Journal of Hope

2007 November

American Academy of Pediatrics, Pediatrics in Review. November 2007. Story of our efforts in Laos.

http://pedsinreview.aappublications.org/cgi/content/full/28/11/403

AAP Article AAP Article Page 2

2007 October

This year we helped children from villages near our home travel to Luang Phabang for cleft lip and burn surgery. This is now our Third Annual Journey of Hope. We would like to thank Dr. Panomsit and the staff for acomodating these patients. We would like to thank Dr. Dupuis from Belgium for helping the children we bring to him.

There are not as many patients as in previous years because this year patients were helped at our Provincial Hospital where SFE arranged for Dr. Dupuis to assist Dr. Sadachan with plastic surgeries.

Journey of Hope 2007

2007 September

From a recent email: "When we met in Vientiane three years ago I was so inspired by your work and commitment to health care. After that visit I came home, reasesed my career goals and applied to nursing school. I'm now in a nurse practitioner student at Yale University and you were a great influence on my decision to be here."

2007 Aug 27

Seng (2007 July 30 below) calls us every so often to ask about the biopsy from the growth on his face. He has been waiting for about one month. The surgeons told us that he could die during surgery, or end up paralyzed; and that the surgeons are afraid. So we assume the growth is malignant or the surgeon who offered to help is afraid of the possible outcomes. It's difficult to be in the middle so all we can do is provide the patient with the facts and let make their own decision.>

The Butterfly Children's Center in Muang Sing is doing great with so many activities for children of all ages. We are so fortunate to have 5 teachers from Vientiane helping the children.

Novice Monk paints a butterfly batik

A novice monk from a nearby temple has been here every day learning batik.

A neighbor plays the "si saw" for the children. A si saw is like a violin with two strings

A neighbor stops by to play a violin with 2 strings called a seesaw. The children sang along. He promised to come back and teach the children.

A patient of Dr. Dooley looks at pictures in Dr. Tom Dooley's book about his time in Muang Sing

The violinist was a patient of Dr. Tom Dooley in the 1950's. He is looking at a book written by Dr. Tom Dooley about his experiences in Muang Sing in the 1950s.

Teacher reading to the children at the Butterfly Children's Center in Muang Sing

We would like to thank Room to Read and Big Brother Mouse Books for providing the children with Lao Language story books.

Children at the Butterfly children's center learn paper mache from Ajan Somnuk

A group of children enjoy creating from paper mache. Ajan Somnuk coaches them on technique. The children call him Ajan to show him respect. Ajan is Lao for teacher.

Bacci strings are prepared

We needed to perform a bacci ceremony for one of the children who returned about two months at the Don Khoi Children's Development Center in Vientiane. The children were in charge of cooking. The first step was be purchase a live virgin female chicken.

Bacci strings are tied on both her wrists at the same time.

Bacci strings are tied on her wrists while acknowledging gratitude for her safe return from Vientiane.

Doorway divider made by the Butterfly Chidlren's Center

One of the craft projects was a room divider made from seeds, pieces of paper from magazines, and fishing line.

Nang Sengchan and Nang Bouavy from the Don Khoi Children's Center in Vietiane pose with chidlren at the Butterfly Children's Center in Muang Sing

Nang Sengchan and Nang Bouavy, two of the teachers from from Vientiane pose with the children.

2007 Aug 24

Mengkabua Children display their crafts projects

Mengkabua children proudly display their arts and crafts projects. The two craft teachers are in the back on either side of us..

2007 Aug 21

Model Fish - Nemo Octopus in Muang Sing

Tie-dyeing

Hello from Muang Sing. There are two art and craft teachers from Vientiane staying with us for a couple of weeks. They are teaching the children here how to do many different projects.

The children are learning many different crafts. Yesterday they made key chains, today they are tie-dyeing fabric.

