"Whatup, Clinic Day 1"

Adam and Courtney gave the kids a taste of American culture this morning before breakfast by teaching them to say "Whatup!" (complete with hand gestures), and how to do a "pirouette en dedans."  (Adam also tried to help Courtney demonstrate this move for the kids, who found the whole thing to be hilarious).  Then the kids decided to see who could jump high enough to slap an over-the-head high five Saad, who at 6'4" is the tallest guy on our team, and a towering giant to the tiny Akha children.  I was amazed that these kids were so energetic after staying up to nearly midnight the night before, huddling on the pavilion in their brightly colored blankets and sharing a movie together.  I laid in bed exhausted from our travels and listened to them cheering and laughing together.  How fun it must be for them to be surrounded by friends and playmates all the time.

It was quite chilly at breakfast, much to our amazement, as the day of our arrival had been scorching hot.  Ivan called it a "paradox of atmospheric conditions," explaining that it was cool in this tropical climate due to the abundant "particulate matter" in the air blocking the sun's rays. (That was a lot to take in at 7am!).  This particulate matter is actually smoke created by the practice of "slash and burn" farming, which is an ancient farming technique widely practiced throughout Asia.  Farmers clear the fields the quick and dirty way by burning the underbrush and allowing the charred soil to lie fallow for a season.  Unfortunately, this practice creates lung pathology in young children, which we saw in our clinic today in the form of wheezing, coughing, rhinorrhea, and epistaxis.

Clinic began at 10am today and ended around 6:30pm.  We were able to see 269 of the 430 children!  We are very happy to report that 232 of these were deemed "normal" exams, as the only physical findings were nits and dental carries.  (Many of us began to feel our own scalps start to itch as we meticulously examined each child's scalp!).  Jaimie came up with the great idea of using the children's own hands to "help" her find the nits.  Only 37 exams were considered abnormal: 2 children would need a nutrition consult, 13 needed dermatology, 12 had a URI/strep throat, or otitis media, 2 had questionable GI bleeding, 4 had cardiac pathology on physical exam, 2 had questionable GI worms, 1 had tachycardia and hypertension, and 1 needed follow-up for his long-standing seizures controlled with Dilantin.  (This child also happens to be sponsored by Dr. Ferguson).

We were able to cover so much ground today by splitting strategically into groups.  I heped the nurses with vital signs and triage; Jaimie, Haney, and Ivan set up shop in one of the classrooms; Peter, Quincy, Jenn, and Saad in another; and Courtney, Adam, India, Erin and Angela in the other.  Will photograped the whoe experience, and Dr. Ferguson ran between the rooms to supervise, confirm abnormal physical findings, and hep develop treatment plans.  We also had some lovely high school aged Akha girls volunteer to be our translators for taking the histories.  One of the teens, Api, told us she wants to be a doctor when she grows up.  She also happens to be an excellent artist and drew pictures of the Thai landscape throughout the day.  We were all exhausted by the end, but thrilled to have found Akha children so healthy and happy.

---Kristen