Project Thailand

2011-02-15T16:36:00.003-05:00

Welcome back folks. We've had a great year of fundraising and are in the last planning phases for this year's trip. We are having a fundraiser cocktail party in Bangkok March 1st. Our clerkship group leaves Feb 26 and the spring break group arrives March 6th.

We will provide exam updates, vaccines and dental care. We also hope to make a trip to the villages in the mountains. We hope you'll follow our adventure here on our blogg and we will also post daily to our facebook page PROJECT THAILAND.

More pics from the CGT, clinics and Play therapy

2010-03-09T05:02:00.003-05:00

Clinic at CGT

The children line up and can't help looking through the windows to see the doctors at work. The are very patient but curious and tend to push to the front. While working the students have big crowds watching them.

Here are some more photos from our clinics and other activities. They are registered and a paper chart completed, then they enter this into a electronic database once clinic is closed. With such a system, next year will be much more efficient and we should be able to track their progress and medical issues along the way. The students will be able to see these charts before they leave and we should be able to prepare, and purchase supplies more efficiently. This will improve overall resource utilization and save the center money and our teams a lot of time.

Hard work pays off! Time for some fun

2010-03-09T04:25:00.003-05:00

The team has been hard at work for 3 days now. First clinic was Sunday evening. We went full tilt Monday and had vaccine clinic for evening. We did 300 Japanese encephalitis, and hundreds more polio, and hepatitis B vaccines. We have found a great online EHR that was simple, intuitive and most importantly FREE!! We spent most of today entering the exams and vaccine records into this database. We will be able to access this later via the internet and this will permit us to follow and better plan for future trips. The team will go up into the mountain villages tomorrow to see the Akha families of these children. This will be more of an acute care setting but they have no other access to any care.I did a video interview today of David Stevenson and hope to use it in presentations back home. They plan to build a school here and we are discussing making some rooms dual use as a medical clinic as well. The center has grown significantly since my first visit including chicken coop, food and fruit gardens, playground, and volunteer housing.

I am grateful for the enthusiastic help and support I have received from the students, fellow faculty, Drs. Jennifer Light, Mobeen Rathore, and Rich Petrik, the Emergency Department and the College of Medicine.

We are making a big difference to the Akha kids, not just protecting them from sex-slavery and pedophiles but also providing a true future with training in sustainable farming, and education that can be the foundation for higher education. Indeed, 2 of the CGT graduates are now studying at Universities in Thailand; the first Akha to do so EVER!

We are winding down the clinical phase and will begin to focus on art and play therapy. Tonight is American Movie night. We will be showing Fantasia 2000 and popping popcorn and we have ordered ice cream for all the children.

After tomorrow's village clinic we will be handing out more of the toys we purchased and Thursday we will take 2 children each for elephant rides, and lunch in the mountains. Thursday night we will be leaving to return to Bangkok where we will have 2 days of shopping and R&R. Saturday night we'll return to the airport for our late night flight home. We should be back in G'ville Sunday evening.

From Tourist Central to Northern Villages

2010-03-08T21:06:00.005-05:00

Touch down at Chiang Rai airport and it was off to start another adventure. We were greeted at the airport by David, the founder of the orphanage, and a few excited smiling faces. Dr. Petrik, Dr. Light, Dr. Rathore and William Light on board, we were ready to see some patients! About twenty of us jumped into a large pick-up truck and we raced to the store to pick out toys for the 100's of children.

After seeing the kids jumping all around to greet us at the orphanage, we were energized to start clinic. Impetigo, tinea versicolor, lice, cough, and the occasional heart murmur were some of the clinical pearls of the day. With no labs or imaging to guide us, the skin became important again and stethanie regained her glory. Mosquito nets in place, we slept soundly.

5 AM.

The sound of little running feet and children laughing began to amplify from all corners of the complex culminating at a central location with beautiful songs and hymns. After their morning assembly, the children went straight to their tasks-cleaning, preparing lunch, getting ready for school, and helping the younger ones.

More much needed high-school children were available to translate in clinic. As the sun set, we prepared the vaccines. 100's of children received vaccination for Japanese Encephalitis, and we came together as a group to make some tough ethical decisions regarding the allocation of limited polio vaccines.

