Refugee Relief International After Action Reports

Thailand-Burma - September, 2011

Refugee Relief International, Inc. (RRII) has agreed to the request of the health officials of the Karen Department of Health and Welfare to train a second class of General Medical Officers (GMO). The GMO concept was born of the need to train and deploy clinicians in the Karen-controlled areas along the Thai-Burma border.

The Karen have had the Backpack Medic and Community Health Worker Programs for many years, which have done much to address the medical and trauma needs for the population in the Karen state, but they have not previously been able to train clinicians with a higher level of medical reasoning and clinical skills. In a 2007 meeting with Karen National Union health and displaced people representatives, RRII was tasked with developing a training program for Karen medics which would result in the training and deployment of a mid-level health provider, similar to the physician assistant concept as practiced in the US, Canada, Great Britain, and elsewhere. The Karen mid-level was to be taught incorporating the low-tech and limited formulary realities facing the Karen.

RRII began training the first GMO class in 2008. A competency-based modular concept was devised, allowing the GMO trainees to practice the skills learned in one module for a few months, and then return for more training, building on the previous module. Five GMO out of thirteen candidates were graduated in 2009. The graduates have been successfully integrated into the Karen health structure in positions of responsibility and supervision. GMO refresher training was given in October, 2010. At the request of Karen health officials, the second four module GMO class was begun with 21 medics in April, 2011.

RRII returned to the border area in September to continue the GMO training with Course II, Module 2 of the four module course. This module built upon the training begun in April and included a week of intense training in surgical skills, to include gunshot wounds, shrapnel wounds, lacerations, debridement, I.V. cut-downs, and surgical knot tying. Pre and post-operative care and general and local anesthesia techniques were also taught. The next two weeks were devoted to medical and nutritional topics, to include eye, ear, nose & throat illnesses, dermatology, endocrinology, genitor-urinary problems, malnutrition, food preparation and food safety.
RRII will return to the Thai-Burma border area to train the students in Module 3 in the spring of 2012.

GMO students practicing physical exam techniques, Module 1, GMO Class II
RRII Volunteer and education specialist Vicki Chan-Padgett, MPAS,PA-C, makes a point about the anatomy of the eye during GMO Module 2 training.
The team was fortunate enough to have electricity to enable Power Point presentations.
Cajun Chef and RRII Volunteer "Cajun Vic" Vinson instructing on food safety through an interpreter
The Thai-Burma border area, site for RRII 2011 missions