Mango Nicky Rice

 Back in August, before I arrived here, a Burmese mother arrived at the hospital in labor. She had not wanted another pregnancy, so she took some medicines to try to abort the baby. The medicines didn't take, though, and she remained pregnant. She did not have any prenatal care, so did not know to take vitamins or alter her nutrition. It is also possible she just wasn't able to obtain any of those things.  When she was in the prenatal area, a cursory ultrasound showed that the fetus had an abnormally large head, so the mother was transferred to the bigger hospital for a c-section. The baby girl was born with severe congenital defects, including cleft lip and palate, microphthalmia of her right eye, one shortened arm that never developed a forearm and had a vestigial non-bony finger at the end, abnormal fingers of her other hand and toes of both feet, and of course hydrocephaly. I have not been able to procure the early imaging of the baby's head, but another volunteer here

On Christmas Eve, we received news that the land just across the Thai-Burma border from us would be bombed by the Burmese military government.  The military used RPG’s, air strikes, tanks and other heavy artillery to decimate the area, forcing thousands of the nation’s own people to flee into the forest or to the edge of Burma for safety. Reports said the military government had killed women and children, and many bodies were found burnt to crisps inside vehicles. Just cruelty and fear everywhere.  We have had an influx of the post-bombing casualty patients, from sniper bullets to the skull to paralysis to amputations to extensive wounds and broken bones, lost eye sight and more. We currently have 3 patients with tracheotomies and 3 amputees. After they stay on the unit awhile, they get moved to Patient Housing which is basically an roofed outdoor facility similar to a rest area you might stop at on a long road trip. They sleep on wooden benches in there and have no home you go to anym

​ Sometimes I get frustrated because we just don’t have basic equipment we need for patients.  For example, here is the baby incubator I saw when I first got here. Yikes. I was planning to scrub it down with bleach myself.  Then I saw we had a better one, but it still made me nervous: And then 2 weeks ago we got this amazing one: I was very excited we got a donation of state-of-the-art medical equipment.  There are a lot of other things I hope for here. The thing is, sometimes the hospital isn’t ready for new tech. I’ve been on a bit of a soapbox about us getting more lab test capability. We have CBC, POC Glucose and urine pregnancy, Total bili, malaria smear, and urinalysis without micro.  We have a TON of cirrhosis, alcohol withdrawal and altered mental status patients. I’m working on a sepsis protocol because we have so many deaths from sepsis. But we can’t check lactate, sodium, potassium, calculate anion gap, creatinine, LFTs or anything else for critical patients. We had an alcoh