Primary and secondary school will begin in a couple of weeks. We hope to help more blind or deaf students study in Vientiane this year. Every day children return school books to us. We will loan them to students this year.

We would like to thank the Bayer Foundation in Switzerland for their support. We would like to thank our friends David, Gail, and Jake from Santa Barbara for visiting us and helping with the children and patients. Thank you for your scholarship for the secondary school graduate going to study at business school.

Here is a newsletter article that a friend wrote after her visit to Muang Sing last year.
My Lao Experience

2007 July 30

Mat McCalla has been here from Direct Relief International (DRI) to assess the health care situation and needs in the capital and in the provinces. We have a long relationship with DRI, working with them to receive 2 cargo containers and numerous hand-carry shipments to Laos. Items included supplies and equipment for the Nalae District Hospital and the Muang Sing District Hospital, equipment for the needs of the Internal Medicine and Pediatric Residency Programs in Vientiane. We hope that new partnerships between DRI and other NGOs will be formed as a result of this visit. We encourage you to visit DRI's website www.directrelief.org

Seng telephoned last week from his home to tell us that he was in the hospital because his tumor was bleeding. We still do not have his biopsy results from Chonburri Hospital in Thailand. Here is a photograph of Seng and his sister. She came with Seng to take care of him in the hospital. After Seng went for a CT scan, we went sightseeing on the way back to the hospital.

Sarah and Mike, thank you for your support and for sending us the photographs. The three children at Don Khoi Children's Development Center were delighted to received them.

2007 July 26

Today we paid a $1,900 bill from the National Rehabilitation Center for 6 patients from Muang Sing that we brought to them. The good news is that 4 patients went home walking. Very sadly, 2 patients had to return home with no hope. The 15-year old boy amputee complained about pain in his chest, the diagnosis was cancer. Sengsalit went home to Muang Sing to be with family and friends. We helped to support his family until the end of his illness. The other patient was a young girl with club feet who had additional difficulties that prevent her from ever walking. Bona's photograph is below.

Even when the situation appears hopeless we help as we are able. Families cling to faint glimmers of hope and so must we. At the end of the day, we know we helped all we could, and do not have any regrets. We celebrate the four children who went home walking, and mourn for the two patients we were unable to help. These risks, even with the odds against us, seem necessary when helping individuals and their families.

Santa was fitted with a prosthetic leg and a brace to provide support for his damaged leg. He is now able to walk upright without crutches. In the background, Sengsalit watches Santa. It'sa shame that Santa's father passed away without seeing him walk again.

2007 July 24

Dr. Leila continues to support the Lao Pediatricians Continuing Medical Education through Health Frontiers by helping to plan and coordinate the annual pediatric conferences. In addition she visits the Pediatric Graduates in the provinces to perform an annual assessment of their professional and educational goals.

We have been cooperating and referring people seeking medical assistance to the Muang Sing District Hospital. They sometimes consult with Leila about patients. We are currently helping them with the knowledge, equipment, and supplies for the diagnosis and treatment of diabetes. Leila visits the Luang Nam Tha Provincial Hospital about once a week when she is in Muang Sing. She assists Dr. Phouvieng, a pediatric graduate, with patient diagnosis and treatment. We refer patients to both these hospitals for medical care.

The staff of GTZ in Muang Sing has been extremely helpful. They often find people in need when they visit villages, then visit us with the hope that we are able to provide assistance. They help spread information in the villages about opportunities, such as for cleft-lip surgery. We appreciate and heed their counsel since they have been here for many years and have many experiences to draw from.

