many family members as possible being present, the village chief being present and many friends and well wishers too. We were blessed by the chief and by the family by having bands of string placed on our wrists, one on the right and one on the left by each of the villagers. We were all given beautiful scarves as departure gifts, worn from left to right to signify buddah (apparently right to left represents the communist party). Then we headed back to Luang Prabang for the weekend, feeling exhausted but really good about the work we have done at the same time and looking forward to some creature comforts - GOD BLESS European toilets and showers!
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