After my first week at the Mae Tao Clinic and in Mae Sot, there is much to reflect on. The best way I can represent my time here thus far is "warmth and caring." I spent my first few days at MTC rounding with the adult and pediatric inpatient departments (IPD). MTC is a bustling place with patients and families constantly arriving to receive care they could not access or afford elsewhere. The entire MTC staff, both administrative and clinical, approaches each day with a mission-driven sense of purpose and teamwork. The care they have for their patients is palpable. The breadth of pathology they encounter is immense. When they care for patients who have medical requirements beyond the resources of MTC and require transfer to another hospital, their partner organization, the Suwannimit Foundation (https://suwannimit.org/), will often provide financial assistance to help cover the costs of surgeries or further diagnostic tests such as CT scans.
The following is just a sampling of some of the patients we saw during my first two days of rounding at MTC.
Adult IPD:
-Nephrotic syndrome (problem with your kidneys causing loss of protein in urine and fluid buildup in legs, abdomen, lungs)
-Delirium tremens (the most severe alcohol withdrawal, including hallucinations and seizures)
-Renal failure in the setting of diabetes
-Two patients with strokes
-Sepsis secondary to foot wound
-Leptospirosis
-Several patients with respiratory conditions, including pneumonia and COPD exacerbations
-Acute pancreatitis
Pediatric IPD:
-Infant with congenital right ventricular hypertrophy, a heart condition that requires surgery
-Nephrotic syndrome, 2nd relapse
-Infant with congenital lymphedema thought to be secondary to intrauterine CMV infection
-Child with fever, RLQ abdominal pain, arrived vomiting parasitic worms. Differential based on presentation and ultrasound is appendicitis w/ possible abscess, intussusception due to parasitic worm bezoar, tuberculosis. Not improving on antibiotics and plan to transfer to Mae Sot General Hospital for a CT scan.
-Pneumonia with recurrent respiratory infections
-Multiple patients with bronchiolitis (RSV outbreak ongoing in this region)
-Toddler with severe malnutrition and pneumonia
On a non-medical note, I finished my week with a pad thai and som tam cooking lesson and celebration hosted by Kalya and her wonderful family, who own the apartment building I am living in. The food was delicious, with many ingredients from their garden, but the company was even better. The group consisted of some neighbors living in my building and others living in Mae Sot working within the healthcare and NGO sectors. I was even invited to join a co-ed weekly soccer game by a new friend, Sia, who runs a local non-profit called Freedom Restoration Project (FRP). They focus on domestic violence, especially in the migrant worker and refugee/displaced people populations. FRP hosts support groups, runs parenting classes, and provides emergency shelter for women and children affected by domestic violence. As FRP describes it, their "services and programs designed to empower women and promote safety and a network of support." If you want to learn more about their work, please visit their website at https://frpthailand.org/.
Stay tuned as my next post will discuss the Emergency Care Unit (ECU) project and outline the many factors that must be considered when establishing an emergency department.
Thanks for reading and yes I did make the food pictured below!
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