We started to understand our limitations here as we learned more about the immigrational status of these children and the political climate in this region. Nevertheless, we managed to do what we came here to do by way of medical care. Perhaps our most important contribution this year, we are spending much of our day today compiling medical records for teams to use in the future. We haven't presented the toys yet, so much more to come!!

Week 1, Part 2

2010-03-04T22:10:00.006-05:00

Sawasdee (Hello) from Thailand, blog-followers!

A few nights ago, we had the pleasure of dining in a Thai home in Bangkok. Helen, a woman who grew up in the "mountain villages" of Burma, actually had a liver transplant at UF/Shands about five years ago. She saw an article about Project Thailand on the Gainesville Sun website, and invited us to an authentic Thai dinner in her beautiful home. From her 16th floor condo, we had a gorgeous view of Bangkok's night skyline. Dinner was absolutely delicious - especially the spicy Tom Yum Goon soup with fresh shrimp. Conversation was equally delicious. By the end, we had all fallen in love with Helen's infectious laugh and positive spirit! Her friends, Sumitmai and Flo, graciously transported us to and from the dinner, and shared lots of entertaining stories as well. We thank Helen for inviting us into her home, and we hope to see her again before we leave next weekend.

Since arriving in Phuket, we have visited the Vachira Hospital and Tacuapa Hospital, where we were moved by stories and images of the tsunami that struck 5 years ago. The healthcare workers there are true heros!

Other highlights include the Acupunture lecture and demonstration on Quincy (!), the Muay Thai boxing match, and lunch at the highest point on Phuket island with an amazing view of the mountains, jungles, and beach. Stay tuned for more photos & updates!

We've arrived in Bangkok!

2010-03-02T05:51:00.011-05:00

We finally arrived in Bangkok, after our long, >24 hour trek across the globe! We got into town close to midnight on Sunday night, and everyone was wide awake due to the time change. Thankfully, Khao San Rd (where we're staying) never seems to sleep so we got to catch part of the US-Canada hockey game with some ice cold Chang Beer!

Monday, we were introduced to the Emergency Department at Ramathibodi Hospital Mahidol University. Over the next 2 days, we received lectures about tropical

diseases in SE Asia, advanced airway and RSI, and Thailand's EMS system. We also got to join in on rounds in the emergency room and check out their ambulances. Over the next day, we will learn more about toxicology, pediatrics, and Chinese acupuncture!

Of course, most of us have gone for a Thai massage in the last few days which is quite different from our massages. Let's just say its good to be flexible and its a little more painful! One of the nurse's husband does Thai massage and invited us over to give us a demonstration in its healing properties. Amr was the lucky victim and it was quite entertaining!

ER triage board

Our lab group with Thai students and faculty

Learning about tropical diseases and checking out flukes, worms and parasites

Gmail address

2010-02-16T17:44:00.003-05:00

Project Thailand now has a GMAIL address. If you have supplies to donate, or wish to be a sponsor to support our group you can now contact us at
UFProjectThailand@gmail.com.
Supplies we particularly need are pediatric Singulair, and oral medications that don't require refrigeration. Cash donations can be made by check to UF Foundation with Project Thailand in the memo section.
Due to Pharma conflict of interest rules we cannot accept donations from the pharmaceutical companies but healthcare professionals such as physicians, pharmacists, and nurses can contribute.
Thanks,
Project Thailand

Gainesville Sun article on this year's trip

2010-02-15T16:59:00.001-05:00

http://www.gainesville.com/article/20100215/ARTICLES/2151008/1002/NEWS01?Title=UF-professor-med-students-to-help-kids-in-Thailand-

Sign-up here for our upcoming Project Thailand Golf Tournament!

2009-10-26T18:50:00.015-04:00

When: Saturday, January 30, 12:00 PM start

Where: Haile Plantation Golf and Country Club

Registration: click here

Would you like to be a sponsor? Learn more about how you can help. Sponsorship packages are listed here.

