As the old saying goes, if you give a man a fish you feed him for a day; teach a man to fish and you feed him for a lifetime.
For the University of Calgary’s Dr. Chris Brown and his wife, Dr. Jane Lemaitre, both professors and physicians who have been volunteering in global health initiatives in Southeast Asia for nearly 20 years, it’s not just about teaching a man (or woman) how to fish. It’s also about showing them how to practice medicine in third world conditions so that they can pass along their knowledge to future physicians and create a cycle of sustainability.
Brown and Lemaitre, who own a house in Golden and have made this community a home away from home, began working overseas in 1997 in the Philippines. There they joined an already established group of professionals from the university who were helping to build a brand new medical school.
The government of Laos took notice of the university’s work in the Philippines and reached out to them for help.
“They knew that they were hopeless. They were in a hopeless situation with their medical education. They were like half a century out of date…it was a horrible situation,” Brown explained.
The university’s aid started in a very basic sense in the late 1990s in the form of simple conversations, gradually growing from there.
“They realized that we weren’t going to give them an answer to this, that we were there just to help them form an idea of what they wanted to do and then we would help them achieve what they wanted to do,” Brown said.
In 2002, a few individuals from the university went over there with the idea that they would help disassemble and reconstruct their medical school, located in the Lao capital of Vientiane.
After that five year project, the group from the university stayed around to help, rewriting the med. school curriculum and teaching both instructors and students how to learn medicine in a modern way.
“The next part of modern medical education, is that once you’ve gone through med. school, you’re not really a doctor. You’ve just been given the tools to learn how to be a real doctor,” Brown said.
In developed countries, med. school graduates take on internships and residencies as the teaching process continues. Lao students didn’t have that luxury until the University of Calgary team stepped in.
“(But) they didn’t need brain surgeons and cardiovascular surgeons and fancy, schmancy doctors,” Brown said.
“They formulated this idea of a physician that was specific for the needs of Laos, which is 80 per cent rural…who would be able to work essentially by themselves and still make things better for healthcare in the villages.”
In that newly created role, physicians would not only have to know how to perform a variety of procedures, but they’d have to act as healthcare managers, teachers and community leaders. They became to be known as five star doctors. Essentially they were to become Jacks (and Jills) of all trades.
The university helped them design a training program to that end, establishing training facilities in several locations around the country.
Since the first graduating class of 2007, 150 five star doctors have completed the program and are currently working as rural physicians throughout Laos.
The next step is where the Rotary Club of Golden comes in.
Rotarian Bruce McKenzie caught wind of a documentary that Brown had produced about their work in Laos and instantly felt it was a good project for the club to get involved with.
“I invited him to the club and he presented his (documentary). You can always tell with Rotarians when there’s something interesting. You can hear a pin drop,” McKenzie recalled.
“What struck me with the project…it wasn’t Western medicine coming in and saying this is how you should do it. It was a matter of ‘you tell us what you need and we can try and help with the process’…I thought that was amazing.”
There are three areas where the Lao project needs continued funding, says Brown, and Rotary could play a large role in all three of them. Firstly, funding is needed to continue a medical education conference that began five years ago. The conference brings graduates together for productive dialogue and discussion every year.
“They’ve never had such a conference in Laos for any medical group so this is very unique,” Brown said.
Secondly, graduates of the program, as Brown explains, often come up with all kinds of ideas regarding areas of need in their own communities and are often unsure on how to make their plans a reality.
“So we’re going to teach them the formal process of quality improvement (at the medical conference)…and turn all the graduates into teachers so they’re going to spread the word in their communities.”
Finally, improvements to the education standards of rural healthcare teams is needed to improve the quality of care that five star doctors can deliver. Funding will go towards supporting the five star doctors in their endeavour to improve the education of the support staff (nurses, doctors and other healthcare professionals) around them.
The bill to fund these three initiatives comes in at $50,000 annually for the next three years, a figure that McKenzie feels is more than doable, especially if they get other Rotary clubs in the region on board.
The process towards doing that has already begun, as the Golden club attempts to make this a global Rotary initiative.
“We want to partner with other clubs in the area and once we have that we can perhaps get more partnerships with other clubs in our district and that will support us with the global grant,” McKenzie said.
McKenzie says the club may look at ways of raising funds specifically for this project before the end of the year, but nothing concrete has been set up as of yet.
To view a series of films that Brown has produced on the project in Laos, log on to vimeopro.com/lightfallvideos/a-working-adventure-in-laos-1.