TRAUMA CARE

"No Backup Out There"

© J. WELLS
CPI has helped train more than 300 senior medics to triage patients in the field, provide care in village clinics, and following a Training-of-Trainers model, implement their own workshops for newer health workers in Myanmar.

In the mountainous jungle of eastern Myanmar, a petite 24-year-old Karen woman peels back layers of white plastic and cloth wrapped around a stalk of sugar cane — a prop simulating bone, muscle and skin — before cutting it with a cable saw to practice amputation.

The exercise — part of a trauma skills workshop facilitated by CPI and our partner organization, the Karen Department of Health and Welfare  (KDHW) — is a stark reminder of the border region’s rampant malaria, malnutrition and conflict-related trauma, including one of the world’s highest rates of landmine injuries.

In charge of a health team assigned to an area with about 2,000 villagers, the young medic spends four months hiking through the jungle treating patients before returning to the Thailand-Myanmar border to attend trainings, deliver patient data, and pick up supplies for the next field stint. She is paid $20 a month, which covers little more than the rice, chili oil, and seasonings she carries along with her medical kit — a knife, malaria medicine, antibiotics, IV solution, gloves, sutures and anesthetic.

She knows firsthand the value of continuing education — of practicing how to stop bleeding, create an airway, saw through bone. Skills learned at a previous trauma workshop, she said, helped her save the life of a villager, his left foot and ankle blown off by a landmine.

Her goal to be a health worker has been one constant in a life of dislocation. Her mother died when she was a baby, she said through a translator, and she hasn’t seen her father since he sent her to live in a refugee camp in Thailand thirteen years ago. An older sister died, a brother disappeared.

She trained with senior medics in Myanmar and at the Mae Tao Clinic in Thailand for more than two years before receiving her medic certification. In the field — where even carrying pen and paper can arouse suspicions — she has had her share of close calls. When soldiers came into the hut where she was hiding with her supplies, she pretended she was the village elder’s daughter. “I am very small,” she said, smiling.

Why does she risk her life to provide health services in a dangerous, conflict-affected region? “The villagers are in a bad situation,” she said. “I feel good that this is helping my people.”

The backpack medics “have a can-do attitude,” said Dr. Larry Stock, director of CPI’s Trauma Management Program. “Faced with a health crisis and major trauma, instead of saying, ‘We have no doctors,’ they’ve stepped up and are saving lives. There’s no backup out there, they can’t refer a patient. These medics are it.”

Story adapted from the San Francisco Chronicle Copyright Janet Wells