Project Thailand 2010

2009-10-26T18:19:00.003-04:00

This past spring a group of doctors, nurses and medical students at the University of Florida traveled to Chiang Rai, Thailand to provide care to orphaned children of the Akha tribe. As students at the University of Florida College of Medicine, we are excited for the chance to return once more to provide medical care to the people of Chiang Rai. We expect this year’s trip to be bigger and better than last year’s as we will be increasing the number of students and faculty who will be making the trek.

This coming March, we will be providing health care to 400 orphaned children of Akha ethnicity. These Akha children are stateless refugees, as they are not recognized as Thai or Chinese citizens. Their only medical care comes from visiting groups. This year will be the fifth year UF physicians have made this volunteer trip, and the second time medical students will join the effort. We will set up clinic, where we will provide free basic medical care, including physicals, immunizations, vitamins, and medications. Last year we were able to create an electronic medical record for each of the children and we will be expanding upon this record during our upcoming trip.

We will also be setting up clinics in the surrounding villages of Chiang Rai and providing care for others within the community. This will require more supplies and organization but will provide us with the opportunity to expand our area of outreach.

Like the UF physicians, we medical students are providing our own funds to travel to Thailand. We are also responsible for raising enough money to assist in covering the cost of supplies, immunizations, and medications. As you can imagine, we have a great challenge ahead of us to raise enough funds to support the plans we have for this year’s trip. We have fundraising projects planned but we also wanted to reach out to our friends and loved ones and open the door for you to support us as well.

Project Thailand represents a tremendous opportunity to serve some underserved children of Thailand. It also provides an unparalleled educational experience for us as medical students interested in international community medicine. To see photos from previous years, please visit http://emergency.med.ufl.edu/community_service.shtml or scroll through last year's blog posts.

Finale

2009-03-31T20:27:00.000-04:00

On our last night we were treated to the kids performing traditional Akha dances in their native dress.
This banner was unfurled at the end of the first dance....

Epilog

2009-03-22T16:39:00.006-04:00

We are all home safe and sound. We are planning a picture swapping party and will begin the process of organizing our group and preparing for next year. We have to complete the medical records and I have sent David & Asa growth charts and they will enter the immunization records. We have several potential projects, buying immunizations, establishing sustainable protein with chicken coops, and of course planning the next mission. I have secured space at the upcoming Alachua County Medical Society's Product show and we'll sell some of the Akha art items we brought back. I am donating some black star sapphires to a silent auction and we may have a few other special items for auction.

I have played with a logo design for tagging our equipment and adding to T-shirts and other items we can use for fund raising. Hope you like it but input and suggestions are appreciated.

Elephant rides & Ice cream. The CGT kids have fun

2009-03-17T09:47:00.003-04:00

Each team member treated 2 of the children ( who am I kidding we had fun too) to a day or elephant rides, lunch, cokes and ice cream.

Last Day in Bangkok

2009-03-14T08:43:00.000-04:00

This overcast, windy day propelled many of us to spend a few hours shopping at the Chatuchak Weekend Market, a labyrinth of stalls selling fisherman pants, bright flowy dresses, silk pillowcases, silver jewelry, wares featuring elephants, orchids, lotus bulbs, green mango salad, fresh cut watermelon, and coconut juice right out of the coconut, among other things. One vendor/performer attracted customers by spinning around and around while he was pouring tandem cups of Thai iced tea. After weaving through the crowds, customers could get some reprieve with an hourlong Thai massage for 250 baht (about US$7). Since it was nearly impossible to navigate our way back to the Sky Train station, we bargained with a taxi driver for fare back to the hotel.

All 17 of us met up for one last dinner in Bangkok, this time with two of the Thai Emergency Medicine residents in their first and second year of their three-year program. We dined on the patio and ate family style to sample whole sea bass, tom yum soup, prawns, morning glories, and chilies in nearly every bite. On our way back to the hotel, we walked through aisles of night market stalls and came across the occasional baby elephant, leashed to be fed or ridden at a price. We caught three of the brightly-colored taxi cabs—hot pink, half-yellow half-green, lime green, royal purple, depending on the company—and flew down the highway toward the Suvarnabhumi Airport.

