not my favorite feasting....

A wedding and a feast...

We went with about nine other foreigners to the burmese refugee camp about 45 minutes away today. The main reason we were allowed to go in was because they were having a wedding. We left about 7am (loaded into a car that was definitely not meant for the 14 people it was carrying) and went to the wedding. It was about one hour long and relfected similarly to a christian style wedding in the states (camp is half christian and half buddhist). Of course, we didn't understand much more than the song happy wwedding to you (same tune as happy birthday to you). This obviously wasn't too big a deal as the bride didn't understand most of he wedding herself as it was in burmese and she was from karenni state and didn't speak burmese. we were then invite very graciously to eat at the wedding breakfast/lunch. While this was very nice, it was not greatly appreciated as I had to eat mystery meat again (BAD taste and all fat). I helped jamie and one of the vegetarian girls with the meat they took thinking it was potatos. I have been burbing up nasty meat flavor for hours now. I smiled as inwardly I felt like gagging. But it was VERY nice and they were great hosts. Many of the medics were there so they showed us around the camp afterward.

We went up to a medics house (girl works at mae tao clinic and mom still lives at camp). It was actually much nicer than we expected. Very clean, made out of bamboo and branches with a leaf roofing. About thirty of us came in where they offered us soda, watermelon, and little pastries. Once again treating us very well as guests. Jamie and I are very glad we are feeling better today as if we had not, it would have been impossible to eat the food they served us. The food at the girl's house was good though (i can never complain about watermelon). We then walked to the clinic that was in the opposite direction (we had thought we were walking to the clinic). We walked over a bridge that we were told we weren't supposed to cross by the medical coordinator at the clinic, but the medics said okay, so we went.

We got to the clinic, which was large with a green tarp over it. Outside, teenage boys were playing soccer. We waited to see if we could get permission to see the clinic. After about 15 minutes, it was decided that we could not, so we headed out about 11:45 am to come back to mae sot. It was an interesting experience. For one, I feel guilty for thinking it wasn't as bad as I thought it would be. I am attaching a couple of pictures of the food and the area.

An English Lesson.

One of the medic student's invited me to come to her English class after clinic. So, Jamie and I met her at the clinic at 4:45pm and walked down to her class consisting of 10 people and a Burmese teacher who had only 8 months of official training (although his English was the best I have heard here). They got us a coke and a strawberry fanta to thank us for coming to their class. Then, we introduced ourselves and the students introduced themselves. After that, the students were supposed to ask us questions.

For about the next hour, the students asked us questions ranging from where were we from to what do your parents do to how much our guesthouse is charging per night (they were horrified by the 400baht/night answer). The girl I have been working with asked me how many marriage proposals I had gotten and when was jamie going to ask me to marry him (without any prompting I may add). She also asked how much I was going to pay jamie to marry me. I said zero and explained how he had to buy me a shiny diamond ring if he wanted to marry me.

We really enjoyed ourselves and it was a lot of fun. Oh, and we also learned how to say son of bitch in burmese :-)

another week of clinic finished...

i just finished another week of clinic here. not a good week for infants at the clinic. but, learned a great deal. next week I will be in the child outpatient. Mostly acute URIs from jamie's experience, but I shoul see some malaria, severe pneumonia, mass vaccination, and more. should be interesting.

jamie and i have started doing long walks in the afternoon. and we have also discovered pineapple shakes. those are my favorite. this weeks cuisine has mostly consisted of cashew chicken, fried wide noodles, and fried rice. That is a good week. tomorrow is chinese new year so hopefully we will find the festivities. i am super excited about my day off. we haven't had a whole day to relax in the last two weeks.

i am sleepy.

A place that doesn't exist

It is an interesting place here. A place between two worlds. A place that according to the Thai and Burmese government doesn't exist. If it did exist, it would have to be raided as all the patients and staff are here illegally in this country. The staff can't go out at night as they would be harassed by the thai police. The patients have to either pay 500 baht ($15) to come across legally or sneak across illegally risking getting caught and having to pay a fine or being put in jail. But, the clinic has existed for over 20 years and served thousands of patients.

Today was a sad day for a baby who did exist at a place that didn't. It was born with little chance of living. First, it had a congenital heart defect. Given the Mao Tao Clinic (MTC) does not exist in the eyes of the Thai government, it had to be first referred to a sub-par hospital that does exist in Mae Sot so it could be referred then up to Chiang Mai Hospital which COULD do a surgery. Once at the Mae Sot Hospital, the baby got sicker and sicker developing severe pneumonia and then raging meningitis. After a few days in the ICU, the baby was sent back here as there was "no more to do." It was sent to MTC to die.

The baby received all available treatment. Antibiotics for PNA and meningitis, salbutolol and oxygen, paracetamol/ibuprofen for fevers, and diazepam/phenobarbitol for fevers. Today, at 1:00pm after being at MTC for 24 hours, the baby's heart stopped. After giving compressions, oxygen and epi, death was pronounced with the mother sitting at the baby's side. The mother held the baby for awhile and later I saw she was gone. The worst part is that she cannot even bring her baby home for burial as dead bodies cannot cross the border back into Myanmar. It was a sad day.

