Mission to the Thai-Burma border
Thailand-Burma (Myanmar) Border April 2, 2009
After-Action Report: Refugee Relief International, Inc. Mission 04-2
Learn about the Karen people
Following the 4WD experience, the team took boats up river

A six person team from Refugee Relief International, Inc (RRII), following up on the previous training and deployment of RRII trained indigenous clinicians and the RRII immunization projects, traveled to SE Asia in the area of the Thai-Burma (Myanmar) border to conduct refresher medical and surgical training for the graduate General Medical Officers (GMO) and selected medics from the Karen Department of Health & Welfare. The team also was able to provide requested surgical treatment to patients with a number of traumatic and non-traumatic surgical cases.

RRII was pleased to learn that other NGOs had continued and expanded the vaccination program for Karen-held areas begun by RRII in 2007. The team did not, therefore, conduct a vaccination program on this mission.

Dr. Mohler (l) and Dr. Padgett (c) operate with the assistance of a Karen student (r).
RRII feels it vital to take every opportunity to train indigenous health workers.
Notice the flashlight suspended above the patient to act as a surgical lamp

Following a jarring five hour ride in 4WD trucks through the mountains, a two hour boat ride and an hour on foot carrying rucksacks in the 95degree heat, the team arrived at Freedom Village #9, where we met with four of our five GMO graduates and some Karen village health medics. Following previous discussions with the Karen National Union Minister of Health, classes were given on trauma and emergencies, traumatic amputations, field dentistry, pre and post operative care, and IV therapy.
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The team provided a large amount of medicine and medical and dental supplies, based on the knowledge and experience of team members who have worked with the Karen on numerous missions. As the Karen have no outside government support, their medical system survives primarily on the donations of groups like RRII and its donors.

PA Chan-Padgett discusses the medical training with the Karen Deputy Health Minister

The team’s surgeon, David G. Mohler, MD, was able to do several surgical procedures for patients who otherwise would not have had access to care. After learning of the RRII team’s arrival, patients began coming to the village by foot and by boat, often having had to avoid Burmese Army patrols. Such procedures as flexion contracture releases from burns, hernia repairs and other surgeries were done under field conditions. Anesthesia was provided by Florian Schmitzberger, EMT/Paramedic Instructor. The rest of the team assisted in surgery in various ways.
Chief instructor Vicki Chan-Padgett, MPAS, PA-C, led the training of the GMO and medics, assisted by Jeff Gieseke, RN, and Mr. Schmitzberger, as well as the rest of the team. John Padgett, PA-C, PhD, was the mission’s team leader, and assistant surgeon and instructor.

This mission was a little unusual, as long time supporter and renowned Cajun chef Victor Vinson was a member of the team. Cajun Vic kept the team well fed, using spices he carried in to season meats and vegetables available in the village. He conducted cooking classes for local women, who were very pleasantly surprised to see what could be done with what was at hand. It is the first time that RRII has taught culinary, as well as medical, subjects.

Prior to departing the area, the team met with the Karen leadership to include the Minister of Health and the Chairman of the Karen National Union. They requested assistance in extending the vaccination program previously begun by RRII to their entire population in Karen-controlled areas, and to expand the GMO training program to train and deploy more of these independent duty clinicians.