Mahidol University and the Grand Palace

2009-03-12T15:02:00.000-04:00

It felt familiar this morning when I staggered out of bed onto the street in my scrubs and ate breakfast on the run. Adam, Angela, Courtney, India and I rode the skytrain to meet Dr. Ferguson on our way to the local teaching hospital. At the hospital, we met up with faculty of their emergency department and were able to chat with medical students and emergency medicine residents of the university, see their facilities and learn about how their department operates.

Patients are triaged based on vital signs and chief complaint into one of three acuity levels. We were told that the lowest acuity patients will wait about 2 hours to be seen in Bangkok. All patients are seen, regardless of their ability to pay, however patients are sometimes transferred after stabilization if they hold insurance with another hospital.

We were shown to the resuscitation bay, were we were amused to see a resident caring for a patient by holding a paper bag over the patient’s face (he was having hypocalcemic tetany exacerbated by hyperventilation). The resuscitation bay had a wall with all of the incubation gear laid out on hangers. Each patient care room had a statue of the Buddha. Adam learned the hard way not disrespect the Buddha by pointing a finger at the Buddha statues.

Throughout our tour of the facilities, we had an engaging discussion with faculty about the differences between our respective hospitals. This included systems issues like overcrowding and admission hold overs, as well as specific disease management issues, such as stroke treatment and tropical diseases. It was interesting to hear that physicians radio orders to the ambulance en route to the hospital in contrast to the more protocol driven system independent of physicians at home. Also, overcrowding in the Thailand ED was addressed through the use of an intermediate holding area between the emergency department and the ward floor.

Resident life seemed to be similar to the US in more ways than not, including the use of a simulation lab, sharing one cluttered resident lounge and having test anxiety (we happened to visit on a resident test day). Medical students and residents read textbooks and journal articles in English and receive lectures and discuss information with teachers in Thai. Their bookshelves had the same favorites as we do back home, including Tintinalli’s emergency medicine, William’s hematology and Nelson’s pediatrics.

We had lunch at the Mahidol University cafeteria, were we sampled various Thai dishes and fruit juices. We were astonished by how food could be so cheap but so good, and wondered how our lives might be different if we had access to the Thai cafeteria everyday back home instead of the Shand’s hospital food. Outside of the cafeteria, a poster session was being held for the various scientific disciplines at the university. The program for it included both English and Thai versions of the abstracts.

In the afternoon, we rode a boat bus down to visit the Grand Palace, were we learned about the traditions of the county and gawked at the beauty of sites like the Chapel of the Emerald Buddha. In the evening, the whole project group met up for dinner and ate Thai food before heading out to haggle at a night market.

Mission Accomplished!

2009-03-12T07:04:00.005-04:00

By Tuesday we had seen nearly all the children and a couple of adults. The vast majority were well child exams but there were several with irregularities that needed follow up, such as tachycardia, mild hypertension, stool guiac needed etc. There were about 50-60 that required some intervention, ear infections and fungal skin infestations and most of the younger ones have head lice; there were also some that reported worms in the stool and a couple wheezers. We also discovered several with physical findings that will require more evaluation. Tuesday we each treated 2 children to elephant rides done by the Karan Hill tribe. This was the highlight of the trip so far afterwards we had lunch and ice cream and browsed the Karan shops before heading back to the Akha training center. That night they treated us! After dinner I received the best pro-fee imaginable. The children donned their native Akha costumes and performed several traditional dances and some contemporary Christian music too. The Akha are Christian and have been for centuries, but the blend of native costumes and dance to hymns was quite impressive. At the end of their first dance they held up a hand painted “Thank you Gators” banner. After concluding the dance they called us up to thank us one-by-one and each student was given an hand sewn handbag with exquisite needlepoint decoration. Once that was done each of us got about 400 hugs as each child mobbed us on the stage screaming, “Thank you” and “I love you”. It is as close as I’ll ever come to being a rock star. I took photos and video of the evening events but I took some time to just soak up the atmosphere. It was all very moving. We learned their special “handshake” and there were plenty of American high 5’s too. I was gratified to see several of the children for the 3rd time and one who is enrolled in the local university. This is an exceptional accomplishment as it is nearly unheard of for the Akha. She is studying international business and finance. The Training center is supporting her tuition but she works 3 part-time jobs to meet her living expenses.
Wednesday, we tied up some loose ends, some of the kids had slipped by but we had a mini-clinic and quickly completed the charts. There are still charts to be entered into the databank but this will be done by their staff as they are the essentially normal ones. After more hugs and high 5’s it was time to leave our friends and begin our journey home. This was the toughest part of the mission as many bonds have been forged. We piled our stuff and ourselves into the back of the pick-up one last time and left for the airport to a chorus of good-byes from scores of happy faces.
We are now in Bangkok and settled into our hotels. Tomorrow, I have arranged for the students with EM interests to spend some time in the Emergency Department of Ramathibodi Hospital and after lunch we’ll tour the Grand Palace. We are pouring over the tour books and will plan our R&R for Friday and Saturday. Most of us leave late Saturday night, actually 0135 Sunday. There are many places to shop and many sites to see, no doubt we’ll leave with many still on the list.
The main point though is the Mission went well.

