Medicine in the Jungle

After a few days here in Chiang Mai, we've come to consider ISDSI our second home. It's where we meet up with Pi Poad and Pi Peter, eat most of our lunches, and get to meet some incredible speakers.

This morning we had the amazing opportunity to meet and listen to Dr. Mitch Ryan, a doctor who works for Earth Mission Asia. Dr. Ryan is originally from the United States and went to Wayne State University School of Medicine. He later went into the Air Force to pay for his medical school and practiced medicine in Arkansas before deciding to take his career abroad. His wife, two sons, and himself moved to Northern Pakistan and lived in the Himalayan mountains where he helped treat local communities. After a terrorist attack on the local school, his family moved to Myanmar/ Burma to continue his practice in marginalized medicine.
In 1948, civil war broke out within Myanmar and continued to ravage the country until a cease fire in 2015. Although a cease fire has been signed, there continues to be unrest between the people and the military. This unrest has led to many people being displaced from their homes and living in the mountainous areas of Karen. The persistent fear from the war continues to effect the population by causing them to remain "on the run" rather than care for their well-being and overall health. While most people might seek medical attention for an infected cut or a broken arm, many internally displaced persons do not seek out medical attention for such matters. The mindset tends to remain " as long as I can walk I am fine". Some of the leading causes of death in the Myanmar people are death during childbirth, malaria, diarrhea, and respiratory infections. In the Karen Jungle, the maternal mortality rate is 721 per 100,000 live births while it is only 14 per 100,000 in the United States.

After working in this area, Dr. Ryan saw a need for more marginalized medical doctors and staff. Karen has 7 doctors per 100,000 patients while the World Health Organization recommends 100 doctors per 100,000 patients. So, Dr. Ryan set out to teach men and women from rural areas the practices of remote medicine in hopes of combating this medical crisis. He established the Jungle School of Medicine in 2015 to prepare physicians to accurately diagnose and treat diseases and injuries they commonly encounter in remote locations. The program is five years long and consists of learning basic science, english, and math as well as teaching and practicing clinical medicine. As you can imagine, living in the Jungle would have it's ups and downs. Upon asking Dr. Ryan his favorite and least favorite part of the job, he said that he loves being able to teach local people medicine and connect with the community but that his career comes with many hard choices such as deciding who to relocate to hospitals and who they have the funds available to treat. He also stated that he has loved the creative process of solving issues most doctors in a hospital would never encounter, such as needing to build a bridge across a river to get medical supplies. His discussion of marginalized medicine was definitely eye opening on the needs of refugees and the need of creativity in a remote setting in being able to treat and save the life of these people.

After lunch and the presentation, we visited an M2 (middle referral center) hospital, Sanpatong, that is the leading healthcare center out of seven districts in Chiang Mai. We were treated to a presentation about the hospital and the guidelines/regulations of treating people with HIV and tuberculosis. The hospital has 120 beds and serves over 75,000 people. With a staff of 427, this hospital is able to provide consult for TB, HIV, COPD, and STI's in the area. They aim to lower the number of people affected by TB and HIV by providing early screening, consultations, and family meetings for the local people. We were also able to see the on site labs and blood bank as well as a section of the hospital dedicated to traditional medicine.
One of the most unusual factors of the hospital was that the majority of the building was outdoors. While the majority, if not all, American hospitals are indoor settings and feel extremely sterile, Sanpatong has wildlife surrounding the hospital (and they occasionally wander in) and is open air. Another large difference from American hospitals was that Sanpatong showed very little privacy between patients. Most patients shared rooms and were not isolated from each other despite their illnesses. Even in the ICU, many patients shared one large space and appeared to have no desire to be separated.

After a long, but interesting day, we headed back to the hotel to rest and later head out to dinner and some late night shopping at a market in which we were all able to find delicious foods and souvenirs to remember the trip by!



Hey y'all, Anneliese here!
My favorite part about today was Dr. Ryan's presentation. He showed videos of the work his team has done in Myanmar/Burma and it truly is so incredible and eye opening. He has hand delivered babies in the jungle, treated many children's illnesses, and helped a girl with a broken leg receive care and the ability to walk. During lunch I had the opportunity to sit and talk with him more about his work. I admire and respect him so much for the hard work and dedication he has to improving the lives of others. He is very knowledgable about the cases they see in remote areas, and he has shown true self sacrifice in helping others. He packed up, sold everything, and left America to help and serve those that truly need it in remote areas. I think it is even more amazing how he is working to give back even more by training students to become future physicians in order to help their communities. Dr. Ryan's presentation on marginalized medicine was truly one of my favorite presentations on this trip so far because his work is so special and is truly helping to change lives.

Hey it's Grace!
Just like Anneliese, I loved Dr. Ryan's presentation! It was full of heart warming videos and showed what an impact the Jungle School of Medicine and the Earth Mission Asia have on the Myanmar population. Dr. Ryan's passion on the topic was visible through the presentation and created an engaging environment in which we were all curious how we could be involved. One of the most interesting parts to me were his stories about taking patients across the border illegally into Thailand in order to get them medical care such as surgery. He stated that many Thai officials and doctors were willing and eager to work with him to get these displaced people the medical care they needed. I thought that this was such an incredible example of the Thai culture in regards to the kindness Thai people have for others. I also loved that Dr. Ryan pointed out the importance of creativity in treating people when you have limited resources.
I also LOVED the market ! It was incredible to see Chiang Mai after dark ! All of the street venders were selling food and clothes and cute little souvenirs while a live band played. Overall, this experience has been so eye-opening and has been such a blessing to get to know Thailand and also get to know everyone in the group. Stay tuned for more amazing adventures and stories !


Also, we posted a picture of Pi Poad and Pi Peter! ( They're like brothers and so sweet )
Pi is a Thai word used to mean "older sibling" in which one would show respect to, so we use the term Pi for Poad and Peter to show our respect when we speak to them!