The entrance to the Mae Tao Clinic

Apparently there are around 5 doctors at the clinic. As of yet I've only met one, A Japanese girl called Aya who started yesterday like myself. There are no nurses, instead the clinic is maily run by "Medics". I still cant quite work out exactly whats involved in their training but its nothing like what we get back home. They have to rely on intuition and experience.

The Medics I've met are from Burma living illegally in Thailand. Some plan to complete their training and then head back home to their village's in Burma to use their skills while others head to the refugee camp hospitals. Some become "backpack medics" who illegally trek back into Burma with supplies and provide treatment. 7 of these have never returned.

I've started working in "Surgical Outpatients" which acts as something like A&E meets GP. On my first day I planned to just observe watching how the 2 Medics in our clinic worked. I soon found out that Candy, who was leading the consultations had a mere 5 months clinical experience and was regularly turning to me for a diagnosis and plan. Within half an hour of my first day I was basically co-running this clinic...here's some of the stuff we saw over the last two days:

• A shoulder the size of a coconut. No movement in his arm - probably caused by a tumour or TB
• A guy who was standing in the wrong place 3 months ago when a car blew up. He had burns which covered almost his entire skin, from the top of his head to his thighs. And in a lot of places this had got infected.
• An Inguinal Hernia the size of my head
• A Liposarcoma (fatty tumour) on a guys hip the size of...um...3 or 4 heads is the best comparrison
• A kid, maybe 2 years old with his forearm broken - both bones, the tibia and fibula but not uttering a single cry or moan while we tried (for about half an hour) to organise an x-ray at the local hospital.
• A "pubic shaving accident" that resulted in not one but two completely seperate wounds (each around 3cm long) on the penis and scrotum

Fortunately Aya, the doctor from Japan has also attached herself to our department and while she spends her time doing minor operations and procedures with the Medics, she pops in now and again to help when we get stuck. In fact everyone seems to pop in and out of the small consultation room we work in, often just for a chat, while we're seeing a patient. There's books and notes and people scattered everywhere but i'm beggining to feel that there is at least a little organisation to the chaos.

Elizabeth and Leuronwysi: 2 of the Medics from Surgical Outpatients