Flight of the Flatus

2009-03-11T14:24:00.003-04:00

With great relief that no ants had drilled their way into my ear drums last night, I woke up with residual excitement from the festivities from the night before and a brand-spankin' new energy to see the kids. Our last day at clinic was jam-packed with more visits (including a case of congenital cataracts!) and education about immunizations and catch-up immunization schedules. Time flew by so unbelievable fast! Just as the faces were becoming more and more familiar, and putting names to them as well, we had to say our goodbyes. Crowds of children began smothering each of us, wishing us goodbye and saying "you come visit again!"

We could still smell the lemongrass from the (in)famous "meatloaf patties" on our skin as we boarded the plane to Bangkok. It was during this flight where I began to appreciate what I learned in physics. I'm not sure if it was the dried bananas, coconut juice, meat-on-a-stick, the grass jelly drink, or just plain genetics, but I was farting like crazy on the plane. Thank God it was only an hour-long flight, 'cuz by the end of the flight, the monstrous toots started to smell oozing out of the seat cushion, which had so courageously secured them. After trying to pinpoint the culprit, I realized (with the support of resident physicist Ivan), that the reason I was farting so much was because at that cruising altitude, my intestinal pressure was much higher than the surrounding pressure, causing that oh-so-pleasant odor that Quincy and Kristen could not get enough of.

Elephant Rides

2009-03-10T19:36:00.000-04:00

March 10

2009-03-10T13:53:00.000-04:00

A late post due to technical difficulties....

The children at the Akha training center wake up at 5 am and begin their morning devotion time at 5:15 am. It is an incredible experience to have 400 singing children serve as your wake up call. Our day begins early as well. Many of the children will receive medicine for several days after we leave. Our nursing team, Kathy and Amanda, organized a medication administration record to help the training center staff administer the medication properly. In addition, Kathy collected the urine of a few children to test for urinary tract infections. We identified one infection, and this child will receive an antibiotic.

We purchased a multi-vitamin with iron for one of the older girls. We suspected that she had a significant iron-deficiency anemia based on her history and physical exam. Dr. Ferguson taught us to exam a patient's palms when looking for anemia. If the creases of the palms still have color, it is a good sign. If the creases lack color, "Get on the phone and call the blood bank. Now!"

Later this morning, we took a group of about 30 children into a local market area. There were many local crafts created by the Akha people. We walked around the various stalls and shared ice cream with the children. One shop was home to several large snakes. One weighed 120 kilograms. That is about 264 pounds! For a small fee, you could hold the snake with your friends and take pictures. The children were very excited about the opportunity to have their picture taken with the snake!
After a hot, dusty ride back to the training center, we shared our last evening with the children. Dressed in traditional attire, they performed a tribal dance for our group. They thanked us for coming and offered us many, many hugs. It was like the last night of summer camp. Many children asked if we would return. We are eager to return, and we look forward to seeing how much the children will grow and change over the next year.

We are off to Bangkok tomorrow. The adventure continues!

---Jenn

Morning Routine

2009-03-10T07:17:00.003-04:00

So cute!

