Burma Refugee Children's Project

Birth of the Burma Refugee Children’s Project

In the June of 2019, China Cal board members, John Thorne, Shan Shan Chen and Robert Detrano traveled together to Mae Sot, Thailand to visit the Mae Tao Clinic, a community based not for profit NGO, founded in 1989 by refugee Burmese physician, Dr. Cynthia Maung and sometimes called “Doctor Cynthia’s Clinic”. The clinic serves the impoverished Burmese refugee population on the Thai Burma border.

Mae Tao Clinic

Mae Sot, Thailand

They met with some of the clinic’s international staff and Dr. Detrano consulted on some patients.

Examining heart patient

John Thorne at right.

In September, 2019, Dr. Detrano and Ms. Chen returned to the Mae Tao clinic to meet its founder and director, Dr. Cynthia Maung and to begin screening school children at two local schools in Mae Sot.

CDC School

Mae Sot, Thailand

In December, 2019, Dr. Detrano and Ms. Chen returned a second time to Mae Sot. In December, with the cooperation of Help Without Frontiers, an NGO that supports and coordinates learning at refugee schools, they screened 500 children and referred 10 children for treatment at the Mae Tao clinic and for financial support to the Burma Children’s Medical Foundation.

Hope School

Mae Sot, Thailand

In December, 2019, the China Cal board voted to start a project to support pediatric heart health among Burmese refugee children. China Cal will partner with Mae Tao Clinic, Burma Childrens’ Medical Fund and Help without Frontiers to screen 10,000 children in 2020 and to support care for all children found with heart disease.

We need your help.

December 2017 Externship Report

In December 2017, ChinaCal undertook another externship activity, taking a group of externs from the US and China across rural Yunnan. For a period of 3 weeks, the group set up clinic wherever they could (in an empty room in a hospital, in a motel room) and helped screen many children for free. Externs carried out patient interviews, taking vitals, communicating results and eventual follow up of many children who were diagnosed with heart problems for eventual surgery. At the end of the externship, each extern was asked to write a few of their reflections. We wanted to take this opportunity to share with you from their point of view their experience.

Here are just a few excerpts from their reflections (edited for clarity):

She was really healthy before she caught a cold in 2015. The family brought her to the hospital where they were told  that the girl had a complex condition of her heart and lungs. There are four people in her home including herself: her parents and her sister. The parents still do not have enough money to spend for the expensive medicine, which can help to relieve her pulmonary hypertension. Because the doctor said that this kind of medicine should be taken every day and even a month should cost around 5000 RMB, which is about 3 times of the family income for a year...the money they earn is not available for they to live their life, the parents stopped buying the medicine without telling the doctor.

...I cannot imagine what I should do if this happened to myself even though my parents may able to afford the medicine. She needs help for medicine and she need care from more people, which is conducive to her life. Although people cannot stop her suffering, it is still right to let her have enough money to obtain medicine.

- He, China, writing of 11 year old female with Down's syndrome and ventricular septal defect (VSD)

In one village near the township of Qiu-Bei in Yunnan province, there is a four-year-old girl named little Zhao. Her family has five members; she and her parents and older siblings live in a small village that does not have a doctor. Her brother is 22 years old and makes a small income doing odd jobs, and her 18-year-old sister attends the local high school. Their family growns corn, peppers, and raises three pigs, which brings in only 3,000 yuan as their annual salary. 3,000 yuan is about $448, which in a large city like Shanghai, would only pay for about a month's rent. In the US, that could not even pay a month's rent in a single bedroom in San Francisco or New York. 

Little Zhao's family is of an ethnic minority, dark in complexion and small in stature. None of them could speak Mandarin despite it being taught in schools. When little Zhao was 6 months old, her parents suspected that she may have an illness since she was no growing normally. She was diagnosed with congenital heart disease: a ventral septal defect. She was too young at the time to get surgery. She does not get as much oxygen as a normal child her age. She did not learn how to walk until she was two years old. She now appears to be the size of a one or two-year-old. She is in less than 3 percentile for her age group in both height and weight. 

