Lessons Learned in Laos by Erika Cheung

Erika Cheung 2019 picWords can hardly describe the amazing experience that I had in Luang Prabang, Laos PDR at the Lao Friends’ Hospital for Children. Honestly, where to begin…

Location: Luang Prabang is a picturesque town situated at the confluence of the Mekong and Nam Khan rivers. The center of town has a UNESCO World Erika Cheung 2019 marketplace picHeritage designation and is filled with Buddhist temples and monks strolling around in their bright orange robes. Tourists bustle from restaurant to restaurant and shop to shop. Advertisements for elephant tours and waterfall excursions fill the sidewalks of the main street. Colorful tuk tuks are also sprinkled about, ready to ferry you across town. Every night, dozens of locals descend upon the main street with their pop-up canopies, hoping to sell a few of their wares. Any time someone makes a sale, they take the bill of money and wave it around their stall as a good-luck charm or blessing. It is not difficult to spot the hard work ethic of the people.

 

Hospital: Lao Friends’ Hospital for Children (locally known as LFHC) exceeded all of my expectations. IErika Cheung 2019 group pic felt so welcomed by the staff, and eternally grateful for their patience with me as I struggled to learn the nuances of how their hospital functioned. The hospital has been open since 2015, and the skill and knowledge of the local nurses and doctors truly impressed me. Sometimes, I wondered who was teaching whom. It is amazing how little you need in a low-resource setting to care for sick kids, yet at the same time, heart-breaking for those children that the facility cannot help. One thing in particular that left an impact on me was the importance of breastfeeding. Back home in the USA, you don’t think twice about starting a baby on formula if the mom isn’t producing enough breast milk. However, in Laos, formula often is simply not feasible. Those reasons include:

Can the family afford formula? Do they have a clean water source? Are they going to be able to keep the bottles clean? Can they mix the formula properly (or will they start skimping on formula to make it last longer)? Will they stop using formula all together and try condensed milk instead because it’s cheaper? 

More often than not, formula feeding will be problematic and therefore, the nurses at LFHC have to work especially hard with the mothers in the neonate ward to encourage frequent breast pumping, skin-to-skin, and suckling from the breast (for comfort and/or stimulating ). This was just one of the things that I realized we truly take for granted here in the United States.

Erika Cheung hospital in Laos pic 2019The hospital is a free-standing children’s hospital built at the back end of the government’s provincial hospital in Luang Prabang. It has an inpatient department (up to 36 patients), emergency department (4 patients at a time), neonatal unit (up to 24 patients), an outpatient department (sometimes sees 100 patients a day), and a thalassemia clinic (Weds and Thurs only). The hospital also has an operating theater and x-ray/ultrasound capabilities. It functions independently from the provincial hospital, but a collaboration exists between our neonatal department and their labor & delivery (neonatal nurses and doctors would be called to any high-risk deliveries).
I did not do any hands-on care with the patients. My volunteer nurse role consisted of supervising the local Lao nurses and teaching them about critical thinking skills as related to their patients. I was responsible for helping the Lao shift leader (equivalent of a charge nurse) with patient assignments in the inpatient and neonate wards, updating the handover sheet, and double-checking all medications before administration by the Lao nurses. I also rounded with the doctors and the shift leader and updated the bedside nurses with the plans. I did work on developing a bedside handover sheet for the inpatient department as well.

 

Daily life: I only spent one month total in Laos, and it was not nearly enough time. Most of the month was spent volunteering at the hospital, however, I did take the time to do a little sightseeing. My favoriteErika Cheung pic 2019 excursion was a 3 day-2 night stay at the Elephant Conservation Center in Sayaboury, which was a 3 hour van ride from Luang Prabang. The ECC sits on the edge of the Nam Tien Lake, which is manmade by the government to help irrigate the surrounding farmland, and the camp is very eco-friendly (solar power and bamboo huts for lodging). What made the ECC unique from all the other elephant camps was its focus on conservation in addition to rehabilitation. The ECC prides itself on being a place where you can truly observe elephants in their natural habitat: there are no hooks, elephant rides, or feeding. Instead, we hiked through the jungle, watched them bathe in the lake, and observed a check-up by the vet at the hospital on-site. We also hid sugar grass and banana leaves in old tires and boxes in the enrichment area, and sat in awe as the elephants used their smarts to find all of these hidden treats.

 

Laos was my first medical mission, and it certainly won’t be the last. I am forever grateful to ONAAT and their scholarship that helped to fund my dream. Is it too soon to start planning my next mission?