Pre-school morning stretches before class

Bus ride to school

Pre-schoolers brushing their teeth

Cleaning their dining area after breakfast

Laundry Time

Clinic Day 2

2009-03-10T06:46:00.008-04:00

Today was another exciting day at the camp. We awoke to the usual excitement of kids running, cooking, and talking. It's simply incredible how the entire sleeping camp becomes so alive with activity. In the distance you can hear pots banging and kids singing songs as they work and play, while each area is filled with children doing their assigned task. And this is all by 6 am! After a good breakfast, we started up the clinic and first saw the preschoolers. They are such a cute bunch, how they enthusiastically smile every time we smile at them. Sadly, when I talked with some of them, they were usually very sad because they missed their families. Luckily, most of the children were healthy and their biggest problem seemed to be lice. Also, they are in serious need of dental care and this would improve their situation greatly. I am certain this is because of a lack of fluoride in the water and occasionally poor dental hygiene-although they do brush frequently from what I've seen.

After the little kids were done, we then saw the older kids. They were a little bit more difficult because we had to figure out what kinds of personal questions were appropriate. It's also awkward communicating through an interpreter about something personal. We managed to do it, and finished seeing all of the kids just shy of two days total. After this, most of our group stayed to enter the information on the sick kids into a database. A few of us went with Deng- one of the principle caretakers- into town to get medicine that we needed. When the first store we visited was already closed, it began an amazing adventure. We ran into another shop close by that had a pharmacist who spoke English. He was very friendly and even gave us a discount on the drugs we bought! He then told us about a hospital we could visit that might have the rest of the supplies we needed. When we went to the hospital, we then met a Thai doctor who told us about a lab company that might have the things we needed. We then managed to find this office in the middle of town only five minutes (!!) before they closed. The people in the office were very friendly and even gave us their fecal occult developer solution because ordering it for us would've taken too long. Instead, they will order it for themselves. The cost of the items was of course very cheap, and we were able to afford it.

When we returned, we were greeted by an emergency because a girl had broken her arm. She fell on her outstretched hand, and she appeared to have a classic Colle's fracture. Luckily, the ER nurses were here and knew well how to care for this kind of fracture. We made sure her feeling and pulses were intact, and then splinted the arm to transfer her to the hospital. Just after we took care of this problem, a young boy came in who had gotten a small cut on his head. It was bleeding a lot, but it was not terribly injured. We put antibiotic ointment on it after cleaning it, and then covered it.

We all shared a late dinner, and literally felt exhausted. Living here is a struggle. Everyday is joy and excitement, but it is living- it is not luxurious or easy. Being here reminds me of things that I take for granted everyday. I am also inspired because I see these kids that are so happy now, and I know that they have a good chance to grow up and be educated to succeed in society.

---Ivan

I can do that!

2009-03-09T08:56:00.002-04:00

After we were finished with the morning clinic the children demonstrated their skills in measuring their height.

Curiosity

2009-03-09T08:51:00.002-04:00

The kids were fascinated by our activities. There was nearly always someone looking through the window.

Down to Business

2009-03-08T21:08:00.002-04:00

The long journey, expense and hassles endured seemed to evaporate as hundreds of children surrounded and mobbed us with hugs and hello's as soon as we stepped out of the truck. After 24 hours of flying, and sitting in airports, we arrived at the Akha training center, and the reason we were here was clear. Scores of kids grabbed our luggage and took us to our rooms. They all love to practice their english on us and they have soul melting smiles. I immediately noticed their teeth and skin were vastly improved over my first visit here.
The students and I were introduced to them and we are all making friends by the minute. We held the first day of clinic and saw over 260 children. The mission is to install a medical record database so we can document and follow the health of the children. Many of them are small for age and most have not been fully immunized. The problem is there are no records of most of the care they receive from various volunteer agencies. The myriad questions about their health will remain difficult to answer and manage without medical records. Since many of them are orphans we have little information on their family and past history. We are focusing on ROS and drilling down on issues found and documenting exams. While most are healthy kids with usual childhood issues we found several with significant issues, including cardiac arrhythmias, a mitral regurg murmur and several wheezers. Due to the smoke from the farmers clearing fields with slash & burn methods it is not clear if there is an underlying pulmonary problem. By having a chart to follow them we will hopefully be able to tease this out.
I am extremely proud of our students, they did absolutely yoeman work yesterday. Because of that we should be able to work at a bit more leisurely pace. One of the students is a dietician and will discuss ways of improving the calorie and protein in their diet. With that and growth charts we can begin to evaluate the questions about their size. I believe they are constitutionally small people and some also have superimposed malnutrition.
We will teach the older children the basic metrics and normal exam to continue updating the medical records. With it being web-based I hope to be able to continue to evaluate them from home. Perhaps the residency program directors will be interested in making this available to their docs. There is much to learn and give.
Time to teach more English. Today, "Whatsuuuuuuuuuuuuuuuup!"
KLF

