A Long Awaited and Successful Surgical Team Visit to JSMK
18 April 2022
Karen State, Burma
In January of 2022, a team of Singaporan surgeons had a full month of service at the Free Burma Rangers Jungle School of Medicine (JSMK). Over seven days, the team completed 17 operations, provided ultrasound training to JSMK medics, and much more.
Due to the Covid pandemic and the 2021 military coup, no surgical teams had visited JSMK for almost two years. The last team to visit was in February 2020. The operating room (OR) had been rarely used since, with only a few minor surgical cases and biopsies being done. When the team arrived, they began operating immediately, but also began restoring the OR. This included locating and organizing instruments and supplies that had gone unused over the last two years and giving the OR a good deep clean with the help of the inpatient department (IPD) team. While the IPD team worked to organize, the visiting surgeons were thankful to the Kler Mu Clinic (KMC) of Earth Mission Asia, which donated a generous supply of necessary medications that allowed the team to begin operating right away.
The collaboration between KMC and JSMK was essential during this trip, as many medications were difficult to access from Thailand. JSMK was able to help provide KMC with x-ray facilities they did not yet have, as well as orthopedic tools for their general surgeon to perform an orthopedic procedure while they were there. KMC also supplied JSMK with a battery backup positionable LED light for the operating room. The team said that being able to share necessary equipment, supplies, expertise, and medications was of great benefit to both clinics and there are plans in place for future collaboration as well.
With the combined efforts, the surgical team was able to complete all of the pre-reviewed cases, which included hernias, hydroceles, and lymph node biopsies, and even a palliative gastro-jejunostomy for an advanced stomach cancer with outlet obstruction. Out of all the operations, there were only two minor complications which did not require much additional management. All surgical patients recovered well and were able to be discharged to home outpatient care.
With their remaining time, the team provided specialized training to JSMK medics. There were several JSMK medics who expressed an interest in learning ultrasound for guiding trauma resuscitation, identification of different common abdominal conditions, and to provide prenatal care. The surgical team supported this by leading several teaching sessions using the ultrasound SonoSim program, as well as providing the students with bedside hands-on practice. Specializing in trauma or women’s health allows students a concentration in learning, which builds confidence in advanced skill sets. The team suggested developing JSMK senior medics in several areas, including women’s health, antenatal care, surgery support, minor procedures, trauma stabilization, and transport. The team also expressed that one of the main aspects of the surgical training this year was identifying a few key medics who will be able to continue developing skills in sterile processing, assisting, and circulation as part of a JSMK surgical team.
Besides new education, the team also introduced a new inventory system called Airtable, for storing and accessing electronic medical records using the cloud, and two databases to facilitate other JSMK activities. The team made suggestions about relocating the OR along with other operational details so patients can be transferred and cared for more efficiently.
Though there is always development work to be done, the team believed this was a successful visit to JSMK as it gave them a much better idea of JSMK’s ongoing needs. Without a doubt, this visit also encouraged the dedicated, hard-working medics at JSMK in the importance of their role for their people and their country, and that they are not forgotten.
Thanks and God bless you,
Free Burma Rangers