First week of clinic

Today, we moved into our three room guesthouse plus bathroom and kitchenette. While this is a bit pricey, it is the only room available at Ban Thai Guesthouse for this week, so, we have to stay in the luxurious air con sweet for $25/night. It is probably the nicest place I have every stayed. It is our own little house surrounded by jungle. I could definitely do this.

Jamie and I have settled into a little routine consisting of waking up in the morning, eating breakfast consisting of milo (basically coco puffs), and then heading for our 15 minute walk to work. We get to the clinic about 8:30 and see patients with medics until about noon. Then we head to lunch at a local lunch stall usually costing 40-50 baht for the two of us (about $1.30-$1.50). We then have a fruit for dessert --- pineapple, watermelon, and we will start trying some new things (10 baht). Then back to the clinic until 4pm. At this point, it is kind of slow for the afternoon. I will see a couple of patients and then just hang out with the medics. After this, Jamie and I walk home. We have been taking a nap during the heat of the day and get up around 6:30 to go get some dinner either at the night market or at a more pricey restaurant. We then come home, do some work on the internet, watch a movie on the computer, and relax. This is definitely a lifestyle I like.

As for the clinic, I felt like I did something good today. I helped diagnose a tonsillitis that may have otherwise been missed. Although this is not too hard to diagnose, I was rather proud of myself given that I don’t speak the language and no one had mentioned anything about a sore throat. I asked the patient if she had a sore throat and when she said she did, I looked inside and saw white exudate all over the tonsils WITHOUT a light. Finally, I think I might have helped. I have also spent some time explaining that HPV and not PID causes cervical cancer and that IUDs alone do not cause PID. I also got to do a condom demo to a patient as well as a vaginal exam. I also explained that one could still ride a bicycle with an IUD. So, finally, I do feel as though I have some skills.

Today, I also got a bit more insight into the refugee situation here. Given that it was a quiet afternoon, I talked to the medic who has the best english speaking ability and discussed refugee issues. All the medics here, the medic students, and staff at the clinic are Burmese (mostly from Karen State) who are here in Thailand illegally. Thai police will stop them at will and threaten jail or sending them back to Burma. Most have lived in refugee camps. Most fear both the Burmese Army and the Karen Army as these soldiers have burned their villages in Burma, beaten them, and worse. The secretive Burmese government keeps this out of the news. Not that anyone would probably care anyways.

First day at the clinic! It has been both an okay day and a bad day. Okay, it wasn't that bad. But, I'm pretty tired. First, Jamie and I were thinking, we can stay at this place. Yes, there are holes in the walls and the beds are hard as rocks, but it is in a nice locations, quiet, big kitchen, on a beautiful rice paddy. This isn't so bad. That was until 2am when we were woken up by roosters and dogs next door for the next fives hours. Blah. That was the one thing neither of us was willing to deal with. So, we are staying at a local guesthouse that is really cute. Only problem is that we have to change rooms three times. It won't be bad though.

As for the clinic, I am starting in the women's health outpatient clinic and Jamie is in the children's outpatient area. I spent my day working with a medic who is doing 3 weeks of each department at the clinic (surgery/trauma, women's health outpt, reproductive health inpt, adults outpt, adults inpt, child inpt, child outpt). We were measuring fundal heights, listening to heartbeats (thru stethescopes, not U/S), doing leopold manuevers to figure out where the babies head was, and going through the woman's history. For lunch, we quickly moved all of our stuff. That was pretty exhausting. I came back and was explaining that HPV caused cervical cancer and not PID and how IUDs do NOT increase risk of infection depening on the style of string, when things went bad. And I almost cried!

This awful white lady from Vienna starting tearing me a new one on how it was so horrible, disrespectful, and rude that I was wearing scrubs. I needed to donate these scrubs and wear my other clothes. When I said I didn't bring that much of other clothes, she told me I should buy some. When I told her I didn't have a ton of money, she said I should go back to the U.S. Then she yelled at me for Bush's taking away reproductive health money and how they haven't seen Obama's money yet. I was like, sorry, I don't agree with it, but Austria isn't donating any money either. It's not like I am a huge fan of the U.S., but at least we are trying. Anyway, I talked to the coordinator at the Thai clinic and she said this woman was crazy an I shouldn't be too upset. So, I'm working on getting over it. I think Jamie and I might just wear the same outfit everyother day so we don't have any more run in's with her.

After that, Jamie and I came back to our new guesthouse and chilled for awhile. We went down to the night market and got some DELICIOUS noodles, pork/chicken, basil for 40 baht (equal to about $1.30). That was for the two of us! 20 baht each! and it was super yummy. We are both exhausted from a long day. Our goal is to stay up to nine. I'm tired already and it is 7:45.