From Thighland to Thailand

Thailand 3.11

March 1, 2010-Monday-11th day

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www.markchinmd.wordpress.com and www.fcbcfresno.org

WE’VE MOVED!

MTI traveled about 2 hours to the Khmu Eane Village in Chiang Khong on the border of Thailand and Laos divided by the Mekong River.  The mayor is known as King Khong.  We will be working here for the next two days.  To get here the roads are bumpy and winding and I’m glad that Jack has a steady supply of carsickness meds.  We have covered a lot of territory going into Myanmar and across Thailand with long hours on the road.  Thus, the exposure as a passenger subjects us to risks and can be hazardous to our health.  But if you have the opportunity to ride scooters like Pastor Jack, Andy and Dr. Tajiri in Thailand or will be visiting these parts, I have made several observations and recommendations about traveling on the road that might be useful.

Wear a seatbelt even though the driver wraps them up neatly with a rubber band and doesn’t want you to use them. Markings on the roads and traffic signs are for suggestion only.  A few drivers follow the guidelines and even though there are no posted speed limits most vehicles don’t have enough horsepower to drive very fast although some try.  It is suggested to stay on your side of the road (which is opposite to the US, unless you are back in Myanmar and the only direction I want to drive is to the border).  The drivers like to meander around the curves and utilize the principle of “the shortest distance between two points is a straight line” so as long as no one is coming on the other side they have another lane to use.   Although some vehicles have GPS systems and maps they still can get lost so they generally leave them off.  You are really a skilled driver if you can watch a DVD and drive at the same time.

Drivers of scooters have a death wishes.  As a courtesy, two honks alert the scooters who are in the way of a larger vehicle while three honks, whaling on the last one means the driver really means it and you are about to be road kill. And if you are on a scooter and get hit it was your fault for being there in the first place.   If you get in an accident, the larger vehicle wins.  Scooters are a one-size-fits-all.  If you have 1,2,3,4, or 5 members of the family plus a pet and fit on the scooter and the scooter moves, you have transportation.  Remember, it’s not that impressive since 2-3 of them make up one average American.  Pets may travel in a basket, on the seat in front of the driver, or if you are a monkey you can sit behind the driver if you know how to hold on with two hands around the driver’s waist. The scooters, who are like ants, yield to the larger vehicles. Scooters are multi-functional and you may stack things as high as you want as long as you adhere the physics principle of center of gravity.  The centrifugal force allows you to drive in a straight line.  You can use an umbrella as a windshield.  You don’t have to have a license to drive a scooter and there doesn’t seem to be an age limit.  Scooters can drive on either side of the roads in any direction. A recent helmet law reinforces the emphasis of driver safety involving scooters.  Women passengers like to ride sidesaddle because straddling the seat with a dress is not lady like; they have uncanny balance even when reading a book.  Children often sit in the front, unless they want to stand, in order to block the flying debris and bugs from hitting the driver, which might cause an accident. Interestingly there doesn’t seem to be road rage. I think because there are no traffic rules no one gets disrespected, no one has expectations, so no one breaks the rules, so no one gets angry, therefore, no road age. Americans should learn from this simple lesson. Remember to share the road. Driving is a privilege, not right. Happy and safe driving!

Now that we made it safely here at our intended destination, safe and sound, our local contact for Eane village is Pastor Khoon and Pastor Phonekeo.  Pastor Phonekeo is from Fresno and is associated with the Laotian congregation at the Mennonite Brethren Church in Fresno.  Born in Laos, of Khmu heritage, he felt that God led him to this village and seven years ago he started this church.  In the first year of the churches existence there were three Christians and today there are over 100.  He will leave the church in Fresno and become a full time missionary back in this area next year.

We arrived at the one room church and set up shop.  They had to retrofit the sanctuary that we are working in with more power lines since the dental and optical teams are power hungry.  They were shocked at the lack of outlets.  These teams have a constant power struggle because some feel empowered with all the energy that they can get.  Some of them are AC/DC. Watts the problem here. You need a high voltage guy like Bill to take control and keep us grounded.  All the equipment seems to work so the team gets charged.  Currently, it’s electrifying to see how we all work together.

The initial group of patients we treated traveled from communist Laos up and over the mountain and illegally crossed the Mekong River just to come to the clinics.  We have to see them first so that they can return to Laos before sunset.  They seem to have more illness than some of the other groups we’ve treated with multiple conditions requiring more medications, some, which we do not even have.  They   have traveled so far with vague complaints of total body numbness or pain or achiness “all over” and it’s hard to pinpoint a cause for their complaints.  Furthermore the language barrier compounds the translation of their symptoms. Without lab tests or X-rays we really have to use our diagnostic skills and treat our best guesstimate. I just say, “When in doubt, cut it out.”  A lot of them are dehydrated and Andy is antsy to start an I.V. to rehydrate a patient.  I suggested giving him bottled water but there were several gasps amongst the team.  Apparently there is a water shortage and they want to conserve our supply.  Okay, go ahead and spend $50 on that I.V. ;that sure makes sense  That’s why there is a health care crisis in the US.  Then add all the unnecessary surgery that is done…wait that’s all I do, but my patients want it.  I’ll get off my soapbox now.

I think that Lynelle is carrying the team. In fact, I know she is.  She spent at least 45 minutes alone on this one patient with a 50-year build up of tartar.  Exhausted, she felt triumphant and yelled, “Victory!” and raised her hands.  It’s not unusual to have the dentists gathering around talking about the stock market or golf swings while Lynelle is working in the background.  Is that why you invited her, Bill?  And Bill has way too much time on his hands.  He comes around the medical turf and tries to triage the patients and wants us to pick up the pace.  We’re just doing fine, thank you very much.  Why it was just yesterday during one of Pastor’s dinner lessons that we talked about teamwork and he was teaching us  “Each of you should look not only to your own interests but also to the interest of others. (Phil 2:1-4).  Is that what your doing?  Pastor Jack prepared a lesson book for each night with scripture and responsive readings.  At dinnertime it is a nice way to reflect on the days experience to see how both the group we treated and how the team was touched.  It also gives us encouragement for the next day because we feel that we are doing what God wants us to do: serve his children and spread the Gospel by example.

MTI saw about 200 patients today and we are expecting 200-300 from three villages tomorrow.  It’s a testament to their trust in foreign doctors and to those who refer them to the clinic.  Many of them are in dire need of care and endure hardships including illegal crossings of the border that we don’t want to disappoint them by either not providing health care or not being able to improve their health status.  Many of the medicines only last a month and we hope by identifying a disease we can educate them to help themselves.  For example a patient who had GI pain and chronic cough was advised to stop smoking, stop her daily whiskey consumption, and avoid spicy and fatty foods.  A newly diagnosed diabetic can be taught about hydration and limiting sugar intake to slow the progression of the disease in addition to some of the limited medications.  There are a lot of repetitive strain injuries that can be helped with proper ergonomics.  Of course the optometry dept. continue to improve vision and ability to read and provide an instant cure for most patients.  Even in the US we have to wait 2-3 weeks for glasses.  The dental dept. also provides eventual relief by tooth extraction or restoration.

At some point the questions will be raised as to “Who are these people that make sacrifices for us?” that will give us the opportunity to spread the gospel.  Despite our trials and tribulations and the hardships and setbacks that the team experience during this trip, I believe that there is no bad news, only Good News.

Medical Team International half was through…more to come, stay tuned for part 2.