We have hosted many visitors to our home in Muang Sing. Drs. Hakon, Karen, Cindy, Louisa and Kevin from Health Frontiers in Vientiane visited. Even Ning, the mayban from Health Frontiers arrived for a short visit. Dr. Paul Newton from the Mahosot Hospital Microbiology Laboratory went to visit villages with us. He was very helpful when we came across a leprosy patient. As a result of this visit, a link formed between Luang Nam Tha Provincial Hospital and Mahosot Hospital Microbiology Laboratory improving the diagnostic capability of the Luang Nam Tha Provincial Hospital. Dr. Hubert from the Institute Francophonie Medecin Tropical (IFMT) in Vientiane. After his visit he arranged for students from IFMT to research medical and public health issues in the province. Ruth and Joe from COPE in Vientiane came to visit. They visited some villages with us, and were able to offer guidance about their rehabilitation services. Several children were helped as a result of this visit. Clowns Without Borders came to visit to entertain the children is our village and a few surrounding villages. He juggled balls, sang, and played guitar. He left us with a generous donation.

This baby was born with a cleft lip and could not suck. They walked for two days from their village to Muang Sing. A friend of theirs brought them to our home. They were feeding the baby coffee creamer in a toy squeeze bottle. Right away we went to the market to find a breast pump, boxes of formula, and a baby bottle.

The mother never produced any milk. The father visited us every couple of months asking for more formula. One box costs about $6, equivalent to 3 days wages.

When a surgical team from Singapore visited, we brought the family to Vientiane. The surgical team did a great job allowing the baby to feed well.

On our last trip from Muang Sing to Vientiane, we brought along 3 children from our village. We took the bus, stopping for three nights along the way. One day, we took a boat ride on the Mekong. This was the furthest they had ever traveled. We ate noodle soup at quick lunch stops, and went out to a nice restaurant one evening. Everyone enjoyed mango fruitshakes. Boonphun ate that whole fish by himself. Later, when a beggar walked by, Boonphun wrapped the fish head in a napkin then handed it to her.

These three children are now attending the Don Khoi Children's Development Center in Vientiane. They will be there for two months before returning to Muang Sing. They were welcomed with a sign, songs, and flowers. The other children at the center gave them clothing because they were wearing all the clothes they own.

Mr. Bounliem fell off a roof 10 years ago and has not been able to walk since. He lived with his brother and never left the house. We were able to help bring him two wheelchairs. This chair has a hand lever to propel it along the road. We learned that he cuts hair, so we are helping to set up a barbershop in front of his home.

We helped to connect a boy with valvular rheumatic heart disease from Luang Nam Tha to a team of visiting heart surgeons. The surgery could not be done here so the team took the boy to Germany for care. The boy is doing well now and receiving regular checkups in Vientiane. His father offered us a baby monkey in appreciation. After some negotiations, one of his sons was offered in exchange for the monkey. More negotiations finally resulted in a solution that pleased everyone. Leila was given a lovely skirt hand-woven by the boy's mother.

We would like to thank everyone who brings us clothes, especially children's clothes. The Women's International Group (WIG) in Vientiane has given us boxes, bags, and more boxes of clothes. We appreciate their help, especially all the help they provide to patients that we refer to hospitals in Vientiane. We could not do what we do without their help.

I hope someone recognizes their beautiful dress.

Sengsalit is on the right, arm in arm with his brother. Sengsalit's father asked me to take family photographs. At this time, only Sengsalit and his father know he was dying from cancer.

A noma survivor we brought to a team of visiting surgeons at Settatirath Hospital traveled to Singapore for plastic surgery to improve her facial appearance. Now, after three surgeries, including micro-surgery, her face is much nicer. She even came to visit us at our home in Muang Sing. She travelled alone all day on two busses to reach our home. She has come so far from her hiding place in a dark corner of her family home. We talk to her several times a week on the telephone we gave her. Dr. Leila continues to follow up on rumors of noma survivors. We are aware of one survivor in Muang Sing, and three survivors from Nalae District. We are hoping that Mahosot Hospital is able to help them with facial reconstructive surgery when the surgical team from the Netherlands comes to assist. The WHO official map shows no reported cases of noma in Laos.

