February 8, 2017

Other Health Services

Physiotherapy

In 2016, an average of 50 patients a month were managed, which increased to 96 patients in 2017. Early 2018, the physiotherapy activities were moved to a designated department within Mae Tao Clinic. Highly immobile patients are still managed in the in-patient department, but others can now come to the appointed area for management and care.

 

History of the Physiotherapy department

Until 2014, Mae Tao Clinic did not have physiotherapy services. In March that year, Roslyn Finch, a physiotherapist, began working at Mae Tao Clinic through Australian Volunteers International (AVI). She helped to develop staff’s capacity to manage the exercise and rehabilitation needs of patients. The capacity building was both theoretical, with building understanding of the scope of practice of physiotherapy, and practical. She helped developing patient and staff education materials in the areas of safe feeding and back pain before, during and after labour. With her help, MTC could adapt best practice principles to the resource poor environment of Mae Tao Clinic, including low patient to staff ratios.

In 2015, the clinic’s first Allied Health Assistant was appointed to be trained by the physiotherapist. This enabled on-going support for clinic staff to help them manage mobility and exercise care for patients. The successful introduction of a system for pressure care management in the medical in-patient department saw a reduction in the prevalence of new pressure sores at the end of 2015. Other elements of training are exercise and pain management for antenatal and postnatal care and for women in labour; safe feeding practices, patient mobility, stroke care, management of development delay in children, back care for patients and health workers, patient handling and amputee care.

A patient who could not sit or stand at first now can walk with walking assist device

In 2016, a new assistant joined the physiotherapy team. An average of 50 patients a month were managed, which increased to 96 patients in 2017. MTC staff received training of the trainer on physiotherapy issues. The physiotherapy team also assisted with training of the first intake of nursing students at MTC.

Early 2018, the physiotherapy activities were moved to a designated department within Mae Tao Clinic. Highly immobile patients are still managed in the in-patient department, but others can now come to the appointed area for management and care.

 

Challenges

Training materials at the physiotherapy department

While allocated budget for the physiotherapy department is limited, the caseload of new patients has been growing. Physiotherapy patients usually stay in the clinic long-term for rehabilitation and their caregivers are often absent. This results in increasing workload for physiotherapy staff and the medics from inpatient departments. In addition, physiotherapy staff are occasionally but inevitably engaged in assisting patients after discharge — looking for accommodation or transportation, as some patients with mobility difficulties cannot return to their previous housing situation.

Physiotherapy department also finds it hard to provide essential equipment for rehabilitation or wheelchairs to patients due to insufficient funding.

Staff

Currently, 2 staff are providing physical therapy to an average of 96 patients per month.

(Last Update: 18 May 2018)


Prosthetic Department

Our prosthetic department provides around 200 consultations annually to clients in need of assistance. The majority of them cross the border from Burma to access prosthetic care. Landmine survivors make up for around 80% of all clients, while the other clients suffer from the consequences of (congenital) medical conditions or accidents.

 

History and Services

The prosthetic workshop was started in 2000. The department has grown every year – from a simple workshop into a more sophisticated production facility. Initially, lamination was the primary method of making artificial limbs by 2005, and the monolimb was introduced; Light and partly vacuum formed, this technical improvement made faster production possible.

In 2004 the referral programme of landmine triage cases to Mae Sot Hospital started. After amputation, patients return to MTC to begin their rehabilitation. All patients receive food, housing and physical therapy to help them learn to walk again.

Currently, the prosthetics workshop produces over 160 new and replacement limbs per year, utilising both lamination and monolimb methods. Most of the prosthetic workshops’ clients come from inside Burma (75% of all clients in 2017), with some even coming all the way from central Burma. Over 80% of the beneficiaries are landmine survivors, although some are the victims of car accidents, have congenital issues and so on. Of them, under 5 years old children accounted for around 5 %. The majority of the clients requires lower limbs.

The legacy of MTC’s programme will not only be the landmine survivors it has served, but the many technicians that have graduated from the programme’s prosthetics workshop training. Some from ethnic minorities have returned to their communities inside Burma to apply what they learned in Mae Sot, bringing hope to landmine survivors who are unable to make the arduous trek to the border. In addition, Mae Tao Clinic closely cooperates with prosthetic care services in Karen state, Burma, to share knowledge and experience with partner organisations in the field.

MTC prosthetic department staff providing technical support at the prosthetic clinic in Karen State, Burma

Though the prosthetic limbs are an imperfect replacement for what was physically lost, they are pivotal to recovering a wholeness of being.

(Last Update: 1 August 2018)


Aucupuncture

The Acupuncture staff treat around 15 patients every day. Although acupuncture is more or less unknown and rarely practiced both in Thailand and Burma, most of patients that receive treatment in the acupuncture department leave feeling more comfortable and in much less pain.

Most of the patients that visit the acupuncture department are chronic cases and need to stay at clinic for long periods of time due to their ongoing needs. Currently, a long-term volunteer doctor from South Korea as well as 3 health workers, including 1 clinical intern, have been providing patients with acupuncture and moxa treatment. The acupuncture department is located in compound of the new MTC with enough space that accommodates 5 beds and waiting area. In 2017, the acupuncture department provided a total of 3,736 consultations; of them, 957 were new cases and 47% (1,738) clients were from Burma.

 
History

The Acupuncture Department was inaugurated in January 2010, getting its own place between the Dental and the Eye Department. As acupuncture is more or less unknown and rarely practiced in Thailand, the degree of acceptance by the patients had to be tested.

The idea of acupuncture at MTC was launched during the multiple visits of Mrs. Harmony Wagner from Canada, who taught the staff the basic techniques. Later the NGO “Help Without Frontiers” helped the department with the necessary resources to launch the department. Dr Ulrich Huehne came to MTC at the end of 2009 and helped set-up the department by teaching acupuncture techniques.

Over years, a number of dedicated volunteer doctors have developed the structure of acupuncture department to continue providing traditional oriental medicine to people in need.

Successes and Treatments

The department is proud of its great success, especially with patients suffering from chronic, long term problems, where traditional Western medicine has not been able to help them. The acupuncture department provides a relaxed atmosphere for the patients, positive conversation, and good understanding amongst the staff while patients receive acupuncture or moxa treatment.

As well as ‘traditional’ acupuncture methods, the department was donated a soft laser which is primarily used on infants and patients who are afraid of needles. But its true success can be seen in its use treating non-healing wounds. In addition to the laser, infrared therapy lamp from South Korea is being used to enhance the effect of treatment.

Challenge

Traditional oriental medicine is almost unknown and uncommon practice both in Thailand and Burma while the efficacy of the combination of traditional oriental medicine with western medicine has been recognised increasingly. Most of patients that receive treatment in the acupuncture department visit the department with skepticism at first but after the treatment the majority leave feeling more comfortable and in much less pain.

As with most other departments at MTC the acupuncture department had a serious space limitations when it was located in old MTC. Since the department moved into the new MTC compound, it has an enough space with waiting areas as well as the treatment room. With the support of donors, the department has been under renovation; constructing waiting areas, remodeling ceilings and power supply, and planning to install the air conditioners to provide more comfortable settings to patients.

The current biggest challenge is the restricted medical supplies due to the reduced funding availability.

Staff

Today the Acupuncture department is open 5 days per week and works with staff of 3.

(Last update: 30 August 2018)

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