"Whatup, Clinic Day 1"

2009-03-08T19:54:00.005-04:00

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

The Akha Training Center

2009-03-08T01:51:00.004-05:00

After 5 hours of much needed rest, we awoke this morning to our first full day in Thailand! We enjoyed a nice breakfast at the hotel and left for the airport to catch a flight into Chiang Rai that we had not yet booked. It was somewhat of an amazing race to find the cheapest tickets! Luckily we were all able to find round trip tickets from Bangkok to Chiang Rai at the last minute. The flight into Chiang Rai was about an hour. Upon arriving at the airport, we were greeted by David Stevenson and some of the children from the Akha Training Center. The 17 of us, along with the 5 of them, loaded into 2 small trucks and began the one hour long drive to the center. For some of us the drive was an exciting experience, as we were piled into the back of the trucks with luggage and groceries going at least 60 miles per hour on winding roads. While those of us in the backs of the trucks did not have the most comfortable seat, we definitely enjoyed the best view of the amazing landscape!

Once we arrived at the center we were greeted by hundreds of smiling children from the Akha tribe. They all rushed to grab our luggage or simply grab our hand and lead us around the center. We were served a delicious dinner of rice, chicken and vegetables by some of the children. Afterwards we watched all 400 plus kids enjoy a time of devotion and singing. When they were done singing, it was our turn. We introduced ourselves one by one to them and then sang the song “If your happy and you know it.”

Our original plan was to hold a vaccine clinic this evening, but we have not yet been able to get vaccines. We are still working on this and hopefully we will be able to purchase the vaccines and administer them to the children before leaving. So far, now the plan is to get some rest before starting a long day of clinic tomorrow! We will start clinic after breakfast and our goal is to examine around 150 children in about 12 hours.

---Quincy

I've got Seoul

2009-03-06T14:34:00.005-05:00

We are half-way through our travels and maxin' in the Rest n' Relax area at the Seoul Korea airport. We didn't get into the nicer lounge because we weren't "elite" members (I knew I should've worn my tux). After checking our email at the free WiFi spot (where you at ATL airport?!?) we decided to get some real authentic food. After finding a squid swimming in Kristen's soup, Courtney got a 15cm Subway sub and I opted for a Whopper meal. I was slightly offended that the cashier at the BK asked me to pay "five dollars" instead of whatever the local currency was (I didn't check) like everyone else had to pay. I was even more enraged that after profiling me as an American she still only gave me one ketchup packet. I thought to myself, maybe she's had a long shift and politely asked for more. I received a second ketchup packet; I politely asked for more. It was at this time that the manager came to the front to see what was going on. I explained the situation to him and offered to pay whatever kind and amount of money to get a sufficient amount of ketchup packets. Fortunately he was delightful and gave me an American handful of the most amazing, high fructose corn syrupy ketchup of the day. I bowed and went on my way to eat my Seoul food.

The flight to Bangkok was uneventful. Between naps I had woken up to eat, drink, and fall back asleep. The high point of the flight was the Red Carpet Cheesecake ice cream for dessert; the low point was accidently catching a glimpse of the movie Twilight on my way to the restroom. When we landed in Bangkok and proceeded to customs I was quickly reminded that I am not a US citizen and was delightfully asked to leave the group and head

back to get a visa. Since there were armed guards walking around

I figured I would just do what they said. When I got to the visa parlor I waited in line behind a large group from China. Five sweaty minutes later I was informed that there was a form I needed to fill out behind where the line starts; I did. Ten nervous minutes in line later I was kindly asked to provide a photo for the visa. Hmm. Where did I put those passport photos... Oh yea, in my imaginary "never got 'em" pocket. Luckily, there was a photobooth a few miles east and, yes, you guessed it, they only take Baht and nath the US dollars. A currency exchange booth was conveniently located back at the visa shop. A few long moments later I was reunited with my American group and we were on our way to our hotel.