Santa's father was deaf. Two years ago, he motioned for his son to cross the road. He did not hear the sugar cane truck, and when he saw it, it was too late. Santa was run over. He lost one leg and damaged his other leg so he could not walk. We took him to the National Rehabilitation Center early this year where he had surgery for his damaged leg.

We were asked to visit a village to see a baby born without an anus. We brought the baby to Mahosot Hospital where Dr. Phedavanh did surgery to correct the problem. Professor Liem from Hanoi assisted with a one-step surgical procedure.

Here is photograph of the baby breastfeeding from her mother at home in their village.

The baby died about one year later from diarrhea. Diarrheal illness accounts for many deaths in children under 5 years of age.

Dr. Phedavanh repeated the procedure on another baby we referred to him in July.

Bona, a ten year old girl, stopped walking seven years ago due to peripheral neuropathy. We had been visiting her village for over one year and never saw her. Then one day, she crawled over to us wearing flip-flops on her hands to ask for help. After two surgeries, and many months of therapy she is walking again. She went home earlier this month walking with braces on her legs and no crutches. We look forward to visiting her at home.

We visited Bona's family in the village. They enjoyed talking together when she was in the hospital.

Khamphat wearing his prosthetic leg We took Khampat to Vientiane for a prosthetic leg over a year ago. He wore out the leg, so last year we took him again for a new leg in January. It's very rewarding to see him riding his parent's bicycle past our home, or find him play ball or climbing trees with other boys.

Aju had a difficult delivery that resulted in a urinary fistula. Dr. Phet performed two surgeries to correct the problem. We do not yet know if the surgery was successful. Her village is hard to get to, and we have not yet visited her. Urinary fistulas are a very difficult problem because of extensive tissue damage. We have tried to solicit help from WHO to provide specialized urinary fistula repair training for Dr. Phet, but they have not been responsive. Patum is another urinary fistula patient. Dr. Phet did two surgeries that cured her. She just married the schoolteacher in the village and is pregnant. Even specially trained surgeons are only successful 2/3'rds of the time, even after two surgeries.

The egg slicer makes eating eggs a lot more fun. Pisho from an Akha village about 20 km from Muang Sing. He came to us with osteomyelitis in his leg and arm. We took him to Mitthapab Hospital earlier this year where his bones were debrided. He is continuing to take antibiotics orally. We visit him to ensure his disease is resolving successfully. He is the third child with osteomyelitis that we have been able to help. All three children are doing fine.

The Muang Sing Hospital was treating Seju for leprosy. His village did not help him, so he had to work. Since he has no feeling in his hands and feet, he injured them, but did not attend to his wounds. We took him to the Skin Hospital in Vientiane where he improved, but afterwards he returned to his village where his condition deteriorated. Last month in June, we brought him to live in a leprosy village where he will learn self-care. We will visit him at the end of August to see how he is doing there and whether he prefers to stay or return to his village in Muang Sing.

Almost everyday, if both of us are at home in Muang Sing, the children from our village come to play. We provide art supplies, puzzles, and sport equipment. Last year two Lao teachers from the Don Khoi Children’s Development Center in Vientiane stayed for one week to direct children’s activities. The children’s parents were invited to a song, dance, and acting performance. Last year three children from Ban Nong Boua came to the Don Khoi Children’s Development Center in Vientiane for a two month scholarship.

This year we are planning for Dr. Dupuis to assist Dr. Sadachan at the Luang Nam Tha provincial hospital. We will screen patients at the Muang Sing Hospital. The patients will be screened again at the Luang Nam Tha Provincial Hospital for immediate surgery, or surgery at the Luang Phabang Provincial Hospital. We are also planning to assist with helping patients requiring facial plastic surgery when a visiting Dutch team arrives in January. We established a relationship with them last year while they were at Mahosot Hospital.

