It wasn't an easy year- by any stretch. It was, however, the best year I've ever had.
At the beginning of 2003, I packed up and went to London to attend the London School of Hygiene and Tropical Medicine. After 3 months of lectures, discussions, parasitology lab, and hospital rounds I completed a Diploma in Tropical Medicine and Hygiene.
I then traveled to Bangkok, Thailand to work with the American Refugee Committee (ARC). The ARC Country Director had met Dr. Durant in the very office we met during the 1980's while "Doc" was there working on the Thai-Cambodian border.
In addition to other activities, ARC provides health care, water, and sanitation to three of the ten refugee camps along the Thai-Burmese border. These three camps comprise approximately 33,000 of the 110,000 refugees living along that border.
The camps were all remote, without electricity, and constructed of woven bamboo huts on stilts. The field hospitals had busy inpatient units, outpatient departments, basic labs with light microscopes, a pharmacy- and no shortage of patients. Due to security concerns, we were forced to stay in Thai villages and commute 1 ½ hours each way to the camps daily along rough roads that just became rougher with the monsoons.
During May and June, I served as the interim medical coordinator of the southernmost camp called Ban Don Yang with a population of 4000. I was the only doctor but far from alone, providing care in the field hospital along with nine refugee medics.
I then moved further north to work for the next four months out of a Thai village in between the two other camps serviced by ARC. The camps were larger, one with 12,000 and the other with 17,000 refugees. Unfortunately, the commute was no shorter. I rounded in the two field hospitals, this time with one doctor in each camp from a French organization, Aide Medicale Internationale. My role expanded to include helping train the midwives in newborn resuscitation and care. It expanded further when ARC asked me to perform an assessment of HIV and the feasibility of implementing a control program in the camps to help prevent the magnitude of epidemic seen in Thailand and suspected in Burma. This task had me interacting with other Non-Governmental Organizations, migrant worker clinics, the UN High Commission for Refugees, Thai Government Hospitals, and the Refugee Government in exile. ARC is now planning implementation of a program specifically addressing HIV.
I had the good fortune of being mentored by Dr. Durant before his death. With the help of this Fellowship, I've started out on what I hope will be a long career involving International Medicine. I think I already have an idea of what Dr. Durant meant when he slapped me on the shoulder and said he was jealous of what I was getting into. I'm already jealous of the next fellow and what's ahead for him. With far greater than 20 million refugees worldwide, there is no shortage of work to do.
Kristian Olson MD,MPH,DTMH
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