At the hotel we were warmly greeted and quickly showed to our rooms. The rooms are very nice and modern, and include a kitchenette and flat screen TVs... very snazzy. After we got settled in we showered up (except for India and Angela... P-U) and got ready for the big adventures that tomorrow will surely bring. Stay tuned...

Adam Vytykac

And we're off!

2009-03-06T04:14:00.007-05:00

We're almost there! 22 hours down and 8 more hours to go (I think... the time changes are a little confusing). But, we've made it successfully to Seoul, South Korea. We left Gainesville this morning... or I guess that was yesterday... with no bumps or troubles. With a few hours to browse in Atlanta, we prepared for our 15-hour flight. We actually flew straight north over the North Pole. India happened to glance out and see icy peaks. I was asleep. We then flew south over Russia and probably China, but avoiding North Korea. A passenger told us that North Korea has threatened to shoot down any South Korean flights over their borders.

We flew on Korean Airlines and the service was excellent. I have to say, the flight attendant's outfits are pretty cute, too (see right). I had two meals, took a snooze, took an occasional lap and watched 3 movies to pass time. Overall, it was good except for when I got nautious on our descent. I asked the attendant for a barf bag and she gave me a huge shopping bag instead! Thank goodness I didn't end up needing it!

Everyone is roaming the airport now for food and money exchange before our last flight. This airport has free wi-fi and couches to lounge on, unlike Atlanta! It's pretty comfy! Whew, this is a long day/s of traveling. Nap time!

--- Courtney

Pictures from Previous Trips

2009-02-21T16:16:00.009-05:00

insider - UF College of Medicine News Resource - University of Florida

2009-02-21T10:31:00.000-05:00

Nice write up of our Inaugural Mission. insider - UF College of Medicine News Resource - University of Florida

Our trip is created!

2009-02-16T10:28:00.005-05:00

Well, our trip to Thailand is now a reality. Thirteen University of Florida medical students have joined our team to venture across the globe. With Dr Ferguson at the lead, we will travel to Chiang Rai, Thailand, where we will provide basic health care needs and immunizations to the children of the Golden Triangle. Dr. Ferguson, who is Director of Emergency Critical Care at UF, first traveled to Thailand to assist in emergency relief after it was devastated by a tsunami in 2004. On this trip, there was need in the north region of the country, and he traveled to an orphanage in Chiang Rai filled with children without access to healthcare. Since then, he has returned to the orphanage each year with other volunteer nurses and doctors.

This year, we have begun Project Thailand, where medical students are joining the cause and will be able to take history and physicals of ~100 children each day (as a team). This will be an invaluable learning experience for us as medical students. Our goal this year is to bring continuity to the orphanage's access to healthcare. Last year, each child's medical history was recorded on a 3x5 card and filed. The orphanage is converting these files into electronic records so that we can create a medical SOAP note (fancy doctor word for medical record including history, physical exam, and what the assessment and plan will be) for each patient electronically. This way, other volunteers and healthcare providers that visit the orphanage will be able to see what has been done and what needs to be done for the children. Another goal is to teach the older children how to do basic health measurements, such as weight and blood pressure so that they can be recorded throughout the year.

We are traveling to Thailand over UF's spring break with a few extra days since flying there requires ~24 hours. Our entire trip length is March 5-15, 2009. The plan is to spend 4 days at the orphanage before heading back to Bangkok. In the city, students will have the option of shadowing emergency medicine residents in the ER. This will also be our destination to buy souvenirs and trinkets to sell at home for next year's fundraising. It will be a quick, hard-working, whirlwind of a trip, but will be completely worth it. Please follow our blog to read up to date activities from our adventures!