Day Five

I'm learning a great deal as I observe the Mae Tao Clinic in action and discuss possible training needs with the medics that we've trained over the years and who have now taken over positions of major responsibility. I struggle to describe the current situation. Perhaps think of a major US hospital with all of it's departments functioning in crowded buildings connected by muddy paths on a space about the size of a football field. The overall sense I get is of competence, compassion, dedication and extremely difficult medical challenges.

A conclusion to which I've come after interviewing these former students and others is that they do not need training in delivering mental health services and if they did, wouldn't have the time to devote to it. I think the place for counseling training at Mae Tao Clinic is in the training program for the nurses and medics. When Dr. Cynthia raised this in July of 2003 those familiar with BBP history will remember that Peggy sequestered herself with a computer for three days and emerged with a 53 page mental health curriculum that takes a teacher through the specific teaching techniques of the key concepts of our training, e.g. Trauma and its Consequences for an overall understanding of the effects of war on the psyches of the victims, Stages of Change for addictions, The Cycle of Violence for domestic violence, and Breaking Bad News for dealing with terminally ill patients.

The BBP mental health team could certainly be available to consult or train the people doing this training of medics. I also think that it would be very helpful to the medics to have the opportunity to meet with Kathy Allden to discuss psychopharmacology. However, the only medics that are constantly faced with counseling as the primary function of their job are those who deal with the HIV/AIDS patients. I'll be interviewing some of their patients next Tuesday morning and then meeting with the counselors in the afternoon. I am hopeful that this experience leads to a plan for specific counseling/trauma training in the future.

I believe this direction would allow the Mae Tao Clinic to take advantage of the particular strengths of the BBP mental health team. I also think that focusing on this issue will allow BBP to work in the intersection of several of the key social action organizations in Mae Sot. For example, the Migrant Assistant Program (MAP) has a major initiative on prevention, Social Action for Women has a BBP supported program for babies who've been abandoned and are in the process of creating a safe house in which women with HIV/AIDS can live with their children, and SMRU has a major HIV/AIDS in the three refugee camps in the greater Mae Sot area.

Also on the upcoming agenda are a meeting with the medics who deal with exploited migrant factory workers and a guy who has a program that deals with former child soldiers.

Stay tuned.