We helped the first Akha medical student in Laos through the admission process. He has completed his first year of medical school supported through an anonymous sponsorship. He told us that all the Akha people are following his progress, so he has to succeed. We are providing nursing scholarships to two nursing students from Muang Sing studying at the Nursing School in Vientiane. We provided a Scholarship for an Akha female student from Muang Sing to graduate from the minority boarding school in Luang Nam Tha.

Tuseh, a 14 year old boy from Muang Sing is deaf and never went to school. We took him to the deaf school in Vientiane where he has completed grade 1. He is the boy on the left with the blue eyeglasses and the spiky hair. I brought his photographs from his village. We think he will return in September for grade two.

Children saying hello in deaf sign language

Here are Tuseh's friends at home in his village saying hello to him in sign language. I brought them pictures of Tuseh at the deaf school. The only way he could communicate to his family was through facial expressions in the photographs.

Tuseh returned to his village for the first time in 9 months during the school holiday. He rode a bicycle from his village to our home to tell us his muscles were sore and to show us the blisters on his hands. Planting rice is difficult work.

Next school year, we hope to help 2 blind boys attend the blind school in Vientiane. We also hope to support 3 more deaf students at the deaf school in Vientiane. Many children around Muang Sing become deaf from childhood ear infections.

When we first visited Tegu, he was living with his father. The boy was filthy. We climbed up the stairs and sat on the balcony with Tegu. There must have been around 40 people from the village crowded around. We gave away toys and clothing. We learned that Tegu was accidentally shot in the face loosing both eyes. We told the people in the village about the blind school in Vientiane. His father did not come outside the whole time we were there. He just said "sure, take him"

We have visited several times since. Tegu in living in the same house, but with his grandparents. His father is not around. They are taking better care of him and tell us that they would like him to go to the blind school. We hope to enroll him in September 2007.

The other blind boy fell off a balcony and damaged his brain. He has good parents. They would like the doctors to put in new eyes.

2007 July 13

Today a patient arrived from Luang Nam Tha. Seng has a tumor on his face that was surgically removed at least three times. The tumor has recently grown back and the surgeons from Mitthapab Hospital planned to help him. With the help of a visiting surgical team from Dallas Texas ( L.E.A.P.) they examined his face and CT scan last week. The surgeons concluded that the surgery would not be safe here due to equipment limitations. They did a biopsy, sent it to Chonburri Hospital in Thailand, and are waiting for results. We hope that they will be able to help him.

Murphy, part of the L.E.A.P. team brought a Medtronic external pacemaker to donate. We arranged for them to meet with the director of cardiology. He was very pleased to receive this donation. He said that many patients whom could benefit from a temporary pacemaker. This is the first external pacemaker in Laos.

2006 October

Journey of Hope 2006

Second Annual "Journey of Hope" trip.

We took 25 patients and their families from Muang Sing to Luang Phabang Provincial Hospital for plastic surgery by Dr. Panomsit and Dr. Dupuis from Belgium. The hospital was only able to help 22 of these patients due to unavailability of time and equipment. Here is everyone posing on the front steps of the hospital as they left to return to Muang Sing.

Dr. Panomsit and Dr. Dupuis are standing in the back row.

We wonder how many patients will want to be included in the 2007 Journey of Hope.

Here is the first "Journey of Hope" trip in 2006. We took eight patients and their families from Muang Sing to Luang Phabang Provincial Hospital for plastic surgery by Dr. Panomsit and Dr. Dupuis from Belgium.

Photographs from this trip were incorporated into the "journey of Hope" DVD.

2006

This young girl was introduced to us by a friend. Her eye, about the size of a golf ball, was sticking out, black, and uncomfortable. It had been getting worse over the previous year. Her parents had no money to take her to the hospital. Despite the odds, we helped her get to Vientiane and find a surgeon willing to try. Her eye was removed and she returned to her village where she lived happily for several months.

Later she stopped eating and died. Her parents called us with the sad news, and to express their gratitude everyone who helped them.

How to Help Children in Humanitarian Disasters Book Cover