The surgery (for treatment) is generally very effective, especially for smaller VSDs. Little Zhao will soon be having this surgery at the FuWai hospital in Kunming, a few hours bus and train ride from where we examined her, QiuBei County Hospital. Now, she enjoys playing with her friends, but gets about one cold a month. She eats and drinks but has difficulty sleeping. 

I really wanted to write about little Zhao because she is so sweet and personal. She was initially quite cranky and unwiling to be examined, but after she had a nap, she started running around us, giggling. My interaction with little Zhao and other patients like her, is one of hte movitations for my continuation into the field of healthcare and medicine. 

While working with the citizens of Yunnan in a medical setting, I experienced their culture and humanity in a more intimate way than when I was traveling as a tourist. We felt like people helping people, rather than Americans coming to a foreign county to gawk at their clothing or buy their trinkets. Although I was merely helping with intake, interacting with the patients and their families to gather past medical history, family situation, and anything else helpful to the doctor, I was able to appreciate the doctor-patient bond and trust. 

- Ning, USA, writing of a 4-year-old girl diagnosed with a VSD

Little Duan's mother was surprised with the doctor's diagnosis of her son... I asked her if she had ever considered the possibility that her son might have a congenital heart disease prior to the clinic visit and she said no. She told me she was aware of the smallness of her son, but she did not see a problem with that. Doctor Lian examined little Duan and confirmed that Duan has an ASD. Duan's ASD is about 8 mm in length, resulting in an 8x10 mm hole. 

Little Duan will be having his ASD repair surgery at Kunming hospital. ChinaCal strongly recommends Kunming Hospital to all their patients because of how well trained their doctors are. Little Duan does not need to have open heart surgery. Rather, he will have catheter surgery. This procedure consists of carefully measuring the size of the ASD so the correct catheter size is used. After selecting the correct size, the catheter is inserted into the femoral vein in the leg. The catheter will then travel all the way up to the targeted part of the heart. Once the catheter has reached the hole in the heart, one side of the catheter will open and the other side of the catheter will open afterwards. The two sides of the catheter will then come together and seal the ASD. This procedure usually takes 30-45 minutes without complications. 

- Selin, USA, writing of little Duan's diagnosis of atrial septal defect (ASD) and describing closure of it in the heart catheterization lab

Thank you as always for your valuable support. Your donations continue to help us to find and refer children for heart surgery in rural Yunnan, together with our volunteer students. We plan to host several more externships this year in support of this program.

December 2017 Externs (pictured from right to left): Nina, Kevin, Annie, He, Ning, Silverdew, Zhang Rui, Xiao Liu, Dr. Liang

China Cal Patients December 2017

Little Shi is an 8-month old baby boy, with several holes between the left and right sides of his heart.  He lives in Luxi county.  His parents are poor farmers.  This baby weighed only 5 kilograms and was not growing.  His parents are farmers, earning about $3000 per year. China Cal doctors diagnosed his condition and its partners supported his surgery at West China Hospital and he was recently discharged home and is recovering.

Little Guo is a 5 years old girl from Meng La County in Xi Shuang Ban Na prefecture. Her family are farmers earning less than $1000 per year.  China Cal doctors diagnosed her with an atrial septal defect. She underwent successful surgery at Kunming Fu Wai Hospital in September.  She is home with her family.

Little Chang is a 6 year old boy from Meng Hai county in Xi Shuang Ban Na prefecture.  His family are poor minority farmers earning about $1500 per year from their farm.  China Cal doctors diagnosed her with two holes his heart. He underwent successful surgery supported by China Cal foundation partners at Yunnan Province Fu Wai hospital.  He will go home soon.

