After spending two months in Laos as a volunteer Support Paediatrician, Dr Peter Forrest has brought back a new perspective and fresh appreciation for life down under.
“I learnt how people cope with being told their child has a life-threatening illness, and that there’s nothing that can be done about it, because they can’t afford specialist medical care,” he said.
While at the Lao Friends Hospital for Children (LFHC) during February and March, the Dandenong Hospital General Paediatrician supported, offered supervision, and educated the existing Lao doctors.
In a hospital with only two Senior Paediatricians, they greatly relied on the support of volunteers to meet the ever-increasing demand for in-patient care of increasingly complex medical conditions.
“We’d go on the ward rounds in the morning with the Lao doctors and discuss the management of all the patients. We would be rostered to the Special Care Nursery, the ICU, or the Children’s Ward before assisting in Outpatient clinics in the afternoon or alternatively having time to prepare for educational meetings, teaching, or audits,” he said.
“Without the volunteers, the two Senior Lao doctors are on call every second night.”
Slide through some snapshots of Peter's time in Laos:
For Peter, one of the main differences between paediatric care in Laos and Australia was the types of injuries and diseases that were more prevalent.
“Surgical problems were common at the LFHC, particularly bone infections such as osteomyelitis and septic arthritis, as so many kids get scrapes and scratches that aren’t properly cared for and escalate into a more serious problem,” he said.
“Laos is a more dangerous environment for children, and we saw a lot of burns as kids were falling into the open fires or utensils that families used to cook soup and heat water in their homes.”
Within our paediatric departments, the common presentations are children with behavioural and developmental issues or infectious illnesses.
The differences between paediatric healthcare in Australia and Laos were profound, according to Dr Peter Forrest.
While Peter was given the opportunity to give educational talks to expand the knowledge of the Lao doctors, he also was able to improve his own clinical expertise while overseas.
“I learnt more about tropical diseases that are quite common in Laos but quite rare over here, like Dengue fever, Salmonella, Japanese Encephalitis and Neurocysticercosis, which is a tape worm type condition contracted from eating undercooked pork,” he said.
Being able to have the opportunity to converse and learn from other volunteer doctors from different countries was also a highlight for Peter, who volunteered simultaneously with three doctors from UK, America and Canada, as well as two visiting Australians.
At Dandenong Hospital, Peter works as a General Paediatrician, where he manages and treats the kids in the children’s wards, the special care nursery, the maternity ward, and occasionally the ED – but he’s been with Monash Health in various roles for over 31 years.
As a General Paediatrician at Dandenong Hospital, Dr Peter Forrest cares for lots of babies and children every day, including baby Faith.
After his time in Laos, Peter said he had a new perspective on the impact of malnutrition on children and what a significant difference it can make to one’s health.
“One thing I’ve noticed since I’ve come back is just how well the average child is here compared to in Laos, and the difference it makes to their defence against infections, when they’re well nourished,” he said.
“What I know now is that one of the main reason parents are concerned about their children having a poor diet is because they are restrictive in the types of foods they eat, whereas in Laos, no one ever complains that their children don’t eat.”
Most of the families in Northern Laos that were treated at the LFHC were subsistence farmers living on their own rice crops.
“They often don’t have any sort of financial support, so sadly, many children just don’t get treated when the level of care they need exceeds what we’re able to do at ‘Lao Friends’, as it is known in the local community in Luang Prabang,” Peter said.
For Dr Peter Forrest, his time in Laos was an experience he will remember forever.
The LFHC has provided a high level of care to many financially disadvantaged children and families in Northern Laos since 2015, and aims to provide comprehensive and free healthcare to children who would otherwise have no access to acute or preventive care.
More than 100 outpatients and 40 inpatients are seen on an average day – meaning the LFHC provides free, accessible care to over 30,000 children per year.
The hospital is interested in other General Paediatricians prepared to take a two-month volunteer opportunity. Peter said it is a unique opportunity to broaden your perspective, knowledge and enhance your teaching skills, while making a contribution to the care of the children in Laos.
“You’re so much closer to the acute problems that present, due to the lack of alternative care,” he said.
“One of the concerns there is related to the number of children coming through the outpatient clinics where the junior Lao doctors are gaining clinical skills and knowledge. They benefit from more experienced people coming to assist with supervision and support.”
To find out more please contact Dr Peter Forrest at peter.forrest@monashhealth.org.