Laos Cycle: A Mud Map

May 16, 2013

I sat in a neat meeting room, sipping the juice directly from a coconut while listening to the local doctor share about the success of the hospital and surrounding 7 clinics in the Nan district.

The implementation of the Save the Children Primary Health Care project in this district, servicing 54 villages with over 5,500 families, has seen a steady decline in both infant and maternal deaths, plus a dramatic increase in access to basic sanitary like water and toilet facilities.

I’ll throw a few stats out here.  Since the Maternal and Child Health Clinic was built in 2007, there’s been a steady decline in maternal deaths, from 450 to zero in 2012, and the infant death rate reduced over 60% in this time period.  Currently 97% of families have access to clean water, an increase from 40%; 96% have toilets and 97% have access to health care.

Maternal and Child Health Clinic, Hub of the Nan District

save the children cycle laos challenge

“A child has broken their arm,” she said to me as a way of explanation.   Only moments before, I sat in a neat meeting room, sipping the juice directly from a coconut while listening to the local doctor share about the success of the hospital and surrounding 7 clinics in the Nan district.  The implementation of the Save the Children Primary Health Care project in this district, servicing 54 villages with over 5,500 families, has seen a steady decline in both infant and maternal deaths, plus a dramatic increase in access to basic sanitary like access to water and toilet facilities.   I’ll throw a few (amazing) stats out here.  Since the Maternal and Child Health Clinic was built in 2007, there’s been a steady decline in maternal deaths, from 450 to zero in 2012, and the infant death rate reduced over 60% in this time period.  Currently 97% of families have access to clean water, an increase from 40%; 96% have toilets and 97% have access to health care.   Maternal and Child Health Clinic, Hub of the Nan District     This, THIS is what we are all cycling for.  As I absorbed information throughout the day, one thing kept jumping out at me as to why this project is such a success.  Trust. Building on trust.  There was a small hospital facility here before Save the Children started this project is 2007, but very few people came.  There were “lots of problems” Doctor Hong Chanh said: no equipment; not enough support and training. “It wasn’t nice,” someone said. People didn’t use the service.  They didn’t trust the service.   Intentional investment, built on trust, has turned this project into a life saving, life changing success.  And Carol Perks. I have to mention Carol here.  Originally from Melbourne, Carol answered an ad in paper for a 2 year placement in Laos and is still here 21 years later.  I see Carol as the driving force behind implementing this project and after meeting her, I can see why.  She has a heart for these people; she has built relationships with these people; she poured her skills as a midwife into systems that make (so much) sense.   The hospital is the hub to 7 district clinics and the team visited one of these clinics in the hot afternoon.  I was excited to see the clinic because this is where the money, raised by our cycle team, will go towards: building another clinic just like this one below.   Pictured below: 3 nurses, staff at the clinic, and carol     This clinic provides care for 4 villages (358 families), and is a huge success with 100% of pregnant women receiving antenatal care from the midwife pictured there in the centre. Again, the word trust came out in conversations.  Nice clean and neat facility with basic equipment and medicines; a network of support from the hub hospital; plus a staff member who has built trust with the people, equals: people come; they use the facility and health outcomes (especially for women and children) improve. I can’t go into detail here about all the systems that are in place to make this project both successful and sustainable, but I will show one thing: this is a basic, but in my mind, utterly BRILLIANT record keeping system for reporting.   The poster sized simple mud map is broken into 4 sections to represent the 4 villages this clinic services.  Then a key is used to record each birth, how it was conducted, and every death.  As you can see, there have been no infant or maternal deaths this year in these 4 villages.   (Pic) A child, of about eight years old, broke their arm on the day I visited this particular project.  I watched Carol arrange for the cost of petrol so the ambulance could take the child to the closest major hospital to get a cast.  The family came was from a very poor village, and the father wanted to take the child home again.  Perhaps that may have happened if Carol wasn’t there at the time. I don’t know. But what I do know: these are the untold stories that need to be told: People with big hearts doing great things, and not only great things but seemingly small things too, by helping where they can.  That’s the challenge.

save the children laos

This, THIS is what we are cycling for.

As I absorbed information throughout the day, one thing kept jumping out at me as to why this project is such a success.  Trust. Building on trust.  There was a small hospital facility here before Save the Children started this project is 2007, but very few people came.  There were “lots of problems” Doctor Hong Chanh said: no equipment; not enough support and training. “It wasn’t nice,” someone said. People didn’t use the service.  They didn’t trust the service.

Intentional investment, built on trust, has turned this project into a life saving, life changing success.  And Carol Perks. I have to mention Carol here.  Originally from Melbourne, Carol answered an ad in paper for a 2 year placement in Laos and is still here 21 years later.  I see Carol as the driving force behind implementing this project and after meeting her, I can see why.  She has a heart for these people; she has built relationships with these people; she’s poured her skills as a midwife into systems that make (so much) sense.

carol perks

The hospital is the hub to 7 district clinics and the team visited one of these clinics in the hot afternoon.  I was excited to see the clinic because this is where the money, raised by our cycle team, will go towards: building another clinic just like this one below.

Pictured below: Clinic Staff & Carol

 clinic

 This clinic provides care for 4 villages (358 families), and is a huge success with 100% of pregnant women receiving antenatal care from the midwife pictured there in the center. Again, the word trust came out in conversations.  Nice clean and neat facility with basic equipment and medicines; a network of support from the hub hospital; plus a staff member who has built trust with the people, equals: people come; they use the facility and health outcomes (especially for women and children) improve.

clinic -- laos -- save the children

I can’t go into detail here about all the systems that are in place to make this project both successful and sustainable, but I will show one thing: this is a basic, but in my mind, utterly BRILLIANT record keeping system for reporting.   The poster sized simple mud map is broken into 4 sections to represent the 4 villages this clinic services.  Then a key is used to record each birth, how it was conducted, and every death.  As you can see, there have been no infant or maternal deaths in these 4 villages for the specified time period.

save the children laos

save the children laos

1. Child born with midwife / doctor

2. Child born with trained birth attendant

3. Child born with no assistance

4. Child death under 1 year

5. Child death 1 – 5 years

6. Maternal death

7. Elderly person death

These are the often untold stories that need to be told: People with big hearts doing great things by helping where and how they can.  That’s the challenge.

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{ 3 comments… read them below or add one }

katepickleNo Gravatar May 16, 2013 at 12:32 pm

wow those stats tell such a story…. no maternal deaths… none. Just like in any western country women should not expect to die when they have a baby! This is such important stuff and I am loving hearing about it!

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Nathalie BrownNo Gravatar May 16, 2013 at 1:57 pm

It’s a right everyone should have. Thank you for going out there and sharing.

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Matthew BurstowNo Gravatar May 20, 2013 at 7:39 pm

Fantastic improvement…such a difference compared with what we are used too!

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