Little Li. Is a one year old boy with a patent ductus, an abnormal tube that persisted after he was born and was causing him to suffer from heart failure with breathing difficulty and frequent sweating.  His parents are poor farmers earning about $1500 per year from Ning Er county in Pu Er Prefecture.  Little Li was diagnosed by China Cal doctors and underwent surgery at  Yunnan Fu Wai hospital in early October.  He is home with his family and doing well.

Newborn Training Program Concluded

Fangqi Guo: Project Lead with two newborns in Nan Jian County

As of the new year, we have concluded our Newborn Training project. The following is a brief overview of what we have done.

The purpose of the Newborn Training Program is to understand if training of pulse oximetry and auscultation is an effective method for CCHD early detection. Hospitals in rural china have virtually no knowledge of these screening methods.

So in 2015, ChinaCal collaborated with Yunnan first affiliated hospital and designed a training program to educate rural obstetric personnel on this screening method. The target population included doctors and nurses working at Yunnan county hospitals, where majority of births occur. Training team includes cardiac specialist in Kunming, a student, and previous research assistant. Volunteers from all over the world (Amelia’s students from Harbin). Training provided is on-site. Teams travelled to each of county hospitals and conducted training in classrooms. Before training started in each of the hospitals, we donated a pulse oximeter (donated through our partnership with Massimo corporation). Training consisted of 3 parts: 30 min of lecture, training on pulse oximetry, and stethoscope practice training.

Since then, the program has run for 2.5 years. We have visited 105 hospitals in total (there are approximately 125 in Yunnan province). We have covered 14/16 prefectures in Yunnan. On average, total trained staff include 20-25 doctors and obstetric nurses at each hospital. This amounts to ~2000 to 3000 staff. “Knowledge tests” were given before and after training to measure the effectiveness of sessions. Post-training, additional observation was made to ensure that staff were using skills learned correctly. As a result more than 50,000 newborns' hearts have been properly examined and those with abnormal results have undergone cardiac ultrasound and those with heart disease referred for treatment.

We would like to thank you for your persistent support over the past 2.5 years. We could not have done this without you. A  study is currently being written by a PhD student at UC Irvine, and a link to that paper will be published shortly.

Happy Chinese New Year!

June and July Externship Report

China Cal 2017 July Externship in South City Hospital of Mengla County

June and July Missions Find, Refer and Support 76 Poor Yunnan Children with Congenital Heart Disease.

The China Cal team of doctors, staff and students examined over 300 children in six counties of Yunnan Province during June and July. Out of these 300 children, the team discovered 76 children with severe heart defects that can be corrected by surgery. China Cal doctors referred these 76 sick children to cardio-vascular centers in Yunnan and Sichuan provinces for treatment.

China Cal’s Grant for Kids Program helps to improve healthcare accessibility by involving both Chinese and foreign chari­table foundations to cover treatment costs. These charitable foundations agree to match donations many times over covering the bulk of operation costs, allowing donors to China Cal to have a far greater impact. A lifesaving procedure costing $3000 may be covered through a single $500 donation.

Little Jiang's story

Little Jiang is a 15 year old girl from Mengla County. Her father works 8 months out of the year on the rubber plantation, earning the family about just under $3000 a year. Her mother has been diagnosed with a neurological disease leaving her unable to work. Her little sister is currently attending school. Little Jiang and her family live in a small dormitory provided by the rubber plantation.

Little Jiang came to us because she was experiencing fainting spells, and shortness of breath. Her symptoms became so prominent this past year she was declared unfit to attend school. During her ultrasound exam, Dr. Detrano discovered that Little Jiang has a three chamber heart with only one ventricle. Due to her heart abnormality, Little Jiang will continue to experience a severely diminished quality of life and life expectancy. Fortunately, this past year the renowned Beijing Fu Wai Cardiac hospital has opened a branch in Kunming. There Little Jiang can receive the lifesaving treatment she needs.

Please consider donating to help fund Little Jiang’s surgery. With your help we can ensure that Little Jiang has the opportunity to go back to school and live a normal, healthy life.

Little Jiang with mother