The Karen State in the eastern region of Burma has been in the midst of civil war for more than 60 years. Human rights violations are an everyday reality for many ethic minority groups. Rape, forced labor and intentional killings are a part of everyday life.
In early January 2012, leaders of the Karen National Union (KNU), Burma's oldest ethnic armed group, signed a provisional ceasefire agreement with the government. Talks continue and there is hope, although at this time fighting, landmines and illness continue to be an everyday reality.
For seven years, AAI together with partner groups Global Health Access Plan (GHAP) and the Karen Department of health and Welfare (KDHW) have been enabling medics working throughout Karen state in Burma to undergo intense trauma training. The training enables the rapid transfer of necessary lifesaving techniques that in turn save lives. The medics have been providing primary healthcare for over ten years in the conflict and rural areas of Burma, where access to healthcare is otherwise unavailable. Each district/village has access to a healthcare worker who works as a part of a larger network of medics (usually 3-4 per team). Together these medics deliver much-needed healthcare to undeserved populations. Each year, a small group of medics are chosen to attend the trauma training, and once completed they return to their villages as the trauma medic. These medics train other medics in there team which enables the transfer of skills.
This year a group of eleven doctors, nurses and one human rights lawyer, - travelling from Australia and America - met in Thailand to participate in trauma training of Karen and Karenni medics. Doctor Stock is a senior partner of the Emergency Department at Antelope Valley Hospital in California, a clinical professor at UCLA medical school and Global Medical Director on AAI's Advisory Board. Frank Tyler has been involved in the humanitarian industry for 20 years and holds a Masters of Public Health and Tropical Medicine, Bachelor of Health Science Nursing, Certificates in Aviation, Underwater Medicine Training and is currently an AAI Director.
This year, 34 medics attended the course. Some of the medics must travel hundreds of kilometers to the course; travelling by foot, boat and car through dangerous terrain and in some instances this can take as long as one month. Two female medics participated in the training and also joining for the first time were medics from the Karenni state. The trauma skills of the medics varied, ten medics had never attended the course before and for others this was their fifth trauma course. A great opportunity to revise old skills and learn new techniques.
The trauma training focuses on treatment and stabilization of traumatic injuries. The training started with a review of the situation on the ground throughout 2011. Cumulatively over the past year, there have been 115 traumas with approximately 34 landmine injuries and 28 gunshot wounds. One of the most amazing facts is that there is rarely a death following treatment by the medics, highlighting the importance of this lifesaving training. In 2011, there were three deaths (one landmine, one gunshot injury and one car accident). In Karen state most of the traumas occurred from landmines and gunshot wounds.
The medics shared stories on how supplies could not be kept near the village clinics due to the uncertainty of the Burmese military raiding the village. There were teams that had not received there supplies throughout the year due to the shipments being captured. All of the instructors learnt a lot during this time and had a small glance of the obstacles that these medics face everyday.
One of the medics provided a raw account of what it is like to be a medic at times, "arriving on the scene after a day, I found my friend injured from a mine blast. I had to make the decision to amputate the limb. Initial examination showed me there was nothing that could be done to save the leg. I conducted the amputation and saved his life. I know I did the right thing but now everyday I think about what I did and I see him and see how sad he is. We do not speak much now and I dream about my decision; was it the right one? This happened nearly one year ago and to this day he complains of pain in the foot of the amputated leg. What can I do now?" It was explained to the medic that this is known as phantom limb pain and is often a side effect of amputation. Being able to explain that this occurs because of the amputation, allowed the medic to understand that this is not unusual and that he had not made an error.
Another medic explained their story of treating a gun shot wounded patient under a plastic cover makeshift shelter, with the Burmese military searching for them in the background and torrential rain pelting the shelter. These stories of bravery make it clear to see that the medics are an amazing group of people, dedicated to their job and saving lives.
Traumas often occur great distances from where the medics live. Data collected showed that the average response time to a trauma, can range from 1.5 hours to 2 days. And this is just to arrive at the treatment site.
The training focused on lifesaving treatments such as faciotomy, amputation, venous cutdown, fractures, splinting, anaesthesia and much more. The training consisted of both lectures and hands-on demonstration and application.
All of the medics were successful in passing the course exam and were presented with a certificate and a lapel pin to identify them as a trained trauma medic.
The medics are an amazing group of people who are skilled and well trained, doing amazing work in traumatic, dangerous areas. It is thanks to generous donors and supportive volunteers that GHAP and AAI, along with its partners, is able to deliver high quality training and resources to the dedicated trauma medics.