Last year, I had the privilege of joining a team, led by Dr Steff Nash that trained these young medics through a two-level programme. Level one consisted of classroom tutorials and hands-on basic clinical skills while Level two focused on tropical and infectious disease. Both these levels run for 13 weeks a year. Our team was based at Mae Sot, a small town near the Thai/ Burma border, close to several refugee camps.
We travelled three hours a day through the winding mountain roads to Umpian Camp, where the trainees had their clinical attachment. Security was tight and we had to show both identification and official camp passes to move through numerous checkpoints. It was akin to a prison – if any of the 10,000 refugees at the camp thought about leaving, they would most certainly think twice. The village itself was in a squalid condition, the stilt houses made with bamboo and Nipah leaves. There was neither electricity nor water supply in most homes. We were happy to learn that there were NGO-run schools in the area and a village hospital set up by ‘Aide Medicale International’ (AMI), where we held the training program.
Tuk and his colleagues travelled several days to reach the camp and receive their training. It was an intense week for everyone as we taught them to perform physical examinations, venepuncture, cannulation, administering intravenous fluids, suturing and dressing wounds, splinting, bandaging and administering local anaesthetics. Although most of the participants understood basic English, some creativity was required to improve communication. We used pictures and live demonstrations to teach some of the clinical skills. A translator was also at hand when needed.
The lack of medical resources could not be more evident than when I taught a session on the assessment of a patient with an acute asthmatic attack. I was impressed by the participants’ knowledge of the drugs needed to treat the condition. However, I was greeted with silence when I emphasised the importance of administering oxygen. At the end of the class, one of the trainees meekly asked: “What should we do if we don’t have any oxygen?” I was taken aback. I had assumed that oxygen was readily available at all community health clinics; it wasn’t.
At the end of the week, the trainees sat a formative test, which they all passed. It was a joy to teach such an enthusiastic, passionate and intelligent group. I was humbled by their genuine desire to help their community in spite of being plagued by poverty, forced labour, infectious disease and landmines. Although some reside in refugee camps, many live in the jungle, in perpetual fear of persecution from the Burmese military.
My short time as a volunteer in Umpian Camp has opened my eyes; the thirst for freedom, peace and a place to call home is as distressing as lacking material resources. I have a renewed appreciation for the NHS and for everything I have taken for granted. We are often accustomed to advances in technology that aid our diagnosis and management.