My friend Fitz and his wife Meredith went back to Kwai River Christian hospital this year. I believe this is his 2nd or third trip after we were there as medical students. It is hard to imagine we were there as medical students 12 years ago. I am embarrassed to say that I have not been back to the hospital since then. I went back and visited my friends in other parts of Thai-Burma border but not back to the hospital. My lame excuse now is "I am here busy with work and busy taking care of my family with 3 young kids". You go Fitz! Here is Fitz's experience:

"

Hello,

Meredith and I are at the Kwai River Christian Hospital in western Thailand about 5 miles from the Burma border. The hospital provides healthcare to many refuges and ethnic minorities as well as Thais living in the area. Dr. Scott Murray is the Medical Director and has been here about a year. He is originally from Scotland but has lived most of his adult life in Thailand. He is a Surgeon, but really “does it all”, from peds, to ob-gyn, to ID, to even giving chemo.

We round on about 20 inpatients and then have outpatient clinic for the rest of the morning. The afternoon is usually less busy and we have been finished by 5pm most days. The patients and their medical conditions are extraordinarily varied. So far we have admitted 3 patients with pf malaria and one with pv. Many patients have tuberculosis and I had 1 new diagnosis today and 3 follow-ups. They average about 100-150 new cases per year at this hospital. There is a lot of MDRTB and they have an extremely well organized TB program but it continues to be a huge problem. The instability on the border complicates things. We have had 2 case of dengue and 1 leptospirosis. I diagnosed a woman with PID (it was the first gyn exam I had done in 10 years!) and on ultrasound it looked like she might have an ovarian abscess. I admitted a 5 month old with what has turned out to be bowel obstruction, a 26 year old with severe post partum cardiomyopathy, a 70 year old lady with diabetes, and a hill tribe man with pancreatitis. There are 2 gunshot wounds in the hospital that have been here a while, but fortunately there has not been any fighting along the border since we have been here. There is also a baby with tetrology of falot that they have kept alive for about 8 months and has recently been sponsored for surgery in Bangkok by the Thai Heart Society.

In clinic I’ve seen epilepsy, hyperthyroidism, found a fungating cervical mass, pneumonia, hepatitis, otitis, lymphadenitis, trapped lung, and well child checks! I am overwhelmed with the dedication and professionalism of the staff. It is truly amazing how much they are able to do with the resources they have.

The capabilities of the hospital have changed a lot since I was here 12 years ago. Many medications that we take for granted in the States were not available then but are now. They have an EKG, an incubator, an ultrasound, a defibrillator, and significantly expanded lab capabilities - all in the last few years. Dr. Scott performs a huge variety of surgeries from general to orthopedic to gyn - Meredith watched a c-section today for a 30 week pregnancy with abruption (baby and mom doing well!).

The attached pictures are some of the patients we have seen, a 2 yr old with pneumonia, the 5 month old with obstruction, and a 12 year old with malaria. The lizard is a Toh-Kay gecko - huge things, over a foot long, that have a loud bark.

The food is incredible and the hospital grounds are like a tropical fruit plantation, 3 kinds of bananas, papaya, pineapple, mangosteen, pomelo, and jackfruit grow everywhere.

Having hot running water is a definite improvement over the last visit as well!

So, I may try to send some more pictures later. I hope all is going well and we will see everyone soon.

Fitz"